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Deconstructing the differences: a comparison of GBD 2010 and CHERG's approach to estimating the mortality burden of diarrhea, pneumonia, and their etiologies

Kovacs, Stephanie D., Mulholland, E. Kim, Bosch, Julia, Campbell, Harry, Forouzanfar, Mohammad H., Khalil, Ibrahim, Lim, Stephen, Liu, Li, Maley, Stephen N., Mathers, Colin D., Matheson, Alastair, Mokdad, Ali H., O'Brien, Kate, Parashar, Umesh, Schaafsma, Torin T., Steele, Duncan, Hawes, Stephen E. and Grove, John T. (2015). Deconstructing the differences: a comparison of GBD 2010 and CHERG's approach to estimating the mortality burden of diarrhea, pneumonia, and their etiologies. BMC Infectious Diseases,15(Article No. 16).

Document type: Journal Article
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Title Deconstructing the differences: a comparison of GBD 2010 and CHERG's approach to estimating the mortality burden of diarrhea, pneumonia, and their etiologies
Author Kovacs, Stephanie D.
Mulholland, E. Kim
Bosch, Julia
Campbell, Harry
Forouzanfar, Mohammad H.
Khalil, Ibrahim
Lim, Stephen
Liu, Li
Maley, Stephen N.
Mathers, Colin D.
Matheson, Alastair
Mokdad, Ali H.
O'Brien, Kate
Parashar, Umesh
Schaafsma, Torin T.
Steele, Duncan
Hawes, Stephen E.
Grove, John T.
Journal Name BMC Infectious Diseases
Publication Date 2015
Volume Number 15
Issue Number Article No. 16
ISSN 1471-2334   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84923928841
Total Pages 15
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
Pneumonia and diarrhea are leading causes of death for children under five (U5). It is challenging to estimate the total number of deaths and cause-specific mortality fractions. Two major efforts, one led by the Institute for Health Metrics and Evaluation (IHME) and the other led by the World Health Organization (WHO)/Child Health Epidemiology Reference Group (CHERG) created estimates for the burden of disease due to these two syndromes, yet their estimates differed greatly for 2010.

Methods
This paper discusses three main drivers of the differences: data sources, data processing, and covariates used for modelling. The paper discusses differences in the model assumptions for etiology-specific estimates and presents recommendations for improving future models.

Results
IHME’s Global Burden of Disease (GBD) 2010 study estimated 6.8 million U5 deaths compared to 7.6 million U5 deaths from CHERG. The proportional differences between the pneumonia and diarrhea burden estimates from the two groups are much larger; GBD 2010 estimated 0.847 million and CHERG estimated 1.396 million due to pneumonia. Compared to CHERG, GBD 2010 used broader inclusion criteria for verbal autopsy and vital registration data. GBD 2010 and CHERG used different data processing procedures and therefore attributed the causes of neonatal death differently. The major difference in pneumonia etiologies modeling approach was the inclusion of observational study data; GBD 2010 included observational studies. CHERG relied on vaccine efficacy studies.

Discussion
Greater transparency in modeling methods and more timely access to data sources are needed. In October 2013, the Bill & Melinda Gates Foundation (BMGF) hosted an expert meeting to examine possible approaches for better estimation. The group recommended examining the impact of data by systematically excluding sources in their models. GBD 2.0 will use a counterfactual approach for estimating mortality from pathogens due to specific etiologies to overcome bias of the methods used in GBD 2010 going forward.
DOI http://dx.doi.org/10.1186/s12879-014-0728-4   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 4.0 License
URL https://creativecommons.org/licenses/by/4.0/au


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