Certainty of the Global Burden of Disease 2019 Modelled Prevalence Estimates for Musculoskeletal Conditions: A Meta-Epidemiological Study.

Objectives: To describe and assess the risk of bias of the primary input studies that underpinned the Global Burden of Disease Study (GBD) 2019 modelled prevalence estimates of low back pain (LBP), neck pain (NP), and knee osteoarthritis (OA), from Australia, Brazil, Canada, Spain, and Switzerland. To evaluate the certainty of the GBD modelled prevalence evidence. Methods: Primary studies were identified using the GBD Data Input Sources Tool and their risk of bias was assessed using a validated tool. We rated the certainty of modelled prevalence estimates based on the GRADE Guidelines 30-the GRADE approach for modelled evidence. Results: Seventy-two primary studies (LBP: 67, NP: 2, knee OA: 3) underpinned the GBD estimates. Most studies had limited representativeness of their study populations, used suboptimal case definitions and applied assessment instruments with unknown psychometric properties. The certainty of modelled prevalence estimates was low, mainly due to risk of bias and indirectness. Conclusion: Beyond the risk of bias of primary input studies for LBP, NP, and knee OA in GBD 2019, the certainty of country-specific modelled prevalence estimates still have room for improvement.
Competing Interests: JML, CAH, RDP, and BD report support for attending a meeting of the European Cooperation in Science and Technology – COST Action CA18218 (European Burden of Disease Network). JML, CAH, RDP, JVS, GMAW, and BD are members of the European COST Action CA18218. CAH and MAP report grants from the Swiss National Science Foundation (SNSF) and the European Centre for Chiropractic Research Excellence (ECCRE) outside the submitted work. The remaining author declares that they do not have any conflicts of interest.
(Copyright © 2023 Muñoz Laguna, Puhan, Rodríguez Artalejo, De Pauw, Wyper, Devleesschauwer, Santos and Hincapié.)