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Travor MD, Levine ES, Catomeris AJ, Purt B, Gensheimer WG, Justin GA, Trevino JD, Haagsma JA, Colyer MH, Staudt AM. Disability-Adjusted Life Years Resulting from Ocular Injury among Deployed Service Members, 2001-2020. Ophthalmology 2024; 131:534-544. [PMID: 38008289 DOI: 10.1016/j.ophtha.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/16/2023] [Accepted: 11/20/2023] [Indexed: 11/28/2023] Open
Abstract
PURPOSE To quantify the burden of ocular injuries on deployed US service members by calculating disability-adjusted life years (DALYs). DESIGN Retrospective, observational cohort study. PARTICIPANTS US service members with ocular injuries sustained in combat zones from January 1, 2001 to May 19, 2020. METHODS Health states and duration of injuries were identified using data from the Defense and Veterans Eye Injury and Vision Registry. These health states were mapped to disability weights from the Global Burden of Disease (GBD) study. Average duration of injury or illness was calculated until remission or death. For the latter, life expectancy at age of sustaining injury, as identified from US Life Tables from the National Vital Statistics Reports 2020, was used. Using Defense Manpower Data Center reports capturing number of service members deployed per year, incidence rates were calculated for ocular injury and DALYs. MAIN OUTCOME MEASURES Disability-adjusted life years of ocular injury. RESULTS Seventeen thousand five hundred fifty-five patients sustained ocular injury that incurred DALYs. In total, these injuries resulted in 11 214 DALYs (average, 0.64 DALYs per included patient and 20.6 DALYs per 10 000 US service members per year). Severe impairment of distance vision (77.9%) and blindness (10.6%) were the primary contributors of DALYs. Although only 9.3% of patients sustained a permanent ocular injury, permanent disability accounted for 99.5% of total DALYs. The average yearly incidence rate of ocular injury was 32.0 cases per 10 000 US service members. Foreign body was the most frequent injury type (2754 occurrences), followed by abrasion (2419 occurrences) and multiple injury types (1429 occurrences). The most DALYs occurred in patients with multiple injury types (2485 DALYs), followed by abrasion (accounting for 725 DALYs) and foreign body (accounting for 461 DALYs). DISCUSSION We report higher average DALYs per case ratio among US service members compared with the general population studied by the GBD study, highlighting the differences in probabilities of permanent injury between the two studies. Our study provides understanding of the impact of ocular injuries on active-duty service members and lays the groundwork for further research and interventions to mitigate their burden. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Mark D Travor
- Ophthalmology Section, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Emily S Levine
- Ophthalmology Section, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Andrew J Catomeris
- Ophthalmology Section, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Boonkit Purt
- Walter Reed-Uniformed Services University Department of Surgery, Uniformed Services University, Bethesda, Maryland; Department of Ophthalmology, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan
| | - William G Gensheimer
- Ophthalmology Section, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; Ophthalmology Section, White River Junction VA Medical Center, White River Junction, Vermont
| | - Grant A Justin
- Walter Reed-Uniformed Services University Department of Surgery, Uniformed Services University, Bethesda, Maryland
| | - Jennifer D Trevino
- Department of Data Analytics and Epidemiology, The Geneva Foundation, JBSA Fort Sam Houston, San Antonio, Texas
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marcus H Colyer
- Walter Reed-Uniformed Services University Department of Surgery, Uniformed Services University, Bethesda, Maryland
| | - Amanda M Staudt
- Department of Data Analytics and Epidemiology, The Geneva Foundation, JBSA Fort Sam Houston, San Antonio, Texas.
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Corda MO, Charalampous P, Haagsma JA, Assunção R, Martins C. Mortality burden of cardiovascular disease attributable to ambient PM 2.5 exposure in Portugal, 2011 to 2021. BMC Public Health 2024; 24:1188. [PMID: 38678185 DOI: 10.1186/s12889-024-18572-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Exposure to high levels of environmental air pollution causes several health outcomes and has been associated with increased mortality, premature mortality, and morbidity. Ambient exposure to PM2.5 is currently considered the leading environmental risk factor globally. A causal relationship between exposure to PM2.5 and the contribution of this exposure to cardiovascular morbidity and mortality was already demonstrated by the American Heart Association. METHODS To estimate the burden of mortality attributable to environmental risk factors, a comparative risk assessment was performed, considering a "top-down" approach. This approach uses an existing estimate of mortality of the disease endpoint by all causes as a starting point. A population attributable fraction was calculated for the exposure to PM2.5the overall burden of IHD and stroke was multiplied by the PAF to determine the burden attributable to this risk factor. The avoidable burden was calculated using the potential impact fraction (PIF) and considering the WHO-AQG 2021 as an alternative scenario. RESULTS Between 2011 and 2021, the ambient exposure to PM2.5 resulted in a total of 288,862.7 IHD YLL and a total of 420,432.3 stroke YLL in Portugal. This study found a decreasing trend in the mortality burden attributable to PM2.5 exposure, for both males and females and different age-groups. For different regions of Portugal, the same trend was observed in the last years. The mortality burden attributable to long-term exposure to PM2.5 was mainly concentrated in Lisbon Metropolitan Area, North and Centre. Changes in the exposure limits to the WHO recommended value of exposure (WHO-AQG 2021) have a reduction in the mortality burden due to IHD and stroke attributable to PM2.5 exposure, in Portugal. CONCLUSION Between 2011 and 2021, approximately 22% and 23% of IHD and stroke deaths were attributable to PM2.5 exposure. Nevertheless, the mortality burden attributable to cardiovascular diseases has been decreasing in last years in Portugal. Our findings provide evidence of the impact of air pollution on human health, which are crucial for decision-making, at the national and regional level.
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Affiliation(s)
- Mariana O Corda
- NOVA National School of Public Health, Public Health Research Centre, NOVA University Lisbon, Lisbon, Portugal
| | - Periklis Charalampous
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ricardo Assunção
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, Almada, Portugal
- CESAM, Center for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Carla Martins
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal.
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Chen-Xu J, Varga O, Mahrouseh N, Eikemo TA, Grad DA, Wyper GMA, Badache A, Balaj M, Charalampous P, Economou M, Haagsma JA, Haneef R, Mechili EA, Unim B, von der Lippe E, Baravelli CM. Subnational inequalities in years of life lost and associations with socioeconomic factors in pre-pandemic Europe, 2009-19: an ecological study. Lancet Public Health 2024; 9:e166-e177. [PMID: 38429016 DOI: 10.1016/s2468-2667(24)00004-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Health inequalities have been associated with shorter lifespans. We aimed to investigate subnational geographical inequalities in all-cause years of life lost (YLLs) and the association between YLLs and socioeconomic factors, such as household income, risk of poverty, and educational attainment, in countries within the European Economic Area (EEA) before the COVID-19 pandemic. METHODS In this ecological study, we extracted demographic and socioeconomic data from Eurostat for 1390 small regions and 285 basic regions for 32 countries in the EEA, which was complemented by a time-trend analysis of subnational regions within the EEA. Age-standardised YLL rates per 100 000 population were estimated from 2009 to 2019 based on methods from the Global Burden of Disease study. Geographical inequalities were assessed using the Gini coefficient and slope index of inequality. Socioeconomic inequalities were assessed by investigating the association between socioeconomic factors (educational attainment, household income, and risk of poverty) and YLLs in 2019 using negative binomial mixed models. FINDINGS Between Jan 1, 2009, and Dec 31, 2019, YLLs lowered in almost all subnational regions. The Gini coefficient of YLLs across all EEA regions was 14·2% (95% CI 13·6-14·8) for females and 17·0% (16·3 to 17·7) for males. Relative geographical inequalities in YLLs among women were highest in the UK (Gini coefficient 11·2% [95% CI 10·1-12·3]) and among men were highest in Belgium (10·8% [9·3-12·2]). The highest YLLs were observed in subnational regions with the lowest levels of educational attainment (incident rate ratio [IRR] 1·19 [1·13-1·26] for females; 1·22 [1·16-1·28] for males), household income (1·35 [95% CI 1·19-1·53]), and the highest poverty risk (1·25 [1·18-1·34]). INTERPRETATION Differences in YLLs remain within, and between, EEA countries and are associated with socioeconomic factors. This evidence can assist stakeholders in addressing health inequities to improve overall disease burden within the EEA. FUNDING Research Council of Norway; Development, and Innovation Fund of Hungary; Norwegian Institute of Public Medicine; and COST Action 18218 European Burden of Disease Network.
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Affiliation(s)
- José Chen-Xu
- Comprehensive Health Research Centre, Public Health Research Centre, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal; Public Health Unit, Local Health Unit Baixo Mondego, Figueira da Foz, Portugal
| | - Orsolya Varga
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Syreon Research Institute, Budapest, Hungary
| | - Nour Mahrouseh
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Terje Andreas Eikemo
- Department of Sociology and Political Science, Centre for Global Health Inequalities Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Diana A Grad
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Grant M A Wyper
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK; Population Health and Wellbeing, Public Health Scotland, Glasgow, Scotland
| | - Andreea Badache
- Swedish Institute of Disability Research, School of Health Sciences, Örebro University, Örebro, Sweden; School of Health Sciences, Örebro University, Örebro, Sweden
| | - Mirza Balaj
- Department of Sociology and Political Science, Centre for Global Health Inequalities Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Periklis Charalampous
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Mary Economou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Romana Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - Enkeleint A Mechili
- Department of Healthcare, Faculty of Health, University of Vlora, Vlora, Albania; School of Medicine, University of Crete, Crete, Greece
| | - Brigid Unim
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Italian National Institute of Health, Rome, Italy
| | - Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Quartey NKA, Haagsma JA, Jakobsen LS, Ofosu IW. Dietary acrylamide-linked burden of cancers in four sub-sahara African countries: A review and data synthesis. Heliyon 2024; 10:e23075. [PMID: 38169883 PMCID: PMC10758739 DOI: 10.1016/j.heliyon.2023.e23075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/21/2023] [Accepted: 11/26/2023] [Indexed: 01/05/2024] Open
Abstract
Acrylamide (AA) is a food processing byproduct that forms at high temperatures and is classified as a probable human carcinogen. Previous studies have linked AA to kidney, uterus, and ovary cancer burdens, but its study in African countries remains underexplored. This study systematically used six recent articles on dietary AA concentration data from scholarly databases using specific search terms. We also collected health metrics secondary data from the Institute of Health Metrics and Evaluation and other sources for the period 2015-2019. We used a Monte-Carlo simulation to integrate the dietary AA exposure, risks, and health metrics to estimate the cancer burdens. The results showed that the modal healthy life years lost ranged from 0.00488 (Ghana) to 0.218 (Ethiopia) per 100,000 population. The median statistic indicated 1.2 and 26.10 healthy life years lost for Ghana and Ethiopia, respectively, due to the three cancer types. The four-country study areas' total disability-adjusted life years (DALYs) were 63.7 healthy life-year losses. Despite the limitations of the non-standardized age-related food consumption data and the few inclusive articles, the probabilistic approach may account for the uncertainties and provide valid conclusions.
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Affiliation(s)
- Naa K.-A Quartey
- Food Systems Chemistry, Toxicology and Risk Study Group, Department of Food Science and Technology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Juanita A. Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Lea S. Jakobsen
- Research Group for Risk-Benefit, National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Isaac W. Ofosu
- Food Systems Chemistry, Toxicology and Risk Study Group, Department of Food Science and Technology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Stassen HS, Atalik T, Haagsma JA, Wolvius EB, Verdonschot RJCG, Rozeboom AVJ. Effect of helmet use on maxillofacial injuries due to bicycle and scooter accidents: a systematic literature review and meta-analysis. Int J Oral Maxillofac Surg 2024; 53:28-35. [PMID: 37031014 DOI: 10.1016/j.ijom.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 04/10/2023]
Abstract
Maxillofacial injury is a common injury resulting from bicycle (including e-bike) and scooter accidents. With 80,000 admissions to emergency departments in 2019, bicycle accidents account for more than half of all traffic-related emergency department visits in the Netherlands. The United States reports approximately 130,000 injuries and 1000 fatalities related to cycling annually. This systematic review and meta-analysis was performed to examine the protective effect of helmets against maxillofacial injuries resulting from bicycle and scooter (including e-bike and e-scooter) accidents. After a systematic literature search, 14 studies were found to be eligible for this systematic review. Of these, 11 were included in the meta-analysis. None of the included studies focused on vehicles with motors (e-bikes and e-scooters); all focused only on non-motorized vehicles. All included studies were non-randomized, which could have led to bias in the pooled results. Data from the included studies were tested for heterogeneity using the binary random-effects model (DerSimonian-Laird method), and the odds ratio for the occurrence of maxillofacial injury in cyclists wearing a helmet versus those not wearing a helmet was calculated by random-effects meta-analysis. Patients who had worn a helmet suffered significantly fewer maxillofacial injuries than patients who had not, in bicycle accidents (odds ratio 0.682). In conclusion, wearing a helmet has a significant protective effect against maxillofacial injury, indicating the need for strict helmet legislation.
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Affiliation(s)
- H S Stassen
- Department of Oral and Maxillofacial Surgery, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - T Atalik
- Department of Emergency Medicine, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - J A Haagsma
- Department of Emergency Medicine, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Public Health, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - E B Wolvius
- Department of Oral and Maxillofacial Surgery, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - R J C G Verdonschot
- Department of Emergency Medicine, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - A V J Rozeboom
- Department of Oral and Maxillofacial Surgery, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands.
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Wyper GMA, McDonald SA, Haagsma JA, Devleesschauwer B, Charalampous P, Maini R, Smith P, Pires SM. A proposal for further developing fatigue-related post COVID-19 health states for burden of disease studies. Arch Public Health 2023; 81:193. [PMID: 37919765 PMCID: PMC10621107 DOI: 10.1186/s13690-023-01212-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/30/2023] [Indexed: 11/04/2023] Open
Abstract
Previous efforts to estimate the burden of fatigue-related symptoms due to long COVID have a very high threshold for inclusion of cases, relative to the proposed definition from the World Health Organization. In practice this means that milder cases, that may be occurring very frequently, are not included in estimates of the burden of long COVID which will result in underestimation. A more comprehensive approach to modelling the disease burden from long COVID, in relation to fatigue, can ensure that we do not only focus on what is easiest to measure; which risks losing focus of less severe health states that may be more difficult to measure but are occurring very frequently. Our proposed approach provides a means to better understand the scale of challenge from long COVID, for consideration when preventative and mitigative action is being planned.
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Affiliation(s)
- Grant M A Wyper
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, United Kingdom.
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
| | - Scott A McDonald
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | | | - Rishma Maini
- Clinical and Protecting Health Directorate, Public Health Scotland, Edinburgh, United Kingdom
- Public Health Department, NHS Fife, Fife, United Kingdom
| | - Pierre Smith
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium
| | - Sara M Pires
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
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Safdarian M, Trinka E, Rahimi-Movaghar V, Thomschewski A, Aali A, Abady GG, Abate SM, Abd-Allah F, Abedi A, Adane DE, Afzal S, Ahinkorah BO, Ahmad S, Ahmed H, Amanat N, Angappan D, Arabloo J, Aryannejad A, Athari SS, Atreya A, Azadnajafabad S, Azzam AY, Babamohamadi H, Banik PC, Bardhan M, Bashiri A, Berhie AY, Bhat AN, Brown J, Champs AP, Charalampous P, Chukwu IS, Coberly K, Dadras O, Yada DY, Dai X, Dandona L, Dandona R, Dessalegn FN, Desta AA, Dhingra S, Diao N, Diaz D, Dibas M, Dongarwar D, Dsouza HL, Ekholuenetale M, El Nahas N, Elhadi M, Eskandarieh S, Fagbamigbe AF, Fares J, Fatehizadeh A, Fereshtehnejad SM, Fischer F, Franklin RC, Garg T, Getachew M, Ghaffarpasand F, Gholamrezanezhad A, Gholizadeh Mesgarha M, Ghozy S, Golechha M, Goleij P, Graham SM, Gupta VK, Haagsma JA, Hamidi S, Harlianto NI, Harorani M, Hasanian M, Hassan A, Hassen MB, Hoveidaei AH, Iravanpour F, Irilouzadian R, Iwu CCD, Jacob L, Jaja CJ, Joseph N, Joshua CE, Jozwiak JJ, Kadashetti V, Kandel A, Kantar RS, Karaye IM, Karkhah S, Khader YS, Khan EA, Khan MJ, Khayat Kashani HR, Khonji MS, Khormali M, Kim G, Krishnamoorthy V, Kumaran SD, Malekpour MR, Meretoja TJ, Mesregah MK, Mestrovic T, Micheletti Gomide Nogueira de Sá AC, Miller TR, Mirahmadi A, Mirghaderi SP, Mirza M, Misganaw A, Misra S, Mohammad Y, Mohammadi E, Mokdad AH, Möller H, Momtazmanesh S, Moni MA, Mostafavi E, Mulita F, Naghavi M, Nassereldine H, Natto ZS, Nejati K, Nguyen HLT, Nguyen VT, Nogueira de Sá AT, Olagunju AT, Olufadewa II, Omotayo AO, Owolabi MO, Patil S, Pawar S, Pedersini P, Petcu IR, Polinder S, Pourbagher-Shahri AM, Qureshi MF, Raghav PR, Rahman M, Rahnavard N, Rajabpour-Sanati A, Rashidi MM, Rawaf S, Roberts NLS, Saddik B, Saeed U, Samadzadeh S, Samy AM, Sarveazad A, Seylani A, Shafie M, Shahbandi A, Sharew MMS, Sheikhi RA, Shetty PH, Yigit A, Shobeiri P, Shool S, Shorofi SA, Sibhat MM, Sinaei E, Singh P, Singh S, Solomon Y, Sotoudeh H, Tadesse BA, Umair M, Valadan Tahbaz S, Valdez PR, Venketasubramanian N, Vu LG, Wickramasinghe ND, Zare I, Yazdanpanah F, Wu AM, Zhang ZJ. Global, regional, and national burden of spinal cord injury, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol 2023; 22:1026-1047. [PMID: 37863591 PMCID: PMC10584692 DOI: 10.1016/s1474-4422(23)00287-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/05/2023] [Accepted: 07/21/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Spinal cord injury (SCI) is a major cause of health loss due to premature mortality and long-term disability. We aimed to report on the global, regional, and national incidence, prevalence, and years of life lived with disability (YLDs) for SCI from 1990 to 2019, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS Using GBD 2019 data pooled in DisMod-MR 2.1, a Bayesian meta-regression tool, we systematically derived numbers and age-standardised rate changes with 95% uncertainty intervals (95% UIs) for the incidence, prevalence, and YLDs for SCI from 1990 to 2019 for the whole world, 21 GBD regions, and 204 countries and territories. We report trends based on age, sex, year, cause of injury, and level of injury. FINDINGS Globally, 20·6 million (95% UI 18·9 to 23·6) individuals were living with SCI in 2019. The incidence of SCI was 0·9 million (0·7 to 1·2) cases with an estimated 6·2 million (4·5 to 8·2) YLDs. SCI rates increased substantially from 1990 to 2019 for global prevalence (81·5%, 74·2 to 87·1), incidence (52·7%, 30·3 to 69·8), and YLDs (65·4%, 56·3 to 76·0). However, global age-standardised rates per 100 000 population showed small changes in prevalence (5·8%, 2·6 to 9·5), incidence (-6·1%, -17·2 to 1·5), and YLDs (-1·5%, -5·5 to 3·2). Data for 2019 shows that the incidence of SCI increases sharply until age 15-19 years, where it remains reasonably constant until 85 years of age and older. By contrast, prevalence and YLDs showed similar patterns to each other, with one peak at around age 45-54 years. The incidence, prevalence, and YLDs of SCI have consistently been higher in men than in women globally, with a slight and steady increase for both men and women from 1990 to 2019. Between 1990 and 2019, SCI at neck level was more common than SCI below neck level in terms of incidence (492 thousand [354 to 675] vs 417 thousand [290 to 585]), prevalence (10·8 million [9·5 to 13·9] vs 9·7 million [9·2 to 10·4]), and YLDs (4·2 million [3·0 to 5·8] vs 1·9 million [1·3 to 2·5]). Falls (477 thousand [327 to 683] cases) and road injuries (230 thousand [122 to 389] cases) were the two leading causes of SCI globally in 2019. INTERPRETATION Although age-standardised rates of incidence, prevalence, and YLDs for SCI changed only slightly, absolute counts increased substantially from 1990 to 2019. Geographical heterogeneity in demographic, spatial, and temporal patterns of SCI, at both the national and regional levels, should be considered by policy makers aiming to reduce the burden of SCI. FUNDING Bill & Melinda Gates Foundation.
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Kaplan ZR, van der Vlegel M, van Dijck JT, Pisică D, van Leeuwen N, Lingsma HF, Steyerberg EW, Haagsma JA, Majdan M, Polinder S. Intramural Healthcare Consumption and Costs After Traumatic Brain Injury: A Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study. J Neurotrauma 2023; 40:2126-2145. [PMID: 37212277 PMCID: PMC10541942 DOI: 10.1089/neu.2022.0429] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023] Open
Abstract
Traumatic brain injury (TBI) is a global public health problem and a leading cause of mortality, morbidity, and disability. The increasing incidence combined with the heterogeneity and complexity of TBI will inevitably place a substantial burden on health systems. These findings emphasize the importance of obtaining accurate and timely insights into healthcare consumption and costs on a multi-national scale. This study aimed to describe intramural healthcare consumption and costs across the full spectrum of TBI in Europe. The Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) core study is a prospective observational study conducted in 18 countries across Europe and in Israel. The baseline Glasgow Coma Scale (GCS) was used to differentiate patients by brain injury severity in mild (GCS 13-15), moderate (GCS 9-12), or severe (GCS ≤8) TBI. We analyzed seven main cost categories: pre-hospital care, hospital admission, surgical interventions, imaging, laboratory, blood products, and rehabilitation. Costs were estimated based on Dutch reference prices and converted to country-specific unit prices using gross domestic product (GDP)-purchasing power parity (PPP) adjustment. Mixed linear regression was used to identify between-country differences in length of stay (LOS), as a parameter of healthcare consumption. Mixed generalized linear models with gamma distribution and log link function quantified associations of patient characteristics with higher total costs. We included 4349 patients, of whom 2854 (66%) had mild, 371 (9%) had moderate, and 962 (22%) had severe TBI. Hospitalization accounted for the largest part of the intramural consumption and costs (60%). In the total study population, the mean LOS was 5.1 days at the intensive care unit (ICU) and 6.3 days at the ward. For mild, moderate, and severe TBI, mean LOS was, respectively, 1.8, 8.9, and 13.5 days at the ICU and 4.5, 10.1, and 10.3 days at the ward. Other large contributors to the total costs were rehabilitation (19%) and intracranial surgeries (8%). Total costs increased with higher age and greater trauma severity (mild; €3,800 [IQR €1,400-14,000], moderate; €37,800 [IQR €14,900-€74,200], severe; €60,400 [IQR €24,400-€112,700]). The adjusted analysis showed that female patients had lower costs than male patients (odds ratio (OR) 0.80 [CI 0.75-1.85]). Increasing TBI severity was associated with higher costs, OR 1.46 (confidence interval [CI] 1.31-1.63) and OR 1.67 [CI 1.52-1.84] for moderate and severe patients, respectively. A worse pre-morbid overall health state, increasing age and more severe systemic trauma, expressed in the Injury Severity Score (ISS), were also significantly associated with higher costs. Intramural costs of TBI are significant and are profoundly driven by hospitalization. Costs increased with trauma severity and age, and male patients incurred higher costs. Reducing LOS could be targeted with advanced care planning, in order to provide cost-effective care.
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Affiliation(s)
- Z.L. Rana Kaplan
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Jeroen T.J.M. van Dijck
- Department of Neurosurgery, University Neurosurgical Center Holland (UNCH), Leiden University Medical Center & Haaglanden Medical Center & HAGA Teaching Hospital, Leiden/The Hague, The Netherlands
| | - Dana Pisică
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Nikki van Leeuwen
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hester F. Lingsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Ewout W. Steyerberg
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Juanita A. Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marek Majdan
- Institute for Global Health and Epidemiology, Department of Public Health, Trnava University, Trnava, Slovakia
| | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
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9
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Spronk I, Brus IM, de Groot A, Tieleman P, Olde Loohuis AGM, Haagsma JA, Polinder S. Long-term health outcomes of Q-fever fatigue syndrome patients. Epidemiol Infect 2023; 151:e179. [PMID: 37724460 PMCID: PMC10600735 DOI: 10.1017/s0950268823001401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 09/20/2023] Open
Abstract
This study determined long-term health outcomes (≥10 years) of Q-fever fatigue syndrome (QFS). Long-term complaints, health-related quality of life (HRQL), health status, energy level, fatigue, post-exertional malaise, anxiety, and depression were assessed. Outcomes and determinants were studied for the total sample and compared among age subgroups: young (<40years), middle-aged (≥40-<65years), and older (≥65years) patients. 368 QFS patients were included. Participants reported a median number of 12.0 long-term complaints. Their HRQL (median EQ-5D-5L index: 0.63) and health status (median EQ-VAS: 50.0) were low, their level of fatigue was high, and many experienced post-exertional malaise complaints (98.9%). Young and middle-aged patients reported worse health outcomes compared with older patients, with both groups reporting a significantly worse health status, higher fatigue levels and anxiety, and more post-exertional malaise complaints and middle-aged patients having a lower HRQL and a higher depression risk. Multivariate regression analyses confirmed that older age is associated with better outcomes, except for the number of health complaints. QFS has thus a considerable impact on patients' health more than 10 years after infection. Young and middle-aged patients experience more long-term health consequences compared with older patients. Tailored health care is recommended to provide optimalcare for each QFS patient.
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Affiliation(s)
- Inge Spronk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Iris M. Brus
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | | | | | - Juanita A. Haagsma
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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10
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Andrade CAS, Mahrouseh N, Gabrani J, Charalampous P, Cuschieri S, Grad DA, Unim B, Mechili EA, Chen-Xu J, Devleesschauwer B, Isola G, von der Lippe E, Baravelli CM, Fischer F, Weye N, Balaj M, Haneef R, Economou M, Haagsma JA, Varga O. Inequalities in the burden of non-communicable diseases across European countries: a systematic analysis of the Global Burden of Disease 2019 study. Int J Equity Health 2023; 22:140. [PMID: 37507733 PMCID: PMC10375608 DOI: 10.1186/s12939-023-01958-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Although overall health status in the last decades improved, health inequalities due to non-communicable diseases (NCDs) persist between and within European countries. There is a lack of studies giving insights into health inequalities related to NCDs in the European Economic Area (EEA) countries. Therefore, the aim of the present study was to quantify health inequalities in age-standardized disability adjusted life years (DALY) rates for NCDs overall and 12 specific NCDs across 30 EEA countries between 1990 and 2019. Also, this study aimed to determine trends in health inequalities and to identify those NCDs where the inequalities were the highest. METHODS DALY rate ratios were calculated to determine and compare inequalities between the 30 EEA countries, by sex, and across time. Annual rate of change was used to determine the differences in DALY rate between 1990 and 2019 for males and females. The Gini Coefficient (GC) was used to measure the DALY rate inequalities across countries, and the Slope Index of Inequality (SII) to estimate the average absolute difference in DALY rate across countries. RESULTS Between 1990 and 2019, there was an overall declining trend in DALY rate, with larger declines among females compared to males. Among EEA countries, in 2019 the highest NCD DALY rate for both sexes were observed for Bulgaria. For the whole period, the highest DALY rate ratios were identified for digestive diseases, diabetes and kidney diseases, substance use disorders, cardiovascular diseases (CVD), and chronic respiratory diseases - representing the highest inequality between countries. In 2019, the highest DALY rate ratio was found between Bulgaria and Iceland for males. GC and SII indicated that the highest inequalities were due to CVD for most of the study period - however, overall levels of inequality were low. CONCLUSIONS The inequality in level 1 NCDs DALYs rate is relatively low among all the countries. CVDs, digestive diseases, diabetes and kidney diseases, substance use disorders, and chronic respiratory diseases are the NCDs that exhibit higher levels of inequality across countries in the EEA. This might be mitigated by applying tailored preventive measures and enabling healthcare access.
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Affiliation(s)
- Carlos Alexandre Soares Andrade
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 26 Kassai Street, 4028, Debrecen, Hungary
| | - Nour Mahrouseh
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 26 Kassai Street, 4028, Debrecen, Hungary
| | - Jonila Gabrani
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Periklis Charalampous
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Sarah Cuschieri
- Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Diana Alecsandra Grad
- Department of Public Health, Babes-Bolyai University, Cluj-Napoca-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca-Napoca, Romania
| | - Brigid Unim
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore Di Sanità, Rome, Italy
| | - Enkeleint A Mechili
- Department of Healthcare, Faculty of Health, University of Vlora, Vlora, Albania
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece
| | - José Chen-Xu
- Public Health Unit, Primary Healthcare Cluster Baixo Mondego, Coimbra, Portugal
- National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Gaetano Isola
- Department of General Surgery and Surgical Medical Specialties, University of Catania, Catania, Italy
| | - Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | | | - Florian Fischer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nanna Weye
- Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Mirza Balaj
- Department of Sociology and Political Science, Centre for Global Health Inequalities Research (CHAIN), Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Romana Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - Mary Economou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Orsolya Varga
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 26 Kassai Street, 4028, Debrecen, Hungary.
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11
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Gerritzen I, Brus IM, Spronk I, Biere-Rafi S, Polinder S, Haagsma JA. Identification of post-COVID-19 condition phenotypes, and differences in health-related quality of life and healthcare use: a cluster analysis. Epidemiol Infect 2023; 151:e123. [PMID: 37462040 PMCID: PMC10540165 DOI: 10.1017/s0950268823001139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 08/05/2023] Open
Abstract
The aim of this cross-sectional study was to identify post-COVID-19 condition (PCC) phenotypes and to investigate the health-related quality of life (HRQoL) and healthcare use per phenotype. We administered a questionnaire to a cohort of PCC patients that included items on socio-demographics, medical characteristics, health symptoms, healthcare use, and the EQ-5D-5L. A principal component analysis (PCA) of PCC symptoms was performed to identify symptom patterns. K-means clustering was used to identify phenotypes. In total, 8630 participants completed the survey. The median number of symptoms was 18, with the top 3 being fatigue, concentration problems, and decreased physical condition. Eight symptom patterns and three phenotypes were identified. Phenotype 1 comprised participants with a lower-than-average number of symptoms, phenotype 2 with an average number of symptoms, and phenotype 3 with a higher-than-average number of symptoms. Compared to participants in phenotypes 1 and 2, those in phenotype 3 consulted significantly more healthcare providers (median 4, 6, and 7, respectively, p < 0.001) and had a significantly worse HRQoL (p < 0.001). In conclusion, number of symptoms rather than type of symptom was the driver in the identification of PCC phenotypes. Experiencing a higher number of symptoms is associated with a lower HRQoL and more healthcare use.
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Affiliation(s)
- Iris Gerritzen
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Iris M. Brus
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Inge Spronk
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Juanita A. Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
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12
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Gorasso V, Morgado JN, Charalampous P, Pires SM, Haagsma JA, Santos JV, Idavain J, Ngwa CH, Noguer I, Padron-Monedero A, Sarmiento R, Pinheiro V, Von der Lippe E, Jakobsen LS, Devleesschauwer B, Plass D. Burden of disease attributable to risk factors in European countries: a scoping literature review. Arch Public Health 2023; 81:116. [PMID: 37355706 DOI: 10.1186/s13690-023-01119-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/24/2023] [Indexed: 06/26/2023] Open
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/ ).
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Affiliation(s)
- Vanessa Gorasso
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Joana Nazaré Morgado
- Environmental Health and Nutrition Laboratory, University of Lisbon, Lisbon, Portugal
| | | | - Sara M Pires
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | | | - João Vasco Santos
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal
- CINTESIS, Centre for Health Technology and Services Research, Porto, Portugal
- Public Health Unit, ACES Grande Porto V - Porto Ocidental, Porto, Portugal
| | - Jane Idavain
- Department of Health Statistics, National Institute for Health Development, Tallinn, Estonia
| | - Che Henry Ngwa
- School of Public Health and Community Medicine, Sahlgrenska Academy, Gothenburg, Sweden
- Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon
| | - Isabel Noguer
- Carlos III Institute of Health, National School of Public Health, Madrid, Spain
| | | | - Rodrigo Sarmiento
- Carlos III Institute of Health, National School of Public Health, Madrid, Spain
- Medicine School, University of Applied and Environmental Sciences, Bogota, Colombia
| | - Vera Pinheiro
- CINTESIS, Centre for Health Technology and Services Research, Porto, Portugal
- Public Health Unit, Matosinhos Local Health Unit, Matosinhos, Portugal
| | - Elena Von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Lea Sletting Jakobsen
- Division for Diet, Disease Prevention and Toxicology, Technical University of Denmark, Lyngby, Denmark
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Dietrich Plass
- Department for Exposure Assessment and Environmental Health Indicators, German Environment Agency, Berlin, Germany
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13
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Brus IM, Spronk I, Haagsma JA, de Groot A, Tieleman P, Biere-Rafi S, Polinder S. The prolonged impact of COVID-19 on symptoms, health-related quality of life, fatigue and mental well-being: a cross-sectional study. Front Epidemiol 2023; 3:1144707. [PMID: 38455946 PMCID: PMC10911032 DOI: 10.3389/fepid.2023.1144707] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 06/01/2023] [Indexed: 03/09/2024]
Abstract
Background A subset of patients experience persisting symptoms after an acute COVID-19 infection, referred to as "post COVID-19 condition". This cross-sectional study aimed to compare symptoms, health-related quality of life (HRQoL), fatigue, mental well-being, and determinants of diminished HRQoL, between patients with post COVID-19 condition categorized by time since acute infection. Methods We performed an online survey and analyzed responses of 10,194 adult respondents with a confirmed or suspected COVID-19 infection, who experienced persisting symptoms ≥3 months after the initial infection. The most debilitating symptoms and health outcomes were studied separately for respondents 3-6, 7-9, 10-12, 13-18, 19-24, and >24 months after acute infection. Results At each time period, fatigue, sensory-processing problems, and concentration problems were the most debilitating symptoms reported by respondents, although the proportion of respondents who reported these symptoms differed significantly between time periods. Respondents 3-6 months post-acute infection had the lowest HRQoL (median EQ-5D utility score: 0.59), the highest fatigue level (median score: 110.0) and the highest proportion with a likely depressive disorder (32.4%), whereas respondents 13-18 months post-infection had the highest HRQoL (0.65), the lowest fatigue level (106.0), and the second lowest proportion with a likely depressive disorder (25.0%) (p = 0.000-0.007). Compared to those 13-18 and 19-24 months post-infection, respondents >24 months post-infection had a slightly lower HRQoL (0.60), lower fatigue level (108.0), and lower proportion with a likely depressive disorder (29.2%), although only the differences in HRQoL were statistically significant (p = 0.001-0.010). Younger age, female gender, lower level of education, not having paid work before COVID-19, comorbidity, and not being vaccinated, seemed to be associated with lower HRQoL. Conclusion Regardless of time since infection, respondents considered fatigue, sensory processing problems and concentration problems the most debilitating symptoms. They experienced a low HRQoL and severe fatigue, even more than two years after acute COVID-19 infection. Respondents 3-6 months post-infection had the worst health outcomes, whereas respondents 13-18 months post-infection had the best outcomes, indicating that, at least for a subgroup of patients, health status may improve over time.
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Affiliation(s)
- Iris M. Brus
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Inge Spronk
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Juanita A. Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | | | | | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
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14
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Scott ES, Lubetkin EI, Janssen MF, Yfantopolous J, Bonsel GJ, Haagsma JA. Cross-sectional and longitudinal comparison of health-related quality of life and mental well-being between persons with and without post COVID-19 condition. Front Epidemiol 2023; 3:1144162. [PMID: 38455931 PMCID: PMC10910898 DOI: 10.3389/fepid.2023.1144162] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/27/2023] [Indexed: 03/09/2024]
Abstract
Background Still little is known about the impact of post COVID-19 condition (PC) on health-related quality of life (HRQOL) and mental well-being. We compared participants with PC with three groups: an acute COVID-19 infection (AC) only, at least one chronic condition (CC) but no COVID-19, or no condition at all, healthy (PH). Between these disease groups, we also estimated and compared HRQOL and mental well-being change over time. Methods Participants from six countries (Greece, Italy, Netherlands, Sweden, United Kingdom and United States) completed two web-based questionnaires (T1 = April-May 2020 and T2 = April-June 2022). Primary outcomes were HRQOL, measured by EQ-5D-5L and EQ VAS, and mental well-being (measured by World Health Organisation-Five (WHO-5) Well-Being Index, Patient Health Questionnaire (PHQ)-9 and General Anxiety Disorder (GAD)-7). All analyses were stratified by the disease groups. Results In total, 4,999 participants filled out both surveys: 240 were in PC, 107 in AC, 1798 in CC and 2,854 in PH. At T2, the mean EQ-5D-5L index values for the PC, AC, CC and PH groups were 0.70, 0.73, 0.75 and 0.92 (p < .001), respectively. Mean EQ VAS scores were 66, 65, 68 and 81 (p < .001), respectively. Poor mental well-being, depression and anxiety mean values were highest in the PC group (47.7; 9.1; 7.4), followed by the AC group (51.1; 7.7; 5.7), CC group (56.1; 5.2; 4.2) and the PH group (65.6; 2.8; 2.5), respectively (p < .001 between groups). Over time, HRQOL deteriorated in all groups, apart from the PH group. We observed the largest deterioration in the CC (EQ-5D-5L index: Δ0.03, p < .001) and AC group (EQ VAS: Δ6.3, p < .001). For the mental well-being outcomes, deterioration for WHO-5 and PHQ-9 were largest in the AC group (Δ4.8, p = .016; Δ-1.3, p = .012). Rates for GAD-7 improved for the PH and CC groups (PH: Δ1.27, CC: Δ0.56, p < .001). Conclusions In the cross-sectional analysis, participants with PC had the worst HRQOL and mental well-being compared to the other groups. In terms of change since the start of the COVID-19 pandemic, HRQOL and mental well-being deterioration was highest among AC participants and had a lower impact among PC participants, most likely due to pre-existing chronic disease.
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Affiliation(s)
| | - Erica I. Lubetkin
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York City, NY, United States
| | - Mathieu F. Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, Netherlands
| | - John Yfantopolous
- Health Department of Economics, National and Kapodistrian University of Athens, Athens, Greece
| | - Gouke J. Bonsel
- Department Scientific Support, EuroQol Research Foundation, Rotterdam, Netherlands
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15
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Brus IM, Spronk I, Haagsma JA, Erasmus V, de Groot A, Olde Loohuis AGM, Bronner MB, Polinder S. Prerequisites, barriers and opportunities in care for Q-fever patients: a Delphi study among healthcare workers. BMC Health Serv Res 2023; 23:319. [PMID: 37004033 PMCID: PMC10064509 DOI: 10.1186/s12913-023-09269-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 03/10/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Q-fever is a zoonotic disease that can lead to illness, disability and death. This study aimed to provide insight into the perspectives of healthcare workers (HCWs) on prerequisites, barriers and opportunities in care for Q-fever patients. METHODS A two-round online Delphi study was conducted among 94 Dutch HCWs involved in care for Q-fever patients. The questionnaires contained questions on prerequisites for high quality, barriers and facilitators in care, knowledge of Q-fever, and optimization of care. For multiple choice, ranking and Likert scale questions, frequencies were reported, while for rating and numerical questions, the median and interquartile range (IQR) were reported. RESULTS The panel rated the care for Q-fever patients at a median score of 6/10 (IQR = 2). Sufficient knowledge of Q-fever among HCWs (36%), financial compensation of care (30%) and recognition of the disease by HCWs (26%) were considered the most important prerequisites for high quality care. A lack of knowledge was identified as the most important barrier (76%) and continuing medical education as the primary method for improving HCWs' knowledge (76%). HCWs rated their own knowledge at a median score of 8/10 (IQR = 1) and the general knowledge of other HCWs at a 5/10 (IQR = 2). According to HCWs, a median of eight healthcare providers (IQR = 4) should be involved in the care for Q-fever fatigue syndrome (QFS) and a median of seven (IQR = 5) in chronic Q-fever care. CONCLUSIONS Ten years after the Dutch Q-fever epidemic, HCWs indicate that the long-term care for Q-fever patients leaves much room for improvement. Facilitation of reported prerequisites for high quality care, improved knowledge among HCWs, clearly defined roles and responsibilities, and guidance on how to support patients could possibly improve quality of care. These prerequisites may also improve care for patients with persisting symptoms due to other infectious diseases, such as COVID-19.
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Affiliation(s)
- Iris M Brus
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands.
| | - Inge Spronk
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | - Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | - Vicki Erasmus
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | | | | | - Madelon B Bronner
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | - Suzanne Polinder
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
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16
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Wyper GM, Assuncao R, Fletcher E, Gourley M, Grant I, Haagsma JA, Hilderink H, Idavain J, Lesnik T, von der Lippe E, Majdan M, Mccartney G, Santric-Milicevic M, Pallari E, Pires SM, Plass D, Porst M, Santos JV, de Haro Moro MT, Stockton DL, Devleesschauwer B. The increasing significance of disease severity in a burden of disease framework. Scand J Public Health 2023; 51:296-300. [PMID: 34213383 PMCID: PMC9969303 DOI: 10.1177/14034948211024478] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Recent estimates have reiterated that non-fatal causes of disease, such as low back pain, headaches and depressive disorders, are amongst the leading causes of disability-adjusted life years (DALYs). For these causes, the contribution of years lived with disability (YLD) - put simply, ill-health - is what drives DALYs, not mortality. Being able to monitor trends in YLD closely is particularly relevant for countries that sit high on the socio-demographic spectrum of development, as it contributes more than half of all DALYs. There is a paucity of data on how the population-level occurrence of disease is distributed according to severity, and as such, the majority of global and national efforts in monitoring YLD lack the ability to differentiate changes in severity across time and location. This raises uncertainties in interpreting these findings without triangulation with other relevant data sources. Our commentary aims to bring this issue to the forefront for users of burden of disease estimates, as its impact is often easily overlooked as part of the fundamental process of generating DALY estimates. Moreover, the wider health harms of the COVID-19 pandemic have underlined the likelihood of latent and delayed demand in accessing vital health and care services that will ultimately lead to exacerbated disease severity and health outcomes. This places increased importance on attempts to be able to differentiate by both the occurrence and severity of disease.
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Affiliation(s)
- Grant M.A. Wyper
- Place and Wellbeing Directorate, Public
Health Scotland, UK,Grant MA Wyper, Public Health Scotland,
Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | | | - Eilidh Fletcher
- Data Driven Innovation Directorate,
Public Health Scotland, UK
| | - Michelle Gourley
- Burden of Disease and Mortality Unit,
Australian Institute of Health and Welfare, Australia
| | - Ian Grant
- Data Driven Innovation Directorate,
Public Health Scotland, UK
| | - Juanita A. Haagsma
- Department of Public Health, Erasmus
MC, University Medical Centre Rotterdam, The Netherlands
| | - Henk Hilderink
- National Institute for Public Health
and the Environment (RIVM), The Netherlands
| | - Jane Idavain
- National Institute for Health
Development, Estonia
| | - Tina Lesnik
- National Institute of Public Health,
Slovenia
| | - Elena von der Lippe
- Department of Epidemiology and Health
Monitoring, Robert Koch Institute, Germany
| | - Marek Majdan
- Faculty of Health Sciences and Social
Work, Trnava University, Slovakia
| | | | - Milena Santric-Milicevic
- Institute of Social Medicine, Centre
School of Public Health and Health Management, Faculty of Medicine University of
Belgrade, Serbia
| | - Elena Pallari
- MRC Clinical Trials and Methodology
Unit, University College London, UK
| | - Sara M. Pires
- National Food Institute, Technical
University of Denmark, Denmark
| | - Dietrich Plass
- Section Exposure Assessment and
Environmental Health Indicators, German Environment Agency, Germany
| | - Michael Porst
- Department of Epidemiology and Health
Monitoring, Robert Koch Institute, Germany
| | - João V. Santos
- MEDCIDS, Department of Community
Medicine, Information and Health Decision Sciences, Faculty of Medicine, University
of Porto, Portugal,CINTESIS, Centre for Health
Technology and Services Research, Portugal,Public Health Unit, ACES Grande Porto
VIII – Espinho/Gaia, ARS Norte, Portugal
| | | | - Diane L. Stockton
- Clinical and Protecting Health
Directorate, Public Health Scotland, UK
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public
Health, Sciensano, Belgium,Department of Veterinary Public
Health and Food Safety, Faculty of Veterinary Medicine, Ghent University,
Belgium
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17
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Spronk I, van Baar ME, Verheij RA, Panneman MJ, Dokter J, Polinder S, Haagsma JA. The burden of disease of fatal and non-fatal burn injuries for the full spectrum of care in the Netherlands. Arch Public Health 2023; 81:3. [PMID: 36617544 PMCID: PMC9827636 DOI: 10.1186/s13690-022-01020-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/28/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND A comprehensive overview of the burden of disease of burns for the full spectrum of care is not available. Therefore, we estimated the burden of disease of burns for the full spectrum in the Netherlands in 2018, and explored whether the burden of disease changed over the past 5 years (2014-2018). METHODS Data were collected at four levels: general practice, emergency department, hospital, and mortality data. For each level, years lived with disability (YLD), years of life lost (YLL), and disability-adjusted life-years (DALY) were estimated using a tailored methodology. RESULTS Burns resulted in a total of 9278 DALYs in the Netherlands in 2018, comprising of 7385 YLDs (80%) and 1892 YLLs (20%). Burn patients who visited the general practice contributed most DALYs (64%), followed by deceased burn patients (20%), burn patients admitted to hospital (14%) and those treated at the emergency department (2%). The burden of disease was comparable in both sexes (4734 DALYs (51%) for females; 4544 DALYs (49%) for males), though the distribution of DALYs by level of care varied; females contributed more DALYs at the general practice level, and males at all other levels of care. Among children boys 0-4 years had the highest burden of disease (784 DALYs (9%)), and among adults, females 18-34 years old (1319 DALYs (14.2%)) had the highest burden of disease. Between 2014 and 2018 there was a marginal increase of 0.8% in the number of DALYs. CONCLUSIONS Burns cause a substantial burden of disease, with burns requiring care at the general practice level contributing most DALYs. Information on burden of burns by the full level of care as well as by subgroup is important for the development of tailored burn prevention strategies, and the updated figures are recommended to be used for priority setting and resource allocation.
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Affiliation(s)
- Inge Spronk
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus MC, University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands ,grid.416213.30000 0004 0460 0556Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands
| | - Margriet E. van Baar
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus MC, University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands ,grid.416213.30000 0004 0460 0556Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands
| | - Robert A. Verheij
- grid.416005.60000 0001 0681 4687Nivel, Netherlands Institute for Health Services Research, Utrecht, The Netherlands ,Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg, The Netherlands
| | - Martien J. Panneman
- grid.491163.80000 0004 0448 3601Consumer Safety Institute, Amsterdam, The Netherlands
| | - Jan Dokter
- grid.416213.30000 0004 0460 0556Burn Centre, Maasstad Hospital, Rotterdam, the Netherlands
| | - Suzanne Polinder
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus MC, University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Juanita A. Haagsma
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus MC, University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands
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18
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Verheij C, Haagsma JA, Koch BCP, Segers AEM, Schuit SCE, Rood PPM. Screening for hazardous alcohol use in the Emergency Department: Comparison of phosphatidylethanol with the Alcohol Use Disorders Identification Test and the Timeline Follow-back. Alcohol Clin Exp Res 2022; 46:2225-2235. [PMID: 36520053 PMCID: PMC10107187 DOI: 10.1111/acer.14958] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/10/2022] [Accepted: 10/07/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Up to 15% of all visits to the Emergency Department (ED) are alcohol related. Identification of problematic alcohol use is important in this setting because it allows for intervention and prevention efforts. This study investigated the correlation between the objective phosphatidylethanol (PEth) marker and the subjective Alcohol Use Disorders Identification Test (AUDIT) and Timeline Followback Questionnaire (TLFB) as screening methods for hazardous alcohol use in the general ED population. METHODS This prospective cohort study included 301 ED patients (57% male) who were seen in the ED and required to give a blood sample. The correlation between the values of PEth (PEth 16:0/18:1 and PEth 16:0/18:2) and the scores on the AUDIT and TLFB were analyzed using Spearman's rank correlation coefficient. Differences between risk categories of PEth and AUDIT were also examined. RESULTS The Spearman correlation coefficients between PEth 16:0/18:1|PEth 16:0/18:2 values and the AUDIT scores were moderate (PEth 16:0/18:1: 0.67, p < 0.001; PEth 16:0/18:2: 0.67, p < 0.001). Of the patients who scored 'low risk drinking/abstinence' according to the AUDIT questionnaire, respectively 1% and 4% had PEth 16:0/18:1|PEth 16:0/18:2 values indicating excessive alcohol use, and another 10% and 12% had PEth 16:0/18:1|PEth 16:0/18:2 values indicating moderate alcohol consumption. Of the 12 (PEth 16:0/18:1) and 25 (PEth 16:0/18:2) patients with high-risk values, respectively 25% and 40% scored in the lowest risk category on the AUDIT questionnaire. Spearman correlation coefficients between PEth 16:0/18:1|PEth 16:0/18:2 values and TLFB two-week scores were high (PEth 16:0/18:1: 0.74, p < 0.001; PEth 16:0/18:2: 0.82, p < 0.001). CONCLUSIONS AUDIT scores were moderately correlated with PEth values in the general ED population. In almost all cases where there was not a good correlation, patients had high PEth values with low AUDIT scores. We conclude that PEth identifies patients with problematic alcohol use who are missed by the AUDIT questionnaire and therefore PEth could be used as an additional screening method for hazardous alcohol use in this population.
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Affiliation(s)
- Carolien Verheij
- Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Juanita A Haagsma
- Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Birgit C P Koch
- Department of Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anne E M Segers
- Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Stephanie C E Schuit
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Board of Directors, University Medical Center Groningen, Groningen, The Netherlands
| | - Pleunie P M Rood
- Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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19
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Long D, Bonsel GJ, Lubetkin EI, Janssen MF, Haagsma JA. Anxiety, depression, and social connectedness among the general population of eight countries during the COVID-19 pandemic. Arch Public Health 2022; 80:237. [PMID: 36397099 PMCID: PMC9672616 DOI: 10.1186/s13690-022-00990-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 10/13/2022] [Indexed: 11/19/2022] Open
Abstract
Background The COVID-19 pandemic affected the mental health of the general population through multiple pathways. The aim of this study was to examine anxiety, depression, self-confidence, and social connectedness among the general population of eight countries during the COVID-19 pandemic, their underlying factors, and vulnerable groups. Methods A web-based survey was administered to persons from the general population of China, Greece, Italy, Netherlands, Russia, Sweden, the United Kingdom, and the United States. The survey included the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9) and items on self-confidence, social connectedness, and socio-demographics. Data were analyzed with descriptive statistics, exploratory factor analysis and regression analysis. Results Twenty-three thousand six hundred twenty-two respondents completed the survey. Overall, 42% of the total sample had mild to severe anxiety symptoms and 43% had mild to severe depression symptoms. 14% to 38% reported suboptimal ratings in self-confidence, social participation, contact with family and friends, and feeling connected to others. In the exploratory factor analyses, in most countries, one dominant factor had a high influence on GAD-7, PHQ-9 sum scores and self-confidence with eigenvalue (% variance) above 3.2 (53.9%). One less dominant factor had a high influence on social connectedness scores with eigenvalue (% variance) ranging above 0.8 (12.8%). Being younger, female, having chronic conditions, perceived as risky to COVID-19 infection, and feeling not very well protected against COVID-19 were significantly associated with the two underlying factors. Conclusions Anxiety, depression, and problems with self-confidence and social connectedness were highly prevalent in the general population of eight countries during the early phase of the COVID-19 pandemic. This highlights the importance of the allocation of additional resources to implement policies to mitigate the impact of the pandemic on mental health. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00990-4.
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20
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Maas AIR, Menon DK, Manley GT, Abrams M, Åkerlund C, Andelic N, Aries M, Bashford T, Bell MJ, Bodien YG, Brett BL, Büki A, Chesnut RM, Citerio G, Clark D, Clasby B, Cooper DJ, Czeiter E, Czosnyka M, Dams-O’Connor K, De Keyser V, Diaz-Arrastia R, Ercole A, van Essen TA, Falvey É, Ferguson AR, Figaji A, Fitzgerald M, Foreman B, Gantner D, Gao G, Giacino J, Gravesteijn B, Guiza F, Gupta D, Gurnell M, Haagsma JA, Hammond FM, Hawryluk G, Hutchinson P, van der Jagt M, Jain S, Jain S, Jiang JY, Kent H, Kolias A, Kompanje EJO, Lecky F, Lingsma HF, Maegele M, Majdan M, Markowitz A, McCrea M, Meyfroidt G, Mikolić A, Mondello S, Mukherjee P, Nelson D, Nelson LD, Newcombe V, Okonkwo D, Orešič M, Peul W, Pisică D, Polinder S, Ponsford J, Puybasset L, Raj R, Robba C, Røe C, Rosand J, Schueler P, Sharp DJ, Smielewski P, Stein MB, von Steinbüchel N, Stewart W, Steyerberg EW, Stocchetti N, Temkin N, Tenovuo O, Theadom A, Thomas I, Espin AT, Turgeon AF, Unterberg A, Van Praag D, van Veen E, Verheyden J, Vyvere TV, Wang KKW, Wiegers EJA, Williams WH, Wilson L, Wisniewski SR, Younsi A, Yue JK, Yuh EL, Zeiler FA, Zeldovich M, Zemek R. Traumatic brain injury: progress and challenges in prevention, clinical care, and research. Lancet Neurol 2022; 21:1004-1060. [PMID: 36183712 PMCID: PMC10427240 DOI: 10.1016/s1474-4422(22)00309-x] [Citation(s) in RCA: 168] [Impact Index Per Article: 84.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 07/22/2022] [Indexed: 02/06/2023]
Abstract
Traumatic brain injury (TBI) has the highest incidence of all common neurological disorders, and poses a substantial public health burden. TBI is increasingly documented not only as an acute condition but also as a chronic disease with long-term consequences, including an increased risk of late-onset neurodegeneration. The first Lancet Neurology Commission on TBI, published in 2017, called for a concerted effort to tackle the global health problem posed by TBI. Since then, funding agencies have supported research both in high-income countries (HICs) and in low-income and middle-income countries (LMICs). In November 2020, the World Health Assembly, the decision-making body of WHO, passed resolution WHA73.10 for global actions on epilepsy and other neurological disorders, and WHO launched the Decade for Action on Road Safety plan in 2021. New knowledge has been generated by large observational studies, including those conducted under the umbrella of the International Traumatic Brain Injury Research (InTBIR) initiative, established as a collaboration of funding agencies in 2011. InTBIR has also provided a huge stimulus to collaborative research in TBI and has facilitated participation of global partners. The return on investment has been high, but many needs of patients with TBI remain unaddressed. This update to the 2017 Commission presents advances and discusses persisting and new challenges in prevention, clinical care, and research. In LMICs, the occurrence of TBI is driven by road traffic incidents, often involving vulnerable road users such as motorcyclists and pedestrians. In HICs, most TBI is caused by falls, particularly in older people (aged ≥65 years), who often have comorbidities. Risk factors such as frailty and alcohol misuse provide opportunities for targeted prevention actions. Little evidence exists to inform treatment of older patients, who have been commonly excluded from past clinical trials—consequently, appropriate evidence is urgently required. Although increasing age is associated with worse outcomes from TBI, age should not dictate limitations in therapy. However, patients injured by low-energy falls (who are mostly older people) are about 50% less likely to receive critical care or emergency interventions, compared with those injured by high-energy mechanisms, such as road traffic incidents. Mild TBI, defined as a Glasgow Coma sum score of 13–15, comprises most of the TBI cases (over 90%) presenting to hospital. Around 50% of adult patients with mild TBI presenting to hospital do not recover to pre-TBI levels of health by 6 months after their injury. Fewer than 10% of patients discharged after presenting to an emergency department for TBI in Europe currently receive follow-up. Structured follow-up after mild TBI should be considered good practice, and urgent research is needed to identify which patients with mild TBI are at risk for incomplete recovery. The selection of patients for CT is an important triage decision in mild TBI since it allows early identification of lesions that can trigger hospital admission or life-saving surgery. Current decision making for deciding on CT is inefficient, with 90–95% of scanned patients showing no intracranial injury but being subjected to radiation risks. InTBIR studies have shown that measurement of blood-based biomarkers adds value to previously proposed clinical decision rules, holding the potential to improve efficiency while reducing radiation exposure. Increased concentrations of biomarkers in the blood of patients with a normal presentation CT scan suggest structural brain damage, which is seen on MR scanning in up to 30% of patients with mild TBI. Advanced MRI, including diffusion tensor imaging and volumetric analyses, can identify additional injuries not detectable by visual inspection of standard clinical MR images. Thus, the absence of CT abnormalities does not exclude structural damage—an observation relevant to litigation procedures, to management of mild TBI, and when CT scans are insufficient to explain the severity of the clinical condition. Although blood-based protein biomarkers have been shown to have important roles in the evaluation of TBI, most available assays are for research use only. To date, there is only one vendor of such assays with regulatory clearance in Europe and the USA with an indication to rule out the need for CT imaging for patients with suspected TBI. Regulatory clearance is provided for a combination of biomarkers, although evidence is accumulating that a single biomarker can perform as well as a combination. Additional biomarkers and more clinical-use platforms are on the horizon, but cross-platform harmonisation of results is needed. Health-care efficiency would benefit from diversity in providers. In the intensive care setting, automated analysis of blood pressure and intracranial pressure with calculation of derived parameters can help individualise management of TBI. Interest in the identification of subgroups of patients who might benefit more from some specific therapeutic approaches than others represents a welcome shift towards precision medicine. Comparative-effectiveness research to identify best practice has delivered on expectations for providing evidence in support of best practices, both in adult and paediatric patients with TBI. Progress has also been made in improving outcome assessment after TBI. Key instruments have been translated into up to 20 languages and linguistically validated, and are now internationally available for clinical and research use. TBI affects multiple domains of functioning, and outcomes are affected by personal characteristics and life-course events, consistent with a multifactorial bio-psycho-socio-ecological model of TBI, as presented in the US National Academies of Sciences, Engineering, and Medicine (NASEM) 2022 report. Multidimensional assessment is desirable and might be best based on measurement of global functional impairment. More work is required to develop and implement recommendations for multidimensional assessment. Prediction of outcome is relevant to patients and their families, and can facilitate the benchmarking of quality of care. InTBIR studies have identified new building blocks (eg, blood biomarkers and quantitative CT analysis) to refine existing prognostic models. Further improvement in prognostication could come from MRI, genetics, and the integration of dynamic changes in patient status after presentation. Neurotrauma researchers traditionally seek translation of their research findings through publications, clinical guidelines, and industry collaborations. However, to effectively impact clinical care and outcome, interactions are also needed with research funders, regulators, and policy makers, and partnership with patient organisations. Such interactions are increasingly taking place, with exemplars including interactions with the All Party Parliamentary Group on Acquired Brain Injury in the UK, the production of the NASEM report in the USA, and interactions with the US Food and Drug Administration. More interactions should be encouraged, and future discussions with regulators should include debates around consent from patients with acute mental incapacity and data sharing. Data sharing is strongly advocated by funding agencies. From January 2023, the US National Institutes of Health will require upload of research data into public repositories, but the EU requires data controllers to safeguard data security and privacy regulation. The tension between open data-sharing and adherence to privacy regulation could be resolved by cross-dataset analyses on federated platforms, with the data remaining at their original safe location. Tools already exist for conventional statistical analyses on federated platforms, however federated machine learning requires further development. Support for further development of federated platforms, and neuroinformatics more generally, should be a priority. This update to the 2017 Commission presents new insights and challenges across a range of topics around TBI: epidemiology and prevention (section 1 ); system of care (section 2 ); clinical management (section 3 ); characterisation of TBI (section 4 ); outcome assessment (section 5 ); prognosis (Section 6 ); and new directions for acquiring and implementing evidence (section 7 ). Table 1 summarises key messages from this Commission and proposes recommendations for the way forward to advance research and clinical management of TBI.
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Affiliation(s)
- Andrew I R Maas
- Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
| | - David K Menon
- Division of Anaesthesia, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - Geoffrey T Manley
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Mathew Abrams
- International Neuroinformatics Coordinating Facility, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Åkerlund
- Department of Physiology and Pharmacology, Section of Perioperative Medicine and Intensive Care, Karolinska Institutet, Stockholm, Sweden
| | - Nada Andelic
- Division of Clinical Neuroscience, Department of Physical Medicine and Rehabilitation, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Marcel Aries
- Department of Intensive Care, Maastricht UMC, Maastricht, Netherlands
| | - Tom Bashford
- Division of Anaesthesia, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - Michael J Bell
- Critical Care Medicine, Neurological Surgery and Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Yelena G Bodien
- Department of Neurology and Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
| | - Benjamin L Brett
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - András Büki
- Department of Neurosurgery, Faculty of Medicine and Health Örebro University, Örebro, Sweden
- Department of Neurosurgery, Medical School; ELKH-PTE Clinical Neuroscience MR Research Group; and Neurotrauma Research Group, Janos Szentagothai Research Centre, University of Pecs, Pecs, Hungary
| | - Randall M Chesnut
- Department of Neurological Surgery and Department of Orthopaedics and Sports Medicine, University of Washington, Harborview Medical Center, Seattle, WA, USA
| | - Giuseppe Citerio
- School of Medicine and Surgery, Universita Milano Bicocca, Milan, Italy
- NeuroIntensive Care, San Gerardo Hospital, Azienda Socio Sanitaria Territoriale (ASST) Monza, Monza, Italy
| | - David Clark
- Brain Physics Lab, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - Betony Clasby
- Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - D Jamie Cooper
- School of Public Health and Preventive Medicine, Monash University and The Alfred Hospital, Melbourne, VIC, Australia
| | - Endre Czeiter
- Department of Neurosurgery, Medical School; ELKH-PTE Clinical Neuroscience MR Research Group; and Neurotrauma Research Group, Janos Szentagothai Research Centre, University of Pecs, Pecs, Hungary
| | - Marek Czosnyka
- Brain Physics Lab, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - Kristen Dams-O’Connor
- Department of Rehabilitation and Human Performance and Department of Neurology, Brain Injury Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Véronique De Keyser
- Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
| | - Ramon Diaz-Arrastia
- Department of Neurology and Center for Brain Injury and Repair, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Ari Ercole
- Division of Anaesthesia, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - Thomas A van Essen
- Department of Neurosurgery, Leiden University Medical Center, Leiden, Netherlands
- Department of Neurosurgery, Medical Center Haaglanden, The Hague, Netherlands
| | - Éanna Falvey
- College of Medicine and Health, University College Cork, Cork, Ireland
| | - Adam R Ferguson
- Brain and Spinal Injury Center, Department of Neurological Surgery, Weill Institute for Neurosciences, University of California San Francisco and San Francisco Veterans Affairs Healthcare System, San Francisco, CA, USA
| | - Anthony Figaji
- Division of Neurosurgery and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Melinda Fitzgerald
- Curtin Health Innovation Research Institute, Curtin University, Bentley, WA, Australia
- Perron Institute for Neurological and Translational Sciences, Nedlands, WA, Australia
| | - Brandon Foreman
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati Gardner Neuroscience Institute, University of Cincinnati, Cincinnati, OH, USA
| | - Dashiell Gantner
- School of Public Health and Preventive Medicine, Monash University and The Alfred Hospital, Melbourne, VIC, Australia
| | - Guoyi Gao
- Department of Neurosurgery, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine
| | - Joseph Giacino
- Department of Physical Medicine and Rehabilitation, Harvard Medical School and Spaulding Rehabilitation Hospital, Charlestown, MA, USA
| | - Benjamin Gravesteijn
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Fabian Guiza
- Department and Laboratory of Intensive Care Medicine, University Hospitals Leuven and KU Leuven, Leuven, Belgium
| | - Deepak Gupta
- Department of Neurosurgery, Neurosciences Centre and JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Mark Gurnell
- Metabolic Research Laboratories, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Flora M Hammond
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Rehabilitation Hospital of Indiana, Indianapolis, IN, USA
| | - Gregory Hawryluk
- Section of Neurosurgery, GB1, Health Sciences Centre, University of Manitoba, Winnipeg, MB, Canada
| | - Peter Hutchinson
- Brain Physics Lab, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - Mathieu van der Jagt
- Department of Intensive Care, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Sonia Jain
- Biostatistics Research Center, Herbert Wertheim School of Public Health, University of California, San Diego, CA, USA
| | - Swati Jain
- Brain Physics Lab, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - Ji-yao Jiang
- Department of Neurosurgery, Shanghai Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hope Kent
- Department of Psychology, University of Exeter, Exeter, UK
| | - Angelos Kolias
- Brain Physics Lab, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - Erwin J O Kompanje
- Department of Intensive Care, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Fiona Lecky
- Centre for Urgent and Emergency Care Research, Health Services Research Section, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Hester F Lingsma
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Marc Maegele
- Cologne-Merheim Medical Center, Department of Trauma and Orthopedic Surgery, Witten/Herdecke University, Cologne, Germany
| | - Marek Majdan
- Institute for Global Health and Epidemiology, Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia
| | - Amy Markowitz
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Michael McCrea
- Department of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Geert Meyfroidt
- Department and Laboratory of Intensive Care Medicine, University Hospitals Leuven and KU Leuven, Leuven, Belgium
| | - Ana Mikolić
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Pratik Mukherjee
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - David Nelson
- Section for Anesthesiology and Intensive Care, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Lindsay D Nelson
- Department of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Virginia Newcombe
- Division of Anaesthesia, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - David Okonkwo
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Matej Orešič
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Wilco Peul
- Department of Neurosurgery, Leiden University Medical Center, Leiden, Netherlands
| | - Dana Pisică
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Neurosurgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Jennie Ponsford
- Monash-Epworth Rehabilitation Research Centre, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Louis Puybasset
- Department of Anesthesiology and Intensive Care, APHP, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Rahul Raj
- Department of Neurosurgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Chiara Robba
- Department of Anaesthesia and Intensive Care, Policlinico San Martino IRCCS for Oncology and Neuroscience, Genova, Italy, and Dipartimento di Scienze Chirurgiche e Diagnostiche, University of Genoa, Italy
| | - Cecilie Røe
- Division of Clinical Neuroscience, Department of Physical Medicine and Rehabilitation, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Jonathan Rosand
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | | | - David J Sharp
- Department of Brain Sciences, Imperial College London, London, UK
| | - Peter Smielewski
- Brain Physics Lab, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - Murray B Stein
- Department of Psychiatry and Department of Family Medicine and Public Health, UCSD School of Medicine, La Jolla, CA, USA
| | - Nicole von Steinbüchel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Goettingen, Goettingen, Germany
| | - William Stewart
- Department of Neuropathology, Queen Elizabeth University Hospital and University of Glasgow, Glasgow, UK
| | - Ewout W Steyerberg
- Department of Biomedical Data Sciences Leiden University Medical Center, Leiden, Netherlands
| | - Nino Stocchetti
- Department of Pathophysiology and Transplantation, Milan University, and Neuroscience ICU, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nancy Temkin
- Departments of Neurological Surgery, and Biostatistics, University of Washington, Seattle, WA, USA
| | - Olli Tenovuo
- Department of Rehabilitation and Brain Trauma, Turku University Hospital, and Department of Neurology, University of Turku, Turku, Finland
| | - Alice Theadom
- National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Studies, Auckland University of Technology, Auckland, New Zealand
| | - Ilias Thomas
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Abel Torres Espin
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Alexis F Turgeon
- Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, CHU de Québec-Université Laval Research Center, Québec City, QC, Canada
| | - Andreas Unterberg
- Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Dominique Van Praag
- Departments of Clinical Psychology and Neurosurgery, Antwerp University Hospital, and University of Antwerp, Edegem, Belgium
| | - Ernest van Veen
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | | | - Thijs Vande Vyvere
- Department of Radiology, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences (MOVANT), Antwerp University Hospital, and University of Antwerp, Edegem, Belgium
| | - Kevin K W Wang
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Eveline J A Wiegers
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - W Huw Williams
- Centre for Clinical Neuropsychology Research, Department of Psychology, University of Exeter, Exeter, UK
| | - Lindsay Wilson
- Division of Psychology, University of Stirling, Stirling, UK
| | - Stephen R Wisniewski
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Alexander Younsi
- Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany
| | - John K Yue
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Esther L Yuh
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Frederick A Zeiler
- Departments of Surgery, Human Anatomy and Cell Science, and Biomedical Engineering, Rady Faculty of Health Sciences and Price Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada
| | - Marina Zeldovich
- Institute of Medical Psychology and Medical Sociology, University Medical Center Goettingen, Goettingen, Germany
| | - Roger Zemek
- Departments of Pediatrics and Emergency Medicine, University of Ottawa, Children’s Hospital of Eastern Ontario, ON, Canada
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21
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Long D, Bonsel GJ, Lubetkin EI, Yfantopoulos JN, Janssen MF, Haagsma JA. Health-Related Quality of Life and Mental Well-Being during the COVID-19 Pandemic in Five Countries: A One-Year Longitudinal Study. J Clin Med 2022; 11:6467. [PMID: 36362694 PMCID: PMC9654255 DOI: 10.3390/jcm11216467] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 10/02/2023] Open
Abstract
This study aimed to investigate socioeconomic and health-related determinants and recent life events and their relation to changes in health-related quality of life (HRQoL) and mental well-being during the first year of the COVID-19 pandemic. A web-based survey was administered repeatedly to participants from Greece, Italy, the Netherlands, the United Kingdom, and the United States. Primary outcome measures were HRQoL (measured by EQ-5D-5L) and mental well-being (measured by WHO-5). Linear regression analyses were performed to estimate the impact of determinants on HRQoL and well-being. In total, 6765 respondents completed the questionnaire at T1 (April-May 2020) and T2 (May-June 2021). Regarding results, 33% showed improved HRQoL at T2, whereas 31% deteriorated. In terms of mental well-being, 44% improved and 41% deteriorated. The greatest deterioration in HRQoL and mental well-being from T1 to T2 was observed with an increasing number of chronic conditions. The effect of negative life events on HRQoL and mental well-being was larger than the effect of positive life events. We conclude that slightly more respondents showed improved rather than deteriorated HRQoL and mental well-being, with some variation by outcome measure and country.
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Affiliation(s)
- Di Long
- Department of Public Health, Erasmus MC, 3000 CA Rotterdam, The Netherlands
| | - Gouke J. Bonsel
- EuroQol Research Foundation, 3068 AV Rotterdam, The Netherlands
| | - Erica I. Lubetkin
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York, NY 10031, USA
| | - John N. Yfantopoulos
- Health Department of Economics, National and Kapodistrian University of Athens, 157 72 Athens, Greece
| | - Mathieu F. Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, 3000 CA Rotterdam, The Netherlands
| | - Juanita A. Haagsma
- Department of Public Health, Erasmus MC, 3000 CA Rotterdam, The Netherlands
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22
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Wulf Hanson S, Abbafati C, Aerts JG, Al-Aly Z, Ashbaugh C, Ballouz T, Blyuss O, Bobkova P, Bonsel G, Borzakova S, Buonsenso D, Butnaru D, Carter A, Chu H, De Rose C, Diab MM, Ekbom E, El Tantawi M, Fomin V, Frithiof R, Gamirova A, Glybochko PV, Haagsma JA, Haghjooy Javanmard S, Hamilton EB, Harris G, Heijenbrok-Kal MH, Helbok R, Hellemons ME, Hillus D, Huijts SM, Hultström M, Jassat W, Kurth F, Larsson IM, Lipcsey M, Liu C, Loflin CD, Malinovschi A, Mao W, Mazankova L, McCulloch D, Menges D, Mohammadifard N, Munblit D, Nekliudov NA, Ogbuoji O, Osmanov IM, Peñalvo JL, Petersen MS, Puhan MA, Rahman M, Rass V, Reinig N, Ribbers GM, Ricchiuto A, Rubertsson S, Samitova E, Sarrafzadegan N, Shikhaleva A, Simpson KE, Sinatti D, Soriano JB, Spiridonova E, Steinbeis F, Svistunov AA, Valentini P, van de Water BJ, van den Berg-Emons R, Wallin E, Witzenrath M, Wu Y, Xu H, Zoller T, Adolph C, Albright J, Amlag JO, Aravkin AY, Bang-Jensen BL, Bisignano C, Castellano R, Castro E, Chakrabarti S, Collins JK, Dai X, Daoud F, Dapper C, Deen A, Duncan BB, Erickson M, Ewald SB, Ferrari AJ, Flaxman AD, Fullman N, Gamkrelidze A, Giles JR, Guo G, Hay SI, He J, Helak M, Hulland EN, Kereselidze M, Krohn KJ, Lazzar-Atwood A, Lindstrom A, Lozano R, Malta DC, Månsson J, Mantilla Herrera AM, Mokdad AH, Monasta L, Nomura S, Pasovic M, Pigott DM, Reiner RC, Reinke G, Ribeiro ALP, Santomauro DF, Sholokhov A, Spurlock EE, Walcott R, Walker A, Wiysonge CS, Zheng P, Bettger JP, Murray CJL, Vos T. Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021. JAMA 2022; 328:1604-1615. [PMID: 36215063 PMCID: PMC9552043 DOI: 10.1001/jama.2022.18931] [Citation(s) in RCA: 262] [Impact Index Per Article: 131.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/25/2022] [Indexed: 01/14/2023]
Abstract
Importance Some individuals experience persistent symptoms after initial symptomatic SARS-CoV-2 infection (often referred to as Long COVID). Objective To estimate the proportion of males and females with COVID-19, younger or older than 20 years of age, who had Long COVID symptoms in 2020 and 2021 and their Long COVID symptom duration. Design, Setting, and Participants Bayesian meta-regression and pooling of 54 studies and 2 medical record databases with data for 1.2 million individuals (from 22 countries) who had symptomatic SARS-CoV-2 infection. Of the 54 studies, 44 were published and 10 were collaborating cohorts (conducted in Austria, the Faroe Islands, Germany, Iran, Italy, the Netherlands, Russia, Sweden, Switzerland, and the US). The participant data were derived from the 44 published studies (10 501 hospitalized individuals and 42 891 nonhospitalized individuals), the 10 collaborating cohort studies (10 526 and 1906), and the 2 US electronic medical record databases (250 928 and 846 046). Data collection spanned March 2020 to January 2022. Exposures Symptomatic SARS-CoV-2 infection. Main Outcomes and Measures Proportion of individuals with at least 1 of the 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after SARS-CoV-2 infection in 2020 and 2021, estimated separately for hospitalized and nonhospitalized individuals aged 20 years or older by sex and for both sexes of nonhospitalized individuals younger than 20 years of age. Results A total of 1.2 million individuals who had symptomatic SARS-CoV-2 infection were included (mean age, 4-66 years; males, 26%-88%). In the modeled estimates, 6.2% (95% uncertainty interval [UI], 2.4%-13.3%) of individuals who had symptomatic SARS-CoV-2 infection experienced at least 1 of the 3 Long COVID symptom clusters in 2020 and 2021, including 3.2% (95% UI, 0.6%-10.0%) for persistent fatigue with bodily pain or mood swings, 3.7% (95% UI, 0.9%-9.6%) for ongoing respiratory problems, and 2.2% (95% UI, 0.3%-7.6%) for cognitive problems after adjusting for health status before COVID-19, comprising an estimated 51.0% (95% UI, 16.9%-92.4%), 60.4% (95% UI, 18.9%-89.1%), and 35.4% (95% UI, 9.4%-75.1%), respectively, of Long COVID cases. The Long COVID symptom clusters were more common in women aged 20 years or older (10.6% [95% UI, 4.3%-22.2%]) 3 months after symptomatic SARS-CoV-2 infection than in men aged 20 years or older (5.4% [95% UI, 2.2%-11.7%]). Both sexes younger than 20 years of age were estimated to be affected in 2.8% (95% UI, 0.9%-7.0%) of symptomatic SARS-CoV-2 infections. The estimated mean Long COVID symptom cluster duration was 9.0 months (95% UI, 7.0-12.0 months) among hospitalized individuals and 4.0 months (95% UI, 3.6-4.6 months) among nonhospitalized individuals. Among individuals with Long COVID symptoms 3 months after symptomatic SARS-CoV-2 infection, an estimated 15.1% (95% UI, 10.3%-21.1%) continued to experience symptoms at 12 months. Conclusions and Relevance This study presents modeled estimates of the proportion of individuals with at least 1 of 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after symptomatic SARS-CoV-2 infection.
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Affiliation(s)
- Sarah Wulf Hanson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Cristiana Abbafati
- Department of Juridical and Economic Studies, La Sapienza University, Rome, Italy
| | - Joachim G Aerts
- Department of Pulmonary Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ziyad Al-Aly
- John T. Milliken Department of Internal Medicine, Washington University in St Louis, St Louis, Missouri
- Clinical Epidemiology Center, US Department of Veterans Affairs, St Louis, Missouri
| | - Charlie Ashbaugh
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Tala Ballouz
- Epidemiology, Biostatistics, and Prevention Institute, University of Zürich, Zurich, Switzerland
| | - Oleg Blyuss
- Wolfson Institute of Population Health, Queen Mary University of London, London, England
- Department of Pediatrics and Pediatric Infectious Diseases, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Polina Bobkova
- Clinical Medicine (Pediatric Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Gouke Bonsel
- EuroQol Research Foundation, Rotterdam, the Netherlands
| | - Svetlana Borzakova
- Pirogov Russian National Research Medical University, Moscow
- Research Institute for Healthcare Organization and Medical Management, Moscow Healthcare Department, Moscow, Russia
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Agostino Gemelli University Polyclinic IRCCS, Rome, Italy
- Global Health Research Institute, Catholic University of Sacred Heart, Rome, Italy
| | - Denis Butnaru
- I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Austin Carter
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Helen Chu
- Department of Medicine, University of Washington, Seattle
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Agostino Gemelli University Polyclinic IRCCS, Rome, Italy
| | - Mohamed Mustafa Diab
- Center for Policy Impact in Global Health, Duke University, Durham, North Carolina
- Department of Surgery, Duke University, Durham, North Carolina
| | - Emil Ekbom
- Uppsala University Hospital, Uppsala, Sweden
| | - Maha El Tantawi
- Pediatric Dentistry and Dental Public Health Department, Alexandria University, Alexandria, Egypt
| | - Victor Fomin
- Rector's Office, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Robert Frithiof
- Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden
| | - Aysylu Gamirova
- Clinical Medicine (General Medicine Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Petr V Glybochko
- Administration Department, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Shaghayegh Haghjooy Javanmard
- Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Erin B Hamilton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Majanka H Heijenbrok-Kal
- Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
- Neurorehabilitation, Rijndam Rehabilitation, Rotterdam, the Netherlands
| | - Raimund Helbok
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Merel E Hellemons
- Department of Pulmonary Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - David Hillus
- Department of Infectious Diseases and Respiratory Medicine, Charité Medical University Berlin, Berlin, Germany
| | - Susanne M Huijts
- Department of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Michael Hultström
- Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Waasila Jassat
- Department of Public Health Surveillance and Response, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Florian Kurth
- Department of Infectious Diseases and Respiratory Medicine, Charité University Medical Center Berlin, Berlin, Germany
- Department of Clinical Research and Tropical Medicine, Bernhard-Nocht Institute of Tropical Medicine, Hamburg, Germany
| | - Ing-Marie Larsson
- Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden
| | - Miklós Lipcsey
- Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden
| | - Chelsea Liu
- Department of Epidemiology, Harvard University, Boston, Massachusetts
| | | | | | - Wenhui Mao
- Center for Policy Impact in Global Health, Duke University, Durham, North Carolina
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Lyudmila Mazankova
- Russian Medical Academy of Continuous Professional Education, Ministry of Healthcare of the Russian Federation, Moscow
| | | | - Dominik Menges
- Epidemiology, Biostatistics, and Prevention Institute, University of Zürich, Zurich, Switzerland
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Daniel Munblit
- Department of Pediatrics and Pediatric Infectious Diseases, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
- National Heart and Lung Institute, Imperial College London, London, England
| | - Nikita A Nekliudov
- Clinical Medicine (General Medicine Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Osondu Ogbuoji
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Ismail M Osmanov
- Pirogov Russian National Research Medical University, Moscow
- ZA Bashlyaeva Children's Municipal Clinical Hospital, Moscow, Russia
| | - José L Peñalvo
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Maria Skaalum Petersen
- Department of Occupational Medicine and Public Health, Faroese Hospital System, Torshavn, Faroe Islands
- Centre of Health Science, University of Faroe Islands, Torshavn
| | - Milo A Puhan
- Epidemiology, Biostatistics, and Prevention Institute, University of Zürich, Zurich, Switzerland
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland
| | - Mujibur Rahman
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Verena Rass
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Nickolas Reinig
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Gerard M Ribbers
- Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Antonia Ricchiuto
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Sten Rubertsson
- Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden
- Department of Surgical Sciences, Hedenstierna Laboratory, Uppsala University, Uppsala, Sweden
| | - Elmira Samitova
- Russian Medical Academy of Continuous Professional Education, Ministry of Healthcare of the Russian Federation, Moscow
- ZA Bashlyaeva Children's Municipal Clinical Hospital, Moscow, Russia
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Anastasia Shikhaleva
- Clinical Medicine (Pediatric Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Kyle E Simpson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Dario Sinatti
- Department of Woman and Child Health and Public Health, Agostino Gemelli University Polyclinic IRCCS, Rome, Italy
| | - Joan B Soriano
- Hospital Universitario de La Princesa, Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Respiratorias (Center for Biomedical Research in Respiratory Diseases Network), Madrid, Spain
| | - Ekaterina Spiridonova
- Clinical Medicine (General Medicine Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Fridolin Steinbeis
- Department of Infectious Diseases and Respiratory Medicine, Charité Medical University Berlin, Berlin, Germany
| | - Andrey A Svistunov
- Administration Department, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Agostino Gemelli University Polyclinic IRCCS, Rome, Italy
| | - Brittney J van de Water
- Department of Global Health and Social Medicine, Harvard University, Boston, Massachusetts
- Nursing and Midwifery Department, Seed Global Health, Boston, Massachusetts
| | - Rita van den Berg-Emons
- Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ewa Wallin
- Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden
| | - Martin Witzenrath
- Department of Infectious Diseases and Respiratory Medicine, Charité University Medical Center Berlin, Berlin, Germany
- German Center for Lung Research, Berlin
| | - Yifan Wu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Hanzhang Xu
- Department of Family Medicine and Community Health, Duke University, Durham, North Carolina
| | - Thomas Zoller
- Department of Infectious Diseases and Respiratory Medicine, Charité Medical University Berlin, Berlin, Germany
| | - Christopher Adolph
- Department of Political Science, University of Washington, Seattle
- Center for Statistics and the Social Sciences, University of Washington, Seattle
| | - James Albright
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Joanne O Amlag
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Aleksandr Y Aravkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Applied Mathematics, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Bree L Bang-Jensen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Catherine Bisignano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Rachel Castellano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Emma Castro
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Suman Chakrabarti
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Global Health, University of Washington, Seattle
| | - James K Collins
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Farah Daoud
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Carolyn Dapper
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Amanda Deen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Bruce B Duncan
- Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Megan Erickson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Samuel B Ewald
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Alize J Ferrari
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Abraham D Flaxman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Nancy Fullman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - John R Giles
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Gaorui Guo
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Jiawei He
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Monika Helak
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Erin N Hulland
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Global Health, University of Washington, Seattle
| | - Maia Kereselidze
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Kris J Krohn
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Alice Lazzar-Atwood
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Akiaja Lindstrom
- School of Public Health, University of Queensland, Brisbane, Australia
- School of Public Health, Queensland Centre for Mental Health Research, Wacol, Australia
| | - Rafael Lozano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Deborah Carvalho Malta
- Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Johan Månsson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Ana M Mantilla Herrera
- School of Public Health, University of Queensland, Brisbane, Australia
- West Moreton Hospital Health Services, Queensland Centre for Mental Health Research, Wacol, Australia
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Shuhei Nomura
- Department of Health Policy and Management, Keio University, Tokyo, Japan
- Department of Global Health Policy, University of Tokyo, Tokyo, Japan
| | - Maja Pasovic
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - David M Pigott
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Grace Reinke
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Antonio Luiz P Ribeiro
- Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Centre of Telehealth, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Damian Francesco Santomauro
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- School of Public Health, University of Queensland, Brisbane, Australia
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, Australia
| | - Aleksei Sholokhov
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Emma Elizabeth Spurlock
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Social and Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut
| | - Rebecca Walcott
- Evans School of Public Policy and Governance, University of Washington, Seattle
| | - Ally Walker
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Durban
| | - Peng Zheng
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Janet Prvu Bettger
- Department of Orthopedic Surgery, Duke University, Durham, North Carolina
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
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23
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Santos JV, Viana J, Devleesschauwer B, Haagsma JA, Costa Santos C, Ricciardi W, Freitas A. Measuring health expectancy in the European Union. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Healthy life expectancy (HLE) is a population health measure that combines mortality and morbidity, which can be calculated using different methods. In this study, we aimed to assess the correlation, reliability and (dis)agreement between two estimates monitored in the European Union (EU), that is, the European Commission's HLE based on self-perceived health (SPH-HLE) and the Institute for Health Metrics and Evaluation's HLE based on disability weight (DW-HLE), by sex, and comparing these results with LE and proportion of life spent in good health (%GH).
Methods
We performed a retrospective study in the EU28 countries, between 2010 and 2017. The HLE methods differ in definition, measurement and valuation of health states. While SPH-HLE relies directly on one question, DW-HLE relies on epidemiological data adjusted for DW. Spearman's r, intraclass correlation coefficient, information-based measure of disagreement and Bland-Altman plots were used to assess reliability, correlation and disagreement in HLE resulting from both methods and in LE or %GH measured by both institutions.
Results
Correlation and reliability between SPH-HLE and DW-HLE were good (better for males), with low disagreement, and were even better for LE between both institutions. The HLE Bland-Altman plots suggest a variability range of approximately 6 years for both sexes, higher for females. There was also an increasing HLE difference between methods with higher average HLE for both sexes.
Conclusions
We showed wide variations between both methods with a clear and different high impact on female and male HLE, showing a tendency for countries with higher health expectancies to yield larger gaps between SPH-HLE and DW-HLE.
Acknowledgements: This presentation was supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia,I.P., within CINTESIS, R&D Unit (reference UIDP/4255/2020)
Key messages
• Different methods for evaluating health expectancy lead to significantly different results.
• There is a systematic tendency with countries with higher health expectancies to yield larger gaps between SPH-HLE and DW-HLE.
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Affiliation(s)
- JV Santos
- Public Health Unit, ACES Espinho/Gaia, ARS Norte , Porto, Portugal
- MEDCIDS, Faculty of Medicine, University of Porto , Porto, Portugal
- CINTESIS, Centre for Health Technology and Services Research , Porto, Portugal
| | - J Viana
- MEDCIDS, Faculty of Medicine, University of Porto , Porto, Portugal
- CINTESIS, Centre for Health Technology and Services Research , Porto, Portugal
| | - B Devleesschauwer
- Department of Epidemiology and Public Health , Sciensano, Brussels, Belgium
- Department of Veterinary Public Health and Food Safety, Ghent University , Merelbeke, Belgium
| | - JA Haagsma
- Erasmus MC, University Medical Center , Rotterdam, Netherlands
| | - C Costa Santos
- MEDCIDS, Faculty of Medicine, University of Porto , Porto, Portugal
- CINTESIS, Centre for Health Technology and Services Research , Porto, Portugal
| | - W Ricciardi
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore , Rome, Italy
| | - A Freitas
- MEDCIDS, Faculty of Medicine, University of Porto , Porto, Portugal
- CINTESIS, Centre for Health Technology and Services Research , Porto, Portugal
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24
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Devleesschauwer B, Haagsma JA, Charalampous P, Assunção R, Bari CD, Gorasso V, Grant I, Hilderink H, Idavain J, Lesnik T, Majdan M, Santric-Milicevic M, Pallari E, Pires SM, Plass D, Wyper GMA, Von der Lippe E. Reporting guidelines for burden of disease studies: why and how? Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The Disability Adjusted Life Year (DALY) is a frequently used metric to assess burden of disease (BoD). Many independent BoD studies have been performed across Europe, showing wide variations and inconsistencies in the application and reporting of DALY specific methods. The European Burden of Disease Network (burden-eu) aims to develop guidelines for reporting DALY calculation studies which may enhance transparency and comparability of BoD estimates across Europe and beyond.
Methods
A burden-eu working group of experts generated a list of potential reporting items based on existing literature, guidance for developing guidelines and consultations with BoD experts. To pilot the drafted product, we asked BoD experts and non-experts to apply it to existing BoD studies. We received feedback and we revised the guidelines accordingly.
Results
The guide for DALY calculation studies comprises about 25 items that should be reported in BoD studies. We included information about the study setting, data input sources including methods for data corrections, DALY-specific methods (e.g., YLL life table, YLD approach, disability weights etc), data analyses, and data limitations. We also included information on how users can compare their new estimates with previously available BoD estimates.
Conclusions
We introduced a reporting instrument for DALY calculations that can be used to document input data and methodological design choices in BoD studies. The application of such guidelines will enhance usability of BoD estimates for decision-makers as well as global, regional, and national health experts.
Key messages
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Affiliation(s)
| | - JA Haagsma
- European Burden of Disease Network, COST Action CA18218
| | | | - R Assunção
- European Burden of Disease Network, COST Action CA18218
| | - C Di Bari
- European Burden of Disease Network, COST Action CA18218
| | - V Gorasso
- European Burden of Disease Network, COST Action CA18218
| | - I Grant
- European Burden of Disease Network, COST Action CA18218
| | - H Hilderink
- European Burden of Disease Network, COST Action CA18218
| | - J Idavain
- European Burden of Disease Network, COST Action CA18218
| | - T Lesnik
- European Burden of Disease Network, COST Action CA18218
| | - M Majdan
- European Burden of Disease Network, COST Action CA18218
| | | | - E Pallari
- European Burden of Disease Network, COST Action CA18218
| | - SM Pires
- European Burden of Disease Network, COST Action CA18218
| | - D Plass
- European Burden of Disease Network, COST Action CA18218
| | - GMA Wyper
- European Burden of Disease Network, COST Action CA18218
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25
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Meyer MA, van den Bosch T, Haagsma JA, Heng M, Leenen LPH, Hietbrink F, Houwert RM, Kromkamp M, Nelen SD. Influence of psychiatric co-morbidity on health-related quality of life among major trauma patients. Eur J Trauma Emerg Surg 2022; 49:965-971. [PMID: 36152068 DOI: 10.1007/s00068-022-02114-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 09/17/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE The purpose of this study was to compare 1-year post-discharge health-related quality of life (HRQL) between trauma patients with and without psychiatric co-comorbidity. METHODS A retrospective single-center cohort study identified all severely injured adult trauma patients admitted to a Level 1 trauma center between 2018 and 2019. Bivariate analysis compared patients with and without psychiatric co-morbidity, which was defined as prior diagnosis by a healthcare provider or acute psychiatric consultation for new or chronic mental illness. HRQL metrics included the EuroQol-5D-5L (EQ-5D) questionnaire, visual analogue scale (EQ-VAS), and overall index score. A multiple linear regression model was utilized to identify predictors of EQ-5D index scores. RESULTS Analysis of baseline characteristics revealed significantly greater rates of substance abuse, severe extremity injuries, inpatient morbidity, and hospital length-of-stay among patients with psychiatric illness. At 1-year follow-up, patients with psychiatric co-morbidity had lower median EQ-5D index scores compared to the control group (0.71, interquartile range [IQR] 0.32 vs. 0.79, IQR 0.22, p = 0.03). There were no differences between groups in individual EQ-5D dimensions, nor in EQ-VAS scores. Presence of psychiatric co-morbidity was not found to independently predict EQ-5D index scores in the linear regression model. Instead, Injury Severity Score (standardized regression coefficient [SRC] - 0.15, 95% confidence interval [CI] - 0.010 to - 0.001) and American Society of Anesthesiologists Physical Status score (SRC - 0.13, 95% CI - 0.08 to - 0.004) predicted poor HRQL 1-year after injury. CONCLUSIONS Psychiatric co-morbidity does not independently predict low HRQL 1 year after injury. Instead, lower HRQL scores among patients with psychiatric co-morbidity appear to be mediated by baseline health status and injury severity.
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Affiliation(s)
- Maximilian A Meyer
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. .,Department of Orthopedic Surgery, Massachusetts General Hospital, 55 Fruit Street, White Building 535, Boston, MA, 02114, USA.
| | - Tijmen van den Bosch
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marilyn Heng
- Department of Orthopedic Surgery, Massachusetts General Hospital, 55 Fruit Street, White Building 535, Boston, MA, 02114, USA
| | - Loek P H Leenen
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Falco Hietbrink
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Marjan Kromkamp
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Stijn D Nelen
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
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26
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Liu X, Wang F, Yu C, Zhou M, Yu Y, Qi J, Yin P, Yu S, Zhou Y, Lin L, Liu Y, Wang Q, Zhong W, Huang S, Li Y, Liu L, Liu Y, Ma F, Zhang Y, Tian Y, Yu Q, Zeng J, Pan J, Zhou M, Kang W, Zhou JY, Yu H, Liu Y, Li S, Yu H, Wang C, Xia T, Xi J, Ren X, Xing X, Cheng Q, Fei F, Wang D, Zhang S, He Y, Wen H, Liu Y, Shi F, Wang Y, Sun P, Bai J, Wang X, Shen H, Ma Y, Yang D, Mubarik S, Cao J, Meng R, Zhang Y, Guo Y, Yan Y, Zhang W, Ke S, Zhang R, Wang D, Zhang T, Nomura S, Hay SI, Salomon JA, Haagsma JA, Murray CJ, Vos T. Eliciting national and subnational sets of disability weights in mainland China: Findings from the Chinese disability weight measurement study. Lancet Reg Health West Pac 2022; 26:100520. [PMID: 35910433 PMCID: PMC9335373 DOI: 10.1016/j.lanwpc.2022.100520] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
BACKGROUND The disability weight (DW) quantifies the severity of health states from disease sequela and is a pivotal parameter for disease burden calculation. We conducted a national and subnational DW measurement in China. METHODS In 2020-2021, we conducted a web-based survey to assess DWs for 206 health states in 31 Chinese provinces targeting health workers via professional networks. We fielded questions of paired comparison (PC) and population health equivalence (PHE). The PC data were analysed by probit regression analysis, and the regression results were anchored by results from the PHE responses on the DW scale between 0 (no loss of health) and 1 (health loss equivalent to death). FINDINGS We used PC responses from 468,541 respondents to estimate DWs of health states. Eight of 11 domains of health had significantly negative coefficients in the regression of the difference between Chinese and Global Burden of Disease (GBD) DWs, suggesting lower DW values for health states with mention of these domains in their lay description. We noted considerable heterogeneity within domains, however. After applying these Chinese DWs to the 2019 GBD estimates for China, total years lived with disability (YLDs) increased by 14·9% to 177 million despite lower estimates for musculoskeletal disorders, cardiovascular diseases, mental disorders, diabetes and chronic kidney disease. The lower estimates of YLDs for these conditions were more than offset by higher estimates of common, low-severity conditions. INTERPRETATION The differences between the GBD and Chinese DWs suggest that there might be some contextual factors influencing the valuation of health states. While the reduced estimates for mental disorders, alcohol use disorder, and dementia could hint at a culturally different valuation of these conditions in China, the much greater shifts in YLDs from low-severity conditions more likely reflects methodological difficulty to distinguish between health states that vary a little in absolute DW value but a lot in relative terms. FUNDING This work was supported by the National Natural Science Foundation of China [grant number 82173626], the National Key Research and Development Program of China [grant numbers 2018YFC1315302], Wuhan Medical Research Program of Joint Fund of Hubei Health Committee [grant number WJ2019H304], and Ningxia Natural Science Foundation Project [grant number 2020AAC03436].
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Affiliation(s)
- Xiaoxue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Fang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou 221004, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
- Global Health Institute, Wuhan University, Wuhan 430072, China
- Corresponding authors.
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China
- Corresponding authors.
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Jinlei Qi
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Peng Yin
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Shicheng Yu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuchang Zhou
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Lin Lin
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Yunning Liu
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Qiqi Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenling Zhong
- Fujian Provincial Center for Disease Control and Prevention, No. 78 Jintai Road, Gulou District, Fuzhou City 350001, Fujian province, China
| | - Shaofen Huang
- Fujian Provincial Center for Disease Control and Prevention, No. 78 Jintai Road, Gulou District, Fuzhou City 350001, Fujian province, China
| | - Yanxia Li
- Liaoning Provincial Center for Disease Control and Prevention, No. 79 Jixian Street, Heping District, Shenyang City 110005, China
| | - Li Liu
- Liaoning Provincial Center for Disease Control and Prevention, No. 79 Jixian Street, Heping District, Shenyang City 110005, China
| | - Yuan Liu
- Hunan Provincial Center for Disease Control and Prevention, No. 450 first section of Middle Furong Road, Changsha City 410005, Hunan Province, China
| | - Fang Ma
- Ningxia Center for Disease Control and Prevention, No. 528 Shengli Street, Xingqing District, Yinchuan City 750004, Ningxia, China
| | - Yine Zhang
- Ningxia Center for Disease Control and Prevention, No. 528 Shengli Street, Xingqing District, Yinchuan City 750004, Ningxia, China
| | - Yuan Tian
- Ningxia Center for Disease Control and Prevention, No. 528 Shengli Street, Xingqing District, Yinchuan City 750004, Ningxia, China
| | - Qiuli Yu
- Yunnan Center for Disease Control and Prevention, No. 158 Dongsi Street, Xishan District, Kunming City 650022, Yunnan Province, China
| | - Jing Zeng
- Sichuan Center for Disease Control and Prevention, No. 6 Middle School Road, Wuhou District, Chengdu City 610041, Sichuan Province, China
| | - Jingju Pan
- Hubei Provincial Center for Disease Control and Prevention, No. 6 Zhuodaoquan North Road, Hongshan District, Wuhan City 430079, Hubei Province, China
| | - Mengge Zhou
- Hubei Provincial Center for Disease Control and Prevention, No. 6 Zhuodaoquan North Road, Hongshan District, Wuhan City 430079, Hubei Province, China
| | - Weiwei Kang
- Inner Mongolia Integrative Center for Disease Control and Prevention, No. 50 Ordos Street, Hohhot 010031, China
| | - Jin-Yi Zhou
- Jiangsu Provincial Center for disease Control and Prevention, Public Health Research Institute of Jiangsu Province, Jiangsu Road No. 172, Gulou District, Nanjing city 210009, Jiangsu Province, China
| | - Hao Yu
- Jiangsu Provincial Center for disease Control and Prevention, Public Health Research Institute of Jiangsu Province, Jiangsu Road No. 172, Gulou District, Nanjing city 210009, Jiangsu Province, China
| | - Yuehua Liu
- Heilongjiang Provincial Center for Disease Control and Prevention, No. 40 Youfang Street, Xiangfang District, Harbin City 150030, China
| | - Shaofang Li
- Henan Provincial Center for Disease Control and Prevention, No. 105 Nongye South Street, Zhengdong New District, Zhengzhou City 450016, China
| | - Huiting Yu
- Shanghai Municipal Center for Disease Control and Prevention, No. 1380 Zhongshan West Street, Changning District, Shanghai City 200051, China
| | - Chunfang Wang
- Shanghai Municipal Center for Disease Control and Prevention, No. 1380 Zhongshan West Street, Changning District, Shanghai City 200051, China
| | - Tian Xia
- Shanghai Municipal Center for Disease Control and Prevention, No. 1380 Zhongshan West Street, Changning District, Shanghai City 200051, China
| | - Jinen Xi
- Gansu Provincial Center for Disease Control and Prevention, No. 230 Donggang West Street, Chengguan District, Lanzhou City 73000, China
| | - Xiaolan Ren
- Gansu Provincial Center for Disease Control and Prevention, No. 230 Donggang West Street, Chengguan District, Lanzhou City 73000, China
| | - Xiuya Xing
- Anhui Provincial Center for Disease Control and Prevention, No. 12560 Fanhua Avenue, Economic and Technological Development District, Hefei City 230601, China
| | - Qianyao Cheng
- Anhui Provincial Center for Disease Control and Prevention, No. 12560 Fanhua Avenue, Economic and Technological Development District, Hefei City 230601, China
| | - Fangrong Fei
- Zhejiang Provincial Center for Disease Control and Prevention, No. 3399 Binsheng Street, Binjiang District, Hangzhou City 310051, China
| | - Dezheng Wang
- Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Street, Hedong District, Tianjin City 300011, China
| | - Shuang Zhang
- Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Street, Hedong District, Tianjin City 300011, China
| | - Yuling He
- Shanxi Center for Disease Control and Prevention, No. 6 Xiaonanguan Shuangta West Street, Yingze District, Taiyuan City 030012, China
| | - Haoyu Wen
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Yan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Fang Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Yafeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Panglin Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Jianjun Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Xuyan Wang
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Hui Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Yudiyang Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Donghui Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Jinhong Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Runtang Meng
- Department of Preventive Medicine, School of Medicine, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Yunquan Zhang
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yan Guo
- Wuhan Centers for Disease Control and Prevention, Wuhan 430024, Hubei, China
| | - Yaqiong Yan
- Wuhan Centers for Disease Control and Prevention, Wuhan 430024, Hubei, China
| | - Wei Zhang
- Wuhan Centers for Disease Control and Prevention, Wuhan 430024, Hubei, China
| | - Sisi Ke
- Wuhan Centers for Disease Control and Prevention, Wuhan 430024, Hubei, China
| | - Runhua Zhang
- Beijing Tiantan Hospital, Capital Medical University Beijing, China
| | - Dingyi Wang
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital; National Center for Respiratory Medicine, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Tingting Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100083, China
| | - Shuhei Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Japan
| | - Simon I. Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Joshua A. Salomon
- Department of Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Juanita A. Haagsma
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
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27
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Zwaans JJM, Raven W, Rosendaal AV, Van Lieshout EMM, Van Woerden G, Patka P, Haagsma JA, Rood PPM. Non-sterile gloves and dressing versus sterile gloves, dressings and drapes for suturing of traumatic wounds in the emergency department: a non-inferiority multicentre randomised controlled trial. Emerg Med J 2022; 39:650-654. [PMID: 35882525 DOI: 10.1136/emermed-2021-211540] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/04/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Patients with traumatic wounds frequently present to the ED. Literature on whether to treat these wounds sterile or non-sterile is sparse. Non-sterile treatment has the advantage of saving resources and costs, and could be of value in health settings where sterile materials are not readily available. Our objective was to compare the rate of wound infection after suturing traumatic lacerations with non-sterile gloves and dressings versus sterile gloves, dressings and drapes in the ED. We hypothesised that non-sterile gloves and dressings would be non-inferior to sterile gloves, dressings and drapes. The non-inferiority margin was set at 2%. METHODS A multicentre single-blinded randomised controlled trial testing for non-inferiority of non-sterile gloves and dressings versus sterile gloves, dressings and drapes for suturing of traumatic wounds was performed in 3 EDs in The Netherlands. Adults with uncomplicated wounds were included from July 2012 to December 2016. At the time of treatment, patient and wound characteristics and management were documented. The outcome was wound infection, which was identified during follow-up in the treating ED at 5-14 days postprocedure. RESULTS From 2468 eligible patients, 1480 were randomised in a sterile (n=747) or non-sterile (n=733) protocol. Baseline characteristics were similar in both study arms. The observed wound infection rate in the non-sterile group was 5.7% (95% CI 4.0% to 7.5%) vs 6.8% (95% CI 5.1% to 8.8%) in the sterile group. The mean difference of the wound infection rate of the two groups was -1.1% (95% CI -3.7% to 1.5%). CONCLUSION Although recruitment ceased prior to reaching our planned sample size, the findings suggest that there is unlikely to be a large difference between the non-sterile gloves, dressings and sterile gloves, dressings and drapes for suturing of traumatic wounds in the ED. TRIAL REGISTRATION NUMBER NL 34798.078.11, NTR3541.
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Affiliation(s)
- Juliette J M Zwaans
- Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Wouter Raven
- Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Emergency Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Arthur V Rosendaal
- Department of Emergency Medicine, Franciscus Gasthuis en Vlietland, Rotterdam, The Netherlands
| | - Esther M M Van Lieshout
- Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Geesje Van Woerden
- Department of Emergency Medicine, Haaglanden Medisch Centrum, Den Haag, The Netherlands
| | - Peter Patka
- Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Juanita A Haagsma
- Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Public Health, Erasmus MC, Rotterdam, The Netherlands
| | - Pleunie P M Rood
- Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Charalampous P, Pallari E, Gorasso V, von der Lippe E, Devleesschauwer B, Pires SM, Plass D, Idavain J, Ngwa CH, Noguer I, Padron-Monedero A, Sarmiento R, Majdan M, Ádám B, AlKerwi A, Cilovic-Lagarija S, Clarsen B, Corso B, Cuschieri S, Dopelt K, Economou M, Fischer F, Freitas A, García-González JM, Gazzelloni F, Gkitakou A, Gulmez H, Hynds P, Isola G, Jakobsen LS, Kabir Z, Kissimova-Skarbek K, Knudsen AK, Konar NM, Ladeira C, Lassen B, Liew A, Majer M, Mechili EA, Mereke A, Monasta L, Mondello S, Morgado JN, Nena E, Ng ESW, Niranjan V, Nola IA, O'Caoimh R, Petrou P, Pinheiro V, Ortiz MR, Riva S, Samouda H, Santos JV, Santoso CMA, Milicevic MS, Skempes D, Sousa AC, Speybroeck N, Tozija F, Unim B, Uysal HB, Vaccaro FG, Varga O, Vasic M, Violante FS, Wyper GMA, Polinder S, Haagsma JA. Methodological considerations in injury burden of disease studies across Europe: a systematic literature review. BMC Public Health 2022; 22:1564. [PMID: 35978333 PMCID: PMC9382747 DOI: 10.1186/s12889-022-13925-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
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. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13925-z.
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Affiliation(s)
- Periklis Charalampous
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Elena Pallari
- Health Innovation Network, Minerva House, Montague Close, London, UK
| | - Vanessa Gorasso
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.,Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Sara M Pires
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Dietrich Plass
- Department for Exposure Assessment, and Environmental Health Indicators, German Environment Agency, Berlin, Germany
| | - Jane Idavain
- Department of Health Statistics, National Institute for Health Development, Tallinn, Estonia
| | - Che Henry Ngwa
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Isabel Noguer
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | | | - Rodrigo Sarmiento
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain.,Medicine School, University of Applied and Environmental Sciences, Bogota, Colombia
| | - Marek Majdan
- Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia
| | - Balázs Ádám
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ala'a AlKerwi
- Directorate of Health, Service Epidemiology and Statistics, Luxembourg, Luxembourg
| | | | - Benjamin Clarsen
- Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway.,Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Barbara Corso
- Institute of Neuroscience, National Research Council, Rome, Italy
| | - Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel.,Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Mary Economou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Florian Fischer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Alberto Freitas
- CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | | | | | - Artemis Gkitakou
- Department of Internal Medicine and Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Hakan Gulmez
- Department of Family Medicine, Faculty of Medicine, İzmir Democracy University, Izmir, Turkey
| | - Paul Hynds
- Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Lea S Jakobsen
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Zubair Kabir
- Public Health & Epidemiology, School of Public Health, University College Cork, Cork, Ireland
| | - Katarzyna Kissimova-Skarbek
- Department of Health Economics and Social Security, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Ann Kristin Knudsen
- Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Naime Meriç Konar
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Kirsehir Ahi Evran University, Kirsehir, Turkey
| | - Carina Ladeira
- H&TRC - Health & Technology Research Center, Escola Superior de Tecnologia da Saúde (ESTeSL), Instituto Politécnico de Lisboa, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Brian Lassen
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Aaron Liew
- Clinical Sciences Institute, School of Medicine, National University of Ireland, Galway, Galway City, Ireland
| | - Marjeta Majer
- Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Enkeleint A Mechili
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece.,Department of Healthcare, Faculty of Public Health, University of Vlora, Vlora, Albania
| | - Alibek Mereke
- Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Lorenzo Monasta
- Institute of Maternal, Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Joana Nazaré Morgado
- Environmental Health and Nutrition Laboratory, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Evangelia Nena
- Laboratory of Social Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Vikram Niranjan
- School of Public Health, Physiotherapy and Sport Sciences, University College Dublin, Dublin, Ireland
| | - Iskra Alexandra Nola
- Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Rónán O'Caoimh
- Department of Geriatric Medicine, Mercy University Hospital, Grenville Place, Cork City, Ireland
| | - Panagiotis Petrou
- Pharmacoepidemiology-Pharmacovigilance, Pharmacy School, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus
| | - Vera Pinheiro
- CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Silvia Riva
- Department of Psychology and Pedagogic Science, St Mary's University, London, UK
| | - Hanen Samouda
- Population Health Department, Luxembourg Institute of Health, Nutrition and Health Research Group, Luxembourg, Luxembourg
| | - João Vasco Santos
- CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.,Public Health Unit, ACES Grande Porto VIII - Espinho/Gaia, ARS Norte, Lisbon, Portugal
| | | | | | | | - Ana Catarina Sousa
- Department of Biology, School of Science and Technology, University of Évora, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
| | - Niko Speybroeck
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Fimka Tozija
- Institute of Public Health of Republic of North Macedonia, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia.,Faculty of Medicine, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia
| | - Brigid Unim
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore Di Sanità, Rome, Italy
| | - Hilal Bektaş Uysal
- Department of Internal Medicine, Adnan Menderes University School of Medicine, Aydin, Turkey
| | | | - Orsolya Varga
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Milena Vasic
- Faculty of Dentistry Pancevo, University Business Academy in Novi Sad, Pancevo, Serbia.,Institute of Public Health of Serbia Dr Milan Jovanović Batut, Belgrade, Serbia
| | - Francesco Saverio Violante
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.,Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Grant M A Wyper
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, Scotland, UK
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Zeldovich M, Bockhop F, Covic A, Cunitz K, Polinder S, Haagsma JA, von Steinbuechel N. Reference Values for the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) from General Population Samples in the United Kingdom, Italy, and The Netherlands. J Clin Med 2022; 11:jcm11164658. [PMID: 36012895 PMCID: PMC9410233 DOI: 10.3390/jcm11164658] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/03/2022] [Accepted: 08/07/2022] [Indexed: 11/16/2022] Open
Abstract
After traumatic brain injury (TBI), individuals may experience short- or long-term health burdens, often referred to as post-concussion symptoms (PCS). The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) is one of the commonly used instruments to assess self-reported PCS. To date, no reference values for RPQ have been provided, although they are crucial for clinical practice when evaluating a patient’s health status relative to a comparable healthy population. Therefore, the aim of this study is to provide reference values for the United Kingdom, the Netherlands, and Italy. A total of 11,759 individuals (50.3% women) from representative general population samples participated in an online survey (4646 individuals from the UK, 3564 from the Netherlands, and 3549 from Italy). The factorial structure of the RPQ was examined using confirmatory factor analysis (CFA), and results from the general population samples were compared with those from respective TBI samples recruited within the international CENTER-TBI study using multigroup CFA. Reference values were stratified by sex, health status, age, and education using percentiles. The three-factorial model outperformed the one-factorial structure. The general population samples were largely comparable to the corresponding TBI samples, except for items such as dizziness, vision, and sensory sensitivity, which can be considered more TBI-specific. Because of the significant differences between the general population samples, we provided reference values for the total score and for the somatic, emotional, and cognitive scales for each country separately. The reference values provided can now be used in clinical practice and research. Future studies should obtain stratified reference values for other countries and languages to improve accuracy in the diagnosis and treatment of symptom burden after TBI.
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Affiliation(s)
- Marina Zeldovich
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany
- Correspondence:
| | - Fabian Bockhop
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany
| | - Amra Covic
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany
| | - Katrin Cunitz
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Juanita A. Haagsma
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Nicole von Steinbuechel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany
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van der Vlegel M, Mikolić A, Lee Hee Q, Kaplan ZLR, Retel Helmrich IRA, van Veen E, Andelic N, Steinbuechel NV, Plass AM, Zeldovich M, Wilson L, Maas AIR, Haagsma JA, Polinder S. Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study. Injury 2022; 53:2774-2782. [PMID: 35725508 DOI: 10.1016/j.injury.2022.05.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/11/2022] [Accepted: 05/08/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The incidence of Traumatic Brain Injury (TBI) is increasingly common in older adults aged ≥65 years, forming a growing public health problem. However, older adults are underrepresented in TBI research. Therefore, we aimed to provide an overview of health-care utilization, and of six-month outcomes after TBI and their determinants in older adults who sustained a TBI. METHODS We used data from the prospective multi-center Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. In-hospital and post-hospital health care utilization and outcomes were described for patients aged ≥65 years. Ordinal and linear regression analyses were performed to identify determinants of the Glasgow Outcome Scale Extended (GOSE), health-related quality of life (HRQoL), and mental health symptoms six-months post-injury. RESULTS Of 1254 older patients, 45% were admitted to an ICU with a mean length of stay of 9 days. Nearly 30% of the patients received inpatient rehabilitation. In total, 554/1254 older patients completed the six-month follow-up questionnaires. The mortality rate was 9% after mild and 60% after moderate/severe TBI, and full recovery based on GOSE was reported for 44% of patients after mild and 6% after moderate/severe TBI. Higher age and increased injury severity were primarily associated with functional impairment, while pre-injury systemic disease, psychiatric conditions and lower educational level were associated with functional impairment, lower generic and disease-specific HRQoL and mental health symptoms. CONCLUSION The rate of impairment and disability following TBI in older adults is substantial, and poorer outcomes across domains are associated with worse preinjury health. Nonetheless, a considerable number of patients fully or partially returns to their preinjury functioning. There should not be pessimism about outcomes in older adults who survive.
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Affiliation(s)
- Marjolein van der Vlegel
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands.
| | - Ana Mikolić
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands
| | - Quentin Lee Hee
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands
| | - Z L Rana Kaplan
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands
| | - Isabel R A Retel Helmrich
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands
| | - Ernest van Veen
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands; Department of Intensive Care Adults, Rotterdam, the Netherlands
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital and University of Oslo, 0424 Oslo, Norway
| | - Nicole V Steinbuechel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany
| | - Anne Marie Plass
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany
| | - Marina Zeldovich
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen (UMG)/ Georg-August-University, Göttingen, Germany
| | - Lindsay Wilson
- Division of Psychology, University of Stirling, Stirling, UK
| | - Andrew I R Maas
- Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands
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Lubetkin EI, Long D, Haagsma JA, Janssen MF, Bonsel GJ. Health inequities as measured by the EQ-5D-5L during COVID-19: Results from New York in healthy and diseased persons. PLoS One 2022; 17:e0272252. [PMID: 35901071 PMCID: PMC9333246 DOI: 10.1371/journal.pone.0272252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/07/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction
The effects of the COVID-19 pandemic caused considerable psychological and physical effects in healthy and diseased New Yorkers aside from the effects in those who were infected. We investigated the relationship between known risk-enhancing and health-promoting factors (social and medical), comorbidity indicators, and, as the primary outcome, health-related quality of life (HRQoL).
Methods
Between April 22 and May 5, 2020, a market research agency (Dynata) administered a digital survey including the EQ-5D-5L and items related to individual characteristics, social position, occupational and insurance status, living situation, exposures (smoking and COVID-19), detailed chronic conditions, and experienced access to care to an existing internet panel representative of New Yorkers.
Results
2684 persons completed the questionnaire. The median age was 48 years old, and most respondents were non-Hispanic white (74%) and reported at least higher vocational training or a university education (83%). During COVID-19, mean HRQoL scores were 0.82 for the EQ-5D-5L index and 79.3 for the EQ VAS. Scores varied for healthy and diseased respondents differently by the above determinants. Lower age, impaired occupational status, loss of health insurance, and limited access to care exerted more influence on EQ-5D-5L scores of diseased persons compared to healthy persons. Among diseased persons, the number of chronic conditions and limited access to health care had the strongest association with EQ-5D-5L scores. While EQ-5D-5L scores improved with increasing age, gender had no noticeable effect. Deprivation factors showed moderate effects, which largely disappeared in (stratified) multivariable analysis, suggesting mediation through excess chronic morbidity and poor healthcare access. Generally, modifying effects were larger in the EQ-5D-5L as compared to the EQ VAS.
Conclusions
Almost all factors relating to a disadvantaged position showed a negative association with HRQoL. In diseased respondents, pre-existing chronic comorbidity and experienced access to health care are key factors.
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Affiliation(s)
- Erica I. Lubetkin
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York, New York, United States of America
- * E-mail:
| | - Di Long
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Juanita A. Haagsma
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Mathieu F. Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - Gouke J. Bonsel
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- EuroQol Research Foundation, Rotterdam, The Netherlands
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Cuschieri S, Hatziyianni A, Karayiannis P, Haagsma JA, Wyper GMA, Kantaris M, Theodorou M, Pallari E. Re-engineering the Cypriot General Healthcare System for Syndemics. Front Public Health 2022; 10:734796. [PMID: 35899154 PMCID: PMC9309491 DOI: 10.3389/fpubh.2022.734796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
To date in Cyprus, there is no dedicated “Quality Improvement” body or Public Health authority. The long-awaited general healthcare system (known as GeSy or GHS) has been completed, mid-stream of the COVID-19 pandemic. A recently proposed resilience plan in response to the lessons learnt from the pandemic was put forward by the Government of the Republic of Cyprus to strengthen the capacity of the GHS and support public health defense. The negotiator of GeSy and Health Minister 2015–2018 also provided his view that the health system needs a holistic transformation of service provision. Recognizing failures and thinking from a syndemogenesis perspective how the envisioned patient-centric healthcare delivery can be achieved, we propose that the public health response could also be linked to a politico-economic one in shielding GeSy. We make such case for a syndemic strategy (simultaneous management of COVID-19 and pre-existing epidemics on the island) and the development of the five-district model where each main district hospital is to complement the activities of the GHS through developing: 1. A training Center for training and sharing of best practices for COVID-19 and other public emergencies. 2. A public health body. 3. A quality improvement institute. 4. A commissioning center on planning and streamlining healthcare services. 5. A clinical trial platform. The rationale is based on the management literature and use of existing resources and capabilities for transforming the GeSy and generating value.
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Affiliation(s)
- Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | | | | | - Juanita A. Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Grant M. A. Wyper
- European Burden of Disease Network, European Cooperation in Science and Technology, Scotland, United Kingdom
| | | | | | - Elena Pallari
- Health Innovation Network, London, United Kingdom
- *Correspondence: Elena Pallari
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Hoek AE, Geraerds AJLM, Rood PPM, Joosten M, Dippel DWJ, van Beeck EF, van den Hengel L, Dijkstra B, Papathanasiou D, van Rijssel D, van den Hamer M, Schuit SCE, Burdorf A, Haagsma JA, Polinder S. The Effect of Written and Video Discharge Instructions After Mild Traumatic Brain Injury on Healthcare Costs and Productivity Costs. J Head Trauma Rehabil 2022; 37:E231-E241. [PMID: 34320553 DOI: 10.1097/htr.0000000000000720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare healthcare and productivity costs between patients with mild traumatic brain injury (mTBI) who received verbal discharge instructions only and patients who received an additional flyer with or without video instructions. SETTING Emergency departments (EDs) of 6 hospitals in the Netherlands. PARTICIPANTS In total, 1155 adult patients with mTBI (384 with verbal instructions; 771 with additional flyer with or without video instructions) were included. DESIGN Cost study with comparison between usual care and intervention. METHODS Medical and productivity costs up to 3 months after presentation at the ED were compared between mTBI patients with usual care and mTBI patients who received the intervention. RESULTS Mean medical costs per mTBI patient were slightly higher for the verbal instructions-only cohort (€337 vs €315), whereas mean productivity costs were significantly higher for the flyer/video cohort (€1625 vs €899). Higher productivity costs were associated with higher working age, injury severity, and postconcussion symptoms. CONCLUSION This study showed that the implementation of flyer (and video) discharge instructions for patients with mTBI who present at the ED increased reports of postconcussion symptoms and reduced medical costs, whereas productivity costs were found to be higher for the working population in the first 3 months after the sustained head injury.
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Affiliation(s)
- Amber E Hoek
- Departments of Emergency Medicine (Drs Hoek, Rood, Joosten, and Haagsma), Public Health (Drs Geraerds, van Beeck, Burdorf, Haagsma and Polinder), Neurology (Drs Dippel), and Internal Medicine (Dr Schuit), Erasmus Medical Center, Rotterdam, the Netherlands; Department of Emergency Medicine, Franciscus Gasthuis, Rotterdam, the Netherlands (Dr van den Hengel); Department of Emergency Medicine, Dijklanderziekenhuis, Hoorn, the Netherlands (Dr Dijkstra); Department of Emergency Medicine, Haaglanden Medical Center, the Hague, the Netherlands (Dr Papathanasiou); Department of Emergency Medicine, Reinier de Graaf, Delft, the Netherlands (Dr van Rijssel); and Department of Emergency Medicine, Admiraal de Ruyter Hospital, Goesthe Netherlands (Dr van den Hamer)
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Wulf Hanson S, Abbafati C, Aerts JG, Al-Aly Z, Ashbaugh C, Ballouz T, Blyuss O, Bobkova P, Bonsel G, Borzakova S, Buonsenso D, Butnaru D, Carter A, Chu H, De Rose C, Diab MM, Ekbom E, El Tantawi M, Fomin V, Frithiof R, Gamirova A, Glybochko PV, Haagsma JA, Javanmard SH, Hamilton EB, Harris G, Heijenbrok-Kal MH, Helbok R, Hellemons ME, Hillus D, Huijts SM, Hultström M, Jassat W, Kurth F, Larsson IM, Lipcsey M, Liu C, Loflin CD, Malinovschi A, Mao W, Mazankova L, McCulloch D, Menges D, Mohammadifard N, Munblit D, Nekliudov NA, Ogbuoji O, Osmanov IM, Peñalvo JL, Petersen MS, Puhan MA, Rahman M, Rass V, Reinig N, Ribbers GM, Ricchiuto A, Rubertsson S, Samitova E, Sarrafzadegan N, Shikhaleva A, Simpson KE, Sinatti D, Soriano JB, Spiridonova E, Steinbeis F, Svistunov AA, Valentini P, van de Water BJ, van den Berg-Emons R, Wallin E, Witzenrath M, Wu Y, Xu H, Zoller T, Adolph C, Albright J, Amlag JO, Aravkin AY, Bang-Jensen BL, Bisignano C, Castellano R, Castro E, Chakrabarti S, Collins JK, Dai X, Daoud F, Dapper C, Deen A, Duncan BB, Erickson M, Ewald SB, Ferrari AJ, Flaxman AD, Fullman N, Gamkrelidze A, Giles JR, Guo G, Hay SI, He J, Helak M, Hulland EN, Kereselidze M, Krohn KJ, Lazzar-Atwood A, Lindstrom A, Lozano R, Magistro B, Malta DC, Månsson J, Mantilla Herrera AM, Mokdad AH, Monasta L, Nomura S, Pasovic M, Pigott DM, Reiner RC, Reinke G, Ribeiro ALP, Santomauro DF, Sholokhov A, Spurlock EE, Walcott R, Walker A, Wiysonge CS, Zheng P, Bettger JP, Murray CJ, Vos T. A global systematic analysis of the occurrence, severity, and recovery pattern of long COVID in 2020 and 2021. medRxiv 2022. [PMID: 35664995 PMCID: PMC9164454 DOI: 10.1101/2022.05.26.22275532] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance: While much of the attention on the COVID-19 pandemic was directed at the daily counts of cases and those with serious disease overwhelming health services, increasingly, reports have appeared of people who experience debilitating symptoms after the initial infection. This is popularly known as long COVID. Objective: To estimate by country and territory of the number of patients affected by long COVID in 2020 and 2021, the severity of their symptoms and expected pattern of recovery Design: We jointly analyzed ten ongoing cohort studies in ten countries for the occurrence of three major symptom clusters of long COVID among representative COVID cases. The defining symptoms of the three clusters (fatigue, cognitive problems, and shortness of breath) are explicitly mentioned in the WHO clinical case definition. For incidence of long COVID, we adopted the minimum duration after infection of three months from the WHO case definition. We pooled data from the contributing studies, two large medical record databases in the United States, and findings from 44 published studies using a Bayesian meta-regression tool. We separately estimated occurrence and pattern of recovery in patients with milder acute infections and those hospitalized. We estimated the incidence and prevalence of long COVID globally and by country in 2020 and 2021 as well as the severity-weighted prevalence using disability weights from the Global Burden of Disease study. Results: Analyses are based on detailed information for 1906 community infections and 10526 hospitalized patients from the ten collaborating cohorts, three of which included children. We added published data on 37262 community infections and 9540 hospitalized patients as well as ICD-coded medical record data concerning 1.3 million infections. Globally, in 2020 and 2021, 144.7 million (95% uncertainty interval [UI] 54.8–312.9) people suffered from any of the three symptom clusters of long COVID. This corresponds to 3.69% (1.38–7.96) of all infections. The fatigue, respiratory, and cognitive clusters occurred in 51.0% (16.9–92.4), 60.4% (18.9–89.1), and 35.4% (9.4–75.1) of long COVID cases, respectively. Those with milder acute COVID-19 cases had a quicker estimated recovery (median duration 3.99 months [IQR 3.84–4.20]) than those admitted for the acute infection (median duration 8.84 months [IQR 8.10–9.78]). At twelve months, 15.1% (10.3–21.1) continued to experience long COVID symptoms. Conclusions and relevance: The occurrence of debilitating ongoing symptoms of COVID-19 is common. Knowing how many people are affected, and for how long, is important to plan for rehabilitative services and support to return to social activities, places of learning, and the workplace when symptoms start to wane.
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35
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Haagsma JA, Charalampous P, Ariani F, Gallay A, Moesgaard Iburg K, Nena E, Ngwa CH, Rommel A, Zelviene A, Abegaz KH, Al Hamad H, Albano L, Liliana Andrei C, Andrei T, Antonazzo IC, Aremu O, Arumugam A, Atreya A, Aujayeb A, Ayuso-Mateos JL, Engelbert Bain L, Banach M, Winfried Bärnighausen T, Barone-Adesi F, Beghi M, Bennett DA, Bhagavathula AS, Carvalho F, Castelpietra G, Caterina L, Chandan JS, Couto RAS, Cruz-Martins N, Damiani G, Dastiridou A, Demetriades AK, Dias-da-Silva D, Francis Fagbamigbe A, Fereshtehnejad SM, Fernandes E, Ferrara P, Fischer F, Fra.Paleo U, Ghirini S, Glasbey JC, Glavan IR, Gomes NGM, Grivna M, Harlianto NI, Haro JM, Hasan MT, Hostiuc S, Iavicoli I, Ilic MD, Ilic IM, Jakovljevic M, Jonas JB, Jerzy Jozwiak J, Jürisson M, Kauppila JH, Kayode GA, Khan MAB, Kisa A, Kisa S, Koyanagi A, Kumar M, Kurmi OP, La-Vecchia C, Lamnisos D, Lasrado S, Lauriola P, Linn S, Loureiro JA, Lunevicius R, Madureira-Carvalho A, Mechili EA, Majeed A, Menezes RG, Mentis AFA, Meretoja A, Mestrovic T, Miazgowski T, Miazgowski B, Mirica A, Molokhia M, Mohammed S, Monasta L, Mulita F, David Naimzada M, Negoi I, Neupane S, Oancea B, Orru H, Otoiu A, Otstavnov N, Otstavnov SS, Padron-Monedero A, Panda-Jonas S, Pardhan S, Patel J, Pedersini P, Pinheiro M, Rakovac I, Rao CR, Rawaf S, Rawaf DL, Rodrigues V, Ronfani L, Sagoe D, Sanmarchi F, Santric-Milicevic MM, Sathian B, Sheikh A, Shiri R, Shivalli S, Dora Sigfusdottir I, Sigurvinsdottir R, Yurievich Skryabin V, Aleksandrovna Skryabina A, Smarandache CG, Socea B, Sousa RARC, Steiropoulos P, Tabarés-Seisdedos R, Roberto Tovani-Palone M, Tozija F, Van de Velde S, Juhani Vasankari T, Veroux M, Violante FS, Vlassov V, Wang Y, Yadollahpour A, Yaya S, Sergeevich Zastrozhin M, Zastrozhina A, Polinder S, Majdan M. The burden of injury in Central, Eastern, and Western European sub-region: a systematic analysis from the Global Burden of Disease 2019 Study. Arch Public Health 2022; 80:142. [PMID: 35590340 PMCID: PMC9121595 DOI: 10.1186/s13690-022-00891-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/02/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Injury remains a major concern to public health in the European region. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were to: 1) compare GBD 2019 estimates on injury mortality and DALYs across European sub-regions and countries by cause-of-injury category and sex; 2) examine changes in injury DALY rates over a 20 year-period by cause-of-injury category, sub-region and country; and 3) assess inequalities in injury mortality and DALY rates across the countries. METHODS We performed a secondary database descriptive study using the GBD 2019 results on injuries in 44 European countries from 2000 to 2019. Inequality in DALY rates between these countries was assessed by calculating the DALY rate ratio between the highest-ranking country and lowest-ranking country in each year. RESULTS In 2019, in Eastern Europe 80 [95% uncertainty interval (UI): 71 to 89] people per 100,000 died from injuries; twice as high compared to Central Europe (38 injury deaths per 100,000; 95% UI 34 to 42) and three times as high compared to Western Europe (27 injury deaths per 100,000; 95%UI 25 to 28). The injury DALY rates showed less pronounced differences between Eastern (5129 DALYs per 100,000; 95% UI: 4547 to 5864), Central (2940 DALYs per 100,000; 95% UI: 2452 to 3546) and Western Europe (1782 DALYs per 100,000; 95% UI: 1523 to 2115). Injury DALY rate was lowest in Italy (1489 DALYs per 100,000) and highest in Ukraine (5553 DALYs per 100,000). The difference in injury DALY rates by country was larger for males compared to females. The DALY rate ratio was highest in 2005, with DALY rate in the lowest-ranking country (Russian Federation) 6.0 times higher compared to the highest-ranking country (Malta). After 2005, the DALY rate ratio between the lowest- and the highest-ranking country gradually decreased to 3.7 in 2019. CONCLUSIONS Injury mortality and DALY rates were highest in Eastern Europe and lowest in Western Europe, although differences in injury DALY rates declined rapidly, particularly in the past decade. The injury DALY rate ratio of highest- and lowest-ranking country declined from 2005 onwards, indicating declining inequalities in injuries between European countries.
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Affiliation(s)
- Juanita A. Haagsma
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Periklis Charalampous
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Filippo Ariani
- Epidemiology Unit, Central Tuscany Local Health Authority, Florence, Italy
| | - Anne Gallay
- grid.493975.50000 0004 5948 8741Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - Kim Moesgaard Iburg
- grid.7048.b0000 0001 1956 2722Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Evangelia Nena
- grid.12284.3d0000 0001 2170 8022Laboratory of Social Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Che Henry Ngwa
- grid.8761.80000 0000 9919 9582School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden ,grid.22903.3a0000 0004 1936 9801Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Alexander Rommel
- grid.13652.330000 0001 0940 3744Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Ausra Zelviene
- Institute of Hygiene, Health Information Center, Kaunas, Lithuania
| | - Kedir Hussein Abegaz
- grid.412132.70000 0004 0596 0713Department of Biostatistics, Near East University, Nicosia, Cyprus ,Department of Biostatistics and Health Informatics, Madda Walabu University, Bale Robe, Ethiopia
| | - Hanadi Al Hamad
- grid.413548.f0000 0004 0571 546XGeriatrics and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar
| | - Luciana Albano
- grid.9841.40000 0001 2200 8888Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Catalina Liliana Andrei
- grid.8194.40000 0000 9828 7548Cardiology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Tudorel Andrei
- grid.432032.40000 0004 0416 9364Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Ippazio Cosimo Antonazzo
- grid.7563.70000 0001 2174 1754Research Center On Public Health, University of Milan-Bicocca, Monza, Italy
| | - Olatunde Aremu
- grid.19822.300000 0001 2180 2449Department of Public Health, Birmingham City University, Birmingham, UK
| | - Ashokan Arumugam
- grid.412789.10000 0004 4686 5317Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Alok Atreya
- grid.429382.60000 0001 0680 7778Department of Forensic Medicine, Lumbini Medical College, Palpa, Nepal
| | - Avinash Aujayeb
- grid.451090.90000 0001 0642 1330Northumbria Healthcare NHS Foundation Trust, Cramlington, UK
| | - Jose Luis Ayuso-Mateos
- grid.411251.20000 0004 1767 647XHospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain ,grid.413448.e0000 0000 9314 1427Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
| | - Luchuo Engelbert Bain
- grid.36511.300000 0004 0420 4262Lincoln International Institute for Rural Health (LIIRH), University of Lincoln, Lincoln, UK ,Global South Health Services and Research, GSHS, Amsterdam, The Netherlands
| | - Maciej Banach
- grid.8267.b0000 0001 2165 3025Department of Hypertension, Medical University of Lodz, Lodz, Poland ,grid.415071.60000 0004 0575 4012Polish Mothers’ Memorial Hospital Research Institute, Lodz, Poland
| | - Till Winfried Bärnighausen
- grid.7700.00000 0001 2190 4373Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany ,grid.38142.3c000000041936754XT.H. Chan School of Public Health, Harvard University, Boston, MA USA
| | - Francesco Barone-Adesi
- grid.16563.370000000121663741Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | | | - Derrick A. Bennett
- grid.4991.50000 0004 1936 8948Clinical Trials Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Akshaya S. Bhagavathula
- grid.43519.3a0000 0001 2193 6666Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates ,grid.4491.80000 0004 1937 116XDepartment of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Prague, Czech Republic
| | - Félix Carvalho
- grid.5808.50000 0001 1503 7226Research Unit On Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Giulio Castelpietra
- Outpatient and Inpatient Care Service, Central Health Directorate, Friuli Venezia Giulia Region, Trieste, Italy
| | - Ledda Caterina
- grid.8158.40000 0004 1757 1969Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Joht Singh Chandan
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Rosa A. S. Couto
- grid.5808.50000 0001 1503 7226Department of Chemical Sciences, University of Porto, Porto, Portugal
| | - Natália Cruz-Martins
- grid.5808.50000 0001 1503 7226Faculty of Medicine, University of Porto, Porto, Portugal ,grid.5808.50000 0001 1503 7226Institute for Research & Innovation in Health (i3S), University of Porto, Porto, Portugal ,Institute of Research and Advanced, Training in Health Sciences and Technologies (INFACTS), Gandra, Portugal
| | - Giovanni Damiani
- grid.4708.b0000 0004 1757 2822Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, University of Milan, Milan, Italy ,grid.67105.350000 0001 2164 3847Department of Dermatology, Case Western Reserve University, Cleveland, OH USA
| | - Anna Dastiridou
- grid.411299.6Department of Ophthalmology, University Hospital of Larissa, Larissa, Greece
| | - Andreas K. Demetriades
- grid.418716.d0000 0001 0709 1919Edinburgh Spinal Surgery Outcome Studies Group, Department of Neurosurgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Diana Dias-da-Silva
- grid.5808.50000 0001 1503 7226Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Adeniyi Francis Fagbamigbe
- grid.9582.60000 0004 1794 5983Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Seyed-Mohammad Fereshtehnejad
- grid.28046.380000 0001 2182 2255Division of Neurology, Department of Medicine, University of Ottawa, Ottawa, ON Canada ,grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Department of Neurobiology, Karolinska Institute, Stockholm, Sweden
| | - Eduarda Fernandes
- grid.5808.50000 0001 1503 7226Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal
| | - Pietro Ferrara
- grid.7563.70000 0001 2174 1754Research Center On Public Health, University of Milan-Bicocca, Monza, Italy
| | - Florian Fischer
- grid.6363.00000 0001 2218 4662Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Urbano Fra.Paleo
- grid.8393.10000000119412521Research Institute for Sustainable Land Development (Interra), University of Extremadura, Caceres, Spain
| | - Silvia Ghirini
- grid.416651.10000 0000 9120 6856National Center On Addictions and Doping, Istituto Superiore Di Sanità, Rome, Italy
| | - James C. Glasbey
- grid.6572.60000 0004 1936 7486NIHR Global Health Research Unit On Global Surgery, University of Birmingham, Birmingham, UK
| | - Ionela-Roxana Glavan
- grid.432032.40000 0004 0416 9364Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Nelson G. M. Gomes
- grid.5808.50000 0001 1503 7226Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal ,grid.5808.50000 0001 1503 7226Department of Chemistry, University of Porto, Porto, Portugal
| | - Michal Grivna
- grid.43519.3a0000 0001 2193 6666Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Netanja I. Harlianto
- grid.7692.a0000000090126352Department of Orthopedics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Josep Maria Haro
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain ,Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
| | - M. Tasdik Hasan
- grid.414142.60000 0004 0600 7174International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh ,grid.10025.360000 0004 1936 8470Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Sorin Hostiuc
- grid.8194.40000 0000 9828 7548Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania ,Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Ivo Iavicoli
- grid.4691.a0000 0001 0790 385XDepartment of Public Health, University of Naples Federico II, Naples, Italy
| | - Milena D. Ilic
- grid.413004.20000 0000 8615 0106Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia
| | - Irena M. Ilic
- grid.7149.b0000 0001 2166 9385Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Mihajlo Jakovljevic
- grid.448878.f0000 0001 2288 8774N. A. Semashko Department of Public Health and Healthcare, I. M. Sechenov First Moscow State Medical University, Moscow, Russia ,grid.413004.20000 0000 8615 0106Department of Global Health, Economics and Policy, University of Kragujevac, Kragujevac, Serbia
| | - Jost B. Jonas
- grid.7700.00000 0001 2190 4373Department of Ophthalmology, Heidelberg University, Mannheim, Germany ,grid.414373.60000 0004 1758 1243Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China
| | - Jacek Jerzy Jozwiak
- grid.107891.60000 0001 1010 7301Department of Family Medicine and Public Health, University of Opole, Opole, Poland
| | - Mikk Jürisson
- grid.10939.320000 0001 0943 7661Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Joonas H. Kauppila
- grid.4714.60000 0004 1937 0626Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden ,grid.10858.340000 0001 0941 4873Surgery Research Unit, University of Oulu, Oulu, Finland
| | - Gbenga A. Kayode
- grid.421160.0International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria ,grid.5477.10000000120346234Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands
| | - Moien A. B. Khan
- grid.43519.3a0000 0001 2193 6666Department of Family Medicine, United Arab Emirates University, Al-Ain, United Arab Emirates ,grid.451052.70000 0004 0581 2008Primary Care Department, NHS North West London, London, England
| | - Adnan Kisa
- grid.457625.70000 0004 0383 3497School of Health Sciences, Kristiania University College, Oslo, Norway ,grid.265219.b0000 0001 2217 8588Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA USA
| | - Sezer Kisa
- grid.412414.60000 0000 9151 4445Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Ai Koyanagi
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain ,grid.425902.80000 0000 9601 989XCatalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Manasi Kumar
- grid.10604.330000 0001 2019 0495Department of Psychiatry, University of Nairobi, Nairobi, Kenya ,grid.83440.3b0000000121901201Division of Psychology and Language Sciences, University College London, London, UK
| | - Om P. Kurmi
- grid.25073.330000 0004 1936 8227Division of Respirology, Department of Medicine, McMaster University, Hamilton, Canada ,grid.8096.70000000106754565Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Carlo La-Vecchia
- grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Demetris Lamnisos
- grid.440838.30000 0001 0642 7601Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Savita Lasrado
- grid.414767.70000 0004 1765 9143Department of Otorhinolaryngology, Father Muller Medical College, Mangalore, India
| | - Paolo Lauriola
- grid.5326.20000 0001 1940 4177Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Shai Linn
- grid.18098.380000 0004 1937 0562School of Public Health, University of Haifa, Haifa, Israel
| | - Joana A. Loureiro
- grid.5808.50000 0001 1503 7226Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), University of Porto, Porto, Portugal
| | - Raimundas Lunevicius
- grid.10025.360000 0004 1936 8470Department of General Surgery, School of Medicine, Liverpool University Hospitals NHS Foundation Trust, University of Liverpool, Liverpool, UK
| | - Aurea Madureira-Carvalho
- Institute of Research and Advanced, Training in Health Sciences and Technologies (INFACTS), Gandra, Portugal ,grid.5808.50000 0001 1503 7226Laboratório de Farmacognosia, Departamento de Química, Faculdade de Farmácia, Universidade Do Porto, Porto, Portugal
| | - Enkeleint A. Mechili
- grid.8127.c0000 0004 0576 3437Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece ,Department of Healthcare, Faculty of Public Health, University of Vlora, Vlora, Albania
| | - Azeem Majeed
- grid.7445.20000 0001 2113 8111Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Ritesh G. Menezes
- grid.411975.f0000 0004 0607 035XForensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Alexios-Fotios A. Mentis
- grid.418497.7Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece ,grid.411299.6Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Atte Meretoja
- grid.1008.90000 0001 2179 088XSchool of Health Sciences, University of Melbourne, Melbourne, VIC Australia ,grid.15485.3d0000 0000 9950 5666Neurology Unit, Helsinki University Hospital, Helsinki, Finland
| | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Dr Zora Profozic Polyclinic, Zagreb, Croatia ,grid.502995.20000 0004 4651 2415University Centre Varazdin, University North, Varazdin, Croatia
| | - Tomasz Miazgowski
- grid.107950.a0000 0001 1411 4349Department of Propedeutics of Internal Diseases & Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland
| | - Bartosz Miazgowski
- grid.107950.a0000 0001 1411 4349Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
| | - Andreea Mirica
- grid.432032.40000 0004 0416 9364Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Mariam Molokhia
- grid.13097.3c0000 0001 2322 6764Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Shafiu Mohammed
- grid.7700.00000 0001 2190 4373Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany ,grid.411225.10000 0004 1937 1493Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Francesk Mulita
- grid.412458.eDepartment of General Surgery, University General Hospital of Patras, Patras, Greece
| | - Mukhammad David Naimzada
- grid.18763.3b0000000092721542Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia ,grid.411191.d0000 0000 9146 0440Experimental Surgery and Oncology Laboratory, Kursk State Medical University, Kursk, Russia
| | - Ionut Negoi
- grid.8194.40000 0000 9828 7548Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania ,Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Subas Neupane
- grid.502801.e0000 0001 2314 6254Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland ,grid.502801.e0000 0001 2314 6254Gerontology Research Center, Tampere University, Tampere, Finland
| | - Bogdan Oancea
- grid.5100.40000 0001 2322 497XAdministrative and Economic Sciences Department, University of Bucharest, Bucharest, Romania
| | - Hans Orru
- grid.10939.320000 0001 0943 7661Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia ,grid.12650.300000 0001 1034 3451Department of Public Health and Clinical Medicine, Sustainable Health, Umea University, Umea, Sweden
| | - Adrian Otoiu
- grid.432032.40000 0004 0416 9364Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Nikita Otstavnov
- grid.18763.3b0000000092721542Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
| | - Stanislav S. Otstavnov
- grid.18763.3b0000000092721542Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia ,grid.410682.90000 0004 0578 2005Department of Project Management, National Research University Higher School of Economics, Moscow, Russia
| | - Alicia Padron-Monedero
- grid.512889.f0000 0004 1768 0241National School of Public Health, Institute of Health Carlos III, Madrid, Spain
| | - Songhomitra Panda-Jonas
- grid.7700.00000 0001 2190 4373Department of Ophthalmology, Heidelberg University, Mannheim, Germany
| | - Shahina Pardhan
- grid.5115.00000 0001 2299 5510Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
| | - Jay Patel
- grid.9909.90000 0004 1936 8403Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Paolo Pedersini
- grid.418563.d0000 0001 1090 9021IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Marina Pinheiro
- grid.5808.50000 0001 1503 7226Department of Chemistry, University of Porto, Porto, Portugal
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Chythra R. Rao
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka India
| | - Salman Rawaf
- grid.7445.20000 0001 2113 8111Department of Primary Care and Public Health, Imperial College London, London, UK ,grid.271308.f0000 0004 5909 016XAcademic Public Health Department, Public Health England, London, UK
| | - David Laith Rawaf
- grid.7445.20000 0001 2113 8111World Health Organization (WHO) Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK ,grid.439749.40000 0004 0612 2754University College London Hospitals, London, UK
| | | | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Dominic Sagoe
- grid.7914.b0000 0004 1936 7443Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Francesco Sanmarchi
- grid.6292.f0000 0004 1757 1758Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Milena M. Santric-Milicevic
- grid.7149.b0000 0001 2166 9385Faculty of Medicine, University of Belgrade, Belgrade, Serbia ,grid.7149.b0000 0001 2166 9385School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Brijesh Sathian
- grid.413548.f0000 0004 0571 546XGeriatrics and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar ,grid.17236.310000 0001 0728 4630Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Aziz Sheikh
- grid.4305.20000 0004 1936 7988Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK ,grid.38142.3c000000041936754XDivision of General Internal Medicine, Harvard University, Boston, MA USA
| | - Rahman Shiri
- grid.6975.d0000 0004 0410 5926Finnish Institute of Occupational Health, Helsinki, Finland
| | - Siddharudha Shivalli
- grid.8991.90000 0004 0425 469XDepartment of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Inga Dora Sigfusdottir
- grid.9580.40000 0004 0643 5232Department of Psychology, Reykjavik University, Reykjavik, Iceland ,Icelandic Centre for Social Research and Analysis (ICSRA), Reykjavik, Iceland ,grid.21729.3f0000000419368729Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY USA
| | - Rannveig Sigurvinsdottir
- grid.9580.40000 0004 0643 5232Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | | | | | - Catalin-Gabriel Smarandache
- grid.8194.40000 0000 9828 7548Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Bogdan Socea
- grid.8194.40000 0000 9828 7548Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Raúl A. R. C. Sousa
- Professional Association of Licensed Optometry Professionals, Linda-a-Velha, Portugal
| | - Paschalis Steiropoulos
- grid.12284.3d0000 0001 2170 8022Department of Respiratory Medicine, Medical School, Democritus University of Thrace, University General Hospital Dragana, Alexandroupolis, Greece
| | - Rafael Tabarés-Seisdedos
- grid.413448.e0000 0000 9314 1427Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain ,grid.5338.d0000 0001 2173 938XDepartment of Medicine, University of Valencia, Valencia, Spain
| | - Marcos Roberto Tovani-Palone
- grid.11899.380000 0004 1937 0722Department of Pathology and Legal Medicine, University of São Paulo, Ribeirão Preto, Brazil
| | - Fimka Tozija
- grid.7858.20000 0001 0708 5391Institute of Public Health of Republic of North Macedonia, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia
| | - Sarah Van de Velde
- grid.5284.b0000 0001 0790 3681Centre for Population, Family and Health, Department of Sociology, University of Antwerp, Antwerp, Belgium
| | | | - Massimiliano Veroux
- grid.8158.40000 0004 1757 1969Department of Medical, Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Francesco S. Violante
- grid.6292.f0000 0004 1757 1758Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy ,grid.412311.4Occupational Health Unit, Sant’Orsola Malpighi Hospital, Bologna, Italy
| | - Vasiliy Vlassov
- grid.410682.90000 0004 0578 2005Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia
| | - Yanzhong Wang
- grid.13097.3c0000 0001 2322 6764School of Population Health and Environmental Sciences, King’s College London, London, UK
| | - Ali Yadollahpour
- grid.11835.3e0000 0004 1936 9262Psychology Department, University of Sheffield, Sheffield, UK
| | - Sanni Yaya
- grid.28046.380000 0001 2182 2255School of International Development and Global Studies, University of Ottawa, Ottawa, ON Canada ,grid.4991.50000 0004 1936 8948The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Mikhail Sergeevich Zastrozhin
- Laboratory of Genetics and Genomics, Moscow Research and Practical Centre On Addictions, Moscow, Russia ,grid.465497.dAddictology Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Anasthasia Zastrozhina
- grid.465497.dPediatrics Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Suzanne Polinder
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Marek Majdan
- grid.412903.d0000 0001 1212 1596Department of Public Health, Institute for Global Health and Epidemiology, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia
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van Essen TA, Lingsma HF, Pisică D, Singh RD, Volovici V, den Boogert HF, Younsi A, Peppel LD, Heijenbrok-Kal MH, Ribbers GM, Walchenbach R, Menon DK, Hutchinson P, Depreitere B, Steyerberg EW, Maas AIR, de Ruiter GCW, Peul WC, Åkerlund C, Amrein K, Andelic N, Andreassen L, Anke A, Antoni A, Audibert G, Azouvi P, Azzolini ML, Bartels R, Barzó P, Beauvais R, Beer R, Bellander BM, Belli A, Benali H, Berardino M, Beretta L, Blaabjerg M, Bragge P, Brazinova A, Brinck V, Brooker J, Brorsson C, Buki A, Bullinger M, Cabeleira M, Caccioppola A, Calappi E, Calvi MR, Cameron P, Carbayo Lozano G, Carbonara M, Castaño-León AM, Cavallo S, Chevallard G, Chieregato A, Citerio G, Clusmann H, Coburn MS, Coles J, Cooper JD, Correia M, Čović A, Curry N, Czeiter E, Czosnyka M, Dahyot-Fizelier C, Dark P, Dawes H, De Keyser V, Degos V, Della Corte F, Đilvesi Đ, Dixit A, Donoghue E, Dreier J, Dulière GL, Ercole A, Esser P, Ezer E, Fabricius M, Feigin VL, Foks K, Frisvold S, Furmanov A, Gagliardo P, Galanaud D, Gantner D, Gao G, George P, Ghuysen A, Giga L, Glocker B, Golubović J, Gomez PA, Gratz J, Gravesteijn B, Grossi F, Gruen RL, Gupta D, Haagsma JA, Haitsma I, Helbok R, Helseth E, Horton L, Huijben J, Jacobs B, Jankowski S, Jarrett M, Jiang JY, Johnson F, Jones K, Karan M, Kolias AG, Kompanje E, Kondziella D, Kornaropoulos E, Koskinen LO, Kovács N, Lagares A, Lanyon L, Laureys S, Lecky F, Ledoux D, Lefering R, Legrand V, Lejeune A, Levi L, Lightfoot R, Maegele M, Majdan M, Manara A, Manley G, Maréchal H, Martino C, Mattern J, McMahon C, Melegh B, Menovsky T, Mikolic A, Misset B, Muraleedharan V, Murray L, Nair N, Negru A, Nelson D, Newcombe V, Nieboer D, Nyirádi J, Oresic M, Ortolano F, Otesile O, Palotie A, Parizel PM, Payen JF, Perera N, Perlbarg V, Persona P, Piippo-Karjalainen A, Pirinen M, Ples H, Polinder S, Pomposo I, Posti JP, Puybasset L, Rădoi A, Ragauskas A, Raj R, Rambadagalla M, Rehorčíková V, Retel Helmrich I, Rhodes J, Richardson S, Richter S, Ripatti S, Rocka S, Roe C, Roise O, Rosand J, Rosenfeld J, Rosenlund C, Rosenthal G, Rossaint R, Rossi S, Rueckert D, Rusnák M, Sahuquillo J, Sakowitz O, Sanchez-Porras R, Sandor J, Schäfer N, Schmidt S, Schoechl H, Schoonman G, Schou RF, Schwendenwein E, Sewalt C, Skandsen T, Smielewski P, Sorinola A, Stamatakis E, Stanworth S, Kowark A, Stevens R, Stewart W, Stocchetti N, Sundström N, Takala R, Tamás V, Tamosuitis T, Taylor MS, Te Ao B, Tenovuo O, Theadom A, Thomas M, Tibboel D, Timmers M, Tolias C, Trapani T, Tudora CM, Unterberg A, Vajkoczy P, Valeinis E, Vallance S, Vámos Z, Van der Jagt M, van der Naalt J, Van der Steen G, van Dijck JT, Van Hecke W, van Heugten C, Van Praag D, Van Veen E, van Wijk R, Vande Vyvere T, Vargiolu A, Vega E, Velt K, Verheyden J, Vespa PM, Vik A, Vilcinis R, von Steinbüchel N, Voormolen D, Vulekovic P, Wang KK, Wiegers E, Williams G, Wilson L, Winzeck S, Wolf S, Yang Z, Ylén P, Zeiler FA, Ziverte A, Zoerle T. Surgery versus conservative treatment for traumatic acute subdural haematoma: a prospective, multicentre, observational, comparative effectiveness study. Lancet Neurol 2022; 21:620-631. [DOI: 10.1016/s1474-4422(22)00166-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/04/2022] [Accepted: 04/06/2022] [Indexed: 01/05/2023]
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Castelpietra G, Knudsen AKS, Agardh EE, Armocida B, Beghi M, Iburg KM, Logroscino G, Ma R, Starace F, Steel N, Addolorato G, Andrei CL, Andrei T, Ayuso-Mateos JL, Banach M, Bärnighausen TW, Barone-Adesi F, Bhagavathula AS, Carvalho F, Carvalho M, Chandan JS, Chattu VK, Couto RA, Cruz-Martins N, Dargan PI, Deuba K, da Silva DD, Fagbamigbe AF, Fernandes E, Ferrara P, Fischer F, Gaal PA, Gialluisi A, Haagsma JA, Haro JM, Hasan MT, Hasan SS, Hostiuc S, Iacoviello L, Iavicoli I, Jamshidi E, Jonas JB, Joo T, Jozwiak JJ, Katikireddi SV, Kauppila JH, Khan MA, Kisa A, Kisa S, Kivimäki M, Koly KN, Koyanagi A, Kumar M, Lallukka T, Langguth B, Ledda C, Lee PH, Lega I, Linehan C, Loureiro JA, Madureira-Carvalho ÁM, Martinez-Raga J, Mathur MR, McGrath JJ, Mechili EA, Mentis AFA, Mestrovic T, Miazgowski B, Mirica A, Mirijello A, Moazen B, Mohammed S, Mulita F, Nagel G, Negoi I, Negoi RI, Nwatah VE, Padron-Monedero A, Panda-Jonas S, Pardhan S, Pasovic M, Patel J, Petcu IR, Pinheiro M, Pollok RCG, Postma MJ, Rawaf DL, Rawaf S, Romero-Rodríguez E, Ronfani L, Sagoe D, Sanmarchi F, Schaub MP, Sharew NT, Shiri R, Shokraneh F, Sigfusdottir ID, Silva JP, Silva R, Socea B, Szócska M, Tabarés-Seisdedos R, Torrado M, Tovani-Palone MR, Vasankari TJ, Veroux M, Viner RM, Werdecker A, Winkler AS, Hay SI, Ferrari AJ, Naghavi M, Allebeck P, Monasta L. The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990-2019: Findings from the Global Burden of Disease Study 2019. Lancet Reg Health Eur 2022; 16:100341. [PMID: 35392452 PMCID: PMC8980870 DOI: 10.1016/j.lanepe.2022.100341] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Mental health is a public health issue for European young people, with great heterogeneity in resource allocation. Representative population-based studies are needed. The Global Burden of Disease (GBD) Study 2019 provides internationally comparable information on trends in the health status of populations and changes in the leading causes of disease burden over time. Methods Prevalence, incidence, Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) from mental disorders (MDs), substance use disorders (SUDs) and self-harm were estimated for young people aged 10-24 years in 31 European countries. Rates per 100,000 population, percentage changes in 1990-2019, 95% Uncertainty Intervals (UIs), and correlations with Sociodemographic Index (SDI), were estimated. Findings In 2019, rates per 100,000 population were 16,983 (95% UI 12,823 - 21,630) for MDs, 3,891 (3,020 - 4,905) for SUDs, and 89·1 (63·8 - 123·1) for self-harm. In terms of disability, anxiety contributed to 647·3 (432-912·3) YLDs, while in terms of premature death, self-harm contributed to 319·6 (248·9-412·8) YLLs, per 100,000 population. Over the 30 years studied, YLDs increased in eating disorders (14·9%;9·4-20·1) and drug use disorders (16·9%;8·9-26·3), and decreased in idiopathic developmental intellectual disability (-29·1%;23·8-38·5). YLLs decreased in self-harm (-27·9%;38·3-18·7). Variations were found by sex, age-group and country. The burden of SUDs and self-harm was higher in countries with lower SDI, MDs were associated with SUDs. Interpretation Mental health conditions represent an important burden among young people living in Europe. National policies should strengthen mental health, with a specific focus on young people. Funding The Bill and Melinda Gates Foundation.
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Affiliation(s)
- Giulio Castelpietra
- Outpatient and Inpatient Care Service, Central Health Directorate, Region Friuli Venezia Giulia, Italy
| | | | - Emilie E. Agardh
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Benedetta Armocida
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, National Institute of Health, Rome, Italy
| | | | | | - Giancarlo Logroscino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Department of Clinical Research in Neurology, Fondazione Cardinale Giovanni Panico Hospital, Tricase, Italy
| | - Rui Ma
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
| | - Fabrizio Starace
- Department of Mental Health & Drug Abuse, AUSL Modena, Modena, Italy
| | - Nicholas Steel
- Department of Primary Care and Public Health, University of East Anglia, Norwich, UK
- Public Health England, London, UK
| | | | | | - Tudorel Andrei
- Department of Statistics and Econometrics Bucharest Carol Davila University of Economic Studies, Bucharest, Romania
| | - Jose L Ayuso-Mateos
- CIBERSAM, Institute of Health Carlos III, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid (Autonomous University of Madrid), Madrid, Spain
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | | | - Akshaya Srikanth Bhagavathula
- Department of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Czech Republic
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Felix Carvalho
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Márcia Carvalho
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
- Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
| | - Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Vijay Kumar Chattu
- Faculty of Medical Sciences, University of the West Indies, St Augustine, Trinidad and Tobago
- Independent Consultant, Athens, Greece
| | - Rosa A.S. Couto
- Department of Chemical Sciences, University of Porto, Porto, Portugal
| | - Natália Cruz-Martins
- Department of Medicine (Prof N Cruz-Martins PhD), University of Porto, Porto, Portugal
- Department of Health Sciences Institute of Research and Advanced Training in Health Sciences and Technologies (CESPU), Famalicão, Portugal
| | - Paul I. Dargan
- Faculty of Life Sciences and Medicine, King's College London, London, UK
- Department of Clinical Toxicology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Keshab Deuba
- National Centre for AIDS and STD Control, Save the Children, Kathmandu, Nepal
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | | | - Adeniyi Francis Fagbamigbe
- Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
- Population and Behavioural Sciences, University of St Andrews, St Andrews, UK
| | - Eduarda Fernandes
- Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal
| | - Pietro Ferrara
- Research Center on Public Health, University of Milan Bicocca, Monza, Italy
| | - Florian Fischer
- Institute of Public Health, Charité Universitätsmedizin Berlin (Charité Medical University Berlin), Berlin, Germany
| | - Peter Andras Gaal
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
- Department of Applied Social Sciences, Sapientia Hungarian University of Transylvania, Târgu-Mureş, Romania
| | | | - Juanita A. Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Josep Maria Haro
- Research Unit, University of Barcelona, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), Barcelona, Spain
| | - M. Tasdik Hasan
- Department of Pharmacy, University of Huddersfield, Huddersfield, UK
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, Australia
| | - Syed Shahzad Hasan
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
- Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
| | - Ivo Iavicoli
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Elham Jamshidi
- Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehram, Iran
- Division of Pulmonary Medicine, University of Lausanne (UNIL), Lausanne, Switzerland
| | - Jost B. Jonas
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
| | - Tamas Joo
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Jacek Jerzy Jozwiak
- Department of Family Medicine and Public Health, University of Opole, Opole, Poland
| | | | - Joonas H. Kauppila
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Surgery Research Unit, University of Oulu, Oulu, Finland
| | - Moien A.B. Khan
- Family Medicine Department, United Arab Emirates University, Al Ain, United Arab Emirates
- Primary Care Department, NHS North West London, London, UK
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, USA
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Mika Kivimäki
- Department of Epidemiology and Public Health University College London, London, UK
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Kamrun Nahar Koly
- Health System and Population Studies Divisions, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Center for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Ai Koyanagi
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Manasi Kumar
- Division of Psychology and Language Sciences, University College London, London, UK
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Caterina Ledda
- Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Paul H. Lee
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Ilaria Lega
- National Center for Disease Prevention and Health Promotion, Istituto Superiore di Sanità - Italian National Insitute of Health, Rome, Italy
| | - Christine Linehan
- UCD Centre for Disability Studies, University College Dublin, Dublin, Ireland
| | - Joana A. Loureiro
- Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE) University of Porto, Porto, Portugal
- School of Health, Polytechnic Institute of Porto, Portugal
| | - Áurea M Madureira-Carvalho
- Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal
- Institute for Research and Advanced Training in Health Sciences and Technologies, Instituto Universitário de Ciências da Saúde (University Institute of Health Sciences), Gandra, Portugal
| | - Jose Martinez-Raga
- Psychiatry Department, Hospital Universitario Doctor Peset, Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
| | - Manu Raj Mathur
- Health Policy Research Public Health Foundation of India, Gurugram, India
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - John J. McGrath
- Queensland Brain Institute, School of Public Health, The University of Queensland, Brisbane, QLD, Australia
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Enkeleint A. Mechili
- Department of Healthcare, University of Vlora, Vlora city, Albania
- Clinic of Social and Family Medicine, University of Crete, Heraklion, Greece
| | | | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Dr. Zora Profozic Polyclinic, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Bartosz Miazgowski
- Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
| | - Andreea Mirica
- Department of Statistics and Econometrics Bucharest University of Economic Studies, Bucharest, Romania
| | - Antonio Mirijello
- Department of Medical Sciences IRCCS Casa Sollievo della Sofferenza General Hospital, San Giovanni Rotondo, Italy
| | - Babak Moazen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt, Germany
| | - Shafiu Mohammed
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
- Department of Health Care Management, Technical University of Berlin, Berlin, Germany
| | - Francesk Mulita
- Department of Surgery, General University Hospital of Patras, Patras, Greece
- Medical School, University of Thessaly, Larissa, Greece
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry Ulm University, Ulm, Germany
| | - Ionut Negoi
- Department of General Surgery Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Ruxandra Irina Negoi
- Department of Anatomy and Embryology Romania, Bucharest, Romania
- Cardio-Aid, Bucharest, Romania
| | - Vincent Ebuka Nwatah
- Department of Pediatrics, National Hospital, Abuja, Nigeria
- Department of International Public Health, University of Liverpool, Liverpool, UK
| | | | | | - Shahina Pardhan
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
| | - Maja Pasovic
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
| | - Jay Patel
- Global Health Governance Programme, University of Edinburgh, Edinburgh, UK
- School of Dentistry, University of Leeds, Leeds, UK
| | - Ionela-Roxana Petcu
- Department of Statistics and Econometrics Bucharest University of Economic Studies, Bucharest, Romania
| | - Marina Pinheiro
- Department of Chemistry, University of Porto, Porto, Portugal
| | | | - Maarten J. Postma
- University Medical Center Groningen, School of Economics and Business University of Groningen, Groningen, Netherlands
| | - David Laith Rawaf
- WHO Collaborating Centre for Public Health Education and Training Imperial College London, London, UK
| | - Salman Rawaf
- Department of Primary Care and Public Health, Imperial College London, London, UK
- University College London Hospitals, London, UK
- Academic Public Health England, London, UK
| | - Esperanza Romero-Rodríguez
- Clinical and Epidemiological Research in Primary Care (GICEAP), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Dominic Sagoe
- Department of Psychosocial Science University of Bergen, Bergen, Norway
| | - Francesco Sanmarchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Michael P Schaub
- Swiss Research Institute for Public Health and Addiction University of Zürich, Zurich, Switzerland
| | - Nigussie Tadesse Sharew
- Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE) University of Groningen, Groningen, Netherlands
- Department of Nursing, Debre Berhan University, Debre Berhan, Ethiopia
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Farhad Shokraneh
- London Institute for Healthcare Engineering, King's College London, London, UK
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| | - Inga Dora Sigfusdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Department of Health and Behavior Studies, Columbia University, New York, NY, USA
| | - João Pedro Silva
- Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Renata Silva
- Department of Biological Sciences, University of Porto, Porto, Portugal
| | - Bogdan Socea
- Surgery, "Sf. Pantelimon" Emergency Clinical Hospital Bucharest, Bucharest, Romania
| | - Miklós Szócska
- Faculty of Health and Public Administration, Semmelweis University, Budapest, Hungary
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, Valencia, Spain
- Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
| | - Marco Torrado
- Psychiatry and Medical Psychology Department, University of Lisbon, Lisbon, Portugal
- Child and Adolescent Mental Health Services (CAMHS), Hospital Garcia de Orta, Almada, Portugal
| | - Marcos Roberto Tovani-Palone
- Department of Pathology and Legal Medicine, University of São Paulo, Ribeirão Preto, Brazil
- Modestum LTD, London, UK
| | - Tommi Juhani Vasankari
- UKK Institute, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Massimiliano Veroux
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Russell M. Viner
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Andrea Werdecker
- Demographic Change and Aging Research Area, Federal Institute for Population Research, Wiesbaden, Germany
| | - Andrea Sylvia Winkler
- Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Neurology, Technical University of Munich, Munich, Germany
| | - Simon I. Hay
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Alize J. Ferrari
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
- School of Public Health (A J Ferrari PhD), The University of Queensland, Brisbane, QLD, Australia
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Peter Allebeck
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
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Charalampous P, Gorasso V, Plass D, Pires SM, von der Lippe E, Mereke A, Idavain J, Kissimova-Skarbek K, Morgado JN, Ngwa CH, Noguer I, Padron-Monedero A, Santi-Cano MJ, Sarmiento R, Devleesschauwer B, Haagsma JA. Burden of non-communicable disease studies in Europe: a systematic review of data sources and methodological choices. Eur J Public Health 2022; 32:289-296. [PMID: 35015851 PMCID: PMC8975530 DOI: 10.1093/eurpub/ckab218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Assessment of disability-adjusted life years (DALYs) resulting from non-communicable diseases (NCDs) requires specific calculation methods and input data. The aims of this study were to (i) identify existing NCD burden of disease (BoD) activities in Europe; (ii) collate information on data sources for mortality and morbidity; and (iii) provide an overview of NCD-specific methods for calculating NCD DALYs. METHODS NCD BoD studies were systematically searched in international electronic literature databases and in grey literature. We included all BoD studies that used the DALY metric to quantify the health impact of one or more NCDs in countries belonging to the European Region. RESULTS A total of 163 BoD studies were retained: 96 (59%) were single-country or sub-national studies and 67 (41%) considered more than one country. Of the single-country studies, 29 (30%) consisted of secondary analyses using existing Global Burden of Disease (GBD) results. Mortality data were mainly derived (49%) from vital statistics. Morbidity data were frequently (40%) drawn from routine administrative and survey datasets, including disease registries and hospital discharge databases. The majority (60%) of national BoD studies reported mortality corrections. Multimorbidity adjustments were performed in 18% of national BoD studies. CONCLUSION The number of national NCD BoD assessments across Europe increased over time, driven by an increase in BoD studies that consisted of secondary data analysis of GBD study findings. Ambiguity in reporting the use of NCD-specific BoD methods underlines the need for reporting guidelines of BoD studies to enhance the transparency of NCD BoD estimates across Europe.
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Affiliation(s)
- Periklis Charalampous
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vanessa Gorasso
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Dietrich Plass
- Department for Exposure Assessment and Environmental Health Indicators, German Environment Agency, Berlin, Germany
| | - Sara M Pires
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Alibek Mereke
- Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Jane Idavain
- National Institute for Health Development, Tallinn, Estonia
| | | | - Joana Nazaré Morgado
- Environmental Health and Nutrition Laboratory, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Che Henry Ngwa
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Isabel Noguer
- Carlos III Institute of Health, National School of Public Health, Madrid, Spain
| | | | - María José Santi-Cano
- Research Group on Nutrition: Molecular, pathophysiological and social issues, Biomedical Research and Innovation Institute of Cádiz (INiBICA), University of Cádiz, Cádiz, Spain
| | - Rodrigo Sarmiento
- Carlos III Institute of Health, National School of Public Health, Madrid, Spain
- Medicine School, University of Applied and Environmental Sciences, Bogota, Colombia
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Charalampous P, Polinder S, Wothge J, von der Lippe E, Haagsma JA. A systematic literature review of disability weights measurement studies: evolution of methodological choices. Arch Public Health 2022; 80:91. [PMID: 35331325 PMCID: PMC8944058 DOI: 10.1186/s13690-022-00860-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/18/2022] [Indexed: 12/13/2022] Open
Abstract
Background The disability weight is an essential factor to estimate the healthy time that is lost due to living with a certain state of illness. A 2014 review showed a considerable variation in methods used to derive disability weights. Since then, several sets of disability weights have been developed. This systematic review aimed to provide an updated and comparative overview of the methodological design choices and surveying techniques that have been used in disability weights measurement studies and how they evolved over time. Methods A literature search was conducted in multiple international databases (early-1990 to mid-2021). Records were screened according to pre-defined eligibility criteria. The quality of the included disability weights measurement studies was assessed using the Checklist for Reporting Valuation Studies (CREATE) instrument. Studies were collated by characteristics and methodological design approaches. Data extraction was performed by one reviewer and discussed with a second. Results Forty-six unique disability weights measurement studies met our eligibility criteria. More than half (n = 27; 59%) of the identified studies assessed disability weights for multiple ill-health outcomes. Thirty studies (65%) described the health states using disease-specific descriptions or a combination of a disease-specific descriptions and generic-preference instruments. The percentage of studies obtaining health preferences from a population-based panel increased from 14% (2004–2011) to 32% (2012–2021). None of the disability weight studies published in the past 10 years used the annual profile approach. Most studies performed panel-meetings to obtain disability weights data. Conclusions Our review reveals that a methodological uniformity between national and GBD disability weights studies increased, especially from 2010 onwards. Over years, more studies used disease-specific health state descriptions in line with those of the GBD study, panel from general populations, and data from web-based surveys and/or household surveys. There is, however, a wide variation in valuation techniques that were used to derive disability weights at national-level and that persisted over time. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00860-z.
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Affiliation(s)
- Periklis Charalampous
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Jördis Wothge
- German Environment Agency, Section Noise Abatement of Industrial Plants and Products, Noise Impact, Wörlitzer Pl. 1, 06844, Dessau-Roßlau, Germany
| | - Elena von der Lippe
- Department of Epidemiology and Health Monitorin, Robert Koch Institute, Berlin, Germany
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Van Der Wilk B, Spronk I, Noordman BJ, Eyck BM, Haagsma JA, Coene PPL, van der Harst E, Heisterkamp J, Lagarde SM, Wijnhoven BP, van Lanschot JJB. Patients’ preferences for active surveillance or standard oesophagectomy: a discrete choice experiment. European Journal of Surgical Oncology 2022. [DOI: 10.1016/j.ejso.2021.12.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Geraerds AJLM, Polinder S, Spronk I, Olde Loohuis AGM, de Groot A, Bronner MB, Haagsma JA. Sensitivity of the EQ-5D-5L for fatigue and cognitive problems and their added value in Q-fever patients. Qual Life Res 2022; 31:2083-2092. [PMID: 35091984 PMCID: PMC8799410 DOI: 10.1007/s11136-021-03069-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2021] [Indexed: 11/24/2022]
Abstract
Purpose Measuring health-related quality of life (HRQoL) with the EQ-5D-5L might lack sensitivity for disease-specific health complaints. This cross-sectional study analyzed whether fatigue and cognitive problems are captured by the EQ-5D-5L in a Q-fever patient population with persistent fatigue/cognitive problems, and whether addition of fatigue/cognition improved the explained variance for HRQoL. Methods A Dutch sample of Q-fever patients filled out the EQ-5D-5L and EQ VAS, the fatigue subscale of the Checklist Individual Strength, and a cognition dimension in the EQ-5D-5L format. The extent to which fatigue and cognition were captured by the EQ-5D-5L was determined based on distributional effects, head-to-head comparisons, Spearman rank correlation coefficients, and regression analyses. Explanatory power was determined of the EQ-5D-5L for the EQ VAS with and without a fatigue and cognition dimension. Results Out of 432 respondents, 373(86%) reported severe fatigue, 387(90%) cognitive problems. EQ-5D-5L utility and EQ VAS scores of respondents reporting severe fatigue/cognitive problems were significantly lower. Fatigue was strongly correlated with EQ-5D-5L dimensions usual activities and pain/discomfort (r = 0.602 and r = 0.510) and moderately with other EQ-5D-5L dimensions (r = 0.305–0.476). Cognition was strongly correlated with usual activities (r = 0.554) and moderately with other dimensions (r = 0.291–0.451). Adding fatigue to the EQ-5D-5L increased explanatory power for the EQ VAS with 6%. Conclusion Fatigue and cognitive problems in Q-fever patients were partially captured by the EQ-5D-5L dimensions. The addition of fatigue to the EQ-5D-5L slightly improved explained variance for the EQ VAS. This potentially also accounts for patients who experience sequelae of other infectious diseases, such as COVID-19. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-03069-9.
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Affiliation(s)
- A J L M Geraerds
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Inge Spronk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.,Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, The Netherlands
| | | | | | - Madelon B Bronner
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
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de Steenwinkel M, Haagsma JA, van Berkel ECM, Rozema L, Rood PPM, Bouwhuis MG. Patient satisfaction, needs, and preferences concerning information dispensation at the emergency department: a cross-sectional observational study. Int J Emerg Med 2022; 15:5. [PMID: 35073836 PMCID: PMC8903487 DOI: 10.1186/s12245-022-00407-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 01/06/2022] [Indexed: 11/18/2022] Open
Abstract
Background Patient satisfaction is an important indicator of emergency care quality and has been associated with information dispensation at the emergency department (ED). Optimal information dispensation could improve patient experience and expectations. Knowing what kind of information patients want to receive and the preferred way of information dispensation are essential to optimize information delivery at the ED. The purpose of this cross-sectional observational study was to evaluate patient satisfaction concerning information dispensation (including general, medical, and practical information), the need for additional information, and preferences with regard to the way of information dispensation at the ED of a teaching hospital in the Netherlands. Results Four hundred twenty-three patients (patients ≥ 18 years with Glasgow Coma Scale 15) were enrolled (response rate 79%). The median patient satisfaction score concerning the overall information dispensation at the ED was 7.5 on a rating scale 0–10. Shorter length of ED stay was associated with higher patient satisfaction in multivariate analysis (P < 0.001). The majority of respondents were satisfied regarding medical (n = 328; 78%) and general information (n = 233; 55%). Patients were less satisfied regarding practical information (n = 180; 43%). Respondents who indicated that they received general, medical and practical information were significantly more often satisfied compared to patients who did not receive this information (P < 0.001). Two thirds (n = 260; 62%) requested more general information. Half of the respondents (n = 202; 48%) requested more practical information and a third (n = 152; 36%) requested more medical information. The preferred way for receiving information was orally (n = 189; 44.7%) or by leaflets (n = 108; 25.5%). Conclusion The majority of respondents were satisfied concerning information dispensation at the ED, especially regarding medical information. Respondents requested more general and practical information and preferred to receive the information orally or by leaflets.
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Affiliation(s)
- Marank de Steenwinkel
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands.
| | - Juanita A Haagsma
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands.,Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Esther C M van Berkel
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Lotte Rozema
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Pleunie P M Rood
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Marna G Bouwhuis
- Department of Emergency Medicine, Erasmus University Medical Center Rotterdam, Room Nc-017, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
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Spronk I, Polinder S, Bonsel GJ, Janssen MF, Haagsma JA. Adding a fatigue item to the EQ-5D-5L improves its psychometric performance in the general population. J Patient Rep Outcomes 2022; 6:1. [PMID: 34982262 PMCID: PMC8727660 DOI: 10.1186/s41687-021-00406-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/15/2021] [Indexed: 12/26/2022] Open
Abstract
Background Fatigue is a common and often disturbing sequela of serious chronic health conditions. In the widely applied HRQL instrument, the EQ-5D, this aspect is not included directly, for its assumed lack of additional information. We investigated the validity of this assumption by determining the gain—if any—of an additional fatigue item to the EQ-5D-5L in a general population sample. Methods A Dutch general population sample (including diseased people) completed a web-based survey including the EQ-5D-5L and the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). The RPQ fatigue item was used to create the EQ-5D-5L + Fatigue. We head-to-head compared the psychometric performance contrasting the EQ-5D-5L and EQ-5D-5L + Fatigue: distribution (e.g. ceiling), informativity cf. Shannon's indices, convergent validity, domain dependency, and explanatory power. Results were compared between subgroups with and without ≥ 1 chronic health condition. Results The study population consisted of 3027 persons of whom 52% had a chronic health condition. The mean EQ-5D-5L utility score was 0.83 and 48% experienced some degree of fatigue. Adding the fatigue item to the EQ-5D-5L decreased the ceiling effect, increased absolute informativity (Hʹ = 6.44 vs. Hʹ = 4.90) and relative informativity (Jʹ = 0.46 vs. Jʹ = 0.42). The extra fatigue item slightly increased convergent validity (Spearman’s rank correlation coefficient = − 0.61 vs. − 0.62). Domain dependency analysis showed that all EQ-5D-5L domains are dominant over the fatigue item. Explanatory power of the EQ-5D-5L + Fatigue was higher compared to the EQ-5D-5L (R2 = 0.42 vs. 0.39). The gain is substantially larger in the subgroup with chronic health conditions. Conclusions Adding a fatigue item to the EQ-5D-5L improved all psychometric performance criteria of the enriched instrument in the general population. Effects are substantially larger in the subgroup with chronic health conditions, indicating that adding a fatigue item to the EQ-5D-5L is especially relevant in evaluating the HRQL of diseased people.
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Affiliation(s)
- Inge Spronk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. .,Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands.
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Gouke J Bonsel
- EuroQol Group Executive Office, Rotterdam, The Netherlands
| | - M F Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
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Van Praag DL, Wouters K, Van Den Eede F, Wilson L, Maas AI, Åkerlund C, Amrein K, Andelic N, Andreassen L, Anke A, Antoni A, Audibert G, Azouvi P, Azzolini ML, Bartels R, Barzó P, Beauvais R, Beer R, Bellander BM, Belli A, Benali H, Berardino M, Beretta L, Blaabjerg M, Bragge P, Brazinova A, Brinck V, Brooker J, Brorsson C, Buki A, Bullinger M, Cabeleira M, Caccioppola A, Calappi E, Calvi MR, Cameron P, Lozano GC, Carbonara M, Cavallo S, Chevallard G, Chieregato A, Citerio G, Ceyisakar I, Clusmann H, Coburn M, Coles J, Cooper JD, Correia M, Čović A, Curry N, Czeiter E, Czosnyka M, Dahyot-Fizelier C, Dark P, Dawes H, De Keyser V, Degos V, Della Corte F, Boogert HD, Depreitere B, Đilvesi Đ, Dixit A, Donoghue E, Dreier J, Dulière GL, Ercole A, Esser P, Ezer E, Fabricius M, Feigin VL, Foks K, Frisvold S, Furmanov A, Gagliardo P, Galanaud D, Gantner D, Gao G, George P, Ghuysen A, Giga L, Glocker B, Golubovic J, Gomez PA, Gratz J, Gravesteijn B, Grossi F, Gruen RL, Gupta D, Haagsma JA, Haitsma I, Helbok R, Helseth E, Horton L, Huijben J, Hutchinson PJ, Jacobs B, Jankowski S, Jarrett M, Jiang JY, Johnson F, Jones K, Karan M, Kolias AG, Kompanje E, Kondziella D, Koraropoulos E, Koskinen LO, Kovács N, Kowark A, Lagares A, Lanyon L, Laureys S, Lecky F, Ledoux D, Lefering R, Legrand V, Lejeune A, Levi L, Lightfoot R, Lingsma H, Maas AI, Castaño-León AM, Maegele M, Majdan M, Manara A, Manley G, Martino C, Maréchal H, Mattern J, McMahon C, Melegh B, Menon D, Menovsky T, Mikolic A, Misset B, Muraleedharan V, Murray L, Negru A, Nelson D, Newcombe V, Nieboer D, Nyirádi J, Olubukola O, Oresic M, Ortolano F, Palotie A, Parizel PM, Payen JF, Perera N, Perlbarg V, Persona P, Peul W, Piippo-Karjalainen A, Pirinen M, Ples H, Polinder S, Pomposo I, Posti JP, Puybasset L, Radoi A, Ragauskas A, Raj R, Rambadagalla M, Rhodes J, Richardson S, Richter S, Ripatti S, Rocka S, Roe C, Roise O, Rosand J, Rosenfeld JV, Rosenlund C, Rosenthal G, Rossaint R, Rossi S, Rueckert D, Rusnák M, Sahuquillo J, Sakowitz O, Sanchez-Porras R, Sandor J, Schäfer N, Schmidt S, Schoechl H, Schoonman G, Schou RF, Schwendenwein E, Sewalt C, Skandsen T, Smielewski P, Sorinola A, Stamatakis E, Stanworth S, Stevens R, Stewart W, Steyerberg EW, Stocchetti N, Sundström N, Synnot A, Takala R, Tamás V, Tamosuitis T, Taylor MS, Ao BT, Tenovuo O, Theadom A, Thomas M, Tibboel D, Timmers M, Tolias C, Trapani T, Tudora CM, Unterberg A, Vajkoczy P, Vallance S, Valeinis E, Vámos Z, van der Jagt M, Van der Steen G, van der Naalt J, van Dijck JT, van Essen TA, Van Hecke W, van Heugten C, Van Praag D, Vyvere TV, van Wijk RP, Vargiolu A, Vega E, Velt K, Verheyden J, Vespa PM, Vik A, Vilcinis R, Volovici V, von Steinbüchel N, Voormolen D, Vulekovic P, Wang KK, Wiegers E, Williams G, Wilson L, Winzeck S, Wolf S, Yang Z, Ylén P, Younsi A, Zeiler FA, Zelinkova V, Ziverte A, Zoerle T. Neurocognitive correlates of probable posttraumatic stress disorder following traumatic brain injury. Brain and Spine 2022; 2:100854. [PMID: 36248103 PMCID: PMC9560676 DOI: 10.1016/j.bas.2021.100854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/07/2021] [Accepted: 12/16/2021] [Indexed: 01/17/2023]
Abstract
Introduction Neurocognitive problems associated with posttraumatic stress disorder (PTSD) can interact with impairment resulting from traumatic brain injury (TBI). Research question We aimed to identify neurocognitive problems associated with probable PTSD following TBI in a civilian sample. Material and methods The study is part of the CENTER-TBI project (Collaborative European Neurotrauma Effectiveness Research) that aims to better characterize TBI. For this cross-sectional study, we included patients of all severities aged over 15, and a Glasgow Outcome Score Extended (GOSE) above 3. Participants were assessed at six months post-injury on the PTSD Checklist-5 (PCL-5), the Trail Making Test (TMT), the Rey Auditory Verbal Learning Test (RAVLT) and the Cambridge Neuropsychological Test Automated Battery (CANTAB). Primary analysis was a complete case analysis. Regression analyses were performed to investigate the association between the PCL-5 and cognition. Results Of the 1134 participants included in the complete case analysis, 13.5% screened positive for PTSD. Probable PTSD was significantly associated with higher TMT-(B-A) (OR = 1.35, 95% CI: 1.14–1.60, p < .001) and lower RAVLT-delayed recall scores (OR = 0.74, 95% CI: 0.61–0.91, p = .004) after controlling for age, sex, psychiatric history, baseline Glasgow Coma Scale and education. Discussion and conclusion Poorer performance on cognitive tests assessing task switching and, to a lesser extent, delayed verbal recall is associated with probable PTSD in civilians who have suffered TBI. Six months after traumatic brain injury 13.5% of people screen positive for PTSD. Task switching performance and verbal memory are related to probable PTSD. PTSD severity is related to processing speed and task switching performance.
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van der Vlegel M, Polinder S, Toet H, Panneman MJM, Geraerds AJLM, Haagsma JA. Anxiety, depression and post-traumatic stress symptoms among injury patients and the association with outcome after injury. Eur J Psychotraumatol 2022; 13:2023422. [PMID: 35111285 PMCID: PMC8803064 DOI: 10.1080/20008198.2021.2023422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Injury patients are at risk for mental health problems, which could result in slower recovery and affect health-related quality of life (HRQoL), health care utilization, and return to work (RTW). OBJECTIVE In this study, we determined the prevalence of symptoms indicative of probable depression, anxiety, and post-traumatic stress disorder (PTSD) and their association with HRQoL, health care utilization, and RTW in adult injury patients. METHOD Data on unintentional injuries in adult patients were retrieved from the Dutch Injury Surveillance System (DISS) and a six-month follow-up questionnaire that included the Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale-Revised (IES-R) to assess depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms, and items on HRQoL (measured with the EQ-5D-5 L and EQ visual analogue scale), health care utilization and RTW. Logistic regression analyses assessed the association between depression, anxiety, and PTSD and HRQoL, health care utilization, and RTW. RESULTS At six months post-injury, 22% (n = 665/3060) of included patients had scores indicative of probable anxiety disorder (14%), depression (16%), and/or PTSD (6%). These patients had reduced EQ-5D utility scores [β: -0.26 (95% CI: -0.28, -0.23)] and were less likely to RTW [OR: 2.12 (95% CI: 1.34, 3.37)] compared to their counterparts. Both mental and physical health care utilization were significantly higher in patients with symptoms indicative of depression, anxiety, and/or PTSD. CONCLUSIONS In injury patients, there is a high occurrence of depression, anxiety, and PTSD symptoms, which is associated with lower HRQoL, higher health care utilization, and lower RTW rates. These results underline the importance of screening and treatment of these symptoms in this population to enhance good recovery of injury patients.
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Affiliation(s)
- Marjolein van der Vlegel
- Department of Public Health, Erasmus Mc, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Suzanne Polinder
- Department of Public Health, Erasmus Mc, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Hidde Toet
- Consumer and Safety Institute, Consumer Safety Institute, Amsterdam, The Netherlands
| | - Martien J M Panneman
- Consumer and Safety Institute, Consumer Safety Institute, Amsterdam, The Netherlands
| | - A J L M Geraerds
- Department of Public Health, Erasmus Mc, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Juanita A Haagsma
- Department of Public Health, Erasmus Mc, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Wang B, Zeldovich M, Rauen K, Wu YJ, Covic A, Muller I, Haagsma JA, Polinder S, Menon D, Asendorf T, Andelic N, von Steinbuechel N. Longitudinal Analyses of the Reciprocity of Depression and Anxiety after Traumatic Brain Injury and Its Clinical Implications. J Clin Med 2021; 10:jcm10235597. [PMID: 34884299 PMCID: PMC8658198 DOI: 10.3390/jcm10235597] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/16/2022] Open
Abstract
Depression and anxiety are common following traumatic brain injury (TBI). Understanding their prevalence and interplay within the first year after TBI with differing severities may improve patients' outcomes after TBI. Individuals with a clinical diagnosis of TBI recruited for the large European collaborative longitudinal study CENTER-TBI were screened for patient-reported major depression (MD) and generalized anxiety disorder (GAD) at three, six, and twelve months post-injury (N = 1683). Data were analyzed using autoregressive cross-lagged models. Sociodemographic, premorbid and injury-related factors were examined as risk factors. 14.1-15.5% of TBI patients reported moderate to severe MD at three to twelve months after TBI, 7.9-9.5% reported GAD. Depression and anxiety after TBI presented high within-domain persistency and cross-domain concurrent associations. MD at three months post-TBI had a significant impact on GAD at six months post-TBI, while both acted bidirectionally at six to twelve months post-TBI. Being more severely disabled, having experienced major extracranial injuries, an intensive care unit stay, and being female were risk factors for more severe MD and GAD. Major trauma and the level of consciousness after TBI were additionally associated with more severe MD, whereas being younger was related to more severe GAD. Individuals after TBI should be screened and treated for MD and GAD early on, as both psychiatric disturbances are highly persistent and bi-directional in their impact. More severely disabled patients are particularly vulnerable, and thus warrant timely screening and intensive follow-up treatment.
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Affiliation(s)
- Biyao Wang
- Institute of Medical Psychology and Medical Sociology, University Medical Center Goettingen, Waldweg 37A, 37073 Goettingen, Germany; (M.Z.); (Y.-J.W.); (A.C.); (I.M.); (N.v.S.)
- Division of Psychology and Language Sciences, University College London, London WC1H 0AP, UK
- Correspondence:
| | - Marina Zeldovich
- Institute of Medical Psychology and Medical Sociology, University Medical Center Goettingen, Waldweg 37A, 37073 Goettingen, Germany; (M.Z.); (Y.-J.W.); (A.C.); (I.M.); (N.v.S.)
| | - Katrin Rauen
- Department of Geriatric Psychiatry, Psychiatric Hospital Zurich, University of Zurich, Minervastrasse 145, 8032 Zurich, Switzerland;
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Feodor-Lynen-Straße 17, 81377 Munich, Germany
| | - Yi-Jhen Wu
- Institute of Medical Psychology and Medical Sociology, University Medical Center Goettingen, Waldweg 37A, 37073 Goettingen, Germany; (M.Z.); (Y.-J.W.); (A.C.); (I.M.); (N.v.S.)
| | - Amra Covic
- Institute of Medical Psychology and Medical Sociology, University Medical Center Goettingen, Waldweg 37A, 37073 Goettingen, Germany; (M.Z.); (Y.-J.W.); (A.C.); (I.M.); (N.v.S.)
| | - Isabelle Muller
- Institute of Medical Psychology and Medical Sociology, University Medical Center Goettingen, Waldweg 37A, 37073 Goettingen, Germany; (M.Z.); (Y.-J.W.); (A.C.); (I.M.); (N.v.S.)
| | - Juanita A. Haagsma
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; (J.A.H.); (S.P.)
- Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands; (J.A.H.); (S.P.)
| | - David Menon
- Division of Anaesthesia, University of Cambridge/Addenbrooke’s Hospital, Box 157, Cambridge CB2 0QQ, UK;
| | - Thomas Asendorf
- Department of Medical Statistics, University Medical Center Goettingen, 37073 Goettingen, Germany;
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, 0424 Oslo, Norway;
- Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, Institute of Health and Society, University of Oslo, 0373 Oslo, Norway
| | - Nicole von Steinbuechel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Goettingen, Waldweg 37A, 37073 Goettingen, Germany; (M.Z.); (Y.-J.W.); (A.C.); (I.M.); (N.v.S.)
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Spronk I, Haagsma JA, Lubetkin EI, Polinder S, Janssen MF, Bonsel GJ. Health Inequality Analysis in Europe: Exploring the Potential of the EQ-5D as Outcome. Front Public Health 2021; 9:744405. [PMID: 34805069 PMCID: PMC8599146 DOI: 10.3389/fpubh.2021.744405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/01/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study explored the additive value of the multi-item EuroQol 5-Dimension 5-Level (EQ-5D-5L) as an outcome measure in health inequality analyses, relative to the single-item EuroQol visual analog scale (EQ VAS). Methods: A sample comprising the general population from Italy, the Netherlands, and United Kingdom (UK) completed the EQ-5D-5L and the EQ VAS. The level of education was selected as a proxy for socio-economic status (SES). EQ-5D-5L level sum scores (LSS) were compared against EQ VAS scores. Stratified and multivariable analyses were used to study the associations between SES and the LSS/EQ VAS relative to the presence of chronic health conditions. Results: A total of 10,172 people participated in this study. In the UK and Netherlands, the LSS was worst for respondents with a low educational level and better for respondents with middle and high educational levels. For Italy, the LSS was best for respondents with a middle educational level compared to respondents with low and high educational levels. The same patterns were observed for the EQ VAS, but differences were slightly smaller. Multivariable analyses showed generally stronger predictive relations in the UK, and with the LSS. The presence of chronic health conditions and being unable to work were independent strong predictors, canceling out the effects of education. Conclusions: In three different European countries, the EQ-5D measures show the presence of education-dependent health inequalities, which are universally explained in regression analysis by independently the presence of chronic health conditions and the inability to work. In stratified analysis, the EQ-5D-5L LSS discriminates slightly better between participants with different levels of SES compared to the EQ VAS.
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Affiliation(s)
- Inge Spronk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.,Association of Dutch Burn Centers, Maasstad Hospital, Rotterdam, Netherlands
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Erica I Lubetkin
- Department of Community Health and Social Medicine, The City University of New York School of Medicine, New York, NY, United States
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - M F Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, Netherlands
| | - G J Bonsel
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.,EuroQol Research Foundation, Rotterdam, Netherlands
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van der Wilk BJ, Spronk I, Noordman BJ, Eyck BM, Haagsma JA, Coene PPLO, van der Harst E, Heisterkamp J, Lagarde SM, Wijnhoven BPL, van Lanschot JJB. Preferences for active surveillance or standard oesophagectomy: discrete-choice experiment. Br J Surg 2021; 109:169-171. [PMID: 34750625 DOI: 10.1093/bjs/znab358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/01/2021] [Indexed: 11/14/2022]
Abstract
Over one-quarter of patients would choose not to undergo standard oesophagectomy again, at least 1 year after they underwent neoadjuvant chemoradiotherapy and standard oesophagectomy. These patients had worse short- and long-term health-related quality of life (HRQoL) than patients who chose standard oesophagectomy. Considering both treatments, 5-year survival and long-term HRQoL were considered most important factors by individual patients.
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Affiliation(s)
- Berend J van der Wilk
- Department of Surgery, Division of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Inge Spronk
- Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Bo J Noordman
- Department of Surgery, Division of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Ben M Eyck
- Department of Surgery, Division of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | | | | | - Joos Heisterkamp
- Department of Surgery, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands
| | - Sjoerd M Lagarde
- Department of Surgery, Division of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Bas P L Wijnhoven
- Department of Surgery, Division of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - J Jan B van Lanschot
- Department of Surgery, Division of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
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Ward JL, Azzopardi PS, Francis KL, Santelli JS, Skirbekk V, Sawyer SM, Kassebaum NJ, Mokdad AH, Hay SI, Abd-Allah F, Abdoli A, Abdollahi M, Abedi A, Abolhassani H, Abreu LG, Abrigo MRM, Abu-Gharbieh E, Abushouk AI, Adebayo OM, Adekanmbi V, Adham D, Advani SM, Afshari K, Agrawal A, Ahmad T, Ahmadi K, Ahmed AE, Aji B, Akombi-Inyang B, Alahdab F, Al-Aly Z, Alam K, Alanezi FM, Alanzi TM, Alcalde-Rabanal JE, Alemu BW, Al-Hajj S, Alhassan RK, Ali S, Alicandro G, Alijanzadeh M, Aljunid SM, Almasi-Hashiani A, Almasri NA, Al-Mekhlafi HM, Alonso J, Al-Raddadi RM, Altirkawi KA, Alvis-Guzman N, Amare AT, Amini S, Aminorroaya A, Amit AML, Amugsi DA, Ancuceanu R, Anderlini D, Andrei CL, Androudi S, Ansari F, Ansari I, Antonio CAT, Anvari D, Anwer R, Appiah SCY, Arabloo J, Arab-Zozani M, Ärnlöv J, Asaad M, Asadi-Aliabadi M, Asadi-Pooya AA, Atout MMW, Ausloos M, Avenyo EK, Avila-Burgos L, Ayala Quintanilla BP, Ayano G, Aynalem YA, Azari S, Azene ZN, Bakhshaei MH, Bakkannavar SM, Banach M, Banik PC, Barboza MA, Barker-Collo SL, Bärnighausen TW, Basu S, Baune BT, Bayati M, Bedi N, Beghi E, Bekuma TT, Bell AW, Bell ML, Benjet C, Bensenor IM, Berhe AK, Berhe K, Berman AE, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bhattarai S, Bhutta ZA, Bijani A, Bikbov B, Biondi A, Birhanu TTM, Biswas RK, Bohlouli S, Bolla SR, Boloor A, Borschmann R, Boufous S, Bragazzi NL, Braithwaite D, Breitborde NJK, Brenner H, Britton GB, Burns RA, Burugina Nagaraja S, Butt ZA, Caetano dos Santos FL, Cámera LA, Campos-Nonato IR, Campuzano Rincon JC, Cárdenas R, Carreras G, Carrero JJ, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catalá-López F, Cerin E, Chandan JS, Chang HY, Chang JC, Charan J, Chattu VK, Chaturvedi S, Choi JYJ, Chowdhury MAK, Christopher DJ, Chu DT, Chung MT, Chung SC, Cicuttini FM, Constantin TV, Costa VM, Dahlawi SMA, Dai H, Dai X, Damiani G, Dandona L, Dandona R, Daneshpajouhnejad P, Darwesh AM, Dávila-Cervantes CA, Davletov K, De la Hoz FP, De Leo D, Dervenis N, Desai R, Desalew A, Deuba K, Dharmaratne SD, Dhungana GP, Dianatinasab M, Dias da Silva D, Diaz D, Didarloo A, Djalalinia S, Dorostkar F, Doshi CP, Doshmangir L, Doyle KE, Duraes AR, Ebrahimi Kalan M, Ebtehaj S, Edvardsson D, El Tantawi M, Elgendy IY, El-Jaafary SI, Elsharkawy A, Eshrati B, Eskandarieh S, Esmaeilnejad S, Esmaeilzadeh F, Esteghamati S, Faro A, Farzadfar F, Fattahi N, Feigin VL, Ferede TY, Fereshtehnejad SM, Fernandes E, Ferrara P, Filip I, Fischer F, Fisher JL, Foigt NA, Folayan MO, Fomenkov AA, Foroutan M, Fukumoto T, Gad MM, Gaidhane AM, Gallus S, Gebre T, Gebremedhin KB, Gebremeskel GG, Gebremeskel L, Gebreslassie AA, Gesesew HA, Ghadiri K, Ghafourifard M, Ghamari F, Ghashghaee A, Gilani SA, Gnedovskaya EV, Godinho MA, Golechha M, Goli S, Gona PN, Gopalani SV, Gorini G, Grivna M, Gubari MIM, Gugnani HC, Guimarães RA, Guo Y, Gupta R, Haagsma JA, Hafezi-Nejad N, Haile TG, Haj-Mirzaian A, Haj-Mirzaian A, Hall BJ, Hamadeh RR, Hamagharib Abdullah K, Hamidi S, Handiso DW, Hanif A, Hankey GJ, Haririan H, Haro JM, Hasaballah AI, Hashi A, Hassan A, Hassanipour S, Hassankhani H, Hayat K, Heidari-Soureshjani R, Herteliu C, Heydarpour F, Ho HC, Hole MK, Holla R, Hoogar P, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsairi M, Huda TM, Humayun A, Hussain R, Hwang BF, Iavicoli I, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Intarut N, Iqbal U, Irvani SSN, Islam MM, Islam SMS, Iso H, Ivers RQ, Jahani MA, Jakovljevic M, Jalali A, Janodia MD, Javaheri T, Jeemon P, Jenabi E, Jha RP, Jha V, Ji JS, Jonas JB, Jones KM, Joukar F, Jozwiak JJ, Juliusson PB, Jürisson M, Kabir A, Kabir Z, Kalankesh LR, Kalhor R, Kamyari N, Kanchan T, Karch A, Karimi SE, Kaur S, Kayode GA, Keiyoro PN, Khalid N, Khammarnia M, Khan M, Khan MN, Khatab K, Khater MM, Khatib MN, Khayamzadeh M, Khazaie H, Khoja AT, Kieling C, Kim YE, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Kivimäki M, Koolivand A, Kosen S, Koyanagi A, Krishan K, Kugbey N, Kumar GA, Kumar M, Kumar N, Kurmi OP, Kusuma D, La Vecchia C, Lacey B, Lal DK, Lalloo R, Lan Q, Landires I, Lansingh VC, Larsson AO, Lasrado S, Lassi ZS, Lauriola P, Lee PH, Lee SWH, Leigh J, Leonardi M, Leung J, Levi M, Lewycka S, Li B, Li MC, Li S, Lim LL, Lim SS, Liu X, Lorkowski S, Lotufo PA, Lunevicius R, Maddison R, Mahasha PW, Mahdavi MM, Mahmoudi M, Majeed A, Maleki A, Malekzadeh R, Malta DC, Mamun AA, Mansouri B, Mansournia MA, Martinez G, Martinez-Raga J, Martins-Melo FR, Mason-Jones AJ, Masoumi SZ, Mathur MR, Maulik PK, McGrath JJ, Mehndiratta MM, Mehri F, Memiah PTN, Mendoza W, Menezes RG, Mengesha EW, Meretoja A, Meretoja TJ, Mestrovic T, Miazgowski B, Miazgowski T, Michalek IM, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Mirzaei H, Mirzaei M, Moazen B, Mohammad DK, Mohammadi S, Mohammadian-Hafshejani A, Mohammadifard N, Mohammadpourhodki R, Mohammed S, Monasta L, Moradi G, Moradi-Lakeh M, Moradzadeh R, Moraga P, Morrison SD, Mosapour A, Mousavi Khaneghah A, Mueller UO, Muriithi MK, Murray CJL, Muthupandian S, Naderi M, Nagarajan AJ, Naghavi M, Naimzada MD, Nangia V, Nayak VC, Nazari J, Ndejjo R, Negoi I, Negoi RI, Netsere HB, Nguefack-Tsague G, Nguyen DN, Nguyen HLT, Nie J, Ningrum DNA, Nnaji CA, Nomura S, Noubiap JJ, Nowak C, Nuñez-Samudio V, Ogbo FA, Oghenetega OB, Oh IH, Oladnabi M, Olagunju AT, Olusanya BO, Olusanya JO, Omar Bali A, Omer MO, Onwujekwe OE, Ortiz A, Otoiu A, Otstavnov N, Otstavnov SS, Øverland S, Owolabi MO, P A M, Padubidri JR, Pakshir K, Palladino R, Pana A, Panda-Jonas S, Pandey A, Panelo CIA, Park EK, Patten SB, Peden AE, Pepito VCF, Peprah EK, Pereira J, Pesudovs K, Pham HQ, Phillips MR, Piradov MA, Pirsaheb M, Postma MJ, Pottoo FH, Pourjafar H, Pourshams A, Prada SI, Pupillo E, Quazi Syed Z, Rabiee MH, Rabiee N, Radfar A, Rafiee A, Raggi A, Rahim F, Rahimi-Movaghar V, Rahman MHU, Rahman MA, Ramezanzadeh K, Ranabhat CL, Rao SJ, Rashedi V, Rastogi P, Rathi P, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Renzaho AMN, Rezaei N, Rezaei N, Rezai MS, Riahi SM, Rickard J, Roever L, Ronfani L, Roth GA, Rubagotti E, Rumisha SF, Rwegerera GM, Sabour S, Sachdev PS, Saddik B, Sadeghi E, Saeedi Moghaddam S, Sagar R, Sahebkar A, Sahraian MA, Sajadi SM, Salem MR, Salimzadeh H, Samy AM, Sanabria J, Santric-Milicevic MM, Saraswathy SYI, Sarrafzadegan N, Sarveazad A, Sathish T, Sattin D, Saxena D, Saxena S, Schiavolin S, Schwebel DC, Schwendicke F, Senthilkumaran S, Sepanlou SG, Sha F, Shafaat O, Shahabi S, Shaheen AA, Shaikh MA, Shakiba S, Shamsi M, Shannawaz M, Sharafi K, Sheikh A, Sheikhbahaei S, Shetty BSK, Shi P, Shigematsu M, Shin JI, Shiri R, Shuval K, Siabani S, Sigfusdottir ID, Sigurvinsdottir R, Silva DAS, Silva JP, Simonetti B, Singh JA, Singh V, Sinke AH, Skryabin VY, Slater H, Smith EUR, Sobhiyeh MR, Sobngwi E, Soheili A, Somefun OD, Sorrie MB, Soyiri IN, Sreeramareddy CT, Stein DJ, Stokes MA, Sudaryanto A, Sultan I, Tabarés-Seisdedos R, Tabuchi T, Tadakamadla SK, Taherkhani A, Tamiru AT, Tareque MI, Thankappan KR, Thapar R, Thomas N, Titova MV, Tonelli M, Tovani-Palone MR, Tran BX, Travillian RS, Tsai AC, Tsatsakis A, Tudor Car L, Uddin R, Unim B, Unnikrishnan B, Upadhyay E, Vacante M, Valadan Tahbaz S, Valdez PR, Varughese S, Vasankari TJ, Venketasubramanian N, Villeneuve PJ, Violante FS, Vlassov V, Vos T, Vu GT, Waheed Y, Wamai RG, Wang Y, Wang Y, Wang YP, Westerman R, Wickramasinghe ND, Wu AM, Wu C, Yahyazadeh Jabbari SH, Yamagishi K, Yano Y, Yaya S, Yazdi-Feyzabadi V, Yeshitila YG, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Yousefinezhadi T, Yu C, Yu Y, Yuce D, Zaidi SS, Zaman SB, Zamani M, Zamanian M, Zarafshan H, Zarei A, Zastrozhin MS, Zhang Y, Zhang ZJ, Zhao XJG, Zhu C, Patton GC, Viner RM. Global, regional, and national mortality among young people aged 10-24 years, 1950-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2021; 398:1593-1618. [PMID: 34755628 PMCID: PMC8576274 DOI: 10.1016/s0140-6736(21)01546-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/07/2021] [Accepted: 06/30/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10-24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS We report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10-24 years by age group (10-14 years, 15-19 years, and 20-24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10-24 years with that in children aged 0-9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10-24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017). FINDINGS In 2019 there were 1·49 million deaths (95% uncertainty interval 1·39-1·59) worldwide in people aged 10-24 years, of which 61% occurred in males. 32·7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32·1% were due to communicable, nutritional, or maternal causes; 27·0% were due to non-communicable diseases; and 8·2% were due to self-harm. Since 1950, deaths in this age group decreased by 30·0% in females and 15·3% in males, and sex-based differences in mortality rate have widened in most regions of the world. Geographical variation has also increased, particularly in people aged 10-14 years. Since 1980, communicable and maternal causes of death have decreased sharply as a proportion of total deaths in most GBD super-regions, but remain some of the most common causes in sub-Saharan Africa and south Asia, where more than half of all adolescent deaths occur. Annual percentage decrease in all-cause mortality rate since 1990 in adolescents aged 15-19 years was 1·3% in males and 1·6% in females, almost half that of males aged 1-4 years (2·4%), and around a third less than in females aged 1-4 years (2·5%). The proportion of global deaths in people aged 0-24 years that occurred in people aged 10-24 years more than doubled between 1950 and 2019, from 9·5% to 21·6%. INTERPRETATION Variation in adolescent mortality between countries and by sex is widening, driven by poor progress in reducing deaths in males and older adolescents. Improving global adolescent mortality will require action to address the specific vulnerabilities of this age group, which are being overlooked. Furthermore, indirect effects of the COVID-19 pandemic are likely to jeopardise efforts to improve health outcomes including mortality in young people aged 10-24 years. There is an urgent need to respond to the changing global burden of adolescent mortality, address inequities where they occur, and improve the availability and quality of primary mortality data in this age group. FUNDING Bill & Melinda Gates Foundation.
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Santos JV, Gorasso V, Souza J, Wyper GMA, Grant I, Pinheiro V, Viana J, Ricciardi W, Haagsma JA, Devleesschauwer B, Plass D, Freitas A. Risk factors and their contribution to population health in the European Union (EU-28) countries in 2007 and 2017. Eur J Public Health 2021; 31:958-967. [PMID: 34468766 DOI: 10.1093/eurpub/ckab145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Global Burden of Disease (GBD) study has generated a wealth of data on death and disability outcomes in Europe. It is important to identify the disease burden that is attributable to risk factors and, therefore, amenable to interventions. This paper reports the burden attributable to risk factors, in deaths and disability-adjusted life years (DALYs), in the 28 European Union (EU) countries, comparing exposure to risks between them, from 2007 to 2017. METHODS Retrospective descriptive study, using secondary data from the GBD 2017 Results Tool. For the EU-28 and each country, attributable (all-cause) age-standardized death and DALY rates, and summary exposure values are reported. RESULTS In 2017, behavioural and metabolic risk factors showed a higher attributable burden compared with environmental risks, with tobacco, dietary risks and high systolic blood pressure standing out. While tobacco and air quality improved significantly between 2007 and 2017 in both exposure and attributable burden, others such as childhood maltreatment, drug use or alcohol use did not. Despite significant heterogeneity between EU countries, the EU-28 burden attributable to risk factors decreased in this period. CONCLUSION Accompanying the improvement of population health in the EU-28, a comparable trend is visible for attributable burden due to risk factors. Besides opportunities for mutual learning across countries with different disease/risk factors patterns, good practices (i.e. tobacco control in Sweden, air pollution mitigation in Finland) might be followed. On the opposite side, some concerning cases must be highlighted (i.e. tobacco in Bulgaria, Latvia and Estonia or drug use in Czech Republic).
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Affiliation(s)
- João Vasco Santos
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal.,Public Health Unit, ACES Grande Porto VIII, ARS Norte, Espinho/Gaia, Portugal
| | - Vanessa Gorasso
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Júlio Souza
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | | | | | - Vera Pinheiro
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal.,Public Health Unit, ULS Baixo Alentejo, ARS Alentejo, Beja, Portugal
| | - João Viana
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | - Walter Ricciardi
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli' IRCCS, Rome, Italy
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.,Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
| | - Dietrich Plass
- German Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Berlin, Germany
| | - Alberto Freitas
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
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