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Does primary biliary cirrhosis cluster in time?

Lookup NU author(s): Dr Colin Muirhead, Emeritus Professor Oliver James, Samantha Ducker, Dr Richard McNallyORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


The aetiology of primary biliary cirrhosis (PBC) is not well established. Previously we found evidence of space-time clustering and seasonal variation in the date of diagnosis, suggesting a possible role for a transient or seasonally varying environmental factor. We examined whether a temporally varying environmental agent may be involved by analysing population-based PBC data from northeast England over 1987-2003. Using an adaptation of a method proposed by Potthoff and Whittinghill, we found significant temporal variation by date of diagnosis at the level of aggregation of one year. However, there was no evidence for general irregular (non-seasonal) temporal clustering within periods less than a year. These results provide little support for the involvement of agents occurring in geographically widespread mini-epidemics, but – taken together with studies of spatial and spatio-temporal clustering - do not preclude the role of more localised sporadic mini-epidemics. Future research should seek to elicit putative environmental agents.

Publication metadata

Author(s): Muirhead CR, James OFW, Ducker SJ, McNally RJQ

Publication type: Article

Publication status: Published

Journal: Spatial and Spatio-temporal Epidemiology

Year: 2015

Volume: 14-15

Pages: 1-8

Print publication date: 01/07/2015

Online publication date: 16/06/2015

Acceptance date: 09/06/2015

Date deposited: 09/06/2015

ISSN (print): 1877-5845

ISSN (electronic): 1877-5853

Publisher: Elsevier BV


DOI: 10.1016/j.sste.2015.06.001


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