Document Detail

When is an apparent excess of neurologic cases epidemiologically significant?
MedLine Citation:
PMID:  1944897     Owner:  NLM     Status:  MEDLINE    
To conserve clinical and public health resources, it is necessary to screen reports from the community of an excess or cluster of cases of chronic neurologic diseases for potential epidemiologic significance, ie, to identify those clusters that may have occurred owing to the operation of an underlying etiologic cause rather than to chance alone. Traditionally, the probability that such a cluster has occurred by chance within the reporting community is computed, ignoring the fact that many other similar communities have not reported a cluster. We propose a modified approach that takes this larger universe of communities into account, thereby raising the threshold for potential epidemiologic significance. As a result, the lowest value for the ratio of observed-to-expected cases that may be considered of epidemiologic significance should be increased by factors of 2 for small clusters (one to three expected cases), 1.5 for intermediate clusters (seven to 30 expected cases), and 1.3 for large clusters (60 to 90 expected cases). Consequently, case ascertainment and full field investigations can be reserved for only those reports that, if confirmed, would represent a cluster not due to chance alone. We illustrate this with a case from our own experience.
C Armon; J R Daube; P C O'Brien; L T Kurland; D W Mulder
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Neurology     Volume:  41     ISSN:  0028-3878     ISO Abbreviation:  Neurology     Publication Date:  1991 Nov 
Date Detail:
Created Date:  1991-12-20     Completed Date:  1991-12-20     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1713-8     Citation Subset:  AIM; IM    
Department of Neurology, Mayo Clinic, Rochester, MN 55905.
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MeSH Terms
Amyotrophic Lateral Sclerosis / epidemiology
Cluster Analysis
Iowa / epidemiology
Nervous System Diseases / epidemiology*
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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