Detection and investigation of temporal clusters of congenital anomaly in Europe: seven years of experience of the EUROCAT surveillance system

Helen Dolk, Maria Loane, C Teljeur, J Densem, Ruth Greenlees, Nichola McCullough, J Morris, V Nelen, F Bianchi, A Kelly

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Detection and investigation of congenital anomaly clusters is one part of surveillance to detect new or changing teratogenic exposures in the population. The EUROCAT (European Surveillance of Congenital Anomalies) cluster monitoring system and results are described here. Monitoring was conducted annually from 2007 to 2013 for 18 registries covering an annual birth population up to 0.5 million births. For each registry and 72 anomaly subgroups, the scan “moving window” technique was used to detect clusters in time occurring within the last 2 years based on estimated date of conception. Registries conducted preliminary investigations using a standardised protocol to determine whether there was cause for concern, and expert review was used at key points. 165 clusters were detected, a rate of 3.4 % of all 4823 cluster tests performed over 7 years, more than expected by chance. Preliminary investigations of 126 new clusters confirmed that 35 % were an unusual aggregation of cases, while 56 % were explained by data quality or diagnostic issues, and 9 % were not investigated. For confirmed clusters, the registries’ course of action was continuing monitoring. Three confirmed clusters continued to grow in size for a limited period in subsequent monitoring. This system is best suited to early detection of exposures which are sudden, widespread and/or highly teratogenic, and was reassuring in demonstrating an absence of a sustained exposure of this type. Such proactive monitoring can be run efficiently without overwhelming the surveillance system with false positives, and serves an additional purpose of data quality control.
LanguageEnglish
Pages1153-1164
JournalEuropean Journal of Epidemiology
Volume30
Issue number11
Early online date4 Apr 2015
DOIs
Publication statusPublished - Nov 2015

Fingerprint

Registries
Parturition
Quality Control
Population
Data Accuracy

Keywords

  • Congenital anomalies
  • Surveillance
  • Clusters

Cite this

Dolk, Helen ; Loane, Maria ; Teljeur, C ; Densem, J ; Greenlees, Ruth ; McCullough, Nichola ; Morris, J ; Nelen, V ; Bianchi, F ; Kelly, A. / Detection and investigation of temporal clusters of congenital anomaly in Europe: seven years of experience of the EUROCAT surveillance system. In: European Journal of Epidemiology. 2015 ; Vol. 30, No. 11. pp. 1153-1164.
@article{188aa2dd1d334d128dadf18ee88ba6b7,
title = "Detection and investigation of temporal clusters of congenital anomaly in Europe: seven years of experience of the EUROCAT surveillance system",
abstract = "Detection and investigation of congenital anomaly clusters is one part of surveillance to detect new or changing teratogenic exposures in the population. The EUROCAT (European Surveillance of Congenital Anomalies) cluster monitoring system and results are described here. Monitoring was conducted annually from 2007 to 2013 for 18 registries covering an annual birth population up to 0.5 million births. For each registry and 72 anomaly subgroups, the scan “moving window” technique was used to detect clusters in time occurring within the last 2 years based on estimated date of conception. Registries conducted preliminary investigations using a standardised protocol to determine whether there was cause for concern, and expert review was used at key points. 165 clusters were detected, a rate of 3.4 {\%} of all 4823 cluster tests performed over 7 years, more than expected by chance. Preliminary investigations of 126 new clusters confirmed that 35 {\%} were an unusual aggregation of cases, while 56 {\%} were explained by data quality or diagnostic issues, and 9 {\%} were not investigated. For confirmed clusters, the registries’ course of action was continuing monitoring. Three confirmed clusters continued to grow in size for a limited period in subsequent monitoring. This system is best suited to early detection of exposures which are sudden, widespread and/or highly teratogenic, and was reassuring in demonstrating an absence of a sustained exposure of this type. Such proactive monitoring can be run efficiently without overwhelming the surveillance system with false positives, and serves an additional purpose of data quality control.",
keywords = "Congenital anomalies, Surveillance, Clusters",
author = "Helen Dolk and Maria Loane and C Teljeur and J Densem and Ruth Greenlees and Nichola McCullough and J Morris and V Nelen and F Bianchi and A Kelly",
year = "2015",
month = "11",
doi = "10.1007/s10654-015-0012-y",
language = "English",
volume = "30",
pages = "1153--1164",
journal = "European Journal of Epidemiology",
issn = "0393-2990",
number = "11",

}

Detection and investigation of temporal clusters of congenital anomaly in Europe: seven years of experience of the EUROCAT surveillance system. / Dolk, Helen; Loane, Maria; Teljeur, C; Densem, J; Greenlees, Ruth; McCullough, Nichola; Morris, J; Nelen, V; Bianchi, F; Kelly, A.

In: European Journal of Epidemiology, Vol. 30, No. 11, 11.2015, p. 1153-1164.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Detection and investigation of temporal clusters of congenital anomaly in Europe: seven years of experience of the EUROCAT surveillance system

AU - Dolk, Helen

AU - Loane, Maria

AU - Teljeur, C

AU - Densem, J

AU - Greenlees, Ruth

AU - McCullough, Nichola

AU - Morris, J

AU - Nelen, V

AU - Bianchi, F

AU - Kelly, A

PY - 2015/11

Y1 - 2015/11

N2 - Detection and investigation of congenital anomaly clusters is one part of surveillance to detect new or changing teratogenic exposures in the population. The EUROCAT (European Surveillance of Congenital Anomalies) cluster monitoring system and results are described here. Monitoring was conducted annually from 2007 to 2013 for 18 registries covering an annual birth population up to 0.5 million births. For each registry and 72 anomaly subgroups, the scan “moving window” technique was used to detect clusters in time occurring within the last 2 years based on estimated date of conception. Registries conducted preliminary investigations using a standardised protocol to determine whether there was cause for concern, and expert review was used at key points. 165 clusters were detected, a rate of 3.4 % of all 4823 cluster tests performed over 7 years, more than expected by chance. Preliminary investigations of 126 new clusters confirmed that 35 % were an unusual aggregation of cases, while 56 % were explained by data quality or diagnostic issues, and 9 % were not investigated. For confirmed clusters, the registries’ course of action was continuing monitoring. Three confirmed clusters continued to grow in size for a limited period in subsequent monitoring. This system is best suited to early detection of exposures which are sudden, widespread and/or highly teratogenic, and was reassuring in demonstrating an absence of a sustained exposure of this type. Such proactive monitoring can be run efficiently without overwhelming the surveillance system with false positives, and serves an additional purpose of data quality control.

AB - Detection and investigation of congenital anomaly clusters is one part of surveillance to detect new or changing teratogenic exposures in the population. The EUROCAT (European Surveillance of Congenital Anomalies) cluster monitoring system and results are described here. Monitoring was conducted annually from 2007 to 2013 for 18 registries covering an annual birth population up to 0.5 million births. For each registry and 72 anomaly subgroups, the scan “moving window” technique was used to detect clusters in time occurring within the last 2 years based on estimated date of conception. Registries conducted preliminary investigations using a standardised protocol to determine whether there was cause for concern, and expert review was used at key points. 165 clusters were detected, a rate of 3.4 % of all 4823 cluster tests performed over 7 years, more than expected by chance. Preliminary investigations of 126 new clusters confirmed that 35 % were an unusual aggregation of cases, while 56 % were explained by data quality or diagnostic issues, and 9 % were not investigated. For confirmed clusters, the registries’ course of action was continuing monitoring. Three confirmed clusters continued to grow in size for a limited period in subsequent monitoring. This system is best suited to early detection of exposures which are sudden, widespread and/or highly teratogenic, and was reassuring in demonstrating an absence of a sustained exposure of this type. Such proactive monitoring can be run efficiently without overwhelming the surveillance system with false positives, and serves an additional purpose of data quality control.

KW - Congenital anomalies

KW - Surveillance

KW - Clusters

UR - http://link.springer.com/article/10.1007%2Fs10654-015-0012-y

U2 - 10.1007/s10654-015-0012-y

DO - 10.1007/s10654-015-0012-y

M3 - Article

VL - 30

SP - 1153

EP - 1164

JO - European Journal of Epidemiology

T2 - European Journal of Epidemiology

JF - European Journal of Epidemiology

SN - 0393-2990

IS - 11

ER -