| Titre : | Classification of surgical procedures for epidemiologic assessment of sporadic Creutzfeldt-Jakob Disease transmission by surgery. (2006) |
| Auteurs : | J. DE PEDRO-CUESTA ; M.J. BLEDA ; M. CRUZ ; LAURSEN (H.) : DNK. Neuropathology Laboratory. Copenhagen. ; MOLBAK (K.) : DNK. Department of Epidemiology. Statens Serum Institut. Copenhagen. ; RABANO (A.) : ESP. Neuropathology Laboratory. Alcorcon Hospital. Alcorcon. ; A. SIDEN ; Carlos 3 Institute of Health. National Center for Epidemiology. Department of Applied Epidemiology. Madrid. ESP ; Eurosurgycjd Research Group. INC ; Karolinska Institutet. Neurology Division. Department of Clinical Neurosciences. Stockholm. SWE |
| Type de document : | Article |
| Dans : | European journal of epidemiology (vol. 21, n° 8, 2006) |
| Pagination : | 595-604 |
| Langues: | Anglais |
| Mots-clés : | Thérapeutique chirurgicale ; Neurochirurgie ; Chirurgie ; Classification ; Procédure ; Epidémiologie ; Maladie Creutzfeldt Jakob ; Infection ; Surveillance soins ; Soins ; Etiologie ; Méthodologie ; Surveillance ; Sécurité ; Homme ; Thérapeutique ; Prion ; Maladie dégénérative ; Système nerveux [pathologie] |
| Résumé : | [BDSP. Notice produite par INIST-CNRS x91R0xL8. Diffusion soumise à autorisation]. Background : In this preparatory phase of a case-control study, we propose and evaluate a new tool for classifying surgical procedures (SPs) in categories useful for epidemiologic research on surgical transmission of sporadic Creutzfeldt-Jakob disease (sCJD). Methods : All SPs reported to the Swedish National Hospital Discharge Registry in the period 1974-2002, and undergone by 212 Swedish patients with registered diagnosis of CJD at death, hospital discharge or notification, in the period 1987-2002,1060 age-sex-and residence-matched controls and 1340 randomly chosen population controls, were reclassified into one of six categories of hypothetical transmission risk level. For that purpose the following two attributes were used : non-disposable instruments involved ; and highest assigned ad-hoc risk level for four tissues or anatomical structures contacting such instruments. Results : A total of 1170 different SP codes were reclassified as follows : 3.1% in the high-risk, 59.1% in the lower-risk, 24.4% in the lowest-risk, and 2.1% in the no-risk groups, with 11.3% procedures negatively defined by rubric as "other than..." being assigned to two spurious diluted-high and diluted-lower risk categories. The high-risk group mainly comprised neurosurgical (53%) and ophthalmic (39%) procedures. Sensitivity of neurosurgery and of ophthalmic surgery excluding neurosurgery, for the high-and diluted-high risk vs. other categories was 46% and 84%, while specificity was 98% and 95%, respectively. Sensitivity analysis based on these indices revealed that non-significant odds ratio effects of 1.4 and 1.3 for neurosurgery and ophthalmic surgery corresponded to statistically significant values of 5.1 after reclassification. Conclusions : This classification might contribute to quantify effects masked by use of body-system SP-categories in case-control studies on sCJD transmission by surgery. |
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