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Journal Article•DOI•

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

Stephen S Lim1, Theo Vos, Abraham D. Flaxman1, Goodarz Danaei2  +207 more•Institutions (92)
15 Dec 2012-The Lancet (Elsevier)-Vol. 380, Iss: 9859, pp 2224-2260
TL;DR: In this paper, the authors estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010.
About: This article is published in The Lancet.The article was published on 2012-12-15 and is currently open access. It has received 9324 citations till now. The article focuses on the topics: Disease burden & Risk factor.

Summary (1 min read)

Jump to: [Convincing evidence] – [Probable evidence] – [Possible evidence] and [Insufficient evidence]

Convincing evidence

  • Evidence based on epidemiological studies showing consistent associations between exposure and disease, with little or no evidence to the contrary.
  • The available evidence is based on a substantial number of studies including prospective observational studies and where relevant, randomised controlled trials of sufficient size, duration, and quality showing consistent effects.

Probable evidence

  • Evidence based on epidemiological studies showing fairly consistent associations between exposure and disease, but for which there are perceived shortcomings in the available evidence or some evidence to the contrary, which precludes a more definite judgment.
  • Shortcomings in the evidence may be any of the following: insufficient duration of trials (or studies); insufficient trials (or studies) available; inadequate sample sizes; or incomplete follow-up.

Possible evidence

  • Evidence based mainly on findings from case-control and cross-sectional studies.
  • Insufficient randomised controlled trials, observational studies, or non-randomised controlled trials are available.
  • Evidence based on non-epidemiological studies, such as clinical and laboratory investigations, is supportive.
  • More trials are needed to support the tentative associations, which should be biologically plausible.

Insufficient evidence

  • Evidence based on findings of a few studies which are suggestive, but insufficient to establish an association between exposure and disease.
  • Burden of disease attributable to individual risk factors are shown sequentially for ease of presentation.

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Citations
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Proceedings Article•DOI•
Long-term blood pressure prediction with deep recurrent neural networks

[...]

Peng Su1, Xiaorong Ding1, Yuan-Ting Zhang1, Jing Liu1, Fen Miao2, Ni Zhao1 •
The Chinese University of Hong Kong1, Chinese Academy of Sciences2
04 Mar 2018
TL;DR: In this article, a deep recurrent neural network (RNN) consisting of multilayered Long Short-Term Memory (LSTM) networks was proposed for arterial blood pressure (BP) estimation.
Abstract: Existing methods for arterial blood pressure (BP) estimation directly map the input physiological signals to output BP values without explicitly modeling the underlying temporal dependencies in BP dynamics. As a result, these models suffer from accuracy decay over a long time and thus require frequent calibration. In this work, we address this issue by formulating BP estimation as a sequence prediction problem in which both the input and target are temporal sequences. We propose a novel deep recurrent neural network (RNN) consisting of multilayered Long Short-Term Memory (LSTM) networks, which are incorporated with (1) a bidirectional structure to access larger-scale context information of input sequence, and (2) residual connections to allow gradients in deep RNN to propagate more effectively. The proposed deep RNN model was tested on a static BP dataset, and it achieved root mean square error (RMSE) of 3.90 and 2.66 mmHg for systolic BP (SBP) and diastolic BP (DBP) prediction respectively, surpassing the accuracy of traditional BP prediction models. On a multi-day BP dataset, the deep RNN achieved RMSE of 3.84, 5.25, 5.80 and 5.81 mmHg for the 1st day, 2nd day, 4th day and 6th month after the 1st day SBP prediction, and 1.80, 4.78, 5.0, 5.21 mmHg for corresponding DBP prediction, respectively, which outperforms all previous models with notable improvement. The experimental results suggest that modeling the temporal dependencies in BP dynamics significantly improves the long-term BP prediction accuracy.

116 citations

Journal Article•DOI•
Basic mechanisms for adverse cardiovascular events associated with air pollution

[...]

Michael T. Chin1•
University of Washington1
15 Feb 2015-Heart
TL;DR: The components of air pollution, an overview of the cardiovascular effects ofAir pollution exposure, and a review of the basic mechanisms that are activated by exposure to promote CVD are provided.
Abstract: Air pollution is a significant cause of cardiovascular morbidity and mortality worldwide. Although the epidemiologic association between air pollution exposures and exacerbation of cardiovascular disease (CVD) is well established, the mechanisms by which these exposures promote CVD are incompletely understood. This review provides an overview of the components of air pollution, an overview of the cardiovascular effects of air pollution exposure, and a review of the basic mechanisms that are activated by exposure to promote CVD.

116 citations

Journal Article•DOI•
Genetic relationships between suicide attempts, suicidal ideation and major psychiatric disorders: A genome-wide association and polygenic scoring study

[...]

Niamh Mullins1, Nader Perroud, Rudolf Uher1, Rudolf Uher2, Amy W. Butler1, Amy W. Butler3, Sarah Cohen-Woods4, Margarita Rivera5, Margarita Rivera1, Karim Malki1, Jack Euesden1, Robert Power1, Katherine E. Tansey6, Lisa Jones7, Ian Jones6, Nicholas John Craddock6, Michael John Owen6, Ania Korszun8, Michael Gill, Ole Mors9, Martin Preisig10, Wolfgang Maier11, Marcella Rietschel11, John P. Rice12, Bertram Müller-Myhsok13, Elisabeth B. Binder13, Susanne Lucae13, Marcus Ising13, Ian W. Craig1, Anne Farmer1, Peter McGuffin1, Gerome Breen1, Gerome Breen14, Cathryn M. Lewis1 •
King's College London1, Dalhousie University2, University of Hong Kong3, University of Adelaide4, University of Granada5, Cardiff University6, University of Birmingham7, Queen Mary University of London8, Aarhus University Hospital9, University of Lausanne10, University of Bonn11, Washington University in St. Louis12, Max Planck Society13, South London and Maudsley NHS Foundation Trust14
01 Jul 2014-American Journal of Medical Genetics
TL;DR: Polygenic score analysis suggests pleiotropy between psychiatric disorders and suicidal ideation whereas the tendency to act on such thoughts may have a partially independent genetic diathesis.
Abstract: Epidemiological studies have recognized a genetic diathesis for suicidal behavior, which is independent of other psychiatric disorders. Genome-wide association studies (GWAS) on suicide attempt (SA) and ideation have failed to identify specific genetic variants. Here, we conduct further GWAS and for the first time, use polygenic score analysis in cohorts of patients with mood disorders, to test for common genetic variants for mood disorders and suicide phenotypes. Genome-wide studies for SA were conducted in the RADIANT and GSK-Munich recurrent depression samples and London Bipolar Affective Disorder Case-Control Study (BACCs) then meta-analysis was performed. A GWAS on suicidal ideation during antidepressant treatment had previously been conducted in the Genome Based Therapeutic Drugs for Depression (GENDEP) study. We derived polygenic scores from each sample and tested their ability to predict SA in the mood disorder cohorts or ideation status in the GENDEP study. Polygenic scores for major depressive disorder, bipolar disorder and schizophrenia from the Psychiatric Genomics Consortium were used to investigate pleiotropy between psychiatric disorders and suicide phenotypes. No significant evidence for association was detected at any SNP in GWAS or meta-analysis. Polygenic scores for major depressive disorder significantly predicted suicidal ideation in the GENDEP pharmacogenetics study and also predicted SA in a combined validation dataset. Polygenic scores for SA showed no predictive ability for suicidal ideation. Polygenic score analysis suggests pleiotropy between psychiatric disorders and suicidal ideation whereas the tendency to act on such thoughts may have a partially independent genetic diathesis.

115 citations

Journal Article•DOI•
Short-term exposure to air pollution and morbidity of COPD and asthma in East Asian area: A systematic review and meta-analysis.

[...]

Siqi Zhang1, Guoxing Li1, Lin Tian1, Qun Guo1, Xiaochuan Pan1 •
Peking University1
01 Jul 2016-Environmental Research
TL;DR: Evidence was found that short-term exposure to air pollution was associated with increasing risk of hospital utilization for COPD and asthma in the whole population, the elderly and children, but not in people aged 15-64.

115 citations

Journal Article•DOI•
Long-term exposure to outdoor air pollution and the incidence of chronic obstructive pulmonary disease in a national English cohort

[...]

Richard Atkinson1, Iain M Carey1, Andrew J. Kent2, T P van Staa3, Hugh Ross Anderson1, Derek G Cook1 •
St George's, University of London1, AeA2, University of London3
01 Jan 2015-Occupational and Environmental Medicine
TL;DR: Limited, inconclusive evidence for associations between air pollution and COPD incidence is found using a large, nationally representative cohort based on primary care records linked to hospital admissions.
Abstract: Objectives The role of outdoor air pollution in the incidence of chronic obstructive pulmonary disease (COPD) remains unclear. We investigated this question using a large, nationally representative cohort based on primary care records linked to hospital admissions. Methods A cohort of 812 063 patients aged 40– 89 years registered with 205 English general practices in 2002 without a COPD diagnosis was followed from 2003 to 2007. First COPD diagnoses recorded either by a general practitioner (GP) or on admission to hospital were identified. Annual average concentrations in 2002 for particulate matter with an aerodynamic diameter <10 mm (PM10) and <2.5 mm (PM2.5), nitrogen dioxide (NO2), ozone and sulfur dioxide (SO2 )a t 1 km 2 resolution were estimated from emission-based dispersion models. Hazard ratios (HRs) per interquartile range change were estimated from Cox models adjusting for age, sex, smoking, body mass index and area-level deprivation. Results 16 034 participants (1.92%) received a COPD diagnosis from their GP and 2910 participants (0.35%) were admitted to hospital for COPD. After adjustment, HRs for GP recorded COPD and PM10 ,P M2.5 and NO2 were close to unity, positive for SO2 (HR=1.07 (95% CI 1.03 to 1.11) per 2.2 mg/m 3 ) and negative for ozone (HR=0.94 (0.89 to 1.00) per 3 mg/m 3 ). For admissions HRs for PM2.5 and NO2 remained positive (HRs=1.05 (0.98 to 1.13) and 1.06 (0.98 to 1.15) per 1.9 mg/m 3 and 10.7 mg/m 3 , respectively). Conclusions This large population-based cohort study found limited, inconclusive evidence for associations between air pollution and COPD incidence. Further work, utilising improved estimates of air pollution over time and enhanced socioeconomic indicators, is required to clarify the association between air pollution and COPD incidence.

115 citations

References
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Journal Article•DOI•
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.

[...]

William C. Knowler1, Elizabeth Barrett-Connor1, Sarah E. Fowler1, Richard F. Hamman1, John M. Lachin1, Elizabeth A. Walker, David M. Nathan1 •
George Washington University1
07 Feb 2002-The New England Journal of Medicine
TL;DR: In this paper, the authors compared a lifestyle intervention with metformin to prevent or delay the development of Type 2 diabetes in nondiabetic individuals. And they found that the lifestyle intervention was significantly more effective than the medication.
Abstract: Background Type 2 diabetes affects approximately 8 percent of adults in the United States. Some risk factors — elevated plasma glucose concentrations in the fasting state and after an oral glucose load, overweight, and a sedentary lifestyle — are potentially reversible. We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes. Methods We randomly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo, metformin (850 mg twice daily), or a lifestyle modification program with the goals of at least a 7 percent weight loss and at least 150 minutes of physical activity per week. The mean age of the participants was 51 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 34.0; 68 percent were women, and 45 percent were members of minority groups. Results The average follow-up was 2.8 years. The incidence of diabetes was 11.0, 7.8, and 4.8 cases per 100 person-years in the placebo, metformin, and lifestyle groups, respectively. The lifestyle intervention reduced the incidence by 58 percent (95 percent confidence interval, 48 to 66 percent) and metformin by 31 percent (95 percent confidence interval, 17 to 43 percent), as compared with placebo; the lifestyle intervention was significantly more effective than metformin. To prevent one case of diabetes during a period of three years, 6.9 persons would have to participate in the lifestyle-intervention program, and 13.9 would have to receive metformin. Conclusions Lifestyle changes and treatment with metformin both reduced the incidence of diabetes in persons at high risk. The lifestyle intervention was more effective than metformin.

17,333 citations

Journal Article•DOI•
Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010

[...]

Rafael Lozano1, Mohsen Naghavi1, Kyle J Foreman2, Stephen S Lim1  +192 more•Institutions (95)
15 Dec 2012-The Lancet
TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex, using the Cause of Death Ensemble model.

11,809 citations

Journal Article•DOI•
Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies.

[...]

Sarah Lewington, Robert Clarke, Nawab Qizilbash, Richard Peto, Rory Collins 
14 Dec 2002-The Lancet
TL;DR: Throughout middle and old age, usual blood pressure is strongly and directly related to vascular (and overall) mortality, without any evidence of a threshold down to at least 115/75 mm Hg.

9,101 citations

Book•
The global burden of disease: a comprehensive assessment of mortality and disability from diseases injuries and risk factors in 1990 and projected to 2020.

[...]

Christopher J L Murray, Alan D. Lopez
01 Jan 1996
TL;DR: This is the first in a planned series of 10 volumes that will attempt to "summarize epidemiological knowledge about all major conditions and most risk factors" and use historical trends in main determinants to project mortality and disease burden forward to 2020.
Abstract: This is the first in a planned series of 10 volumes that will attempt to "summarize epidemiological knowledge about all major conditions and most risk factors;...generate assessments of numbers of deaths by cause that are consistent with the total numbers of deaths by age sex and region provided by demographers;...provide methodologies for and assessments of aggregate disease burden that combine--into the Disability-Adjusted Life Year or DALY measure--burden from premature mortality with that from living with disability; and...use historical trends in main determinants to project mortality and disease burden forward to 2020." This first volume includes chapters summarizing results from the project as a whole. (EXCERPT)

7,154 citations

Journal Article•DOI•
Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

[...]

Theo Vos, Abraham D. Flaxman1, Mohsen Naghavi1, Rafael Lozano1  +360 more•Institutions (143)
15 Dec 2012-The Lancet
TL;DR: Prevalence and severity of health loss were weakly correlated and age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010, but population growth and ageing have increased YLD numbers and crude rates over the past two decades.

7,021 citations

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Frequently Asked Questions (4)
Q1. What are the contributions mentioned in the paper "A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990—2010: a systematic analysis for the global burden of disease study 2010 author" ?

Lim, Stephen S, Vos, Umer, Shibuya, Shibaya, Kenji, AdairRohani, Heather, Amann, Markus, Anderson, H Ross, Andrews, Kathryn G, Aryee, Martin, Gmel, Gerhard, Graham, Kathryn, Grainger, Rebecca, Grant, Bridget, Gunnell, David, Gutierrez, Hialy R, Hall, Wayne, Hoek, Hans W, Hogan, Anne-Charlson, H Dean, this paper, Nolla, Nissim, Nelson, Paul K 

Shortcomings in the evidence may be any of the following: insufficient duration of trials (or studies); insufficient trials (or studies) available; inadequate sample sizes; or incomplete follow-up. 

The available evidence is based on a substantial number of studies including prospective observational studies and where relevant, randomised controlled trials of sufficient size, duration, and quality showing consistent effects. 

In reality, the burden attributable to different risks overlaps because of multicausality and because the effects of some risk factors are partly mediated throughLim et al.