Global Health
Estimating Mortality in Gallbladder and Biliary Diseases Using the CODEm Method: Insights from the Global Burden of Disease Study Mei Wang* Mei Wang Mae Dirac
GBD (Global Burden of Disease Study) is a global scientific effort to quantify the burden of over 360 diseases and injuries by age, sex, and location from 1990 to present. To estimate age, sex, year and location-specific death rates of gallbladder and biliary disease, we utilized Cause of Death (COD) data and applied Cause of Death Ensemble modeling (CODEm) tool. COD data for gallbladder and biliary disease was extracted from vital registration systems and verbal autopsies from 3701 sources covering 126 countries. Raw COD data were standardized to account for different coding practices and age-sex aggregations. Processed COD data were used as an input to CODEm—a highly systemized Bayesian, geo-temporal ensemble model—to analyze death rates of disease. CODEm tested a wide variety of submodels using different sets of predictive covariates and model types. Each submodel was weighted based on its out-of-sample predictively validity. The submodels with the highest predictive validity were combined to make the final ensemble model, ensuring accuracy and robustness in estimating cause-specific mortality rates across diverse populations and regions. Global deaths were estimated at 131,100 (113,600 to 161,800) in 2021. This was a 71.7% increase from 76,400 (60,900 to 85,300) deaths in 1990. The global age-standardized mortality rate was 1.62 (1.4 to 2) per 100,000 in 2021, which was a 28% decrease from 2.25 (1.83 to 2.51) per 100,000 in 1990. Although a significant global increase in gallbladder and biliary diseases death between 1990 and 2021 was noticed, there has been a notable decrease in the age-standardized mortality rate over the same period, suggesting potential advancements in healthcare and management strategies. The application of the CODEm method not only enhances the accuracy of mortality assessments but also facilitates informed decision-making and targeted strategies for addressing different challenges in different parts of the world.