| Titre : | Investigation d'agrégats d'anomalies de la reproduction : théorie et pratique. (1996) |
| Titre original: | Investigation of clusters of adverse reproductive outcomes : Theoretical and practical aspects. |
| Auteurs : | P. DE WALS ; J. LAGUE ; T. NIYONSENGA ; Centre de recherche clinique du Centre universitaire de santé de l'Estrie. INC ; Département des Sciences de la santé communautaire de l'Université de Sherbrooke. CAN ; Direction de la santé publique de la régie régionale de la santé et des services sociaux de Montérégie. INC |
| Type de document : | Article |
| Dans : | Archives of public health (vol. 54, n° 1-2, 1996) |
| Pagination : | 43-58 |
| Langues: | Français |
| Mots-clés : | Gestation [pathologie] ; Foetopathie ; Homme ; Epidémiologie ; Méthodologie ; Recommandation ; Québec ; Canada ; Amérique |
| Résumé : | [BDSP. Notice produite par INIST SHZ9qR0x. Diffusion soumise à autorisation]. Several reports of clusters of adverse reproductive outcomes have lead us to prepare guidelines for their investigation. Firstly, scientific objectives must be met (identifying pathological causes while using sound methodology). In addition, the public health objectives of informing the population and taking control measures when required must be satisfied. Finally, economic constraints require the obtention of a maximum of information to make the best decision, using a minimum of resources. Experts must be involved early in the investigation. The study protocol should remain flexible to take into account the particularities of each cluster and the character of each investigation. A stepwise approach is to be used and the decision to continue or to stop after each step is to be made according to explicit preestablished criteria. We argue that the use of qualitative methods for case studies is to be recommended instead of classic epidemiological approaches. Statistical methods for detecting spaciotemporal clustering are not very useful during the preliminary phase of investigation but they may be usefull when a specific etiological hypothesis has to be tested or when a follow-up is done, assuming a regression of frequency to the mean. There are several methods for monitoring time series in a follow-up study. A simple method consisting in observation of a "fixed window" is proposed. It has the advantages of being conceptually simple and easy to use. (...) |
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