. 2022 Aug 17;22(1):1564.

doi: 10.1186/s12889-022-13925-z.

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

Periklis Charalampous¹, Elena Pallari², Vanessa Gorasso^{3

4}, Elena von der Lippe⁵, Brecht Devleesschauwer^{4

6}, Sara M Pires⁷, Dietrich Plass⁸, Jane Idavain⁹, Che Henry Ngwa^{10

11}, Isabel Noguer¹², Alicia Padron-Monedero¹², Rodrigo Sarmiento^{12

13}, Marek Majdan¹⁴, Balázs Ádám^{15

16}, Ala'a AlKerwi¹⁷, Seila Cilovic-Lagarija¹⁸, Benjamin Clarsen^{19

20

21}, Barbara Corso²², Sarah Cuschieri²³, Keren Dopelt^{24

25}, Mary Economou²⁶, Florian Fischer²⁷, Alberto Freitas^{28

29}, Juan Manuel García-González³⁰, Federica Gazzelloni³¹, Artemis Gkitakou³², Hakan Gulmez³³, Paul Hynds³⁴, Gaetano Isola³⁵, Lea S Jakobsen⁷, Zubair Kabir³⁶, Katarzyna Kissimova-Skarbek³⁷, Ann Kristin Knudsen²⁰, Naime Meriç Konar³⁸, Carina Ladeira^{39

40}, Brian Lassen⁷, Aaron Liew⁴¹, Marjeta Majer⁴², Enkeleint A Mechili^{43

44}, Alibek Mereke⁴⁵, Lorenzo Monasta⁴⁶, Stefania Mondello⁴⁷, Joana Nazaré Morgado⁴⁸, Evangelia Nena⁴⁹, Edmond S W Ng⁵⁰, Vikram Niranjan⁵¹, Iskra Alexandra Nola⁴², Rónán O'Caoimh⁵², Panagiotis Petrou⁵³, Vera Pinheiro²⁸, Miguel Reina Ortiz⁵⁴, Silvia Riva⁵⁵, Hanen Samouda⁵⁶, João Vasco Santos^{28

29

57}, Cornelia Melinda Adi Santoso⁵⁸, Milena Santric Milicevic⁵⁹, Dimitrios Skempes⁶⁰, Ana Catarina Sousa^{61

62}, Niko Speybroeck⁶³, Fimka Tozija^{64

65}, Brigid Unim⁶⁶, Hilal Bektaş Uysal⁶⁷, Fabrizio Giovanni Vaccaro⁶⁸, Orsolya Varga¹⁶, Milena Vasic^{69

70}, Francesco Saverio Violante^{71

72}, Grant M A Wyper⁷³, Suzanne Polinder⁷⁴, Juanita A Haagsma⁷⁴

Affiliations

¹ Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands. p.charalampous@erasmusmc.nl.
² Health Innovation Network, Minerva House, Montague Close, London, UK.
³ Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
⁴ Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
⁵ Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
⁶ Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium.
⁷ National Food Institute, Technical University of Denmark, Lyngby, Denmark.
⁸ Department for Exposure Assessment, and Environmental Health Indicators, German Environment Agency, Berlin, Germany.
⁹ Department of Health Statistics, National Institute for Health Development, Tallinn, Estonia.
¹⁰ School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
¹¹ Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
¹² National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
¹³ Medicine School, University of Applied and Environmental Sciences, Bogota, Colombia.
¹⁴ Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia.
¹⁵ Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
¹⁶ Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
¹⁷ Directorate of Health, Service Epidemiology and Statistics, Luxembourg, Luxembourg.
¹⁸ Institute for Public Health FB&H, Sarajevo, Sarajevo, Bosnia and Herzegovina.
¹⁹ Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
²⁰ Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway.
²¹ Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
²² Institute of Neuroscience, National Research Council, Rome, Italy.
²³ Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
²⁴ Department of Public Health, Ashkelon Academic College, Ashkelon, Israel.
²⁵ Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
²⁶ Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.
²⁷ Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
²⁸ CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.
²⁹ Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.
³⁰ Department of Sociology, Universidad Pablo de Olavide, Seville, Spain.
³¹ Institute and Faculty of Actuaries, London, UK.
³² Department of Internal Medicine and Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
³³ Department of Family Medicine, Faculty of Medicine, İzmir Democracy University, Izmir, Turkey.
³⁴ Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland.
³⁵ Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy.
³⁶ Public Health & Epidemiology, School of Public Health, University College Cork, Cork, Ireland.
³⁷ Department of Health Economics and Social Security, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
³⁸ Department of Biostatistics and Medical Informatics, Faculty of Medicine, Kirsehir Ahi Evran University, Kirsehir, Turkey.
³⁹ H&TRC - Health & Technology Research Center, Escola Superior de Tecnologia da Saúde (ESTeSL), Instituto Politécnico de Lisboa, Lisbon, Portugal.
⁴⁰ Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal.
⁴¹ Clinical Sciences Institute, School of Medicine, National University of Ireland, Galway, Galway City, Ireland.
⁴² Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia.
⁴³ Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece.
⁴⁴ Department of Healthcare, Faculty of Public Health, University of Vlora, Vlora, Albania.
⁴⁵ Al-Farabi Kazakh National University, Almaty, Kazakhstan.
⁴⁶ Institute of Maternal, Child Health - IRCCS Burlo Garofolo, Trieste, Italy.
⁴⁷ Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
⁴⁸ Environmental Health and Nutrition Laboratory, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
⁴⁹ Laboratory of Social Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
⁵⁰ School of Hygiene & Tropical Medicine, London, UK.
⁵¹ School of Public Health, Physiotherapy and Sport Sciences, University College Dublin, Dublin, Ireland.
⁵² Department of Geriatric Medicine, Mercy University Hospital, Grenville Place, Cork City, Ireland.
⁵³ Pharmacoepidemiology-Pharmacovigilance, Pharmacy School, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus.
⁵⁴ College of Public Health, University of South Florida, Tampa, FL, USA.
⁵⁵ Department of Psychology and Pedagogic Science, St Mary's University, London, UK.
⁵⁶ Population Health Department, Luxembourg Institute of Health, Nutrition and Health Research Group, Luxembourg, Luxembourg.
⁵⁷ Public Health Unit, ACES Grande Porto VIII - Espinho/Gaia, ARS Norte, Lisbon, Portugal.
⁵⁸ Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
⁵⁹ Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
⁶⁰ Swiss Paraplegic Research, Nottwil, Switzerland.
⁶¹ Department of Biology, School of Science and Technology, University of Évora, Évora, Portugal.
⁶² Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal.
⁶³ Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium.
⁶⁴ Institute of Public Health of Republic of North Macedonia, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia.
⁶⁵ Faculty of Medicine, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia.
⁶⁶ Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore Di Sanità, Rome, Italy.
⁶⁷ Department of Internal Medicine, Adnan Menderes University School of Medicine, Aydin, Turkey.
⁶⁸ School of Public Health, Università Vita-Salute San Raffaele, Milan, Italy.
⁶⁹ Faculty of Dentistry Pancevo, University Business Academy in Novi Sad, Pancevo, Serbia.
⁷⁰ Institute of Public Health of Serbia Dr Milan Jovanović Batut, Belgrade, Serbia.
⁷¹ Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
⁷² Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.
⁷³ Place and Wellbeing Directorate, Public Health Scotland, Glasgow, Scotland, UK.
⁷⁴ Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

PMID: 35978333
PMCID: PMC9382747
DOI: 10.1186/s12889-022-13925-z

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

Periklis Charalampous et al. BMC Public Health. 2022.

. 2022 Aug 17;22(1):1564.

doi: 10.1186/s12889-022-13925-z.

Authors

Affiliations

¹ Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands. p.charalampous@erasmusmc.nl.
² Health Innovation Network, Minerva House, Montague Close, London, UK.
³ Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
⁴ Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
⁵ Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
⁶ Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium.
⁷ National Food Institute, Technical University of Denmark, Lyngby, Denmark.
⁸ Department for Exposure Assessment, and Environmental Health Indicators, German Environment Agency, Berlin, Germany.
⁹ Department of Health Statistics, National Institute for Health Development, Tallinn, Estonia.
¹⁰ School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
¹¹ Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
¹² National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
¹³ Medicine School, University of Applied and Environmental Sciences, Bogota, Colombia.
¹⁴ Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia.
¹⁵ Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
¹⁶ Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
¹⁷ Directorate of Health, Service Epidemiology and Statistics, Luxembourg, Luxembourg.
¹⁸ Institute for Public Health FB&H, Sarajevo, Sarajevo, Bosnia and Herzegovina.
¹⁹ Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
²⁰ Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway.
²¹ Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
²² Institute of Neuroscience, National Research Council, Rome, Italy.
²³ Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
²⁴ Department of Public Health, Ashkelon Academic College, Ashkelon, Israel.
²⁵ Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
²⁶ Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.
²⁷ Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
²⁸ CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.
²⁹ Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.
³⁰ Department of Sociology, Universidad Pablo de Olavide, Seville, Spain.
³¹ Institute and Faculty of Actuaries, London, UK.
³² Department of Internal Medicine and Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
³³ Department of Family Medicine, Faculty of Medicine, İzmir Democracy University, Izmir, Turkey.
³⁴ Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland.
³⁵ Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy.
³⁶ Public Health & Epidemiology, School of Public Health, University College Cork, Cork, Ireland.
³⁷ Department of Health Economics and Social Security, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
³⁸ Department of Biostatistics and Medical Informatics, Faculty of Medicine, Kirsehir Ahi Evran University, Kirsehir, Turkey.
³⁹ H&TRC - Health & Technology Research Center, Escola Superior de Tecnologia da Saúde (ESTeSL), Instituto Politécnico de Lisboa, Lisbon, Portugal.
⁴⁰ Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal.
⁴¹ Clinical Sciences Institute, School of Medicine, National University of Ireland, Galway, Galway City, Ireland.
⁴² Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia.
⁴³ Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece.
⁴⁴ Department of Healthcare, Faculty of Public Health, University of Vlora, Vlora, Albania.
⁴⁵ Al-Farabi Kazakh National University, Almaty, Kazakhstan.
⁴⁶ Institute of Maternal, Child Health - IRCCS Burlo Garofolo, Trieste, Italy.
⁴⁷ Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
⁴⁸ Environmental Health and Nutrition Laboratory, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
⁴⁹ Laboratory of Social Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
⁵⁰ School of Hygiene & Tropical Medicine, London, UK.
⁵¹ School of Public Health, Physiotherapy and Sport Sciences, University College Dublin, Dublin, Ireland.
⁵² Department of Geriatric Medicine, Mercy University Hospital, Grenville Place, Cork City, Ireland.
⁵³ Pharmacoepidemiology-Pharmacovigilance, Pharmacy School, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus.
⁵⁴ College of Public Health, University of South Florida, Tampa, FL, USA.
⁵⁵ Department of Psychology and Pedagogic Science, St Mary's University, London, UK.
⁵⁶ Population Health Department, Luxembourg Institute of Health, Nutrition and Health Research Group, Luxembourg, Luxembourg.
⁵⁷ Public Health Unit, ACES Grande Porto VIII - Espinho/Gaia, ARS Norte, Lisbon, Portugal.
⁵⁸ Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
⁵⁹ Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
⁶⁰ Swiss Paraplegic Research, Nottwil, Switzerland.
⁶¹ Department of Biology, School of Science and Technology, University of Évora, Évora, Portugal.
⁶² Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal.
⁶³ Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium.
⁶⁴ Institute of Public Health of Republic of North Macedonia, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia.
⁶⁵ Faculty of Medicine, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia.
⁶⁶ Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore Di Sanità, Rome, Italy.
⁶⁷ Department of Internal Medicine, Adnan Menderes University School of Medicine, Aydin, Turkey.
⁶⁸ School of Public Health, Università Vita-Salute San Raffaele, Milan, Italy.
⁶⁹ Faculty of Dentistry Pancevo, University Business Academy in Novi Sad, Pancevo, Serbia.
⁷⁰ Institute of Public Health of Serbia Dr Milan Jovanović Batut, Belgrade, Serbia.
⁷¹ Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
⁷² Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.
⁷³ Place and Wellbeing Directorate, Public Health Scotland, Glasgow, Scotland, UK.
⁷⁴ Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

PMID: 35978333
PMCID: PMC9382747
DOI: 10.1186/s12889-022-13925-z

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.

Keywords: Burden of Injury; Burden of disease; Disability-adjusted life years; Methodology; Review.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

**Fig. 1**
Flowchart of the literature search strategy of existing European burden of disease studies * This systematic literature review is limited to injury-specific BoD assessments undertaken across Europe; January 1990 - May 2021

**Fig. 2**
Number of GBD-linked and independent injury burden of disease studies per multi-country and single-country category

**Fig. 3**
Number of GBD-linked and independent injury burden of disease studies (n = 48) by cause-nature of injury

See this image and copyright information in PMC

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical