Introducing the Descriptive Framework for Assessing Epidemiological Cross-National Transferability: Application to Extrapolating Pediatric Life-Limiting Condition Prevalence Between Two European Countries.

Background: The transfer of epidemiological parameters, such as prevalence, between nations with limited data is a common but unstructured process. Determining how pediatric life-limiting condition (LLC) prevalence rates from one country can be applied to another country is unclear. Objectives: This study introduces the Descriptive Framework for Assessing Epidemiological Cross-National Transferability (FACT), a five-step approach to systematically validate and execute the transfer of epidemiological prevalence estimates. Design: Using the established epidemiological work by Fraser et al., the framework was applied to determine LLC prevalences in Germany (the use case). Measurements: Official population statistics from England and Germany were adjusted for gender and age. Results revealed that many comparative indicators were similar, deviating <2.5/5 percentage (points), supporting the transfer of English pediatric LLC prevalences to Germany. Results: The transfer resulted in an estimated number of 103,566 (65.30 per 10,000) German children and adolescents affected by life-shortening diseases in 2022, with projections between 107,934 and 138,817 by 2030. Conclusions: FACT demonstrates significant utility in transferring prevalence figures and is likely applicable to other epidemiological measures, such as incidence.