Session Title: Epidemiology and Health Services I
Session Type: Abstract Submissions (ACR)
The first Global Burden of Diseases (GBD) Study was conducted by the World Bank and WHO during the 1990’s and ranked diseases by their contribution to burden as measured by disability adjusted life years (DALYs). All MSK disorders, with 2.1% of DALYs, ranked 12th . These were considered to be underestimates. The GBD 2010 Study aimed to repeat these DALYs to look for trends in diseases from 1990 to 2010 with updated disease definitions and literature review. The MSK Expert Group (EG) aimed to identify data for OA, RA, Back Pain, Neck Pain, Gout and Other MSK.
Methods: Systematic reviews of Medline, EMBASE, CINAHL, SIGLE and WHOLIS were screened from 1980 to 2010. Data were extracted from population-based studies using a Quality Assessment tool developed by the MSK EG. These prevalence and incidence data, together with estimates of possible covariates and relative risk of mortality, were entered into the DISMOD3 software developed by the IHME. Disability weights for health states related to MSK conditions were adjusted for distribution of severity and duration and frequency of each condition to calculate years lived with disability (YLDs) for each of the MSK conditions – OA of hip or knee, RA, Low Back Pain (LBP), Neck Pain (NP), Gout and Other MSK.
Globally non-communicable chronic disorders were identified as the growing concern and of these MSK was highlighted.
In the overall global burden (DALYs) MSK disorders had increased from 4.7% in 1990 to 6.8% in 2010, and ranked 5th behind Cardiovascular (11.8%), Injuries (11.2%), All neoplasms (7.6%) and Mental and behavioural disorders (7.4%). For burden (DALYs) of specific disorders, LBP ranked 6th; NP 21st; and Other MSK 24th. In the global disability (YLD) estimates, mental and behavioural disorders combined at 22.7% ranked 1st, while combined MSK disorders at 21.3% was a close 2nd. Collectively MSK conditions affect 2,933,367,000 people, account for 166 million YLDs and represent a relative increase of 44.7% since 1990. For disease specific causes of disability (YLDs), LBP ranked 1st globally with 83.1 million; NP ranked 4th with 33.6 million; Other MSK 6th with 28.2 million; OA was 11th with 17.1 million; and RA was 6.7 million. OA was felt to be underestimated in this analysis. OA was identified as one of the most rapidly rising (64% increase) conditions with a rank of 15th in 1990 to 11thin 2010. When developed country level data are examined MSK conditions play an even greater role, for example in Australia where combined MSK conditions (15% of DALYs) were a close second only to combined Cancer (16% of DALYs) as the leading causes of disease burden, and LBP was estimated as the leading disease specific cause of total burden (DALYs). For disability in Australia MSK conditions were the leading cause with 27% of YLDs. Country level data are derived from ihme.org.
Conclusion: Data are lacking from the African nations, South America, Eastern Europe and Australasia. OA Knee is the most common MSK condition and is showing the greatest increase. Low back and neck pain account for the greatest proportion of MSK burden globally. In many countries MSK disorders are the leading cause of disability.
A. D. Woolf,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/global-and-country-specific-burden-of-musculoskeletal-disordersa-report-from-the-global-burden-of-diseases-musculoskeletal-expert-group/