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To address this, the GBD provides three sources of data which are ideal for generating overviews of global estimates of mental health status without the availability of more detailed estimates. These are World Health Organization (WHO) estimates, GBD estimates and surveys.47 Survey data form the basis for global burden estimations in the absence of any detailed database, and provide an important source of data on epidemiological parameters for a range of diseases. Coverage data from these estimates allow the GBD to produce more detailed estimates based on these parameters using DisMod-MR.47 The GBD estimates, as defined above, are derived from pooled WHO data; this includes both population- and patient-level data. This pooling of data is done using Bayesian meta-regression to reduce the statistical noise associated with small sample sizes. Thus we combine as much of the available data as possible, while retaining the ability to account for known sources of variation in estimates. The combination of these data sources give us the primary and secondary data input for mental health estimations in GBD 2013.

The issues discussed above document the fact that requiring data without any study protocol or quality checks leads to assumptions being made about the numbers available, which can either be reasonable or justifiable as long as they are documented. If there are records available without documented quality checks, we will use them but if it is clear that they have not undergone a quality check, we will be unable to use them in our estimation. This is true of surveys, which are quality checked, as much as they are field checked.

The source of the data is often only defined on the source papers. We have taken it upon ourselves to do some research to confirm the data sources. GBD 2013 starts with the datasource as stated in the published source papers. If other data exist, we ask whether or not they are relevant. If they are not, the paper will state the data source as unknown. The only exceptions to this rule are: (i) surveys with no underlying data source; or (ii) surveys with no underlying descriptive statistics and that clearly do not fulfil the criteria to be a survey. In the former case, we sometimes establish a new data source. d2c66b5586