Davanipour Z, Smoak C, Bohr T, Sobel E, Liwnicz B, Chang S
Department of Neurology, School of Medicine, Loma Linda University, CA 92350.
Neuroepidemiology. 1995;14(1):1-6. doi: 10.1159/000109771.
Case ascertainment for an epidemiologic study of Creutzfeldt-Jakob disease (CJD) can be difficult. This report investigates the efficiency of various sources of case ascertainment for CJD. Cases were identified utilizing neuropathologists, hospitals and death certificates from 11 targeted states. For the period of 1986-1988, 247 death certificates indicating a diagnosis of CJD were obtained. Only 26 potential cases were identified without death certificates. The proportion of neuropathologically confirmed cases identified by death certificates only, i.e., which were not identified through any other source, was 42%. Furthermore, 80% of all the neuropathologically confirmed cases were ascertained utilizing death certificates as a source. Of the remaining 20%, 7% were ascertained through neuropathologists only, 10% through hospitals only, 1.5% through a combination of hospitals and neuropathologists, and 1.5% through another source. The false-positive rate for death certificates with neuropathology (which may have been performed after the death certificate was filled out) was estimated to be 8.3%. The results indicate that death certificates were by far the most efficient source for initial ascertainment of potential CJD cases to be followed by verification of diagnosis.
克雅氏病（CJD）流行病学研究中的病例确诊可能存在困难。本报告调查了CJD病例确诊的各种来源的效率。通过神经病理学家、医院以及来自11个目标州的死亡证明来确定病例。在1986年至1988年期间，共获得了247份表明诊断为CJD的死亡证明。仅通过死亡证明就确定了26例潜在病例。仅通过死亡证明（即未通过任何其他来源确定）确诊的神经病理学确诊病例的比例为42%。此外，所有神经病理学确诊病例中有80%是通过死亡证明确诊的。在其余20%中，7%仅通过神经病理学家确诊，10%仅通过医院确诊，1.5%通过医院和神经病理学家联合确诊，1.5%通过其他来源确诊。伴有神经病理学检查（可能在填写死亡证明后进行）的死亡证明的假阳性率估计为8.3%。结果表明，死亡证明是目前初步确定潜在CJD病例并随后进行诊断核实的最有效来源。
