Summary
Burden of disease analysis is a standard method for collating data of acceptable quality on causes of health loss, to produce comparable and concise policy-relevant evidence. Being able to use data from various sources to develop an internally consistent measure for all diseases is a key strength of a burden of disease study. However, methods used in burden of disease studies have become more complex over time, and the number of diseases and risk factors specifically analysed has increased. This increased complexity makes it much harder to explain the methods, and can result in decreased clarity for stakeholders.
One of the central principles for the Australian Burden of Disease Study (ABDS) 2011 is transparency of data, assumptions and methods. This report describes, as far as practicable, the methods and assumptions used by the ABDS 2011 to quantify the fatal and non-fatal effects and causes of diseases and injuries in the Australian and Aboriginal and Torres Strait Islander populations in 2011 and 2003. It is a companion publication to Impact and causes of illness and death in Australia 2011 (AIHW 2016b) and Impact and causes of illness and death in Aboriginal and Torres Strait Islander people 2011 (AIHW 2016c).
The report is divided into 3 main sections.
The first presents the general methods used to estimate disease burden, followed by disease-specific methods. The second presents the general methods used to estimate the burden attributable to various risk factors, followed by more specific methods for each risk factor. The third presents methods used to account for quality and accuracy. Where they differ from the national methods, methods used to estimate the burden in the Aboriginal and Torres Strait Islander population, subgroups (state/territory, remoteness and socioeconomic group) and in 2003 are explained as necessary within each section.
To make the report easier to read, large tables and additional information are presented in appendixes A to F.
Preliminary materials: Acknowledgments; Abbreviations; Symbols
1 Introduction
- Key considerations
- Expert advice and review
Section I: Estimating the disease burden
2 Overarching methods and choices
- No age weighting or discounting
- Reference years 2011 and 2003
- Reference populations
- Age groups
- Selection and classification of diseases
- Selection and assessment of data sources
- Methodological choices specific to Indigenous estimates
- Methodological choices specific to subnational estimates
- Methodological choices specific to 2003 estimates
3 Estimating the fatal burden
- Overview of methods
- Mortality data
- Reference life table
- Subnational estimates
4 Estimating the non-fatal burden
- Overview of methods
- Conceptual disease models
- Disability weights
- Estimating point prevalence of each sequela
- Dealing with comorbidity
- Estimating YLD for residual diseases
5 Disease specific methods
- Blood and metabolic disorders
- Cancer and other neoplasms
- Cardiovascular diseases
- Endocrine disorders
- Gastrointestinal disorders
- Hearing and vision disorders
- Infant and congenital conditions
- Infectious diseases
- Injuries
- Kidney and urinary conditions
- Mental and substance use disorders
- Musculoskeletal conditions
- Neurological conditions
- Oral disorders
- Reproductive and maternal conditions
- Respiratory diseases
- Skin disorders
Section II: Estimating the burden due to key risk factors
6 Overarching methods and choices for risk factors
- Selection of risk factors
- Selection of risk-outcome pairs
- Population distribution of exposure
- Estimates of effect size (relative risks)
- Theoretical minimum risk exposure distribution
- Calculation of population attributable fractions
- Calculating the attributable burden
- 2003 estimates
- Indigenous estimates
7 Individual risk factor methods
- Tobacco use
- Alcohol use
- Physical inactivity
- Drug use
- Intimate partner violence
- Unsafe sex
- Childhood sexual abuse
- High body mass
- High blood pressure
- High blood plasma glucose
- High cholesterol
- Iron deficiency
- Low bone mineral density
- Occupational exposures and hazards
- Sun exposure
- Air pollution
- Unimproved sanitation
- Dietary risk factors
Section III: Accounting for quality and accuracy
8 ABDS quality framework
- Ensuring quality of inputs to the ABDS 2011
- Measuring the quality of outputs from ABDS 2011
- ABDS 2011 quality index
Appendixes
Appendix A: Additional information and tables for Chapter 2
Appendix B: Additional information and tables for Chapter 3
Appendix C: Additional information and tables for Chapter 4
Appendix D: Additional information and tables for Chapter 5
Appendix E: Additional information and tables for Chapter 6
Appendix F: Additional information and tables for Chapter 8
Appendix G: List of contributors
End matter: Glossary; References; List of tables; List of figures; Related publications