Burden of non-communicable disease studies in Europe: a systematic review of data sources and methodological choices

Periklis Charalampous*, Vanessa Gorasso, Dietrich Plass, Sara M. Pires, Elena Von Der Lippe, Alibek Mereke, Jane Idavain, Katarzyna Kissimova-Skarbek, Joana Nazare Morgado, Che Henry Ngwa, Isabel Noguer, Alicia Padron-Monedero, María Jose Santi-Cano, Rodrigo Sarmiento, Brecht Devleesschauwer, Juanita A. Haagsma, The COST Action CA18218 Participants

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Background: Assessment of disability-adjusted life years (DALYs) resulting from non-communicable diseases (NCDs) requires specific calculation methods and input data. The aims of this study were to (i) identify existing NCD burden of disease (BoD) activities in Europe; (ii) collate information on data sources for mortality and morbidity; and (iii) provide an overview of NCD-specific methods for calculating NCD DALYs. Methods: NCD BoD studies were systematically searched in international electronic literature databases and in grey literature. We included all BoD studies that used the DALY metric to quantify the health impact of one or more NCDs in countries belonging to the European Region. Results: A total of 163 BoD studies were retained: 96 (59%) were single-country or sub-national studies and 67 (41%) considered more than one country. Of the single-country studies, 29 (30%) consisted of secondary analyses using existing Global Burden of Disease (GBD) results. Mortality data were mainly derived (49%) from vital statistics. Morbidity data were frequently (40%) drawn from routine administrative and survey datasets, including disease registries and hospital discharge databases. The majority (60%) of national BoD studies reported mortality corrections. Multimorbidity adjustments were performed in 18% of national BoD studies. Conclusion: The number of national NCD BoD assessments across Europe increased over time, driven by an increase in BoD studies that consisted of secondary data analysis of GBD study findings. Ambiguity in reporting the use of NCD-specific BoD methods underlines the need for reporting guidelines of BoD studies to enhance the transparency of NCD BoD estimates across Europe.

Original languageEnglish
Pages (from-to)289-296
Number of pages8
JournalEuropean Journal of Public Health
Issue number2
Publication statusPrint publication - 1 Apr 2022

Bibliographical note

Publisher Copyright:
© 2022 The Author(s) 2022. Published by Oxford University Press on behalf of the European Public Health Association.


  • Europe/epidemiology
  • Global Burden of Disease
  • Global Health
  • Humans
  • Information Storage and Retrieval
  • Noncommunicable Diseases/epidemiology
  • Quality-Adjusted Life Years


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