Baptiste Andrieu, Manon Roche, Pierre Simeone, Marc Leone, Benjamin De Sainte Marie, Baptiste Andre, Laurent Boyer, Laurent Zieleskiewicz, Guillaume Fond
{"title":"Navigating Healthcare's Dual Fronts — Balancing Quality and the Environment","authors":"Baptiste Andrieu, Manon Roche, Pierre Simeone, Marc Leone, Benjamin De Sainte Marie, Baptiste Andre, Laurent Boyer, Laurent Zieleskiewicz, Guillaume Fond","doi":"10.1016/j.respe.2023.102182","DOIUrl":"10.1016/j.respe.2023.102182","url":null,"abstract":"","PeriodicalId":21346,"journal":{"name":"Revue D Epidemiologie Et De Sante Publique","volume":"71 6","pages":"Article 102182"},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71426475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Etienne Guével , Sonia Priou , Rémi Flicoteaux , Guillaume Lamé , Romain Bey , Xavier Tannier , Ariel Cohen , Gilles Chatellier , Christel Daniel , Christophe Tournigand , Emmanuelle Kempf , On behalf of the AP-HP Cancer Group, a CRAB
{"title":"Development of a Natural Language Processing Model for deriving breast cancer quality indicators : A cross-sectional, multicenter study","authors":"Etienne Guével , Sonia Priou , Rémi Flicoteaux , Guillaume Lamé , Romain Bey , Xavier Tannier , Ariel Cohen , Gilles Chatellier , Christel Daniel , Christophe Tournigand , Emmanuelle Kempf , On behalf of the AP-HP Cancer Group, a CRAB","doi":"10.1016/j.respe.2023.102189","DOIUrl":"https://doi.org/10.1016/j.respe.2023.102189","url":null,"abstract":"<div><h3>Objectives</h3><p>Medico-administrative data are promising to automate the calculation of Healthcare Quality and Safety Indicators. Nevertheless, not all relevant indicators can be calculated with this data alone. Our feasibility study objective is to analyze 1) the availability of data sources; 2) the availability of each indicator elementary variables, and 3) to apply natural language processing to automatically retrieve such information.</p></div><div><h3>Method</h3><p>We performed a multicenter cross-sectional observational feasibility study on the clinical data warehouse of Assistance Publique – Hôpitaux de Paris (AP-HP). We studied the management of breast cancer patients treated at AP-HP between January 2019 and June 2021, and the quality indicators published by the European Society of Breast Cancer Specialist, using claims data from the <em>Programme de Médicalisation du Système d'Information</em> (PMSI) and pathology reports. For each indicator, we calculated the number (%) of patients for whom all necessary data sources were available, and the number (%) of patients for whom all elementary variables were available in the sources, and for whom the related HQSI was computable. To extract useful data from the free text reports, we developed and validated dedicated rule-based algorithms, whose performance metrics were assessed with recall, precision, and f1-score.</p></div><div><h3>Results</h3><p>Out of 5785 female patients diagnosed with a breast cancer (60.9 years, IQR [50.0–71.9]), 5,147 (89.0%) had procedures related to breast cancer recorded in the PMSI, and 3732 (72.5%) had at least one surgery. Out of the 34 key indicators, 9 could be calculated with the PMSI alone, and 6 others became so using the data from pathology reports. Ten elementary variables were needed to calculate the 6 indicators combining the PMSI and pathology reports. The necessary sources were available for 58.8% to 94.6% of patients, depending on the indicators.</p><p>The extraction algorithms developed had an average accuracy of 76.5% (min-max [32.7%–93.3%]), an average precision of 77.7% [10.0%–97.4%] and an average sensitivity of 71.6% [2.8% to 100.0%]. Once these algorithms applied, the variables needed to calculate the indicators were extracted for 2% to 88% of patients, depending on the indicators.</p></div><div><h3>Discussion</h3><p>The availability of medical reports in the electronic health records, of the elementary variables within the reports, and the performance of the extraction algorithms limit the population for which the indicators can be calculated.</p></div><div><h3>Conclusions</h3><p>The automated calculation of quality indicators from electronic health records is a prospect that comes up against many practical obstacles.</p></div>","PeriodicalId":21346,"journal":{"name":"Revue D Epidemiologie Et De Sante Publique","volume":"71 6","pages":"Article 102189"},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134654916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sepsis : Actual numbers and uncertainties","authors":"Marc Leone, Ines Lakbar, Jean-Louis Vincent","doi":"10.1016/j.respe.2023.102176","DOIUrl":"10.1016/j.respe.2023.102176","url":null,"abstract":"","PeriodicalId":21346,"journal":{"name":"Revue D Epidemiologie Et De Sante Publique","volume":"71 6","pages":"Article 102176"},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71426489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Guillaume Fond , Lee Smith , Bastien Boussat , Guillaume Lucas , Dong Keon Yon , Bach Tran , Tham Thi Nguyen , Brendon Stubbs , Laurent Boyer
{"title":"Association between physical activity and health in healthcare professionals : Results from the nationwide AMADEUS survey","authors":"Guillaume Fond , Lee Smith , Bastien Boussat , Guillaume Lucas , Dong Keon Yon , Bach Tran , Tham Thi Nguyen , Brendon Stubbs , Laurent Boyer","doi":"10.1016/j.respe.2023.102183","DOIUrl":"10.1016/j.respe.2023.102183","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of this study was to assess the prevalence of healthcare professionals engaging in insufficient levels of physical activity (PA) and to identify sociodemographic, professional and health characteristics associated with insufficient PA levels.</p></div><div><h3>Methods</h3><p>We conducted a nationwide online cross-sectional study targeting healthcare professionals in France from May 2021 to June 2021. Participant recruitment involved outreach through social networks, professional networks, and email invitations. PA levels were assessed using the International Physical Activity Questionnaire (IPAQ), with insufficient PA defined as weekly PA totaling less than 600 mets/week.</p></div><div><h3>Results</h3><p>The study included a total of 10,325 participants, of whom 3939 (38.1%, 95% confidence interval 37.1–39.0%) exhibited insufficient levels of PA. In the multivariable analysis, we identified factors associated with insufficient PA: ages between 35–44 (aOR=1.58, 95%CI [1.21–2.06], <em>p</em>=.001) and 45–54 years (aOR=1.40, 95%CI [1.07–1.83], <em>p</em> =.015), gender (female aOR=1.47, 95%CI [1.12–1.44], <em>p</em><.001), and professions including health executive (aOR=1.27, 95%CI [1.32–1.64], <em>p</em><.001), nurse assistant (aOR=1.25, 95%CI [1.07–1.47], <em>p</em>=.006), and physician (aOR=1.18, 95%CI [1.03–1.34], <em>p</em>=.015). Additionally, burnout (aOR=1.32, 95%CI [1.21–1.44], <em>p</em><.001), tobacco use (aOR=1.33, 95%CI [1.20–1.58], <em>p</em><.001), being overweight (aOR=1.39, 95%CI [1.28–1.52], <em>p</em><.001), major depression (aOR=1.44, 95%CI [1.20–1.47], <em>p</em><.001), and sleep disorders (aOR=1.14, 95%CI [1.05–1.25], <em>p</em>=.002) were associated with insufficient PA. Work night shifts was associated with sufficient PA.</p></div><div><h3>Conclusion</h3><p>Our study has revealed a substantial prevalence of healthcare professionals with insufficient PA levels. This prevalence, coupled with various associated health-damaging behaviors and mental health issues, underscores the importance of acknowledging the barriers they encounter in adopting a physically active lifestyle.</p></div>","PeriodicalId":21346,"journal":{"name":"Revue D Epidemiologie Et De Sante Publique","volume":"71 6","pages":"Article 102183"},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72015248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vient de paraître","authors":"","doi":"10.1016/j.respe.2023.102178","DOIUrl":"https://doi.org/10.1016/j.respe.2023.102178","url":null,"abstract":"","PeriodicalId":21346,"journal":{"name":"Revue D Epidemiologie Et De Sante Publique","volume":"71 6","pages":"Article 102178"},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50173649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mathilde Alexandre, Delphine Antoine, Martine Ledrans, Anne Perrocheau, Philippe Quénel, Roger Salamon, Louis Rachid Salmi
{"title":"Advocacy and recommendations for better positioning of epidemiologists during future epidemics and pandemics","authors":"Mathilde Alexandre, Delphine Antoine, Martine Ledrans, Anne Perrocheau, Philippe Quénel, Roger Salamon, Louis Rachid Salmi","doi":"10.1016/j.respe.2023.102186","DOIUrl":"10.1016/j.respe.2023.102186","url":null,"abstract":"","PeriodicalId":21346,"journal":{"name":"Revue D Epidemiologie Et De Sante Publique","volume":"71 6","pages":"Article 102186"},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71426472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Analyse de l'hypertension en France : pour une analyse intersectionnelle de la cascade de soins","authors":"L. Silberzan , M. Kelly-Irving , N. Bajos","doi":"10.1016/j.respe.2023.102159","DOIUrl":"https://doi.org/10.1016/j.respe.2023.102159","url":null,"abstract":"<div><p>In metropolitan France, estimates suggest that more than one in three adults has hypertension. Low-cost treatments are available, yet fewer than one in four hypertensive adults has a controlled level of hypertension below 140/90 mmHg. This rate is higher in other high-income countries such as Canada (65%) or Germany (52%). Using a ‘cascade of care’ model, that decomposes the hypertension care <em>continuum</em> in awareness, treatment, and control, provides a better understanding of the origins of poor control. Furthermore, the theoretical framework of intersectionality, which simultaneously considers social positions of gender, class, and ethno-racial origin, could be used to understand the complexity of the social inequalities observed in hypertension-related outcomes. In this article we conducted a critical review of the international literature to identify new lines of analyses that could be applied to examine complex inequalities in France.</p></div>","PeriodicalId":21346,"journal":{"name":"Revue D Epidemiologie Et De Sante Publique","volume":"71 6","pages":"Article 102159"},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50173638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sommaire","authors":"","doi":"10.1016/S0398-7620(23)00793-9","DOIUrl":"https://doi.org/10.1016/S0398-7620(23)00793-9","url":null,"abstract":"","PeriodicalId":21346,"journal":{"name":"Revue D Epidemiologie Et De Sante Publique","volume":"71 6","pages":"Article 102190"},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0398762023007939/pdfft?md5=da0887e01cb24eb757b7ba42345e75df&pid=1-s2.0-S0398762023007939-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138453547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Résumés d'ouvrages","authors":"","doi":"10.1016/j.respe.2023.102179","DOIUrl":"https://doi.org/10.1016/j.respe.2023.102179","url":null,"abstract":"","PeriodicalId":21346,"journal":{"name":"Revue D Epidemiologie Et De Sante Publique","volume":"71 6","pages":"Article 102179"},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50173642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sinisa Stefanac , Lee Smith , Igor Grabovac , Louis Jacob , Guillermo F. López Sánchez , Petre Cristian Ilie , Ai Koyanagi , Tobias Schiffler , Karel Kostev
{"title":"Changes in frequency of urology clinic visits and diagnosis of erectile dysfunction in Germany before and during COVID-19","authors":"Sinisa Stefanac , Lee Smith , Igor Grabovac , Louis Jacob , Guillermo F. López Sánchez , Petre Cristian Ilie , Ai Koyanagi , Tobias Schiffler , Karel Kostev","doi":"10.1016/j.respe.2023.102181","DOIUrl":"10.1016/j.respe.2023.102181","url":null,"abstract":"<div><h3>Objectives</h3><p>To explore and analyze [1] the differences in the total number of patients visiting urology practices in Germany, [2] explore and analyze any differences in the number of newly diagnosed erectile dysfunction (ED) patients as well as [3] the number of new drug prescription, before and during the COVID-19 pandemic in Germany (April 2019-March 2020 and April 2020-March 2021).</p></div><div><h3>Methods</h3><p>This retrospective cross-sectional study used data from the Disease Analyzer database (IQVIA) and included all patients aged ≥18 years with at least one visit to one of 85 urology practices across Germany. Outcomes were the mean number of patients with [1] new diagnosis of ED and [2] new prescription of drugs for erectile dysfunction per practice, in pandemic (April 2020-March 2021) versus non-pandemic (April 2019-March 2020) time periods. Differences between the periods were assessed using Wilcoxon tests.</p></div><div><h3>Results</h3><p>In the non-pandemic period, there were 195,895 men, and in the pandemic period, 192,659 men visiting urology practices in Germany. A total of 10,977 men were initially diagnosed with ED in non-pandemic and 12,213 (+11.26%) men in pandemic time periods. Although the differences of new ED diagnoses were not statistically significant, a non-significant increase of new ED diagnoses was observed across all age groups. Also, a non-significant increase in new ED prescription drugs was detected across all age groups.</p></div><div><h3>Conclusions</h3><p>Even though less urology practice-visits of men with ED were recorded during the COVID-19 pandemic, an increase of new ED diagnosis was observed across all age groups between April 2020 and March 2021.</p></div>","PeriodicalId":21346,"journal":{"name":"Revue D Epidemiologie Et De Sante Publique","volume":"71 6","pages":"Article 102181"},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71426473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}