Abstract
BackgroundEpidemiological studies on the potential role of surgery in Creutzfeldt-Jakob Disease transmission have disclosed associations with history of specific surgical interventions or reported negative results.MethodsWithin the context of a case-control study designed to address surgical risk of sporadic Creutzfeldt-Jakob Disease in Nordic European countries (EUROSURGYCJD Project), a strategy was adopted to categorise reported surgical procedures in terms of potential risk of Creutzfeldt-Jakob Disease acquisition. We took into account elements of biological plausibility, either clinically or experimentally demonstrated, such as tissue infectivity, PrP expression content or successful route of infection.ResultsWe propose a classification of exposed tissues and anatomic structures, drawn up on the basis of their specific putative role as entry site for prion transmission through contact with surgical instruments that are not fully decontaminated.ConclusionsThis classification can serve as a reference, both in our study and in further epidemiological research, for categorisation of surgical procedures in terms of risk level of Creutzfeldt-Jakob Disease acquisition.
Highlights
Epidemiological studies on the potential role of surgery in Creutzfeldt-Jakob Disease transmission have disclosed associations with history of specific surgical interventions or reported negative results
This classification can serve as a reference, both in our study and in further epidemiological research, for categorisation of surgical procedures in terms of risk level of Creutzfeldt-Jakob Disease acquisition
"Development" in this sense refers to theoretical development built on scientific evidence and will focus on classification of surgical procedures, using technical and biological criteria appropriate for identifying characteristics of the intervention reflecting the putative risk level of sporadic Creutzfeldt-Jakob Disease (CJD) transmission
Summary
Epidemiological studies on the potential role of surgery in Creutzfeldt-Jakob Disease transmission have disclosed associations with history of specific surgical interventions or reported negative results. Case-control research on the association between surgery and sporadic Creutzfeldt-Jakob Disease (CJD) encompasses six studies and one meta-analysis [1,2,3,4,5,6,7,8], which frequently yielded diverging, partly inconsistent, positive [5,6] or negative [7,8] results, potentially attributable to methodological difficulties. This paper constitutes the first part of methods development for a case-control study (page number not for citation purposes). "Development" in this sense refers to theoretical development built on scientific evidence and will focus on classification of surgical procedures, using technical and biological criteria appropriate for identifying characteristics of the intervention reflecting the putative risk level of sporadic CJD transmission
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