Spatio-temporal clustering of amyotrophic lateral sclerosis in France: A population-based study.
Eur J Epidemiol
; 37(11): 1181-1193, 2022 Nov.
Article
em En
| MEDLINE
| ID: mdl-36098945
ABSTRACT
OBJECTIVE:
To assess spatial aggregates of amyotrophic lateral sclerosis (ALS) incident cases, using a solid geo-epidemiological statistical method, in France.METHODS:
This population-based study (2003-2011) investigated 47.1 million person-years of follow-up (PYFU). Case ascertainment of incident ALS cases was based on multiple sources (ALS referral centers, hospital centres and health insurance data). Neurologists confirmed all ALS diagnoses. Exhaustiveness was estimated through capture-recapture. Aggregates were investigated in foursteps:
(a) geographical modelling (standardized incidence ratio (SIR) calculation), (b) analysis of the spatial distribution of incidence (Phothoff-Winttinghill's test, Global Moran's Index, Kulldorf's spatial scan statistic, Local Moran's Index), (c) classification of the level of certainty of spatial aggregates (i.e. definite cluster; probable over-incidence area; possible over-incidence area) and (d) evaluation of the robustness of the results.RESULTS:
The standardized incidence of ALS was 2.46/100,000 PYFU (95% CI 2.31-2.63, European population as reference) based on 1199 incident cases. We identified 13 areas of spatial aggregates one cluster (stable in robustness analysis), five probable over-incidence areas (2 stable in robustness analysis) and seven possible over-incidence areas (including 4 stable areas in robustness analysis). A cluster was identified in the Rhône-Alpes region 100 observed vs 54.07 expected cases for 2,411,514 PYFU, SIR 1.85 (95% CI 1.50-2.25).CONCLUSION:
We report here one of the largest investigations of incidence and spatial aggregation of ALS ever performed in a western country. Using a solid methodology framework for case ascertainment and cluster analysis, we identified 13 areas that warrant further investigation.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Esclerose Lateral Amiotrófica
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Eur J Epidemiol
Assunto da revista:
EPIDEMIOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
França