The Burden of Proof Studies

In this issue, Nature Medicine presents the Burden of Proof studies led by the Institute for Health Metrics and Evaluation, which quantitatively evaluate the strength of evidence of risk–outcome relationships to better inform effective clinical and policy recommendations.

New analyses are prompting a shift in how we think about systolic blood pressure, with substantial benefits to be gained from population-wide interventions alongside targeting high-risk groups.

Although questions remain about several diet and disease associations, current evidence supports dietary guidelines to limit red meat and increase vegetable intake.

The Global Burden of Disease provides essential data for evidence-based healthcare, but could be improved by investment in health data systems in low- and middle-income countries

This Perspective reflects on the past, present and future of the dynamic, expanding public health endeavor that is the Global Burden of Disease Study.

A new Burden of Proof meta-analytic method that accounts for between-study heterogeneity and corrects for bias between different study designs is used to interpret the strength of evidence between different pairs of risk factors and health outcomes.

A meta-analysis using the Burden of Proof method reported consistent evidence supporting harmful associations between exposures to secondhand smoke and nine health outcomes.

A meta-analysis using the burden of proof risk function identified consistent evidence supporting harmful associations between the exposure to intimate partner violence against women and childhood sexual abuse on health outcomes.

A meta-analysis using the Burden of Proof function identified modest evidence supporting a protective role of vegetable consumption against ischemic heart disease, stroke and esophageal cancer but not type 2 diabetes.

Using the burden of proof analytical tool, a meta-analysis found weak or no evidence of associations between unprocessed red meat consumption and increased risk of six cardiometabolic disease and cancer outcomes.

A systematic review using the burden of proof meta-analytic method found a significant harmful effect between high systolic blood pressure and ischemic heart disease.

A meta-analysis using the Burden of proof method reported consistent evidence supporting harmful associations between smoking and 28 different health outcomes.

While the number of chewing tobacco users is increasing in many countries, it is often under-emphasized in tobacco control. Here, the authors show that chewing tobacco is a risk factor for major causes of disease burden, including stroke and various cancers, meriting future research and policy attention.