title: Measuring the population burden of fatal and nonfatal injury.
abstract: The value of measuring the population burden of fatal and nonfatal injury is well established. Population health metrics are important for assessing health status and health-related quality of life after injury and for integrating mortality, disability, and quality-of-life consequences. A frequently used population health metric is the disability-adjusted life-year. This metric was launched in 1996 in the original Global Burden of Disease and Injury study and has been widely adopted by countries and health development agencies alike to identify the relative magnitude of different health problems. Apart from its obvious advantages and wide adherence, a number of challenges are encountered when the disability-adjusted life-year is applied to injuries. Validation of disability-adjusted life-year estimates for injury has been largely absent. This paper provides an overview of methods and existing knowledge regarding the population burden of injury measurement. The review of studies that measured burden of injury shows that estimates of the population burden remain uncertain because of a weak epidemiologic foundation; limited information on incidence, outcomes, and duration of disability; and a range of methodological problems, including definition and selection of incident and fatal cases, choices in selection of assessment instruments and timings of use for nonfatal injury outcomes, and the underlying concepts of valuation of disability. Recommendations are given for methodological refinements to improve the validity and comparability of future burden of injury studies.
authors: Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. s.polinder@erasmusmc.nl
authors: Suzanne
authors: S
authors: Polinder
authors: Juanita A
authors: JA
authors: Haagsma
authors: Ronan A
authors: RA
authors: Lyons
authors: Belinda J
authors: BJ
authors: Gabbe
authors: Shanthi
authors: S
authors: Ameratunga
authors: Colin
authors: C
authors: Cryer
authors: Sarah
authors: S
authors: Derrett
authors: James E
authors: JE
authors: Harrison
authors: Maria
authors: M
authors: Segui-Gomez
authors: Ed F
authors: EF
authors: van Beeck
mesh_terms: D017281:Cost of Illness; D004185:Disability Evaluation; D006233:Persons with Disabilities; D006304:Health Status; D006801:Humans; D011634:Public Health; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D014947:Wounds and Injuries / Q000401:mortality*