How do World and European Standard Populations impact Burden of Disease studies? A case study of Disability-Adjusted Life Years in Scotland

Author:

Wyper Grant MAORCID,Grant Ian,Fletcher Eilidh,McCartney Gerry,Fischbacher Colin,Stockton Diane L

Abstract

AbstractBackgroundDisability-Adjusted Life Years (DALYs) are an established method for quantifying population health needs and guiding prioritisation decisions. Global Burden of Disease (GBD) estimates aim to ensure comparability between countries and over time by using age-standardised rates (ASR) to account for differences in the age structure of different populations. Different standard populations are used for this purpose but it is not widely appreciated that the choice of standard may affect not only the resulting rates but also the rankings of causes of DALYs. We aimed to evaluate the impact of the choice of standard, using the example of Scotland.MethodsDALY estimates were derived from the 2016 Scottish Burden of Disease (SBOD) study for an abridged list of 68 causes of disease/injury, representing a three-year annual average across 2014-16. Crude DALY rates were calculated using Scottish national population estimates. DALY ASRs standardised using the GBD World Standard Population (GBD WSP) were compared to those using the 2013 European Standard Population (ESP2013). Differences in ASR and in rank order within the cause list were summarised across all-causes and for each individual cause.ResultsThe ranking of causes by DALYs were similar using crude rates or ASR (ESP2013). As expected, all-cause DALY rates using ASR (GBD WSP) were around 26% lower. Overall 58 out of 68 causes had a lower ASR using GBD WSP compared with ESP2013, with the largest falls occurring for leading causes of mortality observed in older ages. Gains in ASR were much smaller in scale and largely affected causes that operated early in life. These differences were associated with a substantial change to the ranking of causes when GBD WSP was used compared with ESP2013.ConclusionDisease rankings based on DALY ASRs are strongly influenced by the choice of standard population. While GBD WSP offers international comparability, within-country analyses based on DALY ASRs should reflect local age structures. For European countries including Scotland, ESP2013 may better guide local priority setting.

Publisher

Cold Spring Harbor Laboratory

Reference22 articles.

1. Murray CJL , Lopez AD . The global burden of disease: a comprehensive assessment of mortality and disability from deceases, injuries and risk factors in 1990 and projected to 2010. Bost Harvard Sch Public Heal. 1996

2. Lopez AD , Mathers CD , Ezzati M , Jamison DT , Murray CLJ . Global Burden of Disease and Risk Factors: Disease Control Priorities. The World Bank. 2006

3. Institute for Health Metrics and Evaluation [Internet]. The Global Burden of Disease (GBD). http://www.healthdata.org/gbd. Accessed 27 Sept 2019.

4. Institute for Health Metrics and Evaluation. The Global Burden of Disease: Generating Evidence, Guiding Policy. Seattle, WA: IHME, 2013.

5. BURDEN 2020— Burden of disease in Germany at the national and regional level;Bundesgesundheitsblatt— Gesundheitsforsch—Gesundheitsschutz,2018

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