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Delage de Luget C, Blanc J, Chantalat E, Auquier P, Carcopino X. [Database's development for prospective national collection of clinical data on cervical cancer: A Delphi survey identifying consensual variables]. Gynecol Obstet Fertil Senol 2022; 50:615-619. [PMID: 35667561 DOI: 10.1016/j.gofs.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/24/2022] [Accepted: 05/20/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Cervical cancer (CC) is associated with poor prognosis and therapeutic morbidity in young women. The impact of European recommendations for treatments and follow-up of these patients must be assessed. There is no real-time CCU tracking basis. Main objective of our study was to identify the items of the clinical and therapeutic data necessary for the constitution of a national, dynamic and prospective clinical database allowing to characterize treatments and follow-up of patients with CC in France. METHODS An exhaustive bibliographic research was lead with the help of the ESGO recommendations. A list of qualitative and quantitative variables characterizing CC was established. These variables were assessed by a panel of national experts from the Francogyn group, using the Delphi survey. The rate of agreement was calculated for each variable. RESULTS 345 variables divided into 6 sections were identified and submitted to 26 experts. 17 experts responded to the three rounds of the Delphi method. A total of 273 items were validated. The majority of experts (90 %) also gave a favorable opinion on the addition of a quality of life section in the database. CONCLUSION This is the first study identifying 273 items chosen by consensus. The items are collected in a future national gynecological database "Epigyn".
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Affiliation(s)
- Claire Delage de Luget
- Department of Obstetrics and Gynecology, Nord Hospital, APHM, chemin des Bourrely, 13015 Marseille, France.
| | - Julie Blanc
- Department of Obstetrics and Gynecology, Nord Hospital, APHM, chemin des Bourrely, 13015 Marseille, France; EA 3279, Public Health, Chronic Diseases and Quality of Life, Research Unit, Aix-Marseille University, 13284 Marseille, France.
| | - Elodie Chantalat
- Department of Gynecological Surgery, CHU Rangueil, Toulouse, France.
| | - Pascal Auquier
- Department of Public Health, CHU Timone, Aix-Marseille University, 264, rue St-Pierre, Marseille, France.
| | - Xavier Carcopino
- Department of Obstetrics and Gynecology, Nord Hospital, APHM, chemin des Bourrely, 13015 Marseille, France; Aix-Marseille University (AMU), Univ Avignon, CNRS, IRD, IMBE UMR, Marseille, France
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Castagné B, Viprey M, Caillet-Pascal P, Belhassen M, Desjeux G, Bailly S, Estellat C, Soubrier M, Schott AM; groupe REDSIAM. [Algorithms to identify chronic inflammatory rheumatism and psoriasis in medico-administrative databases: A review of the literature]. Rev Epidemiol Sante Publique 2021; 69:225-33. [PMID: 34215479 DOI: 10.1016/j.respe.2021.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 01/31/2021] [Accepted: 02/15/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND We aimed to describe and discuss the algorithms used to identify chronic inflammatory rheumatisms and psoriasis in medico-administrative databases. METHODS We performed a literature review on the Medline database of articles published up to 31 January 2018. Our inclusion criteria were: original articles using medico-administrative databases in accordance with the International Classification of Diseases, version 10 (ICD-10) and concerning rheumatoid arthritis (RA) or ankylosing spondylitis (AS) or psoriatic arthritis (PsoA) or Psoriasis (Pso). Our exclusion criteria were: letters to the editor, commentaries on published articles, studies using codes other than those of the ICD or a previous version. RESULTS Out of the 590 articles identified, 37 studies were included. Concerning RA (n=10), all studies used the M05 code, associated with the M06 code in six studies. The remaining four studies specifically targeted codes M06.0, M06.2, M06.3, M06.8, M06.9, and two of them also used code M12.3. For AS (n=8), 7 studies used the M45 code, while only one study used M45.9, M46.1 or M46.8. For Pso (n=17), all studies used the L40 code and/or at least two dispensations of vitamin D. Concerning PsoA (n=13), all studies used the same codes: M07.0, M07.1, M07.2, M07.3. CONCLUSION We recommend using codes M05 and M06 rather than M06.1 and M06.4 for RA, M45 for AS, the algorithm L40 and/or two dispensations of topical vitamin D for psoriasis, and codes M070 to M073 to identify PsoA patients in medico-administrative databases.
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Trouche-Sabatier SG, Rebillard X, Iborra F, Azria D, Daures JP, Poinas G, Abdo N, Delbos O, Gevorgyan A, Marchal S, Guillon R, Millet I, Lamy PJ, Lauche O, Reis-Borges R, Serre I, Topart D, Tretarre B. [RHESOU (Registry in HErault Specialized in Onco-Urology) : the first French Registry specialized in Onco-Urology. One-year experience]. Prog Urol 2020; 30:1038-1044. [PMID: 33012630 DOI: 10.1016/j.purol.2020.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/13/2020] [Accepted: 09/06/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE In 2016, the Herault tumor registry collected 1961cancers in urology (21.4 % from all Herault cancers this year). RHESOU was created to complete RTH' data with specific parameters in onco-urology. The aim of this study is to describe RHESOU and to give some examples with our first results. MATERIAL AND METHODS In November 2018, RHESOU (Registry HErault Specialised in Onco-Urology) was founded with the same registry recommendations. It collects specific oncologic parameters and also complete RTH's data. For each urological cancer, a specific survey with different choices was performed to collect a maximum of data which could be present in patients' file. These surveys were used for urological cancers cases that live in Herault in 2017. RESULTS In 2017, we collected 970 prostate cancers, 581 bladder cancers, 212 kidney cancers, 51 upper excretory tract cancers, 28 testicle cancers and 9 penil cancers. Our urological data collection gives many possibilities to create many requests for detailed analysis in urological cancers. In this article, we reported data from kidney, bladder and prostate cancers. CONCLUSIONS RHESOU is a new tool opened to the different urologic corporations (urologists, pathologists, oncologists, radiotherapists, radiologists) that permits an overview in urological cancers in Herault. Finally, one important aim is that this tool will be adapted when new treatments or new important parameters appear in the years ahead. LEVEL OF EVIDENCE 3.
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Affiliation(s)
| | - X Rebillard
- Comité de pilotage, Montpellier, France; Clinique Beau Soleil, Montpellier, France
| | - F Iborra
- Comité de pilotage, Montpellier, France; CHU de Montpellier, Montpellier, France
| | - D Azria
- Comité de pilotage, Montpellier, France; Inserm U 1194, ICM, université Montpellier, Montpellier, France
| | - J-P Daures
- Comité de pilotage, Montpellier, France; Clinique Beau Soleil, Montpellier, France; IURC, Montpellier, France
| | - G Poinas
- Comité scientifique du RHESOU, Montpellier, France; Clinique Beau Soleil, Montpellier, France
| | - N Abdo
- Comité scientifique du RHESOU, Montpellier, France; CHU de Montpellier, Montpellier, France
| | - O Delbos
- Comité scientifique du RHESOU, Montpellier, France; Urodoc, Montpellier, France
| | - A Gevorgyan
- Comité scientifique du RHESOU, Montpellier, France; Polyclinique Saint-Privat Boujan sur Libron, Béziers, France
| | - S Marchal
- Comité scientifique du RHESOU, Montpellier, France; Urodoc, Montpellier, France
| | - R Guillon
- Comité scientifique du RHESOU, Montpellier, France; Clinique Beau Soleil, Montpellier, France
| | - I Millet
- Comité scientifique du RHESOU, Montpellier, France; CHU de Montpellier, Montpellier, France
| | - P-J Lamy
- Comité scientifique du RHESOU, Montpellier, France; Imagenome-inovie, Montpellier, France
| | - O Lauche
- Comité scientifique du RHESOU, Montpellier, France; Clinique Clémentville, Montpellier, France
| | - R Reis-Borges
- Comité scientifique du RHESOU, Montpellier, France; Inopath Labosud, Montpellier, France
| | - I Serre
- Comité scientifique du RHESOU, Montpellier, France; CHU de Montpellier, Montpellier, France
| | - D Topart
- Comité scientifique du RHESOU, Montpellier, France; CHU de Montpellier, Montpellier, France
| | - B Tretarre
- Comité de pilotage, Montpellier, France; Registre des tumeurs de l'Hérault, Montpellier, France
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Rochoy M, Chazard E, Gautier S, Bordet R. Vascular dementia encoding in the French nationwide discharge summary database (PMSI): Variability over the 2007-2017 period. Ann Cardiol Angeiol (Paris) 2019; 68:150-154. [PMID: 30409382 DOI: 10.1016/j.ancard.2018.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 10/16/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Vascular dementia (VaD) is the second leading cause of dementia. Diagnostic criteria have evolved from the concept of multiple infarctions to different subtypes: acute onset VaD, subcortical VaD, mixed cortical and subcortical VaD. Our aim was to analyze the evolution in the coding of these different subtypes of VaD in the French nationwide exhaustive hospital discharge database (PMSI) between 2007 and 2017. METHOD We included all principal diagnoses of VaD in the PMSI hospital stays from 2007 to 2017. RESULTS Between 2007 and 2017, we show a relative decrease in the number of hospital stays for VaD compared to all hospital stays (0.0437% to 0.0404%). The 11,654 hospital stays for VaD in 2017 represent 13.5% of mental organic disorders. Subtype analysis shows a decrease in hospital stays for multiple infarctions between 2007 and 2017 (-50%), an increase for subcortical or mixed VaD (+20%), acute onset VaD (+184%) and an increase in "other VaD" (+85%). CONCLUSION These data suggest a slight decrease in hospital stays for VaD, possibly related to better control of cardiovascular risk factors. They also suggest that the coding should be consistent with the evolution of diagnostic criteria.
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Affiliation(s)
- M Rochoy
- University Lille, 59000 Lille, France; U1171, Inserm, Degenerative and Vascular Cognitive Disorders, 59000 Lille, France; Département de médecine générale, 1 Place de Verdun, 59000 Lille, France.
| | - E Chazard
- University Lille, 59000 Lille, France; EA2694, Public Health Department, 59000 Lille, France
| | - S Gautier
- University Lille, 59000 Lille, France; U1171, Inserm, Degenerative and Vascular Cognitive Disorders, 59000 Lille, France
| | - R Bordet
- University Lille, 59000 Lille, France; U1171, Inserm, Degenerative and Vascular Cognitive Disorders, 59000 Lille, France
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Yguel C, Clauzon D, Lacomme S, Lomazzi S, Lardenois E, Pouget C, Taillandier L, Rech F, Rigau V, Vignaud JM, Bauchet L, Gauchotte G. [Use of the PELICAN software for the creation and export of standardized pathology reports in central nervous system tumors: Example of meningiomas]. Ann Pathol 2019; 39:414-424. [PMID: 30853495 DOI: 10.1016/j.annpat.2019.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION PELICAN ("Partager Efficacement en Laboratoire les Informations des Comptes rendus ANatomopathologiques") is a software, which generates standardized reports, and allows to automatically create a database. It has been used in central nervous system tumor pathology at the University Hospital of Nancy since 2014. The purpose of this article was to illustrate the use of this application for meningiomas, with a first statistical evaluation. MATERIALS AND METHODS The export of data included all cases of meningiomas recorded in the PELICAN application until July 2018. The PELICAN application is a Microsoft Excel file containing a software, written in Visual Basic for Applications, and used by the pathologist to create the report. The main clinical data were collected from the Hérault Register census form. Follow-up was systematically reported for atypical meningiomas. RESULTS Two hundred and ninety-five meningiomas were analyzed, including 250 grade I meningiomas, 42 grade II meningiomas, and 3 grade III meningiomas. Grade II meningiomas were characterized by a significantly higher proportion of men (P=0.002) and dural infiltration (P<0.001), a significant increase in the Ki-67 index (P<0.0001), and a significant decrease in progesterone receptor expression (P<0.001). In atypical meningiomas, a Ki-67 index of more than 20 % was significantly correlated with a shorter progression-free survival (P=0.032). CONCLUSION The PELICAN software is an easy-to-use tool that allows to generate standardized reports and feed a database, opening very interesting perspectives from an epidemiological and scientific point of view.
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Affiliation(s)
- Clémence Yguel
- Service d'anatomie et cytologie pathologiques, hôpital Central, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France
| | | | - Stéphanie Lacomme
- Centre de ressources biologiques BB-0033-00035, CHRU de Nancy, 54000 Nancy, France
| | - Sandra Lomazzi
- Centre de ressources biologiques BB-0033-00035, CHRU de Nancy, 54000 Nancy, France
| | - Emilie Lardenois
- Service d'anatomie et cytologie pathologiques, hôpital Central, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France
| | - Celso Pouget
- Service d'anatomie et cytologie pathologiques, hôpital Central, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France
| | - Luc Taillandier
- Service de neurologie, hôpital Central, CHRU de Nancy, 54000 Nancy, France
| | - Fabien Rech
- Service de neurochirurgie, hôpital Central, CHRU de Nancy, 54000 Nancy, France; Institut des neurosciences, Inserm U1051, 34091 Montpellier, France
| | - Valérie Rigau
- Service d'anatomie et cytologie pathologiques, CHU de Montpellier, 34000 Montpelier, France
| | - Jean-Michel Vignaud
- Service d'anatomie et cytologie pathologiques, hôpital Central, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Centre de ressources biologiques BB-0033-00035, CHRU de Nancy, 54000 Nancy, France; Inserm U1256, équipe 3 MIGB, NGERE, université de Lorraine, 54500 Vandœuvre-lès-Nancy, France
| | - Luc Bauchet
- Service de neurochirurgie, CHU de Montpellier, 34000 Montpellier, France
| | - Guillaume Gauchotte
- Service d'anatomie et cytologie pathologiques, hôpital Central, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Centre de ressources biologiques BB-0033-00035, CHRU de Nancy, 54000 Nancy, France; Inserm U1256, équipe 3 MIGB, NGERE, université de Lorraine, 54500 Vandœuvre-lès-Nancy, France.
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Yguel C, Clauzon D, Lacomme S, Siat J, Lomazzi S, Lardenois E, Taillandier L, Vignaud JM, Gauchotte G. [Development and deployment of a standardized pathology report in lung cancer, basing on a data management software: The PELICAN software]. Ann Pathol 2019; 39:87-99. [PMID: 30736988 DOI: 10.1016/j.annpat.2018.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/05/2018] [Accepted: 12/09/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION PELICAN (« Partager Éfficacement en Laboratoire les Informations des Comptes rendus ANatomopathologiques ») is a software which generates standardized reports and, in parallel, allows to automatically create a database that can be used for research purpose. This application has been used in our laboratory since 2014 for central nervous system tumors. The aim of this work was to extend it to another type of tumor, lung cancer. MATERIALS AND METHODS The content of the pathology reports was previously defined using various standards (Société Française de Pathologie, Institut National du Cancer, WHO Classification 2015, …). A double codification was used with SNOMED and ADICAP codes. The PELICAN application is a Microsoft Excel file containing a software specifically developed for pathology laboratories, written in Visual Basic for Applications and respecting the CDA-R2 standard. RESULTS After definition of the software specifications, a beta-version was installed in February 2018. After various updates, the 3.19 version was installed in July 2018. Almost all lung cancer surgical pathology reports are now generated with the PELICAN software; a total of 56 reports were validated at the time of writing this manuscript. The medical time for the generation of the report was globally the same or decreased for some pathologists. The secretarial time was greatly reduced. CONCLUSION The PELICAN software is an easy to use tool that allows to generate standardized reports in pulmonary pathology and to feed a database that can be easily used for statistical purposes.
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Affiliation(s)
- Clémence Yguel
- Service d'anatomie et cytologie pathologiques, hôpital Central, CHRU de Nancy, 29, avenue du Maréchal-De-Lattre de Tassigny, 54000 Nancy, France
| | - Dominique Clauzon
- Ingénieur consultant en solutions et développements informatiques, 54000 Nancy, France
| | - Stéphanie Lacomme
- Centre de ressources biologiques BB-0033-00035, CHRU de Nancy, 54000 Nancy, France
| | - Joelle Siat
- Service de chirurgie thoracique, CHRU de Nancy, 54500 Vandoeuvre-Les-Nancy, France
| | - Sandra Lomazzi
- Centre de ressources biologiques BB-0033-00035, CHRU de Nancy, 54000 Nancy, France
| | - Emilie Lardenois
- Service d'anatomie et cytologie pathologiques, hôpital Central, CHRU de Nancy, 29, avenue du Maréchal-De-Lattre de Tassigny, 54000 Nancy, France
| | - Luc Taillandier
- Service de neurologie, hôpital Central, CHRU de Nancy, 54000 Nancy, France
| | - Jean-Michel Vignaud
- Service d'anatomie et cytologie pathologiques, hôpital Central, CHRU de Nancy, 29, avenue du Maréchal-De-Lattre de Tassigny, 54000 Nancy, France; Centre de ressources biologiques BB-0033-00035, CHRU de Nancy, 54000 Nancy, France; INSERM U1256, équipe 3 MIGB, NGERE, université de Lorraine, 54500 Vandoeuvre-Les-Nancy, France
| | - Guillaume Gauchotte
- Service d'anatomie et cytologie pathologiques, hôpital Central, CHRU de Nancy, 29, avenue du Maréchal-De-Lattre de Tassigny, 54000 Nancy, France; Centre de ressources biologiques BB-0033-00035, CHRU de Nancy, 54000 Nancy, France; INSERM U1256, équipe 3 MIGB, NGERE, université de Lorraine, 54500 Vandoeuvre-Les-Nancy, France.
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Camus D, Thiveaud D, Josseran A. Nouveau règlement européen des dispositifs médicaux : comment l’écosystème français doit saisir l’opportunité d’EUDAMED et du système IUD, tout en dépassant les contraintes. Therapie 2019; 74:59-72. [PMID: 30553534 DOI: 10.1016/j.therap.2018.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 11/05/2018] [Indexed: 10/27/2022]
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Ferdynus C, Huiart L. [Technical improvement of cohort constitution in administrative health databases: Providing a tool for integration and standardization of data applicable in the French National Health Insurance Database (SNIIRAM)]. Rev Epidemiol Sante Publique 2016; 64:263-9. [PMID: 27592033 DOI: 10.1016/j.respe.2016.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 02/04/2016] [Indexed: 11/26/2022] Open
Abstract
AIM Administrative health databases such as the French National Heath Insurance Database - SNIIRAM - are a major tool to answer numerous public health research questions. However the use of such data requires complex and time-consuming data management. Our objective was to develop and make available a tool to optimize cohort constitution within administrative health databases. METHODS We developed a process to extract, transform and load (ETL) data from various heterogeneous sources in a standardized data warehouse. This data warehouse is architected as a star schema corresponding to an i2b2 star schema model. We then evaluated the performance of this ETL using data from a pharmacoepidemiology research project conducted in the SNIIRAM database. RESULTS The ETL we developed comprises a set of functionalities for creating SAS scripts. Data can be integrated into a standardized data warehouse. As part of the performance assessment of this ETL, we achieved integration of a dataset from the SNIIRAM comprising more than 900 million lines in less than three hours using a desktop computer. This enables patient selection from the standardized data warehouse within seconds of the request. CONCLUSION The ETL described in this paper provides a tool which is effective and compatible with all administrative health databases, without requiring complex database servers. This tool should simplify cohort constitution in health databases; the standardization of warehouse data facilitates collaborative work between research teams.
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Affiliation(s)
- C Ferdynus
- Unité de soutien méthodologique, département d'informatique médicale, CHU La-Réunion, allée des Topazes, CS11021, 97400 Saint-Denis, France; Inserm, CIC 1410, 97410 Saint-Pierre, France.
| | - L Huiart
- Unité de soutien méthodologique, département d'informatique médicale, CHU La-Réunion, allée des Topazes, CS11021, 97400 Saint-Denis, France; Inserm, CIC 1410, 97410 Saint-Pierre, France.
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Abstract
THE BIG NATIONAL DATABASES AND STUDIES ON REAL WORLD DATA EXAMPLE OF SARCOMAS IN FRANCE: Sarcomas are rare and heterogeneous tumours, and improvement of knowledge and of patient management need to gather and share data and biological material. The French sarcoma database stores in a warehouse clinical, pathological, molecular, therapeutic and follow-up data as well as data on samples and medical practices. This database and the national structured networks constitute major tools for the French Sarcoma Group.
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Laurendeau C, Chouaid C, Roche N, Terrioux P, Gourmelen J, Detournay B. [Management and costs of chronic pulmonary obstructive disease in France in 2011]. Rev Mal Respir 2015; 32:682-91. [PMID: 25613440 DOI: 10.1016/j.rmr.2014.10.731] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 10/19/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To estimate the prevalence of treated chronic obstructive pulmonary disease (COPD) and its associated costs by stage of severity. METHODS The study was conducted on the 2011 data of the french general beneficiary sample database (EGB). EGB is a 1/97th sample of the whole population of the beneficiaries of the main compulsory national health insurances. COPD cases and the level of severity of the disease have been identified using new algorithms established from the available parameters in EGB. Costs were estimated using a collective perspective. RESULTS The minimal prevalence of treated COPD was estimated at 3.8% in patients of 40 years and older and 1.9% regardless of the age of individuals. This population was predominantly male (58.2%) with a mean age of 68.8 years (±12.7). A total of 6.2% of patients had a health-care utilization suggestive of a very severe stage of COPD and 8.1%, 13.8% and 71.9% suggestive of severe, moderate and mild stages respectively. Over one year, 28.8% of patients visited a specialist respiratory physician, 5.0% were hospitalized (≥24h) for COPD and 6.7% died. Patients experienced an average of 1.7 (±1.5) exacerbations per year and only 61.4% received specific pharmacological treatment for COPD during the year. The average yearly health-care cost of a patient with COPD was estimated at €9382, with €5342 directly related to COPD. CONCLUSION This study based on medico-administrative databases confirms the high epidemiological and economic burden of COPD in France.
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Affiliation(s)
- C Laurendeau
- Cemka-Eval, 43, boulevard du Maréchal-Joffre, 92340 Bourg-la-Reine, France
| | - C Chouaid
- Service de pneumologie, centre hospitalier intercommunal, 94000 Créteil, France
| | - N Roche
- Service de pneumologie, hôpital Inter-Armées du Val-de-Grâce, 75005 Paris, France
| | | | | | - B Detournay
- Cemka-Eval, 43, boulevard du Maréchal-Joffre, 92340 Bourg-la-Reine, France.
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Rigoard P, Slavin K. Neurostimulation options for failed back surgery syndrome: The need for rational and objective measurements. Proposal of an international clinical network using an integrated database and health economic analysis: the PROBACK network. Neurochirurgie 2015; 61 Suppl 1:S131-6. [PMID: 25245927 DOI: 10.1016/j.neuchi.2014.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 04/18/2014] [Accepted: 07/24/2014] [Indexed: 11/21/2022]
Abstract
INTRODUCTION In the context of failed back surgery syndrome (FBSS) treatment, the current practice in neurostimulation varies from center-to-center and most clinical decisions are based on an individual diagnosis. Neurostimulation evaluation tools and pain relief assessment are of major concern, as they now constitute one of the main biases of clinical trials. Moreover, the proliferation of technological devices, in a fertile and unsatisfied market, fosters and only furthers the confusion. There are three options available to apply scientific debates to our daily neurostimulation practice: intentional ignorance, standardized evidence-based practice or alternative data mining approach. OBJECTIVE In view of the impossibility of conducting multiple randomized clinical trials comparing various devices, one by one, the proposed concept would be to redefine the indications and the respective roles of the various spinal cord and peripheral nerve stimulation devices with large-scale computational modeling/data mining approach, by conducting a multicenter prospective database registry, supported by a clinician's global network called "PROBACK". METHODS We chose to specifically analyze 6 parameters: device coverage performance/coverage selectivity/persistence of the long-term electrical response (technical criteria) and comparative mapping of patient pain relief/persistence of the long-term clinical response/safety and complications occurrence (clinical criteria). Two types of analysis will be performed: immediate analysis (including cost analysis) and computational analysis, i.e. demonstration of the robustness of certain correlations of variables, in order to extract response predictors. DISCUSSION/CONCLUSION By creating an international prospective database, the purpose of the PROBACK project was to set up a process of extraction and comparative analysis of data derived from the selection, implantation and follow-up of FBSS patients candidates for implanted neurostimulation. This evaluation strategy should help to change the opinions of each implanter and each health system towards a more rational decision-making approach subtended by mathematical reality.
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Landes G, Boghossian E, Harris PG, Gagnon A, Bou-Merhi J, Bernier C, Grenier-Vallée P, Burke R, Danino MA. [A surgical follow-up platform to reduce complications in free flap surgery]. ANN CHIR PLAST ESTH 2014; 59:9-14. [PMID: 24210968 DOI: 10.1016/j.anplas.2013.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Accepted: 10/07/2013] [Indexed: 11/22/2022]
Abstract
STUDY OBJECTIVE In 2007, the WHO adopted surgical safety as the theme for the 2nd global patient safety challenge. Measurement of surgical services was identified as a surgical care area in need of major improvements. Aware of this recommendation, a preliminary study was conducted in our hospital and showed that the incidence of complete necrosis in free flap surgery was 10.0 %, a rate among the highest found in medical literature. In that context, an interactive surgical follow-up platform (PICS) was implemented to monitor outcomes in free flap surgery. The hypothesis was to reduce the short-term failure of microsurgical reconstructions. PATIENTS AND METHODS In Summer 2010, the tool for capturing and analyzing data (PICS) was implemented. All patients who underwent free flap reconstruction were prospectively registered in the platform. The primary endpoints to evaluate the effectiveness of the tool are the rates of surgical re-exploration and complete necrosis of the flap. RESULTS From May 2010 to December 2011, 129 cases of free flap reconstruction were recorded. The rate of total flap necrosis was 10.0 % before database introduction and declined to 3.1 % afterwards (P<0.05). Take-backs occurred in 27.0 % of free flap reconstructions at baseline and in 10.1 % after implementation (P<0.01). CONCLUSION The implementation of PICS is associated with a significant improvement of postoperative short-term outcomes in free flap surgery. This tool is effective to evaluate care services and provides an increased surgical safety for patients. Surgical teams are encouraged to implement a data collection tool in order evaluate operative care on a routine basis.
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Rivera C, Cancalon C, Schmidt A, Mazieres J, Falcoz PE, Dahan M, Benard S. [Hospital undertaking of patients with a resection of lung cancer]. Rev Mal Respir 2013; 30:529-36. [PMID: 24034457 DOI: 10.1016/j.rmr.2012.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 09/18/2012] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The aim of the study is to describe the hospital management of patients undergoing pulmonary resection for lung cancer in France. METHODS Data from patients who underwent resection for "malignant neoplasm of bronchus and lung" in 2008 were analyzed from French PMSI database. Hospitalizations, chemotherapy and radiotherapy sessions were analyzed one year before and after the procedure. RESULTS In 2008, 9161 patients were hospitalized for a resection of lung tumor. Sex ratio was 2.8 (n=6736 men) and average age was 62.8 years. During hospitalization for surgery, 3.5% of patients (n=323) died. In the year before the procedure, 10% of patients (n=961) received neoadjuvant chemotherapy (mean number: 5.2 sessions per patient). In the year after the procedure, 41% of patients (n=3796) received adjuvant chemotherapy (6.6 sessions per patient), 9% (n=812) received adjuvant radiotherapy (16.8 sessions per patient), 6% (n=562) were re-hospitalized for surgery for an additional procedure. CONCLUSION In France, pulmonary resection for lung cancer was associated for about half of patients in a multimodal treatment with combination between chemotherapy and/or radiotherapy.
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