TY - JOUR
T1 - Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017
T2 - A systematic analysis for the Global Burden of Disease Study 2017
AU - GBD 2017 Risk Factor Collaborators
AU - Stanaway, Jeffrey D.
AU - Afshin, Ashkan
AU - Gakidou, Emmanuela
AU - Lim, Stephen S.
AU - Abate, Degu
AU - Abate, Kalkidan Hassen
AU - Abbafati, Cristiana
AU - Abbasi, Nooshin
AU - Abbastabar, Hedayat
AU - Abd-Allah, Foad
AU - Abdela, Jemal
AU - Abdelalim, Ahmed
AU - Abdollahpour, Ibrahim
AU - Abdulkader, Rizwan Suliankatchi
AU - Abebe, Molla
AU - Abebe, Zegeye
AU - Abera, Semaw F.
AU - Abil, Olifan Zewdie
AU - Abraha, Haftom Niguse
AU - Abrham, Aklilu Roba
AU - Abu-Raddad, Laith Jamal
AU - Abu-Rmeileh, Niveen M.E.
AU - Accrombessi, Manfred Mario Kokou
AU - Acharya, Dilaram
AU - Acharya, Pawan
AU - Adamu, Abdu A.
AU - Adane, Akilew Awoke
AU - Adebayo, Oladimeji M.
AU - Adedoyin, Rufus Adesoji
AU - Adekanmbi, Victor
AU - Ademi, Zanfina
AU - Adetokunboh, Olatunji O.
AU - Adib, Mina G.
AU - Admasie, Amha
AU - Adsuar, Jose C.
AU - Afanvi, Kossivi Agbelenko
AU - Afarideh, Mohsen
AU - Agarwal, Gina
AU - Aggarwal, Anju
AU - Aghayan, Sargis Aghasi
AU - Agrawal, Anurag
AU - Agrawal, Sutapa
AU - Ahmadi, Alireza
AU - Ahmadi, Mehdi
AU - Ahmadieh, Hamid
AU - Ahmed, Muktar Beshir
AU - Aichour, Amani Nidhal
AU - Aichour, Ibtihel
AU - Aichour, Miloud Taki Eddine
AU - Barrero, Lope H.
N1 - Publisher Copyright:
© 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
PY - 2018/11/10
Y1 - 2018/11/10
N2 - Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.
AB - Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.
UR - https://www.scopus.com/pages/publications/85056201749
U2 - 10.1016/S0140-6736(18)32225-6
DO - 10.1016/S0140-6736(18)32225-6
M3 - Article
C2 - 30496105
AN - SCOPUS:85056201749
SN - 0140-6736
VL - 392
SP - 1923
EP - 1994
JO - The Lancet
JF - The Lancet
IS - 10159
ER -