A Software Tool for Estimation of Burden of Infectious Diseases in Europe Using Incidence-Based Disability Adjusted Life Years

PLoS One. 2017 Jan 20;12(1):e0170662. doi: 10.1371/journal.pone.0170662. eCollection 2017.

Abstract

The burden of disease framework facilitates the assessment of the health impact of diseases through the use of summary measures of population health such as Disability-Adjusted Life Years (DALYs). However, calculating, interpreting and communicating the results of studies using this methodology poses a challenge. The aim of the Burden of Communicable Disease in Europe (BCoDE) project is to summarize the impact of communicable disease in the European Union and European Economic Area Member States (EU/EEA MS). To meet this goal, a user-friendly software tool (BCoDE toolkit), was developed. This stand-alone application, written in C++, is open-access and freely available for download from the website of the European Centre for Disease Prevention and Control (ECDC). With the BCoDE toolkit, one can calculate DALYs by simply entering the age group- and sex-specific number of cases for one or more of selected sets of 32 communicable diseases (CDs) and 6 healthcare associated infections (HAIs). Disease progression models (i.e., outcome trees) for these communicable diseases were created following a thorough literature review of their disease progression pathway. The BCoDE toolkit runs Monte Carlo simulations of the input parameters and provides disease-specific results, including 95% uncertainty intervals, and permits comparisons between the different disease models entered. Results can be displayed as mean and median overall DALYs, DALYs per 100,000 population, and DALYs related to mortality vs. disability. Visualization options summarize complex epidemiological data, with the goal of improving communication and knowledge transfer for decision-making.

MeSH terms

  • Communicable Diseases / epidemiology*
  • Cost of Illness*
  • Europe / epidemiology
  • European Union / statistics & numerical data
  • Humans
  • Incidence
  • Models, Statistical
  • Monte Carlo Method
  • Quality-Adjusted Life Years*
  • Software

Grants and funding

The European Centre for Disease Prevention and Control (ECDC), a publicly funded technical agency of the European Commission, funded the development of the BCoDE toolkit software through the framework contract ECDC/2013/020 "Maintenance and further development of the BCoDE software tool" with NextPage Software Daniel Lewandowski. DL, self-employed at NextPage Software Daniel Lewandowski, developed the BCoDE toolkit software but did not have additional roles in the study design, data collection and analysis and decision to publish. He contributed to the preparation of the manuscript concerning the BCoDE toolkit software development technical description. The funder (ECDC) also provided support in the form of salaries for authors EC, AC and PK, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.