Burden of non-communicable disease studies in Europe: a systematic review of data sources and methodological choices
Authors: Charalampous Periklis , Gorasso Vanessa , Plass Dietrich , Pires Sara M , von der Lippe Elena , Mereke Alibek , Idavain Jane , Kissimova-Skarbek Katarzyna , Morgado Joana Nazaré , Ngwa Che Henry , Noguer Isabel , Padron-Monedero Alicia , Santi-Cano María José , Sarmiento Rodrigo , Devleesschauwer Brecht , Haagsma Juanita A ,   The COST Action CA18218 Participants, Ádám Balázs , Alkerwi Ala’a , Bikbov Boris , Bølling Anette Kocbach , Breitner Susanne , Cuschieri Sarah , Dahm Christina C , Eikemo Terje Andreas , Fischer Florian , Freitas Alberto , García-González Juan Manuel , Gazzelloni Federica , Gissler Mika , Hengl Brigita , Hynds Paul , Isola Gaetano , Jakobsen Lea S , Kabir Zubair , Knudsen Ann Kristin , Konar Naime Meriç , Ladeira Carina , Liew Aaron , Majer Marjeta , Mechili Enkeleint A , Mevsim Vildan , Milicevic Milena Santric , Mitchell Louise , Monasta Lorenzo , Mondello Stefania , Nena Evangelia , Ng Edmond S W , Niranjan Vikram , O'Caoimh Rónán , O’Donovan Mark Ryan , Ortiz Alberto , Pallari Elena , Petrou Panagiotis , Ortiz Miguel Reina , Riva Silvia , Samouda Hanène , Santos João V , Adi Santoso Cornelia Melinda , Schmitt Tugce , Skempes Dimitrios , Sousa Ana Catarina , Stevanovic Aleksandar , Terzic Gerhard Sulo Natasa , Terzic-Supic Zorica , Todorovic Jovana , Tozija Fimka , Unim Brigid , Van Wilder Lisa , Varga Orsolya , Violante Francesco S , Wyper Grant M A 
Published: December 2021

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.