Value of a national burden-of-disease study: a comparison of estimates between the Australian Burden of Disease Study 2015 and the Global Burden of Disease Study 2017.

BACKGROUND: Estimates of burden of disease are important for monitoring population health, informing policy and service planning. Burden estimates for the same population can be reported differently by national studies [e.g. the Australian Burden of Disease Study (ABDS) and the Global Burden of Disease Study (GBDS)]. METHODS: Australian ABDS 2015 and GBDS 2017 burden estimates and methods for 2015 were compared. Years of life lost (YLL), years lived with disability (YLD) and disability-adjusted life years (DALY) measures were compared for overall burden and 'top 50' causes. Disease-category definitions (based on ICD-10), redistribution algorithms, data sources, disability weights, modelling methods and assumptions were reviewed. RESULTS: GBDS 2017 estimated higher totals than ABDS 2015 for YLL, YLD and DALY for Australia. YLL differences were mainly driven by differences in the allocation of deaths to disease categories and the redistribution of implausible causes of death. For YLD, the main drivers were data sources, severity distributions and modelling strategies. Most top-50 diseases for DALY had a similar YLL:YLD composition reported. CONCLUSIONS: Differences in the ABDS and GBDS estimates reflect the different purposes of local and international studies and differences in data and modelling strategies. The GBDS uses all available evidence and is useful for international comparisons. National studies such as the ABDS have the flexibility to meet local needs and often the advantage of access to unpublished data. It is important that all data sources, inputs and models be assessed for quality and appropriateness. As studies evolve, differences should be accounted for through increased transparency of data and methods.

The ICF as a framework for national data: the introduction of ICF into Australian data dictionaries.

PURPOSE: A country's data may influence and inform its policy and services, if suitably designed. This paper describes how two related and interacting activities--work on disability concepts and classification as well as the preparation of national data dictionaries--have been carried out in Australia, with this purpose. METHOD: Three key ingredients were combined. A broadly based advisory group was established to ensure the use of disability concepts that are meaningful not only to policy makers but also to the Australian community. This group advised on two 'twin' activities: participation in the revision of the key international classification for disability, and specification of data elements for a national data dictionary according to international standards. RESULTS: National data elements were developed, based on the Beta-2 draft ICIDH-2, and accepted for use in Australian national data dictionaries on a trial basis. CONCLUSION: The purpose and process have been accepted as valuable, and there is interested anticipation of new Australian standard data elements based on the ICF.