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. 2023 Jun 25;81(1):116.
doi: 10.1186/s13690-023-01119-x.

Burden of disease attributable to risk factors in European countries: a scoping literature review

Vanessa Gorasso  1   2 , Joana Nazaré Morgado  3 , Periklis Charalampous  4 , Sara M Pires  5 , Juanita A Haagsma  4 , João Vasco Santos  6   7   8 , Jane Idavain  9 , Che Henry Ngwa  10   11 , Isabel Noguer  12 , Alicia Padron-Monedero  12 , Rodrigo Sarmiento  12   13 , Vera Pinheiro  7   14 , Elena Von der Lippe  15 , Lea Sletting Jakobsen  16 , Brecht Devleesschauwer  17   18 , Dietrich Plass  19 ; COST Action CA18218 participants
Collaborators, Affiliations

Burden of disease attributable to risk factors in European countries: a scoping literature review

Vanessa Gorasso et al. Arch Public Health. .

Abstract

Objectives: Within the framework of the burden of disease (BoD) approach, disease and injury burden estimates attributable to risk factors are a useful guide for policy formulation and priority setting in disease prevention. Considering the important differences in methods, and their impact on burden estimates, we conducted a scoping literature review to: (1) map the BoD assessments including risk factors performed across Europe; and (2) identify the methodological choices in comparative risk assessment (CRA) and risk assessment methods.

Methods: We searched multiple literature databases, including grey literature websites and targeted public health agencies websites.

Results: A total of 113 studies were included in the synthesis and further divided into independent BoD assessments (54 studies) and studies linked to the Global Burden of Disease (59 papers). Our results showed that the methods used to perform CRA varied substantially across independent European BoD studies. While there were some methodological choices that were more common than others, we did not observe patterns in terms of country, year or risk factor. Each methodological choice can affect the comparability of estimates between and within countries and/or risk factors, since they might significantly influence the quantification of the attributable burden. From our analysis we observed that the use of CRA was less common for some types of risk factors and outcomes. These included environmental and occupational risk factors, which are more likely to use bottom-up approaches for health outcomes where disease envelopes may not be available.

Conclusions: Our review also highlighted misreporting, the lack of uncertainty analysis and the under-investigation of causal relationships in BoD studies. Development and use of guidelines for performing and reporting BoD studies will help understand differences, avoid misinterpretations thus improving comparability among estimates.

Registration: The study protocol has been registered on PROSPERO, CRD42020177477 (available at: https://www.crd.york.ac.uk/PROSPERO/ ).

Keywords: Burden of disease; Comparative risk assessment; Risk factors.

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Conflict of interest statement

Brecht Devleesschauwer is in the process of becoming co-editor in chief for Archives of Public Health.

Figures

Fig. 1
Fig. 1
PRISMA flow chart
Fig. 2
Fig. 2
Number of studies by publication year and by type of study
Fig. 3
Fig. 3
Percentage of types of data sources used for exposure assessment in independent BoD studies by risk factor (level 2)—Only risk factors that were investigated more than once are included in the figure; BMI: Body Mass Index
See this image and copyright information in PMC

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