Sensitivity and Uncertainty Analyses for Burden of Disease and Risk Factor Estimates

By Colin D Mathers, Joshua A. Salomon, M. Ezzati, Stephen Begg, S. Hoorn, Alan D. Lopez. 2006

2,141 citations recorded by the source corpus.

Epidemiological studies report confidence or uncertainty intervals around their estimates. Estimates of the burden of diseases and risk factors are subject to a broader range of uncertainty because of the combination of multiple data sources and value choices. Sensitivity analysis can be used to examine the effects of social values that have been incorporated into the design of the disability–adjusted life year (DALY). Age weight, where a year of healthy life lived at one age is valued differently from at another age, is the most controversial value built into the DALY. The discount rate, which addresses the difference in value of current versus future health benefits, also has been criticized. The distribution of the global disease burden and rankings of various conditions are largely insensitive to alternate assumptions about the discount rate and age weighting. The major effects of discounting and age weighting are to enhance the importance of neuropsychiatric conditions and sexually transmitted infections. The Global Burden of Disease study also has been criticized for estimating mortality and disease burden for regions using incomplete and uncertain data. Including uncertain results, with uncertainty quantified to the extent possible, is preferable, however, to leaving blank cells in tables intended to provide policy makers with an overall assessment of burden of disease. No estimate is generally interpreted as no problem. Greater investment in getting the descriptive epidemiology of diseases and injuries correct in poor countries will do vastly more to reduce uncertainty in disease burden assessments than a philosophical debate about the appropriateness of social value

Subfields: General Health Professions, Health, Toxicology and Mutagenesis, Organizational Behavior and Human Resource Management

View Paper: https://www.semanticscholar.org/paper/4e383f669bd3d0f3be00255a448077add594d475

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In General Health Professions

In Health, Toxicology and Mutagenesis

In Organizational Behavior and Human Resource Management

Citations in the corpus

Doubling food production to feed the 9 billion: a critical perspective on a key discourse of food security in the UK (2013, background): “Diet-related heart disease and stroke have already taken over as the two leading causes of death in low and middle-income countries (Lopez et al., 2006).”
Projections of Global Mortality and Burden of Disease from 2002 to 2030 (2006, background): “[15], together with an analysis of uncertainty levels of the results [16].”
Global health and economic impacts of future ozone pollution (2009, methodology): “We use baseline mortality rates from the World Bank Global Burden of Disease study (Lopez et al 2006), for high income (for developed regions) and low–middle income countries (for developing regions).”
Guidelines for Accurate and Transparent Health Estimates Reporting: the GATHER statement (2016, positive): “As estimativas de saúde global geralmente são afetadas por múltiplas fontes de erro, como erro de medição durante a coleta de dados, incapacidade de registrar todos os casos ou obter uma amostra verdadeiramente aleatória, erros no ajustar dos dados de entrada para fontes de viés, e o uso de um model”