The panel-based approach requires a brief lay description of what living with a particular condition is like for a typical case. The description of a typical injury case is difficult because of the potential variation in the severity of the injury and in the injury’s impact on the injured person’s life. In the GBD 2013 study, the lay description of a spinal cord lesion below neck level, as used in the GBD 2010 study, was revised to include “and no urine and bowel control”. This revision led to a sixfold increase in the corresponding disability weight – from 0.047 to 0.296.11 In the case-based approach, the problems associated with the variable scope and specificity of lay descriptions are avoided.