Time to reconsider what Global Burden of Disease studies really tell us about low back pain

Maher, Christopher G.; Ferreira, Giovanni E

doi:10.1136/annrheumdis-2021-221173

Cited by 44 publications

(24 citation statements)

References 18 publications

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“…Annual United States (US) all-payer combined NP and low back pain (LBP) costs are estimated to be $134.5 billion, making spinal disorders the costliest condition type, more than all other musculoskeletal conditions combined ($129.8 billion) and more than the cost of diabetes ($111.2 billion) 3 . NP estimated years lived with disability (YLD) is also high 1,4 , although YLD estimates may over or underrepresent actual NP disability [5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

Neck pain care pathways and costs: association with the type of initial contact health care provider. A retrospective cohort study

Elton

Zhang

2022

Preprint

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Background: For individuals with neck pain (NP) the initial contact health care provider (HCP) and subsequent services used are less well understood than for low back pain (LBP). The purpose of this retrospective observational study of administrative data was to examine the association between type of initial contact HCP, service utilization, and total episode cost for the management of NP. Methods: A US national sample of NP episodes completed in 2017-2019 was analyzed using episode of care as the unit of analysis. Separate analyses of a combined surgical and non-surgical (pooled) sample and a non-surgical sample were performed. Seventeen types of HCP initially contacted by an individual with NP was the primary independent variable. Dependent measures included rate and timing of use of fourteen types of health care services and total episode cost. A mixed effects model applied to pooled and non-surgical samples was used to test the association between initial contact HCP, total episode cost and rate of prescription opioid and NSAID use for NP. Results: The study included 323,348 continuously insured individuals aged 18 years and older with 390,992 complete episodes of NP involving 321,538 HCPs and incurring $472,399,064 in expenditures. 53.0% of episodes had initial contact with a primary care or specialist HCP, with these episodes associated with higher rates of imaging, pharmacologic, and interventional services. 40.4% of episodes had initial contact with a non-prescribing HCP, with these episodes associated with higher rates of non-pharmacological services. Adjusted total episode cost was lowest when a chiropractor was the initial contact HCP. Results were consistent for individuals experiencing single or multiple episodes during the study period. Conclusions: This study of a large national cohort of commercially insured individuals with NP helps fill a knowledge gap regarding NP care pathway attributes. Like LBP, the treatment of NP is highly variable with the initial HCP selected by an individual with NP associated with differences in services received and episode cost. Initial contact with a non-prescribing HCP was associated with lower rates of imaging, pharmacology, and interventional services.

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Section: Introductionmentioning

confidence: 99%

Neck pain care pathways and costs: association with the type of initial contact health care provider. A retrospective cohort study

Elton

Zhang

2022

Preprint

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“…Furthermore, there were a limited number of epidemiological studies carried out in MENA, with more needed in the future to more clearly understand the true burden of this disorder. Furthermore, the data reported in the present study were based on modeled estimates, not observed data (Baxter et al, 2013;Maher & Ferreira, 2022).…”

Section: Discussionmentioning

confidence: 69%

The estimated burden of bulimia nervosa in the Middle East and North Africa region, 1990–2019

Safiri

Noori

Nejadghaderi

et al. 2022

Intl J Eating Disorders

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Objective We aimed to report the burden of bulimia nervosa (BN) in the Middle East and North Africa (MENA) region by age, sex, and sociodemographic index (SDI), for the period 1990–2019. Methods Estimates of the prevalence, incidence, and disability‐adjusted life‐years (DALYs) attributable to BN were retrieved from the Global Burden of Disease study 2019, between 1990 and 2019, for the 21 countries in the MENA region. The counts and age‐standardized rates (per 100,000) were presented, along with their corresponding 95% uncertainty intervals. Results In 2019, the estimated regional age‐standardized point prevalence and incidence rates of BN were 168.3 (115.0–229.6) and 178.6 (117.0–255.6) per 100,000, which represented 22.0% (17.5–27.2) and 10.4% (7.1–14.7) increases, respectively, since 1990. Moreover, in 2019 the regional age‐standardized DALY rate was 35.5 (20.6–55.5) per 100,000, which was 22.2% (16.7–28.2) higher than in 1990. In 2019, Qatar (58.6 [34.3–92.5]) and Afghanistan (18.4 [10.6–29.2]) had the highest and lowest age‐standardized DALY rates, respectively. Regionally, the age‐standardized point prevalence of BN peaked in the 30–34 age group and was more prevalent among women. In addition, there was a generally positive association between SDI and the burden of BN across the measurement period. Discussion In the MENA region, the burden of BN has increased over the last three decades. Cost‐effective preventive measures are needed in the region, especially in the high SDI countries. Public Significance This study reports the estimated burden of BN in the MENA region and shows that its burden has increased over the last three decades.

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“…Furthermore, differences in the definition of LBP and the lack of an appropriate survey for gathering data on the burden and prevalence of LBP in many countries is another major limitation of the GBD study. For instance, an article by Maher et al on LBP reported that only about 16% of countries had at least one report that used an appropriate measurement tool, so the prevalence data across countries and years remains sparse [ 27 ]. Furthermore, there are some unclear points in the results.…”

Section: Discussionmentioning

confidence: 99%

The burden of low back pain and its association with socio-demographic variables in the Middle East and North Africa region, 1990–2019

Safiri

Nejadghaderi

Noori

et al. 2023

BMC Musculoskelet Disord

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Background Low back pain (LBP) is the most common musculoskeletal disorder globally. Providing region- and national-specific information on the burden of low back pain is critical for local healthcare policy makers. The present study aimed to report, compare, and contextualize the prevalence, incidence and years lived with disability (YLDs) of low back pain in the Middle East and North Africa (MENA) region by age, sex and sociodemographic index (SDI), from 1990 to 2019. Methods Publicly available data were obtained from the Global Burden of Disease (GBD) study 2019. The burden of LBP was reported for the 21 countries located in the MENA region, from 1990 to 2019. All estimates were reported as counts and age-standardised rates per 100,000 population, together with their corresponding 95% uncertainty intervals (UIs). Results In 2019, the age-standardised point prevalence and incidence rate per 100,000 in MENA were 7668.2 (95% UI 6798.0 to 8363.3) and 3215.9 (95%CI 2838.8 to 3638.3), which were 5.8% (4.3 to 7.4) and 4.4% (3.4 to 5.5) lower than in 1990, respectively. Furthermore, the regional age-standardised YLD rate in 2019 was 862.0 (605.5 to 1153.3) per 100,000, which was 6.0% (4.2 to 7.7) lower than in 1990. In 2019, Turkey [953.6 (671.3 to 1283.5)] and Lebanon [727.2 (511.5 to 966.0)] had the highest and lowest age-standardised YLD rates, respectively. There was no country in the MENA region that showed increases in the age-standardised prevalence, incidence or YLD rates of LBP over the measurement period. Furthermore, in 2019 the number of prevalent cases were highest in the 35–39 age group, with males having a higher number of cases in all age groups. In addition, the age-standardised YLD rates for males in the MENA region were higher than the global estimates in almost all age groups, in both 1990 and 2019. Furthermore, the burden of LBP was not associated with the level of socio-economic development during the measurement period. Conclusion The burden attributable to LBP in the MENA region decreased slightly from 1990 to 2019. Furthermore, the burden among males was higher than the global average. Consequently, more integrated healthcare interventions are needed to more effectively alleviate the burden of low back pain in this region.

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Time to reconsider what Global Burden of Disease studies really tell us about low back pain

Cited by 44 publications

References 18 publications

Neck pain care pathways and costs: association with the type of initial contact health care provider. A retrospective cohort study

Neck pain care pathways and costs: association with the type of initial contact health care provider. A retrospective cohort study

The estimated burden of bulimia nervosa in the Middle East and North Africa region, 1990–2019

The burden of low back pain and its association with socio-demographic variables in the Middle East and North Africa region, 1990–2019

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