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Population burden of injury

This study examines the limitations of the Global Burden of Disease (GBD) approach to measuring population injury burden and aims to validate alternative methods for measuring non-fatal injury burden. Key issues include disability weights, use of existing knowledge and data, and combining data from different studies. The study also seeks to establish the duration and persistence of disability for injury groupings and develop alternative metrics for measuring population injury burden.

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Population burden of injury

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  1. Population burden of injury Associate Professor Belinda Gabbe School of Public Health and Preventive Medicine Monash University

  2. Introduction Improving measure of population burden has been on the ICE agenda for recent meetings Limitations to the GBD approach to measuring population injury burden Maximising use of existing knowledge and data seen as a priority

  3. Key issues • Disability weights • Panel vs. empirical data • Children • Proxy • LMIC • Combining data from different studies • Use of ED and inpatient data • Injury grouping/classification • ICD-11

  4. Recent developments • ICE driven manuscript in 2012 edition of Epidemiological Reviews • Polinder et al. Measuring the population burden of fatal and non-fatal injury. Epidemiol Rev 2012;34:17-31 • Major competitive grant • NHMRC Project Grant 2012-2013

  5. NHMRC Project Grant 2012-2013 Improving the measurement of non-fatal injury burden – Validating the GBD methods

  6. Investigative team Chief Investigators Belinda Gabbe (Monash University), Ronan Lyons (Swansea University), James Harrison (Flinders University), Fred Rivara (University of Washington), ShanthiAmeratunga (University of Auckland), Suzanne Polinder (Erasmus MC), Sarah Derrett (University of Otago), Damien Jolley (Monash University) Associate Investigators Kavi Bhalla (Johns Hopkins), Theo Vos (University of Queensland), Clare Bradley (Flinders University), Juanita Haagsma (Erasmus MC), John Langley (University of Otago), Gabrielle Davie (University of Otago) Project Officer Pam Simpson (Monash University)

  7. Project aims • Evaluate the influence of existing and alternative classifications of injuries on disability burden estimates. • Identify functional outcome and recovery patterns of multiple injuries and the impact on disability outcomes. • Evaluate methods for integrating the functional outcome associated with multiple injuries into burden of injury measurements. • Establish the duration of disability, and the percentage with persisting disability, for injury groupings based on empirical data, in order to validate the injury outcome estimates on which DALY values from the original and current GBD projects depend. • Establish the comparability of the burden of non-fatal injury (Years Lived with Disability) estimates based on different methodologies (i.e. different definitions of health states, disability weights, and measures of the duration of injuries). • Develop alternative metrics for the measurement of population injury burden

  8. Datasets – adult participants

  9. Brief profile

  10. EUROCOST 39 categories

  11. EQ-5D

  12. GOS-E

  13. SF-12

  14. Program of work to be completed • Classification • Mapping to 1990 GBD, 2010 GBD (GBD-IEG), 2010 GBD (final), other existing • Disability measures • Prevalence of disability • Impact of cut-offs on estimates • “Cross-walks” • New weights • Application of alternative classifications, weight, durations to incidence and prevalence data • Compare YLD and DALY estimates

  15. Expected outcomes Improved understanding of the relationship between disability measures Improved disability weights based on empirical data Improved classification of injury health states for burden studies Improved understanding of the duration of disability experienced by survivors Recommended methodology for injury burden studies Inform future GBD studies

  16. Key remaining challenges Paediatric injury outcomes, durations and weights (limited data in the study at present) Need for disability data from LMIC to better inform burden estimates Ongoing need for disability data from non-hospitalised injury cohorts (limited data in the study at present)

  17. Acknowledgements National Health and Medical Research Council (NHMRC) of Australia Australasian Epidemiological Association (AEA) for funding BG attendance at ICE

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