Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2023-07-27 Cooperative journals: 《中国全科医学》
Abstract： Burden of disease measurement based on the International Statistical Classification of Diseases and Related Health Problems （ICD） codes have been widely used worldwide. However，most of the current studies are based on Western medical codes of ICD. As the internationalization of Traditional Chinese Medicine（TCM），the inclusion of TCM codes in ICD-11 will facilitate the improvement of TCM disease diagnosis，the calculation of prevalence，survival，medication use，and treatment levels of TCM disease，which can further evaluate the disease burden of TCM diseases，promote medical decision making and rational allocation of health resources，thus further promoting the internationalization of TCM. However，the imperfection of TCM codes in ICD-11 and inadequate mapping between it and Western medicine codes，our national standards for TCM has also brought new challenges to the measurement of TCM disease burden. Based on the coding system of disease burden，this paper reviewed the deficiencies in the current research on the calculation of disease burden of TCM，and the impact of ICD-11 inclusion of TCM codes on the calculation of disease burden of TCM，made a preliminary comparison among the TCM codes and Western medical codes in ICD-11 and new national standard codes in China，to provide reference for the improvement of the calculation and coding of TCM disease burden. It is proposed that in the future，big data technologies can be used to facilitate the mapping between standardized TCM terms and ICD-11 TCM codes，ICD-11 TCM codes and Western medical codes，thus facilitating research on the burden of disease in TCM.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-07-24 Cooperative journals: 《中国全科医学》
Abstract： Background The disease burden of esophageal cancer is high in China，more and more studies have shown that tobacco has a greater adverse effect on the development of esophageal cancer. Objective To understand trends inesophageal cancer deaths and burden of disease attributable to tobacco in China from 1990 to 2019，and provide data to inform the development of public health policies and interventions. Methods Global burden of disease 2019 （GBD 2019） data were used to extract the age-specific and sex-specific data on esophageal cancer deaths attributable to tobacco in China from 1990 to 2019. Mortality，disability adjusted life years（DALYs），years of life lost（YLLs），and disability adjusted life years （YLDs） were used to assess the disease burden of esophageal cancer attributable to tobacco in China. Joinpoint regression software and age#2;period-cohort modeling methods were applied to analyze the trends of disease burden and mortality with age，period and cohort. the Bayesian-period-cohort analysis （BAPC） was applied to predict the mortality rate of esophageal cancer attributable to tobacco in China from 2020 to 2030. Results From 1990 to 2019，the number of deaths caused by esophageal cancer attributable to tobacco among Chinese residents rose from 76，400 to 123，900，with an increase of 62.17%，and the standardized mortality rate declined from 9.30/100 000 to 6.20/100 000，with a decrease of 33.33%；the DALYs rose from 1，972，500 person-years to 2，822，600 person-years，with an increase of 43.10%，and the DALYs rate decreased from 220.50/100 000 to 134.47/100 000，with a decrease of 39.02%. In terms of gender，the disease burden of esophageal cancer attributable to tobacco was mainly caused by males，with 117，700 deaths and a standardized mortality rate of 12.82/100 000 in 2019 due to tobacco-attributable esophageal cancer in males，compared to 0.62 million deaths number and a standardized mortality rate of 0.63/100 000 in females. In 2019，the number of esophageal cancer deaths attributable to tobacco among Chinese residents peaked in the age group of >69-74 years，while DALYs peaked in the age group of >64-69 years，at 23，000 and 510，300 cases，respectively. The mortality rate continued to increase with age，especially after 50 years of age. The results of Joinpoint regression analysis showed that the AAPC value of esophageal cancer mortality attributable to tobacco was -1.4〔95%CI（-1.6，-1.2）〕 in China from 1990 to 2019，with -3.3〔95%CI（-3.6，-2.9）〕 for females，and -1.3〔95%CI（-1.4，-1.1）〕 for males；the AAPCfor DALYs rate was -1.7〔95%CI（-1.9，-1.5）〕，with -3.7〔95%CI（-4.0，-3.4）〕 for females and -1.5〔95%CI（-1.7，-1.3）〕 for males. Analysis of the age-period-cohort model of mortality from esophageal cancer attributable to tobacco showed a negative net offset of -1.690%〔95%CI（-2.024%，-1.354%）〕. It is expected that the number of deaths and mortality rates from tobacco-attributable esophageal cancer among Chinese residents will be relatively stable with a small decrease from 2020 to 2030，with mortality rates declining from 12.64/100 000 in 2020 to 12.63/100 000 in 2030 for males，and from 0.6/100 000 in 2020 to 0.46/100 000 for females. Conclusion Mortality rates and DALYs due to tobacco-attributable esophageal cancer among Chinese residents increased and then declined from 1990 to 2019. The burden of disease due to tobacco-attributable esophageal cancer is mainly caused by males in term of gender，by middle-aged and elderly people by age，which should be given sufficient attention. It is expected that the number of deaths and mortality rates from tobacco-attributable esophageal cancer will be stable and slightly decreasing from 2020 to 2030.
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