In epidemiology, a clinical case definition,[1] a clinical definition, or simply a case definition[2] lists the clinical criteria by which public health professionals determine whether a person's illness is included as a case in an outbreak investigation—that is, whether a person is considered directly affected by an outbreak. Absent an outbreak, case definitions are used in the surveillance of public health in order to categorize those conditions present in a population (e.g., incidence and prevalence).
A case definition defines a case by placing limits on time, person, place, and shared definition with data collection of the phenomenon being studied.[3][4] Time criteria may include all cases of a disease identified from, for example, January 1, 2008 to March 1, 2008. Person criteria may include age, gender, ethnicity, and clinical characteristics such as symptoms (e.g. cough and fever) and the results of clinical tests (e.g. pneumonia on chest X-ray). Place criteria will usually specify a geographical entity such as a town, state, or country, but may be as small as an institution, a school class, or a restaurant meal session. Shared definition of the phenomenon impacts the study methods and ensures terminology is used in a consistent manner.
Case definitions are often used to label individuals as suspect, probable, or confirmed cases. For example, in the investigation of an outbreak of pneumococcal pneumonia in a nursing home the case definition may be specified as:
Suspect Case: All residents of Nursing Home A with onset of cough and fever between January 1, 2008 and February 1, 2008.
Probable Case: Meet the suspect case definition plus have pneumonia on chest X-ray.
Confirmed Case: Meet the probable case definition plus have pneumococcal infection confirmed by blood culture or other isolation of pneumococci from normally sterile site.
By creating a case definition, public health professionals are better equipped to study an outbreak and determine possible causes.
As investigations proceed, a case definition may be expanded or narrowed, a characteristic of the dynamic nature of outbreak investigations. At any given time, the case definition is supposed to be the gold standard to diagnose a given disease. A sensitive case definition, often applied early in an outbreak, will capture all cases, but will include many non-cases. A specific case definition, usually applied after the outbreak is considered more well understood, will exclude most non-cases, but will also exclude some actual cases.[5]
The term diagnostic criteria designates a case definition with a specific combination of signs, symptoms, and test results that the clinician uses to attempt to determine the correct diagnosis.
When diagnostic criteria are universally accepted they can be considered a "clinical definition" because they define the limits of the affected population, determining which patients are inside and outside of the set.
A clinical definition should be regarded as a statistical analysis tool, and not a substitute for a pathological definition when this is required.[6]Posthumous diagnosis allows to establish the sensitivity and specificity of the clinical definitions.[7]
^Keou FX1 Bélec L, Esunge PM, Cancre N, Gresenguet G (October 1992). "World Health Organization clinical case definition for AIDS in Africa: an analysis of evaluations". East Afr Med J. 69 (10): 550–3. PMID 1335410.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^. www.cs.columbia.edu. Archived from the original on 2003-02-26.
^Collin, Lindsay; Reisner, Sari L.; Tangpricha, Vin; Goodman, Michael (2016). "Prevalence of Transgender Depends on the "Case" Definition: A Systematic Review". The Journal of Sexual Medicine. 13 (4): 613–626. doi:10.1016/j.jsxm.2016.02.001. PMC4823815. PMID 27045261.
^"Case definitions for outbreak assessment". wiki.ecdc.europa.eu. Retrieved 2020-11-08.
^José Roberto Lambertucci, Revisiting the concept of hepatosplenic schistosomiasis and its challenges using traditional and new tools, Rev. Soc. Bras. Med. Trop. vol. 47 no. 2 Uberaba Mar./Apr. 2014 Epub Apr 11, 2014, doi:10.1590/0037-8682-0186-2013
^Saracci R (1991). "Is necropsy a valid monitor of clinical diagnosis performance?". BMJ. 303 (6807): 898–900. doi:10.1136/bmj.303.6807.898. PMC1671185. PMID 1933005.
March 05, 2023
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In epidemiology a clinical case definition 1 a clinical definition or simply a case definition 2 lists the clinical criteria by which public health professionals determine whether a person s illness is included as a case in an outbreak investigation that is whether a person is considered directly affected by an outbreak Absent an outbreak case definitions are used in the surveillance of public health in order to categorize those conditions present in a population e g incidence and prevalence Contents 1 How are they used 2 Diagnostic criteria 3 Clinical definitions 4 See also 5 ReferencesHow are they used EditA case definition defines a case by placing limits on time person place and shared definition with data collection of the phenomenon being studied 3 4 Time criteria may include all cases of a disease identified from for example January 1 2008 to March 1 2008 Person criteria may include age gender ethnicity and clinical characteristics such as symptoms e g cough and fever and the results of clinical tests e g pneumonia on chest X ray Place criteria will usually specify a geographical entity such as a town state or country but may be as small as an institution a school class or a restaurant meal session Shared definition of the phenomenon impacts the study methods and ensures terminology is used in a consistent manner Case definitions are often used to label individuals as suspect probable or confirmed cases For example in the investigation of an outbreak of pneumococcal pneumonia in a nursing home the case definition may be specified as Suspect Case All residents of Nursing Home A with onset of cough and fever between January 1 2008 and February 1 2008 Probable Case Meet the suspect case definition plus have pneumonia on chest X ray Confirmed Case Meet the probable case definition plus have pneumococcal infection confirmed by blood culture or other isolation of pneumococci from normally sterile site By creating a case definition public health professionals are better equipped to study an outbreak and determine possible causes As investigations proceed a case definition may be expanded or narrowed a characteristic of the dynamic nature of outbreak investigations At any given time the case definition is supposed to be the gold standard to diagnose a given disease A sensitive case definition often applied early in an outbreak will capture all cases but will include many non cases A specific case definition usually applied after the outbreak is considered more well understood will exclude most non cases but will also exclude some actual cases 5 Diagnostic criteria EditThis section does not cite any sources Please help improve this section by adding citations to reliable sources Unsourced material may be challenged and removed September 2019 Learn how and when to remove this template message The term diagnostic criteria designates a case definition with a specific combination of signs symptoms and test results that the clinician uses to attempt to determine the correct diagnosis Some examples of diagnostic criteria are Amsterdam criteria for hereditary nonpolyposis colorectal cancer McDonald criteria for multiple sclerosis ACR criteria for systemic lupus erythematosus Centor criteria for strep throatClinical definitions EditWhen diagnostic criteria are universally accepted they can be considered a clinical definition because they define the limits of the affected population determining which patients are inside and outside of the set A clinical definition should be regarded as a statistical analysis tool and not a substitute for a pathological definition when this is required 6 Posthumous diagnosis allows to establish the sensitivity and specificity of the clinical definitions 7 See also EditPublic Health Epidemiology Outbreak Sensitivity and specificity Diagnostic criteriaReferences Edit Keou FX1 Belec L Esunge PM Cancre N Gresenguet G October 1992 World Health Organization clinical case definition for AIDS in Africa an analysis of evaluations East Afr Med J 69 10 550 3 PMID 1335410 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link http www atsdr cdc gov HEC CSEM cluster case def html Disease Clusters An Overview Case Definition from the United States Department of Health and Human Services Glossary of Epidemiology Terms www cs columbia edu Archived from the original on 2003 02 26 Collin Lindsay Reisner Sari L Tangpricha Vin Goodman Michael 2016 Prevalence of Transgender Depends on the Case Definition A Systematic Review The Journal of Sexual Medicine 13 4 613 626 doi 10 1016 j jsxm 2016 02 001 PMC 4823815 PMID 27045261 Case definitions for outbreak assessment wiki ecdc europa eu Retrieved 2020 11 08 Jose Roberto Lambertucci Revisiting the concept of hepatosplenic schistosomiasis and its challenges using traditional and new tools Rev Soc Bras Med Trop vol 47 no 2 Uberaba Mar Apr 2014 Epub Apr 11 2014 doi 10 1590 0037 8682 0186 2013 Saracci R 1991 Is necropsy a valid monitor of clinical diagnosis performance BMJ 303 6807 898 900 doi 10 1136 bmj 303 6807 898 PMC 1671185 PMID 1933005 Retrieved from https en wikipedia org w index php title Clinical case definition amp oldid 1118575375, wikipedia, wiki, book, books, library,
