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.
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.
ObjectiveThis study aimed to analyze the disease burden of pancreatitis in China from 1990 to 2019 and to provide references for the prevention and treatment of pancreatitis. MethodsThe data were obtained from the Global Burden of Disease Study 2019 (GBD 2019). The incidence, mortality, disability-adjusted life years (DALYs), years of life lost (YLLs), years lived with disability (YLDs) and their corresponding age-standardized rate, and annual average percentage change (AAPC) were selected as the main indicators to compare the burden of pancreatitis in China, the United States and globally from 1990 to 2019. ResultsIn 2019, the age-standardized incidence, mortality, DALY, YLL, and YLD rates in China were 26.76/100 000, 0.59/100 000, 16.09/100 000, 14.61/100 000, and 1.48/100 000, respectively, and decreased by 8.94%, 45.33%, 49.12%, 50.98%, and 18.49%, respectively, compared with those in 1990. The burden of pancreatitis in China gradually increased with age, but was lower than that in the United States and globally. The DALY due to alcohol continually increased in China, the United States, and globally. ConclusionFrom 1990 to 2019, the burden of pancreatitis in China shows a decreasing trend and is lower than that in the United States and globally. However, the disease burden caused by alcohol and aging is increasing; therefore, effective measurements to alleviate the burden of pancreatitis in China are needed.
ObjectivesTo systematically review the disease burden of osteoporotic fracture (OPF) in China.MethodsWe searched PubMed, EMbase, CNKI, WanFang Data and VIP database for observational studies of the disease burden of osteoporosis in China from inception to Jan 30th, 2018. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies.The descriptive analysis was used to analyze the economic burden of OPF in China.ResultsA total of 23 studies were included. The average cost of OPF was 27 561.27 yuan. Women were more prone to OPF than men. Hip and spinal fractures were the diseases which had higher average hospital costs.ConclusionsWomen are more prone to osteoporotic fractures than men. The higher hospital costs of OPF may cause the reason for growing financial burden of patients. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify conclusions.
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.
Objective The Global Burden of Diseases (GBD) data were used to analyze the trend of the burden of disease of tracheal, bronchial, and lung cancer (TBL Cancer) caused by tobacco in China and globally from 1990 to 2021, and to predict the future development trend. Methods We performed descriptive analysis of the indicators of death and disability-adjusted life years (DALY) in the GBD 2021 database; The Joinpoint regression model was used to calculate the average annual percent change (APCC); The age-period-cohort (APC) model was used to estimate the effect of three independent factors, age, period and cohort, on disease mortality; and the BAPC model was used to project the burden of disease for TBL Cancer from 2022 to 2036. Results From 1990 to 2021, the disease burden of TBL Cancer attributable to tobacco showed an increasing trend in both China and globally, with a much higher burden of disease in men than in women, and a much higher burden of disease attributable to smoking than to secondhand smoke. The APC model showed that the net drift values of mortality in China and globally were −0.1982% and −1.5921%, respectively, from 1992 to 2021; the age effect showed that the mortality rate of both China and the world increased with age; the period effect model showed that the mortality rate of China increased and then decreased, and the global mortality rate generally decreased; the cohort model showed that the mortality rate of China and the world increased and then decreased; the BAPC model showed that the mortality rate of China declined slowly in the period of 2022-2036, and the global mortality rate declined even more dramatically. Conclusion The burden of TBL Cancer attributable to tobacco was higher in China than in the world from 1990 to 2021. Tobacco control measures in China have begun to bear fruit in recent years, and we should continue to strengthen our tobacco control initiatives and popularize health knowledge in order to make progress towards the goal of the "Healthy China 2030" plan.
Objective To assess the methodological quality of systematic reviews/ meta-analysis of burden of illness, analyses the factors affecting it, so as to provide a reference basis for improving the methodological quality of related studies. Methods Systematic reviews/ meta-analysis of burden of illness were identified in PubMed, searching from its inception to 12 October 2024. Systematic reviews/ meta-analysis of burden of illness was included, the methodological quality of the included literature was evaluated using AMSTAR-2, and data were extracted using Excel 2021. Results A total of 308 systematic reviews/ meta-analysis were included, with a fluctuating upward trend in the number of publications from 2006 to 2024; of these, a total of 12 were rated as low quality. According to the AMSTAR-2 entries, the largest number of documents fully conformed to entry 16 (82.14%), followed by entry 5 (81.49%), and entry 8 (72.73%); one document conformed to entry 10 (0.32%), and relatively few conformed to entry 12 (68.83%), entry 13 (85.39%), and entry 15 (67.53%). ConclusionThe methodological quality of systematic reviews/ meta-analysis of burden of illness needs to be improved, and the main problems include the lack of pre-study protocols, the absence of a list of excluded literature, and the less than adequate explanation of heterogeneity and risk of bias, etc. There is still a need to further improve the methodological quality of the systematic reviews and to promote the long-term development of evidence based medicine.
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.
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.
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.