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Background Burden of disease and injury methods can be used to summarise and compare the effects of conditions in terms of disability-adjusted life years (DALYs). Burden estimation methods are not inherently complex. However, as commonly implemented, the methods include complex modelling and estimation. Objectives To provide a simple and open-source software tool that allows estimation of incidence-DALYs due to injury, given data on incidence of deaths and non-fatal injuries. The tool includes a default set of ' estimation parameters, which can be replaced by users. Development of the software tool The tool was written in Microsoft Excel. All calculations and values can be seen and altered by users. The parameter sets currently used in the tool are based on published sources. Using the software tool The tool is available without charge online at http://calculator.globalburdenofinjuries. org. To use the tool with the supplied parameter sets, users need to only paste a table of population and injury case data organised by age, sex and external cause of injury into a specified location in the tool. Estimated DALYs can be read or copied from tables and figures in another part of the tool. Conclusions In some contexts, a simple and user-modifiable burden calculator may be preferable to undertaking a more complex study to estimate the burden of disease. The tool and the parameter sets required for its use can be improved by user innovation, by studies comparing DALYs estimates calculated in this way and in other ways, and by shared experience of its use [ABSTRACT FROM AUTHOR]

Background: Priority setting, identification of unmet and changing healthcare needs, service and policy planning, and the capacity to evaluate the impact of health interventions requires valid and reliable methods for quantifying disease and injury burden. The methodology developed for the Global Burden of Disease (GBD) studies has been adopted to estimate the burden of disease in national, regional and global projects. However, there has been little validation of the methods for estimating injury burden using empirical data. Objective: To provide valid estimates of the burden of non-fatal injury using empirical data. Setting: Data from prospective cohort studies of injury outcomes undertaken in the UK, USA, Australia, New Zealand and The Netherlands. Design and participants: Meta-analysis of deidentified, patient-level data from over 40 000 injured participants in six prospective cohort studies: Victorian State Trauma Registry, Victorian Orthopaedic Trauma Outcomes Registry, UK Burden of Injury study, Prospective Outcomes of Injury study, National Study on Costs and Outcomes of Trauma and the Dutch Injury Patient Survey. Analysis: Data will be systematically analysed to evaluate and refine injury classification, development of disability weights, establishing the duration of disability and handling of cases with more than one injury in burden estimates. Developed methods will be applied to incidence data to compare and contrast various methods for estimating non-fatal injury burden. Contribution to the field: The findings of this international collaboration have the capacity to drive how injury burden is measured for future GBD estimates and for individual country or region-specific studies. [ABSTRACT FROM AUTHOR]

Objective To model the population level impact of tai-chi on future rates of falls and fall-related injury in older people as a tool for policy development. Design An epidemiological and economic model for estimating population-level effectiveness of tai-chi. Setting Australia, 2009. Patients or subjects Australian community-dwelling population aged 70+ years, ambulatory and without debilitating conditions or profound visual defects. Intervention Group-based tai-chi, for 1 h twice weekly for 26 weeks, assuming no sustained effect beyond the intervention period. Main outcome measure Total falls and fall-related hospitalisation prevented in 2009. Results Population-wide tai-chi delivery would prevent an estimated 5440 falls and 109 fall-related hospitalisations, resulting in a 0.18% reduction in the fall-related hospital admission rate for community-dwelling older people. The gross costs per fall and per fall-related hospital admission prevented were $A4414 (€3013) and $A220 712 (€150 684), respectively. A total investment of $A24.01 million (€16.39 million), equivalent to 4.2% of the cost of fall-related episodes of hospital care in 2003/4, would be required to provide tai-chi for 31 998 people and achieve this effect. Conclusions Substantial investment in, and high population uptake of, tai-chi would be required to have a large effect on falls and fall-related hospitalisation rates. Although not accounted for in this study, investment in tai-chi is likely to be associated with additional significant health benefits beyond falls prevention. This approach could be applied to other interventions to assist selection of the most cost-effective falls-prevention portfolio for Australia and other countries. [ABSTRACT FROM PUBLISHER]

Background Traumatic injury is a leading contributor to the overall global burden of disease. However, there is a worldwide shortage of population data to inform understanding of non-fatal injury burden. An improved understanding of the pattern of recovery following trauma is needed to better estimate the burden of injury, guide provision of rehabilitation services and care to injured people, and inform guidelines for the monitoring and evaluation of disability outcomes. Objective To provide a comprehensive overview of patient outcomes and experiences in the first 5 years after serious injury. Design This is a population-based, nested prospective cohort study using quantitative data methods, supplemented by a qualitative study of a seriously injured participant sample. Participants All 2547 paediatric and adult major trauma patients captured by the Victorian State Trauma Registry with a date of injury from 1 July 2011 to 30 June 2012 who survived to hospital discharge and did not opt-off from the registry. Analysis To analyse the quantitative data and identify factors that predict poor or good outcome, whether there is change over time, differences in rates of recovery and change between key participant subgroups, multilevel mixed effects regression models will be fitted. To analyse the qualitative data, thematic analysis will be used to identify important themes and the relationships between themes. Contribution to the field The results of this project have the potential to inform clinical decisions and public health policy, which can reduce the burden of non-fatal injury and improve the lives of people living with the consequences of severe injury. [ABSTRACT FROM AUTHOR]

Background The application of disability weights by nature of injury is central to the calculation of disabilityadjusted life years (DALYs). Such weights should represent injury diagnosis groups that demonstrate homogeneity in disability outcomes. Existing classifications have not used empirical data in their development to inform groups that are homogeneous for disability outcomes, limiting the capacity to make informed recommendations for best practice in measuring injury burden. Methods The Validating and Improving injury Burden Estimates (Injury-VIBES) Study includes pooled data from over 30 000 injured participants recruited to six cohort studies. The International Classification of Disease 10th Revision (ICD-10) diagnosis codes were mapped to existing injury burden study groupings and prediction models were developed to measure the capacity of the injury groupings and ICD-10 diagnoses to predict disability outcomes at 12 months. Models were adjusted for age, gender and data source and investigated for discrimination using area under the receiver operating characteristic curve (AUC) and calibration using Hosmer- Lemeshow statistics and calibration curves. Results Discrimination and calibration of models varied depending on the outcome measured. Models using full four-character ICD-10 diagnosis codes, rather than groupings of codes, demonstrated the highest discrimination ranging from an AUC (95% CI) of 0.627 (0.618 to 0.635) for the pain or discomfort item of the EQ-5D to 0.847 (0.841 to 0.853) for the extended Glasgow Outcome Scale independent living outcome. However, gain over other groupings was marginal. Conclusions Prediction performance was best for measures of function such as independent living, mobility and self-care. The classifications were poorer predictors of anxiety/depression and pain/discomfort. There was no clearly superior classification. [ABSTRACT FROM AUTHOR]

Objective To describe the rates of hospitalisation for head and traumatic brain injury among Australian children aged 0-14 years. Design Descriptive analysis of the Australian Institute of Health and Welfare National Hospital Morbidity Database, using data for the period 1 July 2000 to 30 June 2006. Results The rate of hospitalisation for head injury was 395.9 per 100?000 (95% CI 393.4 to 398.4), with 47.6 per 100?000 (95% CI 46.7 to 48.5) being high-threat-to-life injuries. In multivariate analysis, those aged 0-4 years had 1.8 times the rate of head injury of 10-14-year-olds, while boys had 1.7 times the rate of girls. Children living in very remote and remote areas had a 1.3-1.5-fold greater rate of head injury, and a 1.6-1.8-fold greater rate of injuries that were high threat to life, than city-dwelling children. The rate of traumatic brain injury (TBI) was 91.1 per 100?000 (95% CI 89.9 to 92.3), with 34.7 per 100?000 (95% CI 33.9 to 35.4) being high-threat-to-life injuries. In multivariate analysis, children aged 0-4 years had 0.8 times the rate of 10-14-year-olds, and boys had 1.9 times the rate of girls. Children living in the very remote and remote areas had a 1.9-2.8-fold greater rate of TBI, and a 1.5-1.7-fold greater rate of injuries that were high threat to life, than city-dwelling children. Conclusions Children living remotely were disproportionately represented among those sustaining head injuries. Almost a quarter of head injuries were TBI. [ABSTRACT FROM AUTHOR]