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Published on: February 5, 2019
Prevalence of cerebral palsy in Quebec: alternative approaches
M Oskoui1, L Joseph, L Dagenais
1Department of Pediatrics, Neurology and Neurosurgery, McGill University, Montreal, Que., Canada. Maryam.oskoui@mcgill.ca
Insights
The period prevalence of cerebral palsy (CP) in Quebec was estimated using registry data. A Bayesian approach yielded a higher prevalence estimate of 2.30 per 1,000 children, aligning with global figures.
Area of Science:
- Neurology
- Pediatrics
- Public Health
Background:
- Cerebral palsy (CP) is a group of movement disorders affecting muscle tone and posture.
- Accurate prevalence data is crucial for resource allocation and healthcare planning.
Purpose of the Study:
- To estimate the period prevalence of cerebral palsy (CP) in Quebec.
- To compare prevalence estimates using frequentist and Bayesian statistical approaches.
Main Methods:
- Identified children with CP from the Quebec CP Registry across three birth cohorts (1999-2001).
- Applied frequentist and Bayesian inferential methods to estimate period prevalence in 2010.
- Focused on 6 of 17 administrative health regions in Quebec.
Main Results:
- Identified 228 children with CP.
- Frequentist approach estimated prevalence at 1.84 per 1,000 children (9-11 years old).
- Bayesian approach, accounting for registry sensitivity, estimated prevalence at 2.30 per 1,000 children.
Conclusions:
- The Bayesian approach provides a more robust estimate of CP prevalence, adjusting for registry limitations.
- The estimated prevalence aligns with international data and estimates from other Canadian provinces.
- Further research is recommended to validate CP diagnosis in administrative databases and explore regional healthcare disparities.
Aim:
To provide an estimate of the period prevalence of cerebral palsy (CP) in the province of Quebec.
Methods:
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.
Results:
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).
Conclusion:
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.
