Retrospective cohort study definition registration#

In a study group of pediatric hospitals in Germany, Switzerland, and Austria, we conducted a retrospective study on GBS including patients treated between July 1989 and December 1993, followed by a prospective study recruiting from August 1998 until March 2002. 9 The present study aims to compare its application to two historical, large, multicenter studies (one retrospective, one prospective) in children, and adolescents with GBS 10- 12. These Brighton criteria have already been validated in several population- or hospital-based studies in children and adults with GBS 5- 8 and their use is recommended by a recent guideline for diagnosis and treatment of GBS in children and adolescents. GBS excluded due to an alternative diagnosis Or if CSF not collected or results not available electrophysiological studies consistent with GBSĮlectrophysiological and CSF findings lacking/negativeĬases reported as GBS, but data not sufficient for level 3 1 Aiming at a worldwide assessment of the adverse effects of vaccinations, the Brighton definitions are organized in several levels of diagnostic certainty respecting the various diagnostic capabilities over the world (Table 1).īilateral and flaccid weakness of the limbsĪnd decreased or absent tendon reflexes of the weak limbsĪnd monophasic illness pattern and interval between onset and nadir 12 hours to 28-days and subsequent clinical plateauĪnd electrophysiological findings consistent with GBSĪnd cytoalbuminologic dissociation (elevation of CSF protein level above laboratory normal value and CSF total white cell count <50 cells/μL)Īnd absence of an identified alternative diagnosis for weaknessĪll of the abovementioned clinical criteria present 2- 4 The most recent case definitions and diagnostic guidelines were developed by the Brighton Collaboration GBS working group. Several working groups based on their diagnostic criteria for research and clinical use on such evidence, and since 1990 have had them published. Instead, we must rely on a typical combination of clinical signs and paraclinical findings. To date, there is still no gold standard or biomarker for diagnosing GBS. CMV, Haemophilus influenzae, Hepatitis E, and specific strains of rabies have also been strongly associated with GBS. However, a causal role has only been substantially documented for infections with Campylobacter jejuni, infection with Zika virus, and the 1976 formulation of the swine influenza vaccine. In 60% to 80% of cases, GBS is preceded by a nonspecific infectious prodrome or a specific infection there have also been rare cases of GBS following vaccinations. Residual neurological deficits are frequent in adults, but they rarely occur in children. Guillain-Barré syndrome (GBS) is an immune-mediated progressive polyradiculoneuropathy with a variable but monophasic, self-limited course. However, because they are designed to diagnose classical symmetric and ascending GBS and Fisher syndrome, very rare topographical variants of GBS such as the pharyngo-cervico-brachial variant and others could be missed. The Brighton criteria are well suited to capture GBS in retro- and prospective studies. Nerve conduction studies were performed in 61% and 69% of the cohorts, respectively, and were pathological in 92% each. CSF investigations were conducted in all patients and revealed cytoalbuminologic dissociation in 80% of the retrospective and 75% of the prospective cohort. The clinical criteria were met in 91% of the retrospective and all of the prospective cases. We applied these criteria to two historical studies on GBS in children and adolescents performed retrospectively from 1989 to 1994 and prospectively from 1998 to 2002.

Retrospective cohort study definition registration#

The Brighton Collaboration GBS Working Group published in 2011 GBS case definitions and guidelines for diagnosis to improve the registration of GBS cases occurring in conjunction with vaccination programs worldwide. Due to a lack of a pathognomonic finding or biomarker, its diagnosis is based on a typical constellation of clinical and paraclinical symptoms and findings. Guillain-Barré syndrome (GBS) is an immune-mediated polyradiculoneuropathy frequently preceded by an infection with Campylobacter jejuni or nonspecific infections, and rarely by a vaccination.