Instability of Global Burden of Disease Estimates of Deaths and Disability-Adjusted Life-Years From Major Risk Factors

How stable and consistent are the Global Burden of Disease (GBD) estimates for mortality and disability-adjusted life-years (DALYs) that are attributable to major risk factors from 2010 to 2023?This meta-epidemiological assessment comparing estimates across 8 iterations of GBD found substantial instability in behavioral risk, particularly dietary risks. Comparing revised estimates across iterations, half of the estimates had a coefficient of variation exceeding 0.2, and one-third of estimates for dietary risks in GBD 2021 fell outside the corresponding GBD 2019 uncertainty intervals.GBD risk factor estimates, especially for behavioral and dietary risks, show marked inconsistency likely reflecting methodologic or data changes rather than true burden shifts.

Corresponding Author: John P. A. Ioannidis, MD, DSc, Meta-Research Innovation Center at Stanford, Stanford University, 3180 Porter Dr, Stanford Research Park, Room A129, Palo Alto, CA 93404 (jioannid@stanford.edu).

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