Methodological considerations in injury burden of disease studies across Europe: a systematic literature review

Abstract

Background Calculating the disease burden due to injury is complex, as it requires many methodological choices. Until now, an overview of the methodological design choices that have been made in burden of disease (BoD) studies in injury populations is not available. The aim of this systematic literature review was to identify existing injury BoD studies undertaken across Europe and to comprehensively review the methodological design choices and assumption parameters that have been made to calculate years of life lost (YLL) and years lived with disability (YLD) in these studies. Methods We searched EMBASE, MEDLINE, Cochrane Central, Google Scholar, and Web of Science, and the grey literature supplemented by handsearching, for BoD studies. We included injury BoD studies that quantified the BoD expressed in YLL, YLD, and disability-adjusted life years (DALY) in countries within the European Region between early-1990 and mid-2021. Results We retrieved 2,914 results of which 48 performed an injury-specific BoD assessment. Single-country independent and Global Burden of Disease (GBD)-linked injury BoD studies were performed in 11 European countries. Approximately 79% of injury BoD studies reported the BoD by external cause-of-injury. Most independent studies used the incidence-based approach to calculate YLDs. About half of the injury disease burden studies applied disability weights (DWs) developed by the GBD study. Almost all independent injury studies have determined YLL using national life tables. Conclusions Considerable methodological variation across independent injury BoD assessments was observed; differences were mainly apparent in the design choices and assumption parameters towards injury YLD calculations, implementation of DWs, and the choice of life table for YLL calculations. Development and use of guidelines for performing and reporting of injury BoD studies is crucial to enhance transparency and comparability of injury BoD estimates across Europe and beyond.

Burden of infectious disease studies in Europe and the United Kingdom: a review of methodological design choices

“…Methodological design choices of burden of infectious disease studies are more consistent compared to those that have been used in non-communicable and injury burden of disease studies [29,30]. An explanation for this finding may be that most of the studies that were included in our review were from the same country and mostly the same research teams.…”

“…no time discounting), to 1.5% or to 3%. Most of these studies ( n = 7) were conducted in the Netherlands and were in line with the Dutch guidelines for health economic evaluations [ 30 , 31 ]. Five studies used both age-weighting and time-discounting; out of these studies, four were published before 2011 and one in 2021 (Supplementary Material).…”

“…For future burden of infectious disease studies undertaken in Europe, we recommend that the European set of disability weights are used, since they are derived based on the most recent elicitation techniques and cover a wide range of infectious disease-related health states. Methodological design choices of burden of infectious disease studies are more consistent compared to those that have been used in non-communicable and injury burden of disease studies [ 29 , 30 ]. An explanation for this finding may be that most of the studies that were included in our review were from the same country and mostly the same research teams.…”

“…Among studies that did, 10 (56%) https://doi.org/10.1017/S0950268823000031 Published online by Cambridge University Press performed scenario analyses by changing the rates of time-discounting, either by setting it to 0% (i.e., no time discounting), to 1.5% or to 3%. Most of these studies (n=7) were conducted in the Netherlands and were in line with the Dutch guidelines for health economic evaluations [30,31]. Five studies used both age-weighting and time-discounting; out of these studies, four were published before 2011 and one in 2021 (Supplementary Material).…”

“…These studies have varied in terms of scope and methodologies applied. Previous systematic reviews of burden of disease studies, focused on non-communicable diseases and injuries, have revealed considerable variations in methodological approaches used in independent disease burden studies [27][28][29][30][31]. Insight into these variations in methods is important since it affects the calculation, interpretation, and comparability.…”