Department of Pediatrics, Neurology and Neurosurgery, McGill University, Montreal, Que., Canada.
Neuroepidemiology. 2013;40(4):264-8. doi: 10.1159/000345120. Epub 2013 Jan 24.
To provide an estimate of the period prevalence of cerebral palsy (CP) in the province of Quebec.
Children with CP were identified from three consecutive birth cohorts (1999-2001) from the Quebec CP Registry, covering 6 of the 17 administrative health regions of the province. Two inferential approaches were applied for period prevalence estimation, frequentist and bayesian.
228 children were identified with CP. Using a frequentist approach, the overall prevalence of CP was 1.84 per 1,000 children aged 9-11 years living in those areas in 2010 (95% CI 1.60-2.08). Using a bayesian approach taking into account the uncertainty about the registry's sensitivity in capturing all cases, the overall prevalence is higher at 2.30 per 1,000 children with a 95% CI (1.99-2.65).
Using a bayesian approach to adjust for the registry's known high specificity and lower sensitivity, the prevalence estimate is in concordance with worldwide estimates and estimates using administrative databases in western Canadian provinces. Future studies are needed to validate the diagnosis of CP within administrative databases and to evaluate possible regional trends across Canada in both prevalence and health service utilization, which may highlight disparities in healthcare delivery.
估计魁北克省脑瘫(CP)的时期患病率。
从魁北克 CP 登记处的三个连续出生队列(1999-2001 年)中确定 CP 患儿,涵盖该省 17 个行政卫生区中的 6 个。应用了两种推理方法进行时期患病率估计,即频率主义和贝叶斯方法。
共确定 228 名 CP 患儿。采用频率主义方法,2010 年生活在这些地区的 9-11 岁儿童中 CP 的总体患病率为每 1000 名儿童 1.84 例(95%CI 1.60-2.08)。采用贝叶斯方法考虑到登记处在捕捉所有病例方面的敏感性的不确定性,总体患病率更高,为每 1000 名儿童 2.30 例,95%CI(1.99-2.65)。
采用贝叶斯方法调整登记处已知的高特异性和较低的敏感性,患病率估计与全球估计以及使用加拿大西部省份行政数据库的估计相符。需要进一步研究来验证行政数据库中 CP 的诊断,并评估加拿大各地在患病率和卫生服务利用方面可能存在的区域趋势,这可能突出了医疗保健提供方面的差异。