ObjectivesTo estimate the latest burden of disability adjusted life years (DALYs) for liver cancer in China and the long-term trend, and to make future prediction.MethodsBased on the visualization platform of Global Burden of Disease 2016, data on the DALYs for liver cancer in China was extracted. The very recent status in 2016 and the previous trend from 1990 to 2016 were described, using annualized rate of change (ARC). The burden from 2017 to 2050 was further predicted by combining the ARC and the Chinese population data projected by the United Nation.ResultsIn 2016, the total DALYs for liver cancer in China was estimated as 11 539 000 person years (accounting for 54.6% of the global burden), and years of life lost (YLLs) and years lived with disability (YLDs) contributed 98.9% and 1.1%, respectively. The age-standardized DALY rate was 844.1 per 100 000 (3.0 times of the global average) and the male-to-female ratio was 3.4. The DALY rate continuously increased from 1990–2016 (ARC=0.57%), particularly in recent 5 years (ARC=1.75%). Among the DALYs for all cancers, liver cancer contributed approximately 20% and constantly remained as the top 2 (ranking as the number one before year 2005). There were inverse trends in gender, with increasing in males and decreasing in females (ARC was 0.77% and –0.11%, respectively). Hepatitis B infection continually kept the leading cause of DALYs for liver cancer (accounting for nearly 57%), and the DALY rate was gradually increasing (ARC=0.43%). Although the peak age of DALY rate was stable at 65to 69 years, the peak age of the DALYs changed from 55 to 59 years in 1990 to 60 ~ 64 years in 2016. In 2050, the estimated DALYs for liver cancer in China will reach 14.37 million person years, 20.0% more than that in 2017.ConclusionsThe DALYs caused by liver cancer in China exceeds the overall burden of all other countries in the world, and accounts for 1/5 of DALYs for all cancers in local population. The burden in males has been continuously rising, and the leading cause remained unchanged as hepatitis B infection. With population aging, the DALYs for liver cancer in China will be incessant to increase, suggesting the necessity to implement continuous effort in risk factors prevention (e.g. hepatitis B infection), and efficient management in high risk population of liver cancer.
ObjectiveTo analyze the epidemiological burden and trend of skin malignant melanoma in China based on the data from the global burden of disease 2019 (GBD 2019). MethodsThe data about quantity of incidences/illnesses/deaths, age-standardized incidence/prevalence rates/mortality, disability-adjusted life years (DALYs), and DALY rate of skin malignant melanoma in China from 1990 to 2019 were obtained from the GBD 2019 databases. The epidemiological trends, age-period-cohort trends, and the relationship between the incidence and sociodemographic index (SDI) were analyzed.ResultsIn 2019, both prevalence and incidence of skin malignant melanoma in China were at low levels in the world, the age-standardized mortality ranked the 35th in the 204 countries GBD researched, the number of prevalent cases and incident cases increased compared with 1990 (12.65% and 3.57%, respectively), the prevalence and incidence rates showed growth trends, while the DALY rate and mortality decreased slowly. The prevalence of skin malignant melanoma peaked age at 50 to 54 years old. The incidence peak age of males was older than that of females (55-59 years old for males vs. 50-54 years old for females), while the mortality peak age of males was younger than that of females (55-59 years old for males vs. 75-79 years old for females). With the increasing of SDI value, the incidence of skin malignant melanoma showed a linear growth trend. DALY rate was negatively correlated with SDI (P<0.05). ConclusionFrom 1990 to 2019, age-standardized incidence and prevalence of skin malignant melanoma in China are increasing, while DALY rate and mortality are decreasing, and these are correlated with social and medical development.
Objective To explore the evaluation value of burden of amplitudes and epileptiform discharges score (BASED) in the efficacy of adrenocorticotropic hormone (ACTH) combined with magnesium sulfate therapy for infantile epileptic spasms syndrome (IESS). Methods Retrospective collection the clinical and EEG data of 124 patients admitted to the Dongguan Maternal and Child Health Care Hospital from 2015 to 2023, who were diagnosed with IESS and treated with ACTH combined with magnesium sulfate. According to whether there were epileptic seizures 14 days after ACTH treatment, the patients were divided into two groups: non seizure group (n=74 cases) and seizure group (n=50 cases). The BASED system was used to evaluate the relationship between changes in EEG before and after ACTH treatment and clinical efficacy in both groups. The analysis of electroencephalogram included: ① abnormally high amplitude background waves, ② >3 spike foci , ③ grouped multifocal spikes, ④ paroxysmal voltage attenuation. ResultThe control rate of ACTH combined with magnesium sulfate in the treatment of IESS was 59.7% (74/124), and there was no statistically significant difference in the control rate among children with different etiologies (P=0.09). The BASED score suggests that the overall response rate of electroencephalogram (EEG) in infants with epileptic spasm syndrome after treatment was 57.2%. The EEG remission rate in the seizure control group was 81% (60/74), while in the uncontrolled group was 22% (11/50). The EEG remission rate in the seizure control group was significantly higher than that in the uncontrolled group after treatment (P<0.001), and the EEG score was closely related to clinical efficacy (Spearman correlation coefficient rp=0.601, P<0.001). ConclusionThe BASED score is related to clinical efficacy, and it can provide a quantitative basis for evaluating the efficacy of ACTH combined with magnesium sulfate in the treatment of IESS.
ObjectiveTo analyze the burden of digestive diseases attributed to smoking in China from 1990 to 2019 and forecast its change in the next 10 years. MethodsThe Global Burden of Disease database 2019 was used to analyze the burden of digestive diseases attributed to smoking in China from 1990 to 2019. Joinpoint regression model was used to analyze the time variation trend. A time series model was used to predict the burden of digestive diseases attributable to smoking over the next 10 years. ResultsIn 2019, there were 12 900 deaths from digestive diseases attributed to smoking in China, with a DALY of 398 600 years, a crude death rate of 0.91/100 000 and a crude DALY rate of 28.02/100 000. The attributed standardized mortality rate was 0.69 per 100 000, and the standardized DALY rate was 19.79 per 100 000, which was higher than the global level. In 2019, the standardized mortality rate and DALY rate of males were higher than those of females (1.48/ 100 000 vs. 0.11/ 100 000, 38.42/ 100 000 vs. 293/100 000), and the standardized rates of males and females showed a downward trend over time. In 2019, both mortality and DALY rates from digestive diseases attributed to smoking increased with age. ARIMA predicts that over the next 10 years, the burden of disease in the digestive system caused by smoking will decrease significantly. ConclusionFrom 1990 to 2019, the burden of digestive diseases attributed to smoking showed a decreasing trend in China, and the problem of disease burden is more serious in men and the elderly population. A series of effective measures should be taken to reduce the smoking rate in key groups. The burden of digestive diseases caused by smoking will be significantly reduced in the next 10 years.
ObjectiveTo explore the efficacy of community-acquired pneumonia (CAP) by tracheoscopy intervention altimeter and analyze and compare its financial burden.MethodsRetrospective analysis of 419 hospitalized patients with CAP was carried in respiratory medicine department of four hospitals from July 1, 2017 to August 31, 2018 (Changhai Hospital, Shanghai First People’s Hospital, Baoshan Branch of Shanghai First People’s Hospital, and Baoshan Integrated Traditional Chinese and Western Medicine Hospital). According to the time of tracheoscopy intervention treatment, they were divided into 3 groups: 127 patients treated with tracheoscopy intervention during the initial treatment period (within 72 h after obtaining imaging diagnosis) were included in an early intervention group, 158 patients treated with tracheoscopy intervention 72 h after obtaining imaging diagnosis were included in a medium-term intervention group, and 134 patients treated without tracheoscopy intervention were included in a non-intervention group. The total efficiency of treatment, improvement of clinical symptoms, imaging absorption, serum inflammation index level, sputum culture positive rate, change rate, efficiency after drug change, hospital stay and hospitalization cost were compared among three groups.ResultsThe total efficiency of treatment in the early intervention group was higher than that of the medium-term intervention group and the non-intervention group, with statistically significant difference (P<0.05), and the time of normality of body temperature, the time of disappearance of strong sputum and cough in the early intervention group, the absorption time of chest X-rays were shorter than that of the medium-term intervention group and the non-intervention group, and the difference was statistically significant (P<0.05); peripheral blood hemoglobin, serum calcitonin and hypersensitive C reactive protein levels were lower than those in the medium-term intervention group and the non-intervention group, with statistically significant differences (P<0.05), and the sputum-positive and drug-change rates in the early intervention group and the medium-term intervention group were higher than those in the non-intervention group, and the difference was statistically significant (P<0.05); the duration of hospital stay in the early intervention group was shorter than that of the medium-term intervention group and the non-intervention group, and the cost of hospitalization was less than that of the medium-term intervention group and the non-intervention group, and the difference was statistically significant (P<0.05).ConclusionTracheoscopy intervention treatment in the initial period of CAP not only significantly improves the efficacy, but also significantly reduces treatment costs and length of hospitalization, hence it is worth clinical promotion.
The application scenarios and conditions of the burden of disease were sorted out, and the survey databases related to disease surveillance at home and abroad and the GBD research of IHME were introduced. Through the collection of literature, five cases of the burden of disease application of health big data were summarized, and their construction modes were described in detail based on different types of databases. We pointed out the problems and challenges faced by the application of health data, and put forward some ideas and prospects for future research on the application of the burden of disease of health big data.
ObjectivesTo systematically review approaches to derive disability weights (DWs) based on EQ-5D instrument.MethodsPubMed, EMbase, Web of Science, CNKI and WanFang Data databases were electronically searched to collect studies on the approaches to derive disability weights based on EQ-5D from inception to June 1st, 2019. Two reviewers independently screened literature, extracted the basic information and evaluated risk of bias of included studies. Then, systematic review on approaches to derive DWs based on EQ-5D instrument was performed.ResultsA total of 18 studies were included, which were published between 2003 and 2018. The included studies involved a variety of diseases, mostly focusing on quality of life and the burden of disease. The approaches to derive DWs based on EQ-5D health instrument were as follows: DWs=health utility scoreNormal or Control−health utility scoreDisease (7 studies), DWs=1−VAS score/100 (6 studies), DWs=1−health utility scoreDisease (3 studies), linear regression model (1 study), and mapping (1 study).ConclusionsAmong all the included studies using EQ-5D-based disability weight measurement methods involves a variety of diseases, with relatively low comparability. More methodological studies are from abroad. Among all the applied approaches, DWs equally to health utility scoreNormal or Control minus health utility scoreDisease is the most commonly used.
Clarifying the burden of disease is of great significance for determining the focus of healthcare and optimizing the allocation of medical resources. However, differences in research methods and assumptions often affect the comparability of different research results, thus leading to difficulties in healthcare decision-making. Disability-adjusted life year (DALY) is the most commonly used indicator to measure the burden of disease, but the reporting quality of disease burden studies using the DALY metric is uneven. To standardize the reporting of such studies, international scholars developed and recently published the STROBOD statement in Population Health Metrics. Its checklist includes seven parts: title, abstract, introduction, methods, results, discussion, and open science, involving a total of 28 items. To assist domestic scholars in better understanding and applying this reporting standard, this article interprets each item with published examples, aiming to improve the overall quality of disease burden research and provide high-quality evidence for public health decision-making.
Objective To systematically review the incidence, mortality and disease burden of stroke in China. Methods The CNKI, WanFang Data, VIP, CBM, PubMed, Embase, Web of Science and Cochrane Library databases were electronically searched to collect cohort studies on stroke epidemiology and disease burden from inception to June 30, 2024. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 18.0 software. Results A total of 49 studies were included, and the results showed that the overall incidence of stroke in China was 430/100 000 (95%CI 370/100 000 to 490/100 000); The incidence of stroke in men was 510/100 000 (95%CI 450/100 000 to 580/100 000); The incidence of stroke in women was 370/100 000 (95%CI 320/100 000 to 410/100 000). The overall mortality rate of stroke in China was 220/100 000 (95%CI 160/100 000 to 280/100 000); Stroke mortality in men was 160/100 000 (95%CI 120/100 000 to 190/100 000); Stroke mortality in women was 130/100 000 (95%CI 100/100 000 to 160/100 000). The average standard DALY rate of stroke in China was 2 238.09/100 000, and men (3 510.53/100 000) was higher than that of women (2 083.39/100 000). Conclusion The risk of stroke in men in China is significantly higher than that in women, which is mainly attributed to the higher rate of smoking and drinking alcohol, poor eating habits and the neglect of health management. Moreover, interregional differences in aging, especially the higher aging levels in the eastern and northern regions, also have a significant impact on stroke incidence in these regions.
ObjectiveTo investigate the epidemiological and economic burden of acute meningitis and encephalitis syndrome (AMES) in Jinan, so as to provide references for prevention and control of AMES. MethodsThe monitoring data of the AMES Special Reporting System of Jinan City from 2007 to 2014 was collected and the epidemiological characteristics of AMES were analyzed. A questionnaire survey was performed in AMES patients reported in 2013 to collect the basic information, prognosis, medical and non-medical expenses etc. of patients. The DALYs and economic burden of AMES were estimated by using SPSS 13.0 software. ResultsThe average incidence rate of AMES in Jinan was 8.49/100 000 through 2007 to 2014 and the mortality was 4.96‰. The total DALYs were 36 659.51 and the average DALY was 8.27.77.86% were aged less than 14 years old. The average direct economic burden of each case was 19.5 thousand RMB and the average indirect economic burden caused by DALYs was 69.1 thousand RMB. ConclusionThere's heavy burden from AMES, and measures should be made to reduce the incidence and economic burden.