Identifying gaps for research prioritization: global burden of external causes of injury as reflected in the Cochrane Database of Systematic Reviews

Importance

Burden of disease should impact research prioritization.

Objective

To analyze the Cochrane Database of Systematic Reviews (CDSR) and determine whether systematic reviews and protocols accurately represent disease burden, as measured by disability-adjusted life years (DALYs) from the Global Burden of Disease (GBD) 2010 study.

Methods

Two investigators collected GBD disability metrics for 12 external causes of injury in the GBD 2010 study. These external causes were then assessed for systematic review and protocol representation in CDSR. Data were collected during the month of April 2015. There were no study participants aside from the researchers. Percentage of total 2010 DALYs, 2010 DALY rank, and median DALY percent change from 1990 to 2010 of the 12 external causes of injury were compared with CDSR representation of systematic reviews and protocols. Data were analyzed for correlation using Spearman rank correlation.

Results

Eleven of the 12 causes were represented by at least one systematic review or protocol in CDSR; the category collective violence and legal intervention had no representation in CDSR. Correlation testing revealed a strong positive correlation that was statistically significant. Representation of road injury; interpersonal violence; fire, heat, and hot substances; mechanical forces; poisonings, adverse effect of medical treatment, andanimal contact was well aligned with respect to DALYs. Representation of falls was greater compared to DALYs, while self-harm, exposure to forces of nature, and other transport injury representation was lower compared to DALYs.

Conclusions and relevance

CDSR representation of external causes of injury strongly correlates with disease burden. The number of systematic reviews and protocols was well aligned for seven out of 12 causes of injury. These results provide high-quality and transparent data that may guide future prioritization decisions.