Cited by 887Statistical Methods in EpidemiologyHealth Systems, Economic Evaluations, Quality of LifeHealth, Environment, Cognitive Aging

Comparative quantification of health risks conceptual framework and methodological issues

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Murray, Christopher JL, Ezzati, Majid, Lopez, Alan D, Rodgers, Anthony, Vander Hoorn, Stephen·2003·Population Health Metrics

Abstract

Reliable and comparable analysis of risks to health is key for preventing disease and injury. Causal attribution of morbidity and mortality to risk factors has traditionally been conducted in the context of methodological traditions of individual risk factors, often in a limited number of settings, restricting comparability.In this paper, we discuss the conceptual and methodological issues for quantifying the population health effects of individual or groups of risk factors in various levels of causality using knowledge from different scientific disciplines. The issues include: comparing the burden of disease due to the observed exposure distribution in a population with the burden from a hypothetical distribution or series of distributions, rather than a single reference level such as non-exposed; considering the multiple stages in the causal network of interactions among risk factor(s) and disease outcome to allow making inferences about some combinations of risk factors for which epidemiological studies have not been conducted, including the joint effects of multiple risk factors; calculating the health loss due to risk factor(s) as a time-indexed "stream" of disease burden due to a time-indexed "stream" of exposure, including consideration of discounting; and the sources of uncertainty.

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  • The comparative risk assessment approach is predicated on a causal web of hierarchically organised, potentially overlapping health risks.

    “the comparative risk assessment approach, a framework used by GBD since 2002 that is predicated on a causal web of hierarchically organised, potentially overlapping health risks.29, 37”

    From Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021 (2023) · cites this paper as [37]

    The Introduction (page unavailable) identifies comparative risk assessment as a GBD framework and says it considers multiple stages in a causal network, including interactions and joint effects of risk factors. The Risk Quantification Models section (page unavailable) describes layers of a causal web, supporting the claim about hierarchically organised, potentially overlapping risks. The paper identifies the framework with the GBD 2000 study but does not establish that GBD has used it since 2002. (LLM, conf=0.85)

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Research works printed but not linked: 8

  1. Murray CJL Murray CJL, Lopez AD Rethinking DALYs The Global Burden of Disease 1996 Cambridge, MA: Harvard School of Public Health (on behalf of the World Health Organization and the World Bank)
  2. World Health Organization (WHO) International Statistical Classification of Disease and Related Health Problems, Tenth Edition Geneva: World Health Organization 1992
  3. Rothman KJ Greenland S Modern Epidemiology Philadelphia: Lippincott-Raven 1998
  4. Parfit D Reasons and Persons New York: Oxford University Press 1984
  5. Murray CJL Lopez AD eds. The Global Burden of Disease Cambridge, MA: Harvard School of Public Health (on behalf of the World Health Organization and the World Bank) 1996
  6. Anand S Hansen K Geneva: World Health Organization Age Weights and Discounting in Disability-Adjusted Life Years: A Critical Review Summary Measures of Population Health 2002 Murray CJL, Salomon J, Mathers CD, Lopez AD, Lozano R
  7. National Research Council (NRC) Science and Judgment in Risk Assessment Washington, DC: National Academy Press 1994
  8. Morgan MG Henrion M Uncertainty: A Guide to Dealing with Uncertainty in Quantitative Risk and Policy Analysis Cambridge: Cambridge University Press 1990

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Authors
Murray, C. J., Ezzati, M., Lopez, A. D., Rodgers, A., & Vander Hoorn, S.
Affiliations
  • Resources For The Future (US)
  • University of Auckland (NZ)
Corresponding author
Ezzati, Majid
Venue
Population Health Metrics
Published
2003-04-14
Volume
1
Issue
1
Pages
1-1
ISSN
1478-7954 (ISSN-L)
OpenAlex
W2109078197
Cited by
887
References
110
Citations by year
2026: 24 · 2025: 41 · 2024: 50 · 2023: 44 · 2022: 60 · 2021: 30 · 2020: 38 · 2019: 35 · 2018: 31 · 2017: 38 · 2016: 29 · 2015: 41 · 2014: 62 · 2013: 48 · 2012: 50
FWCI
16.72
Type
journal article
Language
en
Open access
Locations
  • Population Health Metrics (publishedVersion)
  • PubMed Central (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Minerva Access (University of Melbourne) (submittedVersion)
Funders
National Institute on Aging (P01AG017625)
Topics
  • Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Health, Environment, Cognitive Aging
Keywords
disease burden, risk factor combinations, causal attribution, discounting, uncertainty, disease prevention

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