The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013

May combine two claims.

Drowning shows large variations, with highest rates in sub-Saharan African and Asian regions.

“Drowning shows large variations with highest rates in sub-Saharan African and Asian regions.”

May combine two claims.

The global decline in drowning DALY rates was apparent in all age categories, but largest for age category 1-4 years (by 64.4%).

“The global decline in DALY rates of drowning was apparent in all age categories, but largest for age category 1–4 years (by 64.4%).”

May combine two claims.

The proportion of DALYs due to disability (YLD) is much higher for collective violence (69.1%; UI 54.3 to 81.8), falls (46.4%; UI 38.3 to 54.1) and forces of nature (43.0%; UI 26.0 to 56.7).

“The proportion of DALYs due to disability (YLD) is much higher for collective violence (69.1%; UI 54.3 to 81.8), falls (46.4%; UI 38.3 to 54.1) and forces of nature (43.0%; UI 26.0 to 56.7).”

May combine two claims.

Over 1990-2013 the rate of YLDs from injuries decreased by 37.0% (UI −30.0 to −45.4) while YLLs due to injuries decreased by 29.6% (UI −24.1 to −33.6).

“Over the period 1990–2013 the rate of YLDs from injuries decreased by −37.0% (UI −30.0 to −45.4) while YLLs due to injuries decreased only by −29.6% (UI −24.1 to −33.6).”

May combine two claims.

Patterns of injury DALY rates in the 50 to 79 years age group follow similar patterns as younger adults, but differences between regions and between men and women are less pronounced.

“Patterns of injury DALY rates in the age group 50–79 years follow similar patterns as those in the younger adult age group but the differences between regions and between men and women are less pronounced: DALY rates in high income regions are higher and those in other regions are lower.”

May combine two claims.

In the 50 to 79 years age group, falls become a more prominent cause of DALYs and self-harm becomes a greater cause than violence in most regions.

“Falls become a more prominent cause of DALYs in this age group and self-harm becomes a greater cause than violence in most regions.”

May combine two claims.

All but four regions showed a significant decline in injury DALY rates, with Oceania and West, central and southern sub-Saharan Africa the exceptions.

“All but four regions showed a significant decline with Oceania, and West, central and southern sub-Saharan Africa the exceptions.”

May combine two claims.

For transport injuries and intentional injuries the change in YLD rates has been greater than the change in YLL rates, but the opposite is the case for unintentional non-transport injuries.

“For transport injuries and intentional injuries the change in YLD rates has been greater than the change in YLL rates but the opposite is the case for unintentional non-transport injuries.”

The quote only partly states this claim.

Between 1990 and 2013 the global age-standardised injury DALY rate decreased by about 31% (30.9%; UI 26.1% to 34.7%), an annualised rate of decline of 1.6%.

“Between 1990 and 2013 the global age-standardised injury DALY rate decreased by 31% (UI 26% to 35%).”

• Also stated in: § Changes between 1990 and 2013—all injury · plain

  “Between 1990 and 2013 injury DALY rates have declined by 30.9%, an annualised rate of decline of 1.6% (table 3).”

May combine two claims.

The main contributors to injury DALYs are road injuries (29.3%; UI 26.4 to 32.2), self-harm (14.0%; UI 11.8 to 16.2), falls (12.0%; UI 9.8 to 14.1), drowning (8.7%; UI 6.3 to 11.2) and interpersonal violence (8.4%; UI 6.5 to 10.4).

“The main contributors to injury DALYs are road injuries (29.3%; UI 26.4 to 32.2), self-harm (14.0%; UI 11.8 to 16.2), falls (12.0%; UI 9.8 to 14.1), drowning (8.7%; UI 6.3 to 11.2) and interpersonal violence (8.4%; UI 6.5 to 10.4).”

Probably not a substantial claim: may not pass S3 (load-bearing).

In women aged 15 to 49 years, DALY rates range from 798 (UI 712 to 907) in Australasia to 3268 (UI 2608 to 3985) in South Asia.

“In women, rates range from a low of 798 (UI 712 to 907) in Australasia to a high of 3268 (UI 2608 to 3985) in South Asia.”

Probably not a substantial claim: may not pass S3 (load-bearing).

At older ages the share of road injuries in pedestrians increases.

“At older ages the share of road injuries in pedestrians increases.”

May combine two claims.

Decreases in road injury DALY rates were mainly apparent in high-income Asia Pacific (−66.9%; UI −69.8 to −63.9), followed by western Europe (−61.1%; UI −63.1 to −58.9), Australasia (−57.0%; UI −60.1 to −53.8), central Europe (−50.6%; UI −55.8 to −47.1) and eastern Europe (−38.3%; UI −42.9 to 33.5).

“Decreases were mainly apparent in high-income Asia Pacific (−66.9%; UI −69.8 to −63.9), followed by western Europe (−61.1%; UI −63.1 to −58.9), Australasia (−57.0%; UI −60.1 to −53.8) central Europe (−50.6%; UI −55.8 to −47.1) and eastern Europe (−38.3%, UI −42.9 to 33.5).”

May combine two claims.

Four-wheeled motor vehicle injuries significantly increased in South Asia (21.7%; UI 1.8 to 44.6) and sub-Saharan Africa (19.8%; UI 6.6 to 35.0).

“Four-wheeled motor vehicle injuries significantly increased in South Asia (21.7%; UI 1.8 to 44.6) and sub-Saharan Africa (19.8%; UI 6.6 to 35.0).”

Probably not a substantial claim: may not pass S3 (load-bearing).

In 2013, 4.8 million (UI 4.5 to 5.1) people died from injuries.

“In 2013, 973 million (uncertainty interval (UI) 942 to 993) people sustained injuries that warranted some type of healthcare and 4.8 million (UI 4.5 to 5.1) people died from injuries.”

• Also stated in: § Incidence, mortality and burden of disease of injuries in 2013 · hedged

  “In 2013, we estimated that 973 million (uncertainty interval (UI) 942 to 993) people sustained injuries that warranted some type of healthcare and 4.8 million (UI 4.5 to 5.1) people died from injuries.”

May combine two claims.

Rates in high-income North America are around 70% higher than in western Europe, Australasia and high-income Asia Pacific, with generally higher rates for most injuries, particularly interpersonal violence.

“Rates in high-income North America are around 70% higher than in western Europe, Australasia and high-income Asia Pacific with generally higher rates for most injuries, but particularly so for interpersonal violence.”

May combine two claims.

Major causes of injury death were road injury (29.1%), self-harm (17.6%), falls (11.6%) and interpersonal violence (8.5%).

“Major causes of injury death were road injury (29.1%), self-harm (17.6%), falls (11.6%) and interpersonal violence (8.5%).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Patterns of change in injury DALY rates were similar between men and women.

“The patterns of change in injury DALY rates were similar between men and women.”

May combine two claims.

In the 50 to 79 years age group, the lowest DALY rates for men and women are seen in Australasia, while South Asia has the highest rates in men and women.

“The lowest DALY rates per 100 000 for men (2873; UI 2668 to 3070) and women (1574.2; UI 1429 to 1720) are seen in Australasia while South Asia has the highest rates in men (7525; UI 6880 to 8172) and in women (4798; UI 4421 to 5173).”

May combine two claims.

Oceania was the only region recording an increase in drowning DALY rate, a non-significant change of 14.9% (UI −38.6 to 72.7).

“Oceania was the only region recording an increase in drowning DALY rate, a non-significant change with large uncertainty (14.9%; UI −38.6 to 72.7).”

Probably not a substantial claim: may not pass S3 (load-bearing).

In boys under 15 years, DALY rates per 100 000 vary from 468.4 (UI 427.7 to 509.7) in western Europe to 6471.4 (UI 4197.1 to 8680.9) in central sub-Saharan Africa.

“In boys under the age of 15 years, DALY rates per 100 000 vary from a low of 468.4 (UI 427.7 to 509.7) in western Europe to a high of 6471.4 (UI 4197.1 to 8680.9) in central sub-Saharan Africa.”

Probably not a substantial claim: may not pass S3 (load-bearing).

In girls under 15 years, DALY rates vary from 307.4 (UI 277.9 to 336.8) in western Europe to 4788.1 (UI 3260.4 to 6354.7) in central sub-Saharan Africa.

“In girls under the age of 15 years DALY rates vary from a low of 307.4 (UI 277.9 to 336.8) in western Europe to a high of 4788.1 (UI 3260.4 to 6354.7) in central sub-Saharan Africa.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

An ageing cohort of people with long-term disabilities from past wars and disasters is prominent in Andean Latin America, South-East Asia, North Africa, the Middle East and sub-Saharan African regions.

“An ageing cohort of people with long-term disabilities from past wars and disasters is quite prominent in Andean Latin America, South-East Asia, North Africa and the Middle East and sub-Saharan African regions.”

May combine two claims.

Road injury DALY rates increased in South Asia (6.5%; UI −11.2 to 26.1), West sub-Saharan Africa (13.1%; UI −0.5 to 28.6) and South sub-Saharan Africa (35.2%; UI −14.1 to 60.6) but not significantly.

“Rates increased in South Asia (6.5%; UI −11.2 to 26.1) and West (13.1%; UI −0.5 to 28.6) and South sub-Saharan Africa (35.2%; UI −14.1 to 60.6) but not significantly.”

May combine two claims.

For communicable, maternal, neonatal and nutritional disorders and non-communicable disease, DALY rates declined by 42.2% (UI −45.0 to −40) and 14.5% (UI −17.3 to −11.6), respectively, between 1990 and 2013.

“For communicable, maternal, neonatal and nutritional disorders and non-communicable disease DALY rates declined by 42.2% (UI −45.0 to −40) and 14.5% (UI −17.3 and −11.6), respectively.”

May combine two claims.

In all regions injury rates are much higher in men than in women, except in the 80 years and older age group where the sex differential largely disappears.

“In all regions injury rates are much higher in men than in women with the exception of the 80 years and older age group where the sex differential largely disappears.”

May combine two claims.

For some cause-of-injury categories one or two nature-of-injury categories are responsible for the majority of YLDs, whereas for others a variety of nature-of-injury categories contribute.

“For some cause-of-injury categories one or two nature-of-injury categories are responsible for the majority of YLDs (eg, fire, heat and hot substances, and burns), whereas for others a variety of nature-of-injury categories contribute to the cause-of-injury categories.”

May combine two claims.

The 15 to 49 years age category is the peak age category for road injuries in all regions, with an eightfold difference in rates between high-income Asia Pacific and western sub-Saharan Africa.

“This is the peak age category for road injuries in all regions but with an eightfold difference in rates between high-income Asia Pacific and western sub-Saharan Africa.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The high rate of fire injuries in South Asian women stands out.

“The high rate of fire injuries in South Asian women stands out.”

May combine two claims.

The decline in road injury DALY rates in Oceania (−16.9%; UI −41.4 to 22.1), East Asia (−14.1%; UI −33.9 to 2.7) and central sub-Saharan Africa (−9.9%; UI −22.5 to 5.5) were not significant.

“The decline in rates in Oceania (−16.9%; UI −41.4 to 22.1), East Asia (−14.1%; UI −33.9 to 2.7) and central sub-Saharan Africa (−9.9%; UI −22.5 to 5.5) were not significant.”

May combine two claims.

Brazil and Russia had significant decreases in road injury DALY rates over 1990-2013.

“Our study shows that these countries have relatively high road injury mortality and DALY rates, but that DALY rates have significantly decreased in Brazil and Russia over the period 1990–2013 while rates for South Africa, India and China showed insignificant changes.”

May combine two claims.

Self-harm DALY rates in South Asia rose, though not significantly, between 1990 and 2013.

“The trends in these regions are in opposite directions, decreasing significantly and by a great margin in East Asia but rising, though not significantly, in South Asia between 1990 and 2013.”

May combine two claims.

Globally, the burden of disease due to road injury has decreased significantly since 1990, but this decrease is largely in high-income regions, with the reverse trend occurring in low-income and middle-income countries.

“Globally, the burden of disease due to road injury has decreased significantly since 1990, but this decrease is largely in high-income regions, with the reverse trend occurring in low-income and middle-income countries.”

May combine two claims.

There was an increase by around 50% in interpersonal violence DALY rates in South sub-Saharan Africa and Oceania, with large uncertainty intervals crossing zero.

“However, the increase by around 50% in the rates of interpersonal violence DALYs in South sub-Saharan Africa and Oceania are reason for concern even though the large UI crosses zero (figure 11).”

May combine two claims.

Interpersonal violence DALY rates decreased significantly in 11 of 21 world regions, with non-significant changes in the other regions.

“The decline in DALY rates for interpersonal violence was −19.1% (UI −24.2% to −11.5%), with significant decreases in 11 of 21 world regions with non-significant changes in the other regions.”

May combine two claims.

Self-harm is the second leading cause of death from injury and it is a main contributor to injury DALYs.

“Self-harm is the second leading cause of death from injury and it is a main contributor to injury DALYs.”

May combine two claims.

The rate of decline was significant for 22 of our 26 cause-of-injury categories, including all the major ones.

“The rate of decline was significant for 22 of our 26 cause-of-injury categories, including all the major ones.”

May combine two claims.

The results vary by cause, age group, sex, geography and over time.

“However, the results vary by cause, age group, sex, geography and over time.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Uncertainty was propagated from all sources using standard GBD methods of repeating all calculations 1000 times, drawing from distributions rather than point estimates for all relevant parameters.

“We have propagated uncertainty from all these sources using standard GBD methods of repeating all calculations 1000 times, each time drawing from distributions rather than point estimates for all the relevant parameters in our models.”

Probably not a substantial claim: may not pass S3 (load-bearing).

All rates of deaths and DALYs presented are age-standardised using the revised GBD 2013 standard population.

“All rates of deaths and DALYs we present are age-standardised using the revised GBD 2013 standard population.”

Probably not a substantial claim: may not pass S3 (load-bearing).

For injury mortality estimates, estimation of model uncertainty is inherent to the ensemble modelling method.

“For the injury mortality estimates the estimation of model uncertainty is inherent to the ensemble modelling method.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

The lack of nationally representative mortality data in many low-income and middle-income countries emphasises the need for investment in vital registration and standardised cause of death certification.

“The lack of nationally representative mortality data in many low-income and middle-income countries emphasises the need for investment in vital registration and standardised cause of death certification.”

Probably not a substantial claim: may not pass S3 (load-bearing).

These findings correspond to the GBD 2013 changes in burden of disease rates due to collective violence.

“These findings correspond to the GBD 2013 changes in burden of disease rates due to collective violence.”

Probably not a substantial claim: may not pass S3 (load-bearing).

For forces of nature and collective violence we retrieved data from vital registrations as well as data sets that were set up particularly for the collection of data from armed conflicts and/or disaster.

“For forces of nature and collective violence we retrieved data from vital registrations as well as data sets that were set up particularly for the collection of data from armed conflicts and/or disaster.”

• cites [53] International Institute for Strategic Studies. Armed Conflict Database. London, UK: International Institute for Strategic Studies. https://acd.iiss.org/https://acd.iiss.org/Not checked yet

  Not checked in the free run.

• cites [54] sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The overall trend in the global homicide rate is decreasing, but regional trends are diverse: in Asia and Europe overall homicide rates are decreasing but other regions have continuing high levels of homicide.

“Our findings on interpersonal violence tally with findings from the United Nations Office on Drugs and Crime (UNODC) Homicide Statistics and WHO which show that the overall trend in the global homicide rate is decreasing, but that regional trends are diverse:26 27 in Asia and Europe overall homicide rates are decreasing but other regions have continuing high levels of homicide.”

• cites [26] UNODC global study on Homicide 2013. United Nations Publication, 2014.Not checked yet

  Not checked in the free run.

• cites [27] Global status report on violence prevention 2014. World Health Organization, 2014.Not checked yet

  Not checked in the free run.

• cites [28] Injuries in the European Union, Report on injury statistics 2008–2010. Amsterdam: EuroSafe, 2013.Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

More recently, studies found evidence that there was an upturn in suicide rates during the financial crisis of 2007/2008 set against an overall decline.

“More recently, studies found evidence that there was an upturn in suicide rates during the financial crisis of 2007/2008 set against this overall decline.”

• cites [38] sourceNot checked yet

  Not checked in the free run.

• cites [39] sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

Rather than discarding these data sets we set a low bar for inclusion if at least 45% of cases had a cause-of-injury code.

“Rather than discarding these data sets we set a low bar for inclusion if at least 45% of cases had a cause-of-injury code.”

Classified as probably not a substantial claim. May combine two claims.

GBD 2013 provides a systematic quantification of mortality, incidence and disability over 1990 to 2013, allowing analyses of time trends and comparison between regions.

“GBD 2013 provides a systematic quantification of mortality, incidence and disability over the time period 1990 to 2013, allowing analyses of time trends and comparison between regions.”

May combine two claims.

Urban speed limit laws, seat belt laws, motorcycle helmet laws and drink-drive laws have shown to substantially reduce road injury mortality.

“These laws have shown to substantially reduce road injury mortality, underlining the importance of implementing these strategies to reduce road traffic injury.”

• cites [25] sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Previous studies have reported similar trends in the most populated countries in these regions, India and China.

“Previous studies have reported similar trends in the most populated countries in these regions, India and China.”

• cites [40] sourceNot checked yet

  Not checked in the free run.

• cites [41] sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Reduction in incidence would be the effect of measures preventing the occurrence of injuries (eg, road safety measures, gun control or safer tools).

“Reduction in incidence would be the effect of measures preventing the occurrence of injuries (eg, road safety measures, gun control or safer tools).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The Human Security Report showed that in Africa conflicts and battle deaths have become more numerous in recent years and often are high-intensity conflicts, causing more than 10 000 battle deaths a year.

“However, the Human Security Report showed that in Africa conflicts and battle deaths have become more numerous in recent years and often are high-intensity conflicts, causing more than 10 000 battle deaths a year.”

• cites [43] Human Security Report Project. Human security report 2013: the decline in global violence: evidence, explanation, and contestation. Vancouver, 2013.Not checked yet

  Not checked in the free run.

May combine two claims.

Coverage of vital registration is low or absent in large parts of the world and there are issues of incompleteness and differences in death certification systems, definitions of variables and methods of data collection.

“Coverage of vital registration is low or absent in large parts of the world and there are issues of incompleteness and differences in death certification systems, definitions of variables and methods of data collection.”

• cites [44] sourceNot checked yet

  Not checked in the free run.

• cites [45] Joubert, 2012, Characteristics, availability and uses of vital registration and other mortality data sources in post-democracy South Africa, Glob Health Action sourceNot checked yet

  Not checked in the free run.

• cites [46] sourceNot checked yet

  Not checked in the free run.

• cites [47] sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The latter is problematic for injuries as our analyses make a strict distinction between cause and nature of injury and therefore requires dual coding of injuries.

“The latter is problematic for injuries as our analyses make a strict distinction between cause and nature of injury and therefore requires dual coding of injuries.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Globally, battle deaths have declined since 1945 and the number of interstate conflicts has decreased since 1990, while the peak of interstate conflicts with more than 1000 battle deaths per year was in the 1970s with a rapid decline thereafter.

“Globally, battle deaths have declined since 1945 and the number of interstate conflicts has decreased since 1990 while the peak of interstate conflicts with more than 1000 battle deaths per year was in the 1970s with a rapid decline thereafter.”

• cites [34] Pinker S . The better angels of our nature. New York: Viking, 2011.Not checked yet

  Not checked in the free run.

• cites [42] sourceNot checked yet

  Not checked in the free run.

• cites [43] Human Security Report Project. Human security report 2013: the decline in global violence: evidence, explanation, and contestation. Vancouver, 2013.Not checked yet

  Not checked in the free run.

May combine two claims.

GBD uses the largest collection of data on causes of death in the world, allowing statistical models that can borrow strength over time and geography.

“GBD uses the largest collection of data on causes of death in the world, allowing us to use statistical models that can borrow strength over time and geography.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

For many countries hospital data collection systems with national coverage exist but, due to country-specific privacy regulations, the data are not made available or made available in summary tabulations only.

“For many countries hospital data collection systems with national coverage exist but, due to country-specific privacy regulations, the data are not made available or made available in summary tabulations only.”

Probably not a substantial claim: may not pass S3 (load-bearing).

In GBD 2013 several steps have been taken to enhance data quality of morbidity and mortality data and adjust for misclassification.

“In the GBD 2013 several steps have been taken to enhance data quality of morbidity and mortality data and adjust for misclassification.”

May combine two claims.

UNODC and WHO report that homicide levels have remained high in the Americas and in Eastern and Southern Africa, and in some countries levels increased.

“UNODC and WHO report that this is particularly the case for the Americas and in Eastern and Southern Africa, where homicide levels have remained high, and in some countries levels increased.”

• cites [29] sourceNot checked yet

  Not checked in the free run.

• cites [30] Krug EG , Dahlberg LL , Mercy JA , et al . World report on violence and health. World Health Organization, 2002. sourceNot checked yet

  Not checked in the free run.

• cites [31] sourceNot checked yet

  Not checked in the free run.

• cites [32] sourceNot checked yet

  Not checked in the free run.

• cites [33] sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

Data protection regulations and legislation are becoming more important, and because of that there may be more countries for which hospital data or other data sources are not made available.

“Data protection regulations and legislation are becoming more important, and because of that there may be more countries for which hospital data or other data sources are not made available.”

Probably not a substantial claim: may not pass S3 (load-bearing).

This increase also resulted in an increase in battle deaths in certain African countries.

“This increase also resulted in an increase in battle deaths in certain African countries.”

• cites [43] Human Security Report Project. Human security report 2013: the decline in global violence: evidence, explanation, and contestation. Vancouver, 2013.Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The greater declines in YLL and YLD rates could be brought about by injury prevention measures reducing the severity of the injury sustained (eg, seat belts and helmets) or by improved access to better quality care after an injury (eg, trauma systems).

“The greater declines in YLL and YLD rates could be brought about by injury prevention measures reducing the severity of the injury sustained (eg, seat belts and helmets) or by improved access to better quality care after an injury (eg, trauma systems).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

While we attempt to capture all sources of uncertainty from sampling error, non-sampling error and model specifications in the 95% UIs, we cannot guarantee that we have captured all uncertainty.

“While we attempt to capture all sources of uncertainty from sampling error, non-sampling error and model specifications in the 95% UIs, we cannot guarantee that we have captured all uncertainty.”

• cites [48] Mathers CD , Salomon JA , Ezzati M , et al . Sensitivity and uncertainty analyses for burden of disease and risk factor estimates. In: Lopez AD , Mathers CD , Ezzati M , et al , eds. Global burden of disease and risk factors. Oxford press, New York, 2006:399–426.Not checked yet

  Not checked in the free run.

• cites [49] sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Police and mortuary data were added for road injuries, self-harm, and interpersonal violence to help predict level and age patterns in countries with sparse or absent cause of death data, even though police records tend to underestimate the true level of deaths.

“We added police and mortuary data for road injuries, self-harm, and interpersonal violence to help predict level and age patterns in countries with sparse or absent cause of death data even though we know from countries with near-complete vital registration data that police records tend to underestimate the true level of deaths.”

Probably not a substantial claim: may not pass S3 (load-bearing).

To estimate the burden of injury we used a methodology similar to GBD 2010 but with several significant changes, including changes with respect to the injury classification.

“To estimate the burden of injury we used a methodology similar to GBD 2010 but with several significant changes, including changes with respect to the injury classification.”

May combine two claims.

These decreases in DALY rates for almost all cause-of-injury categories warrant a general statement that the world is becoming a safer place to live in, although the injury burden remains high in some parts of the world.

“These decreases in DALY rates for almost all cause-of-injury categories warrant a general statement that the world is becoming a safer place to live in, although the injury burden remains high in some parts of the world.”

Classified as probably not a substantial claim.

The estimation of the probability of long-term health loss due to a particular nature of injury is a key step in our analysis that drives the estimation of YLDs from long-term outcomes.

“The estimation of the probability of long-term health loss due to a particular nature of injury is a key step in our analysis that drives the estimation of YLDs from long-term outcomes.”

May combine two claims.

Overall YLDs will only be affected in cases where we observed 100% probability of long-term outcomes; in other cases, higher probability of long-term results in a higher prevalence of cases with long-term consequences, but combined with lower disability weights this will result in the same overall YLDs.

“Overall YLDs will only be affected in cases where we observed 100% probability of long-term outcomes. In other cases, higher probability of long-term results in a higher prevalence of cases with long-term consequences, but combined with lower disability weights this will result in the same overall YLDs.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The probability of treated long-term outcomes is estimated via the ratio of the average level of disability 1 year after an injury relative to the long-term disability weight for each nature of injury category.

“The probability of treated long-term outcomes is estimated via the ratio of the average level of disability 1 year after an injury relative to the long-term disability weight for each nature of injury category.”

May combine two claims.

The follow-up studies used different injury classifications that needed to be mapped into the GBD cause and nature-of-injury categories and the follow-up studies used different patient-reported outcome measures, introducing greater uncertainty and potential bias in our estimation of disability.

“Third, the follow-up studies used different injury classifications that needed to be mapped into the GBD cause and nature-of-injury categories and the follow-up studies used different patient-reported outcome measures, introducing greater uncertainty and potential bias in our estimation of disability.”

• cites [56] sourceNot checked yet

  Not checked in the free run.

• cites [57] sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The duration of short-term injury in case of untreated injuries was based on the opinion of GBD injury collaborators.

“The duration of short-term injury in case of untreated injuries was based on the opinion of GBD injury collaborators.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

For certain outpatient nature-of-injury categories high probabilities of permanent health loss were observed; an explanation for this may be that cases were misclassified as outpatients whereas in fact they were treated in an inpatient setting.

“Fourth, for certain outpatient nature-of-injury categories high probabilities of permanent health loss were observed. An explanation for this may be that cases were misclassified as outpatients whereas in fact they were treated in an inpatient setting.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Postdisaster and war surveys have been carried out to assess related mortality and injury, yet recall bias related to acute postdisaster experiences and postdisaster or postwar migration may hamper the data collection and interpretation of these studies.

“Postdisaster and war surveys have been carried out to assess related mortality and injury, yet recall bias related to acute postdisaster experiences and postdisaster or postwar migration may hamper the data collection and interpretation of these studies.”

May combine two claims.

The patient-reported data were from the Netherlands only, a high-income country with a high access to quality healthcare and these durations may not apply to settings with lower-quality care.

“Second, the patient-reported data were from the Netherlands only, a high-income country with a high access to quality healthcare and these durations may not apply to settings with lower-quality care.”

May combine two claims.

This proxy mostly reflects access to primary care services and may not reflect access to trauma services that are required for injuries.

“It therefore mostly reflects access to primary care services and may not reflect access to trauma services that are required for injuries.”

May combine two claims.

These estimated durations are based on a very limited sample size and the validity and reliability of these estimated durations may be affected by response and recall bias.

“However, these estimated durations are based on a very limited sample size and the validity and reliability of these estimated durations may be affected by response and recall bias.”

May combine two claims.

For GBD 2013 disability weights have changed, including all injury disability weights; this means that the probability of long-term outcomes of injuries has changed.

“For GBD 2013 disability weights have changed, including all injury disability weights. This means that the probability of long-term outcomes of injuries has changed.”

May combine two claims.

Variables such as hospital beds per 1000 or physician density may serve as proxy for the proportion of untreated injury per country-year, but these have been found to vary wildly over time and between countries without face validity as an indicator of access to trauma services.

“There are variables, such as hospital beds per 1000 or physician density that may serve as proxy for the proportion of untreated injury per country-year, but these have been found to vary wildly over time and between countries without face validity as an indicator of access to trauma services.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

We used DisMod-MR to stream out prevalence from incidence and this process assumes a steady state where rates are not changing over time.

“Furthermore, we used DisMod-MR to stream out prevalence from incidence and this process assumes a steady state where rates are not changing over time.”

• AssumptionThe authors state this as an assumption: The DisMod-MR process assumes a steady state where rates are not changing over time.