Is the Mortality Trend of Ischemic Heart Disease by the GBD2013 Study in China Real?

Area of Science:

• Epidemiology
• Public Health
• Biostatistics

Background:

• Mortality trends for ischemic heart disease (IHD) in China differ between the Global Burden of Disease (GBD) 2010 and GBD 2013 studies.
• Accurate mortality statistics rely on precise data redistribution, particularly for conditions like chronic pulmonary heart disease (PHD).

Purpose of the Study:

• To investigate the discrepancies in IHD mortality trends between GBD 2010 and GBD 2013 in China.
• To evaluate the impact of different chronic pulmonary heart disease (PHD) redistribution methods on IHD mortality data.
• To highlight the importance of improving garbage code (GC) redistribution in mortality statistics.

Main Methods:

• Utilized data from the disease surveillance points system in China.
• Compared two distinct proportions for assigning chronic PHD as garbage code (GC) to IHD, derived from GBD 2010 and GBD 2013.
• Analyzed the age-standard mortality rate (ASMR) using both GBD 2010 and GBD 2013 approaches for specific years.

Main Results:

• The GBD 2013 approach resulted in a substantial increase in ASMR compared to the GBD 2010 approach: 100.21% in 1991, 44.81% in 1996, and 42.47% in 2000.
• The method used for redistributing chronic PHD significantly influenced the observed trend of IHD mortality.
• The GBD 2013 approach led to an elevation in IHD mortality during the early 1990s.

Conclusions:

• The redistribution methodology for chronic PHD is a critical factor affecting IHD mortality trends in China.
• Enhancing the redistribution of garbage code (GC) is essential for improving the accuracy of national mortality statistics.
• Discrepancies in GBD studies highlight the need for standardized and refined data handling procedures.