Australian Institute of Health and Welfare, Canberra, Australia.
University of New South Wales, Sydney, Australia.
Int J Epidemiol. 2022 May 9;51(2):668-678. doi: 10.1093/ije/dyab093.
Estimates of burden of disease are important for monitoring population health, informing policy and service planning. Burden estimates for the same population can be reported differently by national studies [e.g. the Australian Burden of Disease Study (ABDS) and the Global Burden of Disease Study (GBDS)].
Australian ABDS 2015 and GBDS 2017 burden estimates and methods for 2015 were compared. Years of life lost (YLL), years lived with disability (YLD) and disability-adjusted life years (DALY) measures were compared for overall burden and 'top 50' causes. Disease-category definitions (based on ICD-10), redistribution algorithms, data sources, disability weights, modelling methods and assumptions were reviewed.
GBDS 2017 estimated higher totals than ABDS 2015 for YLL, YLD and DALY for Australia. YLL differences were mainly driven by differences in the allocation of deaths to disease categories and the redistribution of implausible causes of death. For YLD, the main drivers were data sources, severity distributions and modelling strategies. Most top-50 diseases for DALY had a similar YLL:YLD composition reported.
Differences in the ABDS and GBDS estimates reflect the different purposes of local and international studies and differences in data and modelling strategies. The GBDS uses all available evidence and is useful for international comparisons. National studies such as the ABDS have the flexibility to meet local needs and often the advantage of access to unpublished data. It is important that all data sources, inputs and models be assessed for quality and appropriateness. As studies evolve, differences should be accounted for through increased transparency of data and methods.
疾病负担的估计对于监测人口健康、为政策和服务规划提供信息非常重要。同一人群的负担估计值可能会因国家研究的不同而有所不同[例如,澳大利亚疾病负担研究(ABDS)和全球疾病负担研究(GBDS)]。
比较了澳大利亚 ABDS 2015 年和 GBDS 2017 年的负担估计值和 2015 年的方法。比较了总负担和“前 50 位”病因的寿命损失年(YLL)、残疾生存年(YLD)和残疾调整生命年(DALY)指标。审查了疾病类别定义(基于 ICD-10)、再分配算法、数据源、残疾权重、建模方法和假设。
GBDS 2017 年估计澳大利亚的 YLL、YLD 和 DALY 总量高于 ABDS 2015 年。YLL 差异主要是由于死亡归因于疾病类别和不合理死因再分配的差异造成的。对于 YLD,主要驱动因素是数据源、严重程度分布和建模策略。大多数 DALY 的前 50 种疾病的 YLL:YLD 构成相似。
ABDS 和 GBDS 估计之间的差异反映了本地和国际研究的不同目的以及数据和建模策略的差异。GBDS 利用了所有可用的证据,对于国际比较很有用。ABDS 等国家研究具有满足当地需求的灵活性,通常具有访问未发表数据的优势。评估所有数据源、投入和模型的质量和适宜性非常重要。随着研究的发展,应通过增加数据和方法的透明度来解释差异。