The burden of chronic venous diseases is unknown

One can think about the ‘burden’ of a disease (BoD) in two ways: The first is obvious, i.e. the consequences of the disease on the individual who suffers from it. We already work on symptoms, signs, disability and impairmentofqualityof life(QoL)relatedtotheevolution and complications of chronic venous disorders (CVDs). The literature provides information on these effects, and their description is essentially clear and satisfactory. However, their point of prevalence remains fuzzy because of the lack of epidemiological studies, and because of the differences in disease management or data management between countries. The second, which is less obvious, more specific and certainly unknown to most physicians, is the socioeconomic appraisal of the consequences of a disease in a population. This is the main subject of this editorial; we will call it the Burden of CVD (BoV). The first Global Burden of Diseases campaign began in 1990 and was commissioned by the World Bank. Another campaign, sponsored by the World Health Organization (WHO) and several other institutions and universities, commenced in 2005. The burden of many diseases, not all potentially lethal, has been evaluated from malaria to diabetes. The WHO has provided the following definition: ‘The WHO global burden of disease (GBD) measures burden of disease using the disability-adjusted life year (DALY). This time-based measure combines years of life lost due to premature mortality and years of life lost due to time lived in states of less than full health. The DALY metric was developed in the original GBD 1990 study to assess the burden of disease consistently across diseases, risk factors and regions’. The formula DALY 1⁄4 YLL +YLD (years of life lost + years of life lost due to disability) may look cryptic but deserves some attention. Another measurement, Quality Adjusted Life Years (QALYs) may also be used. The WHO classification of diseases (ICD-10) mentions CVDs in chapters I83, I86.2, I86.3, I87. However, CVD has not been well described or appraised, although it is of utmost importance to us.