Koobatian T J, Birkhead G S, Schramm M M, Vogt R L
Epidemiology Division, Vermont Department of Health, Burlington 05401.
Ann Neurol. 1991 Oct;30(4):618-21. doi: 10.1002/ana.410300418.
The sensitivity of passive reporting of Guillain-Barré syndrome (GBS) to the Vermont Department of Health from 1980 to 1985 was compared to that of computerized hospital discharge abstract data. Written hospital discharge summaries were reviewed for clinical data to validate the computerized abstracts. In all, 51 definite and probable cases of GBS were identified from hospital data during a period when only 4 cases (8%) had been reported to the health department through passive physician reporting. Based on the hospital data, the incidence of this syndrome in Vermont was 1.6/100,000 population/year. The incidence rate for males was 1.5 times that for females. No geographical or seasonal clustering of cases was found. These epidemiological features are consistent with previously published data on the syndrome and suggest that the incidence has not changed significantly in the past 10 years. Incidence rates for GBS based on passively reported cases markedly underestimate the true incidence rate. Although limited by the lack of timeliness for public health surveillance, computerized hospital discharge data are readily available in many states and may be more sensitive in detecting cases, compared to passive surveillance. They may be a useful tool for establishing baseline rates and examining long-term trends for selected acute diseases like GBS for which there are well-established diagnostic criteria and that usually result in hospitalization.
对1980年至1985年期间向佛蒙特州卫生部被动报告吉兰 - 巴雷综合征（GBS）的敏感性与计算机化医院出院摘要数据的敏感性进行了比较。审查书面医院出院总结中的临床数据以验证计算机化摘要。在该时间段内，从医院数据中总共识别出51例确诊和可能的GBS病例，而通过医生被动报告向卫生部门报告的只有4例（8%）。根据医院数据，佛蒙特州该综合征的发病率为每年1.6/10万人口。男性发病率是女性的1.5倍。未发现病例的地理或季节聚集性。这些流行病学特征与先前发表的关于该综合征的数据一致，表明在过去10年中发病率没有显著变化。基于被动报告病例的GBS发病率明显低估了真实发病率。尽管受公共卫生监测及时性不足的限制，但计算机化医院出院数据在许多州都很容易获得，与被动监测相比，在检测病例方面可能更敏感。它们可能是建立基线发病率以及检查选定急性疾病（如GBS，其有完善的诊断标准且通常导致住院）长期趋势的有用工具。
