Burden of Disease - Frequently asked questions

1. When a person dies, is it the place of death or the address of the person who dies that determines which local government area has the death recorded against it?
   It is the address of the person who dies that matters for allocation to a local government area. The person may have died anywhere in Australia, but the death will be recorded against the address of residence at the time of death.

2. What is COPD?
   Chronic Obstructive Pulmonary Disease which is largely made up of the tobacco-related conditions emphysema and chronic bronchitis.

3. What are the confidence intervals around the DALYs?
   Confidence intervals around the DALYs are not calculated because there is no statistical technique available for doing so. There are so many variables which impact on the estimates of Years lived with Disability that it is not possible to calculate confidence intervals. When looking at the DALY rates, and trying to assess the degree of uncertainty in them, it is useful to identify the portion of the DALY rate that is made up of Years of Life Lost (YLL) and the remaining portion that is made up of Years lived with Disability (YLD). Confidence intervals will be made available shortly for YLL rates and thus YLL rates for a LGA can be labelled as significantly higher or lower than the Victorian average.

4. What are the main causes of Unintentional Injury apart from Road Traffic Accidents and Falls?
   The main other causes of unintentional injury are other traffic accidents, striking and crushing accidents, poisoning, drowning, machinery accidents and burns.

5. How are the drug overdose deaths that are not clearly suicides coded?
   Intent is very important in determining suicide coding. Where deaths are coded as "query intentional", the assumption was made that 90% of these were intentional. Where there was no mention of intent, and the drug was an opioid, (occurring most often in young males) the death was coded as drug abuse.

6. What is BPD and GAD?
   These are two Mental disorders: Borderline Personality Disorder and General Anxiety Disorder.

7. What is the logic behind the ordering of the Diseases categories in the output screens?
   The diseases are organised into the International Classification (system) of Diseases chapters, which enable comparisons with other countries and the rest of Australia. It is a widely used classification system based on body systems.

8. Can we compare the total DALY rate for an LGA in 1996 with that in 2001?
   This is not legitimate to do. Methods of evaluating the YLD component of the DALY have changed for some very important diseases (cardiovascular, diabetes, neurological and oral). Only a subset of all diseases is perfectly comparable, and some others are moderately comparable. Details are provided in the Victorian Burden of Disease Study 2001 in Chapter 6. What is legitimate to compare are the former and current relative rankings of diseases (using the total DALY rate) within a LGA, or the rankings of LGAs within their Region and Victoria. Explanations for ranking changes must include consideration of all diseases and LGAs. For example the top ranking of cancers is partly explained by the larger reduction in the burden of cardiovascular disease.

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