Methodological considerations in injury burden of disease studies across Europe: a systematic literature review
Authors: Charalampous Periklis , Pallari Elena , Gorasso Vanessa , von der Lippe Elena , Devleesschauwer Brecht , Pires Sara M. , Plass Dietrich , Idavain Jane , Ngwa Che Henry , Noguer Isabel , Padron-Monedero Alicia , Sarmiento Rodrigo , Majdan Marek , Ádám Balázs , AlKerwi Ala’a , Cilovic-Lagarija Seila , Clarsen Benjamin , Corso Barbara , Cuschieri Sarah , Dopelt Keren , Economou Mary , Fischer Florian , Freitas Alberto , García-González Juan Manuel , Gazzelloni Federica , Gkitakou Artemis , Gulmez Hakan , Hynds Paul , Isola Gaetano , Jakobsen Lea S. , Kabir Zubair , Kissimova-Skarbek Katarzyna , Knudsen Ann Kristin , Konar Naime Meriç , Ladeira Carina , Lassen Brian , Liew Aaron , Majer Marjeta , Mechili Enkeleint A. , Mereke Alibek , Monasta Lorenzo , Mondello Stefania , Morgado Joana Nazaré , Nena Evangelia , Ng Edmond S. W. , Niranjan Vikram , Nola Iskra Alexandra , O’Caoimh Rónán , Petrou Panagiotis , Pinheiro Vera , Ortiz Miguel Reina , Riva Silvia , Samouda Hanen , Santos João Vasco , Santoso Cornelia Melinda Adi , Milicevic Milena Santric , Skempes Dimitrios , Sousa Ana Catarina , Speybroeck Niko , Tozija Fimka , Unim Brigid , Uysal Hilal Bektaş , Vaccaro Fabrizio Giovanni , Varga Orsolya , Vasic Milena , Violante Francesco Saverio , Wyper Grant M. A. , Polinder Suzanne , Haagsma Juanita A. 
Published: August 2022

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.