Publications plus anciennes

@article{rochoy_epidemiology_2019,
	title = {Epidemiology of neurocognitive disorders in {France}},
	volume = {17},
	issn = {2115-7863},
	doi = {10.1684/pnv.2018.0778},
	abstract = {Neurocognitive disorders are common: every year, any physician or health professional comes into contact with patients or relatives with early symptoms of dementia. Nevertheless, their epidemiology remains difficult to estimate, due to real differences in risk factors within a country or region (average age, genetics, level of education, socio-economic level, etc.), differences in data collection, in the interpretation of these data with regard to scientific findings and changes in diagnostic criteria. In this review, we present a state of knowledge of the epidemiology of dementia in France. Epidemiological data on neurocognitive disorders in France come mainly from 3 sources: two prospective cohorts (PAQUID and 3C) and large databases (SNIIRAM, RSI data, PMSI). Neurocognitive disorders are estimated to directly affect more than 1.2 million people in France and about 2 out of 3 cases are attributed to Alzheimer's disease. The prevalence rate is estimated at about 40/1,000 people after 60 years of age and gradually increases to 180/1,000 after 75 years of age, reaching almost one in two people after 90 years of age. The incidence rate is estimated at between 13 and 19/1,000 person-years, and seems to decrease slightly over the decades. The PAQUID and 3C cohorts are coming to an end; despite the development of large databases (SNIIRAM, PMSI, etc.), it seems necessary to continue to set up new prospective cohorts in the general population to monitor the epidemiology of neurocognitive disorders in France.},
	language = {eng},
	number = {1},
	journal = {Geriatrie Et Psychologie Neuropsychiatrie Du Vieillissement},
	author = {Rochoy, Michaël and Chazard, Emmanuel and Bordet, Régis},
	month = mar,
	year = {2019},
	pmid = {30907374},
	keywords = {France, cohort studies, dementia, epidemiology, incidence, prevalence},
	pages = {99--105},
}

Neurocognitive disorders are common: every year, any physician or health professional comes into contact with patients or relatives with early symptoms of dementia. Nevertheless, their epidemiology remains difficult to estimate, due to real differences in risk factors within a country or region (average age, genetics, level of education, socio-economic level, etc.), differences in data collection, in the interpretation of these data with regard to scientific findings and changes in diagnostic criteria. In this review, we present a state of knowledge of the epidemiology of dementia in France. Epidemiological data on neurocognitive disorders in France come mainly from 3 sources: two prospective cohorts (PAQUID and 3C) and large databases (SNIIRAM, RSI data, PMSI). Neurocognitive disorders are estimated to directly affect more than 1.2 million people in France and about 2 out of 3 cases are attributed to Alzheimer's disease. The prevalence rate is estimated at about 40/1,000 people after 60 years of age and gradually increases to 180/1,000 after 75 years of age, reaching almost one in two people after 90 years of age. The incidence rate is estimated at between 13 and 19/1,000 person-years, and seems to decrease slightly over the decades. The PAQUID and 3C cohorts are coming to an end; despite the development of large databases (SNIIRAM, PMSI, etc.), it seems necessary to continue to set up new prospective cohorts in the general population to monitor the epidemiology of neurocognitive disorders in France.

@article{bray_augmentation_2019,
	title = {Augmentation de l’incidence des cholécystectomies associées à une pathologie biliaire en {France} : analyse de 807 307 cholécystectomies sur 7 ans},
	issn = {1878-786X},
	shorttitle = {Augmentation de l’incidence des cholécystectomies associées à une pathologie biliaire en {France}},
	url = {http://www.sciencedirect.com/science/article/pii/S1878786X1830411X},
	doi = {10.1016/j.jchirv.2017.12.008},
	abstract = {Résumé
Introduction
Les calculs biliaires sont un des motifs abdominaux d’admission hospitalière les plus fréquents. Le but de cette étude était d’analyser les tendances et les suites des cholécystectomies pour pathologie biliaire, en France, de 2008 à 2014.
Patients et méthodes
Nous avons mené une étude rétrospective de cohorte, en utilisant des données extraites de la base de données nationale hospitalière Française (PMSI). Nous avons inclus tous les patients ayant bénéficié d’une cholécystectomie pour pathologie biliaire, de janvier 2008 à décembre 2014. Les caractéristiques démographiques, la voie d’abord, la durée de séjour, les complications et la mortalité intrahospitalière ont été analysées.
Résultats
Sur la période étudiée, 807 307 cholécystectomies ont été réalisées en France, avec une augmentation du taux national d’incidence de 167,5 (IC95 \% [166,5 ; 168,5]) à 182,6 (IC95 \% [181,6 ; 183,6]) pour 100 000 habitants. Les femmes représentaient 66,5 \% des interventions (p{\textless}0,001). La moyenne d’âge était plus basse pour les hommes que pour les femmes : 52,1 contre 60,2 ans (p{\textless}0,001). Le taux de cœlioscopies a augmenté significativement de 90 \% en 2008 à 94 \% en 2014 (p{\textless}0,001). La durée moyenne de séjour a significativement diminué, de 6,5 en 2008 à 4,7jours en 2014 (p{\textless}0,001). Les complications les plus fréquentes étaient intra-abdominales (23,1 \% pour les coelioscopies (IC95 \% [22,7 ; 23,5]), la mortalité intra-hospitalière a significativement baissé, de 0,45 \% en 2008 à 0,38 \% en 2014 (p{\textless}0,005).
Conclusion
Nos résultats ont montré une augmentation significative du taux national d’incidence des cholécystectomies pour pathologie biliaire, de 2008 à 2014.
Summary
Purpose
Gallstones are one of the most common abdominal reasons for admission to hospital. The aim of this study was to analyze trends and outcomes in patients undergoing cholecystectomy with gallbladder related disease in France from 2008 to 2014.
Patients and methods
We carried out a population-based, retrospective cohort study using data extracted from the French nationwide hospital discharge database (PMSI). We included all patients having a cholecystectomy related to gallbladder disease from January 2008 to December 2014. Patients’ demographics, primary diagnosis, procedure type, length of stay (LOS), admission in an intensive care unit, discharge disposition, complications, and in-hospital mortality were analyzed.
Results
Overall, 807,307 cholecystectomies were performed in France over the study period, with an increase in the national incidence rate from 167.5 (95\%CI [166.5; 168.5]) to 182.6 (95\%CI [181.6; 183.6]) per 100,000 inhabitants. Females accounted for 66.5\% of procedures (P{\textless}.001). The mean age was lower for females than for males: 52.1 versus 60.2 (P{\textless}.001). The ratio of laparoscopic cholecystectomy significantly increased from 90\% in 2008 to 94\% in 2014 (P{\textless}.001). Average inpatient LOS decreased significantly from 6.5 days in 2008 to 4.7 days in 2014 (P{\textless}.001). Most common complication type was intra-abdominal (23.1\% for laparoscopic procedure (95\%CI [22.7; 23.5]), and in-hospital mortality significantly decreased over time from 0.45\% in 2008 to 0.38\% in 2014 (P{\textless}.005).
Conclusion
Our results showed that the national incidence rate of cholecystectomy related to gallbladder disease increased from 2008 to 2014.},
	urldate = {2019-01-14},
	journal = {Journal de Chirurgie Viscérale},
	author = {Bray, F. and Balcaen, T. and Baro, E. and Gandon, A. and Ficheur, G. and Chazard, E.},
	month = jan,
	year = {2019},
	keywords = {Cholecystectomy, Cholécystectomies, Coelioscopie, Epidemiology, Laparoscopic cholecystectomy, Laparotomie, Nationwide database, Open cholecystectomy, PMSI, Épidémiologie},
}

Résumé Introduction Les calculs biliaires sont un des motifs abdominaux d’admission hospitalière les plus fréquents. Le but de cette étude était d’analyser les tendances et les suites des cholécystectomies pour pathologie biliaire, en France, de 2008 à 2014. Patients et méthodes Nous avons mené une étude rétrospective de cohorte, en utilisant des données extraites de la base de données nationale hospitalière Française (PMSI). Nous avons inclus tous les patients ayant bénéficié d’une cholécystectomie pour pathologie biliaire, de janvier 2008 à décembre 2014. Les caractéristiques démographiques, la voie d’abord, la durée de séjour, les complications et la mortalité intrahospitalière ont été analysées. Résultats Sur la période étudiée, 807 307 cholécystectomies ont été réalisées en France, avec une augmentation du taux national d’incidence de 167,5 (IC95 % [166,5 ; 168,5]) à 182,6 (IC95 % [181,6 ; 183,6]) pour 100 000 habitants. Les femmes représentaient 66,5 % des interventions (p\textless0,001). La moyenne d’âge était plus basse pour les hommes que pour les femmes : 52,1 contre 60,2 ans (p\textless0,001). Le taux de cœlioscopies a augmenté significativement de 90 % en 2008 à 94 % en 2014 (p\textless0,001). La durée moyenne de séjour a significativement diminué, de 6,5 en 2008 à 4,7jours en 2014 (p\textless0,001). Les complications les plus fréquentes étaient intra-abdominales (23,1 % pour les coelioscopies (IC95 % [22,7 ; 23,5]), la mortalité intra-hospitalière a significativement baissé, de 0,45 % en 2008 à 0,38 % en 2014 (p\textless0,005). Conclusion Nos résultats ont montré une augmentation significative du taux national d’incidence des cholécystectomies pour pathologie biliaire, de 2008 à 2014. Summary Purpose Gallstones are one of the most common abdominal reasons for admission to hospital. The aim of this study was to analyze trends and outcomes in patients undergoing cholecystectomy with gallbladder related disease in France from 2008 to 2014. Patients and methods We carried out a population-based, retrospective cohort study using data extracted from the French nationwide hospital discharge database (PMSI). We included all patients having a cholecystectomy related to gallbladder disease from January 2008 to December 2014. Patients’ demographics, primary diagnosis, procedure type, length of stay (LOS), admission in an intensive care unit, discharge disposition, complications, and in-hospital mortality were analyzed. Results Overall, 807,307 cholecystectomies were performed in France over the study period, with an increase in the national incidence rate from 167.5 (95%CI [166.5; 168.5]) to 182.6 (95%CI [181.6; 183.6]) per 100,000 inhabitants. Females accounted for 66.5% of procedures (P\textless.001). The mean age was lower for females than for males: 52.1 versus 60.2 (P\textless.001). The ratio of laparoscopic cholecystectomy significantly increased from 90% in 2008 to 94% in 2014 (P\textless.001). Average inpatient LOS decreased significantly from 6.5 days in 2008 to 4.7 days in 2014 (P\textless.001). Most common complication type was intra-abdominal (23.1% for laparoscopic procedure (95%CI [22.7; 23.5]), and in-hospital mortality significantly decreased over time from 0.45% in 2008 to 0.38% in 2014 (P\textless.005). Conclusion Our results showed that the national incidence rate of cholecystectomy related to gallbladder disease increased from 2008 to 2014.

@article{robert_community-acquired_2019,
	title = {Community-{Acquired} {Acute} {Kidney} {Injury} {Induced} {By} {Drugs} {In} {Older} {Patients}: {A} {Multifactorial} {Event}},
	volume = {Volume 14},
	issn = {1178-1998},
	shorttitle = {Community-{Acquired} {Acute} {Kidney} {Injury} {Induced} {By} {Drugs} {In} {Older} {Patients}},
	url = {https://www.dovepress.com/community-acquired-acute-kidney-injury-induced-by-drugs-in-older-patie-peer-reviewed-article-CIA},
	doi = {10.2147/CIA.S217567},
	abstract = {Purpose: Community-acquired acute kidney injury (CA-AKI) is a frequent and severe adverse drug reaction (ADR) among older patients. The combination of drugs and other CA-AKI risk factors was barely evaluated. The objectives of our study were to both accurately identify CA-AKI induced by drugs in older patients, and to describe their combination with other risk factors. Patients and methods: We conducted a retrospective, single-center study in a general hospital over a two-year period. An automated detection identified CA-AKI according to KDIGO criteria, amongst 4,767 eligible inpatient stays among patients aged 75 years or older. Two independent experts reviewed all CA-AKI events to adjudicate drug involvement (Naranjo scale), identify inappropriate prescriptions (STOPP criteria), evaluate avoidability (Hallas criteria) and identify combined risk factors.
Results: An expert review confirmed 713 CA-AKI (15.0\% of inpatient stays) and determined that 419 (58.8\%) CA-AKI were induced by drugs. A multifactorial cause (i.e., at least one drug with a precipitating factor) was found in 63.2\% of drug-induced CA-AKI. Most of the drug-induced events were avoidable (66.8\%), mainly in relation to a multifactorial cause.
Conclusion: Drug-induced CA-AKI were frequent, multifactorial events in hospitalized older patients and their prevention should focus on combinations with precipitating factors.},
	language = {en},
	urldate = {2019-12-05},
	journal = {Clinical Interventions in Aging},
	author = {Robert, Laurine and Ficheur, Grégoire and Gautier, Sophie and Servais, Alexandre and Luyckx, Michel and Soula, Julien and Decaudin, Bertrand and Glowacki, François and Puisieux, François and Chazard, Emmanuel and Beuscart, Jean-Baptiste},
	month = dec,
	year = {2019},
	pages = {2105--2113},
}

Purpose: Community-acquired acute kidney injury (CA-AKI) is a frequent and severe adverse drug reaction (ADR) among older patients. The combination of drugs and other CA-AKI risk factors was barely evaluated. The objectives of our study were to both accurately identify CA-AKI induced by drugs in older patients, and to describe their combination with other risk factors. Patients and methods: We conducted a retrospective, single-center study in a general hospital over a two-year period. An automated detection identified CA-AKI according to KDIGO criteria, amongst 4,767 eligible inpatient stays among patients aged 75 years or older. Two independent experts reviewed all CA-AKI events to adjudicate drug involvement (Naranjo scale), identify inappropriate prescriptions (STOPP criteria), evaluate avoidability (Hallas criteria) and identify combined risk factors. Results: An expert review confirmed 713 CA-AKI (15.0% of inpatient stays) and determined that 419 (58.8%) CA-AKI were induced by drugs. A multifactorial cause (i.e., at least one drug with a precipitating factor) was found in 63.2% of drug-induced CA-AKI. Most of the drug-induced events were avoidable (66.8%), mainly in relation to a multifactorial cause. Conclusion: Drug-induced CA-AKI were frequent, multifactorial events in hospitalized older patients and their prevention should focus on combinations with precipitating factors.

@article{rochoy_factors_2019,
	title = {Factors associated with the onset of {Alzheimer}'s disease: {Data} mining in the {French} nationwide discharge summary database between 2008 and 2014},
	volume = {14},
	issn = {1932-6203},
	shorttitle = {Factors associated with the onset of {Alzheimer}'s disease},
	doi = {10.1371/journal.pone.0220174},
	abstract = {INTRODUCTION: Identifying modifiable risk factors for Alzheimer's disease (AD) is critical for research. Data mining may be a useful tool for finding new AD associated factors.
METHODS: We included all patients over 49 years of age, hospitalized in France in 2008 (without dementia) and in 2014. Dependent variable was AD or AD dementia diagnosis in 2014. We recoded the diagnoses of hospital stays (in ICD-10) into 137 explanatory variables.To avoid overweighting the "age" variable, we divided the population into 7 sub-populations of 5 years.
RESULTS: We analyzed 1,390,307 patients in the PMSI in 2008 and 2014: 55,997 patients had coding for AD or AD dementia in 2014 (4.04\%). We associated Alzheimer disease in 2014 with about 20 variables including male sex, stroke, diabetes mellitus, mental retardation, bipolar disorder, intoxication, Parkinson disease, depression, anxiety disorders, alcohol, undernutrition, fall and 3 less explored variables: intracranial hypertension (odd radio [95\% confidence interval]: 1.16 [1.12-1.20] in 70-80 years group), psychotic disorder (OR: 1.09 [1.07-1.11] in 70-75 years group) and epilepsy (OR: 1.06 [1.05-1.07] after 70 years).
DISCUSSION: We analyzed 137 variables in the PMSI identified some well-known risk factors for AD, and highlighted a possible association with intracranial hypertension, which merits further investigation. Better knowledge of associations could lead to better targeting (identifying) at-risk patients, and better prevention of AD, in order to reduce its impact.},
	language = {eng},
	number = {7},
	journal = {PloS One},
	author = {Rochoy, Michaël and Bordet, Régis and Gautier, Sophie and Chazard, Emmanuel},
	year = {2019},
	pmid = {31344088},
	pmcid = {PMC6657866},
	pages = {e0220174},
}

INTRODUCTION: Identifying modifiable risk factors for Alzheimer's disease (AD) is critical for research. Data mining may be a useful tool for finding new AD associated factors. METHODS: We included all patients over 49 years of age, hospitalized in France in 2008 (without dementia) and in 2014. Dependent variable was AD or AD dementia diagnosis in 2014. We recoded the diagnoses of hospital stays (in ICD-10) into 137 explanatory variables.To avoid overweighting the "age" variable, we divided the population into 7 sub-populations of 5 years. RESULTS: We analyzed 1,390,307 patients in the PMSI in 2008 and 2014: 55,997 patients had coding for AD or AD dementia in 2014 (4.04%). We associated Alzheimer disease in 2014 with about 20 variables including male sex, stroke, diabetes mellitus, mental retardation, bipolar disorder, intoxication, Parkinson disease, depression, anxiety disorders, alcohol, undernutrition, fall and 3 less explored variables: intracranial hypertension (odd radio [95% confidence interval]: 1.16 [1.12-1.20] in 70-80 years group), psychotic disorder (OR: 1.09 [1.07-1.11] in 70-75 years group) and epilepsy (OR: 1.06 [1.05-1.07] after 70 years). DISCUSSION: We analyzed 137 variables in the PMSI identified some well-known risk factors for AD, and highlighted a possible association with intracranial hypertension, which merits further investigation. Better knowledge of associations could lead to better targeting (identifying) at-risk patients, and better prevention of AD, in order to reduce its impact.

@article{rochoy_shift_2019,
	title = {Shift in {Hospitalizations} for {Alzheimer}'s {Disease} to {Related} {Dementias} in {France} between 2007 and 2017},
	volume = {6},
	issn = {2426-0266},
	doi = {10.14283/jpad.2019.5},
	abstract = {INTRODUCTION: Alzheimer's disease (AD) is the first cause of dementia. Diagnostic criteria have evolved: proposals to revise the NINCDS-ADRDA criteria were published in 2007. Our aim was to analyze the evolution in the coding of AD in the French nationwide exhaustive hospital discharge database (PMSI) between 2007 and 2017.
METHODS: We analyzed evolution of International Classification of Diseases and Related Health Problems, 10th edition (ICD-10) coding for AD and AD dementia in the PMSI database from 2008 to 2017 (285,748,938 inpatient stays).
RESULTS: We observed a 44\% decrease in the number of inpatient stays with a principal diagnosis of AD or AD dementia from 2007 (46,313 inpatient stays) to 2017 (25,856 inpatient stays) in France. Over the same period, we observed a 49\% increase in the number of inpatient stays with a principal diagnosis of related dementias (other organic mental disorders or other degenerative disorders). Overall, the number of inpatient stays for dementia remained stable despite the increase in the total number of inpatient stays: 95,377 in 2007 (0.409\% of inpatient stays) and 99,190 in 2017 (0.344\%).
CONCLUSION: We therefore note a shift from AD and AD dementia to other dementia diagnoses since 2007. This study suggests a more accurate use of AD related ICD-10 codes since the revised criteria in 2007.},
	language = {eng},
	number = {2},
	journal = {The Journal of Prevention of Alzheimer's Disease},
	author = {Rochoy, M. and Chazard, E. and Gautier, S. and Bordet, R.},
	year = {2019},
	pmid = {30756117},
	keywords = {Alzheimer disease, Data reuse, PMSI, big data, vascular dementia},
	pages = {108--111},
}

INTRODUCTION: Alzheimer's disease (AD) is the first cause of dementia. Diagnostic criteria have evolved: proposals to revise the NINCDS-ADRDA criteria were published in 2007. Our aim was to analyze the evolution in the coding of AD in the French nationwide exhaustive hospital discharge database (PMSI) between 2007 and 2017. METHODS: We analyzed evolution of International Classification of Diseases and Related Health Problems, 10th edition (ICD-10) coding for AD and AD dementia in the PMSI database from 2008 to 2017 (285,748,938 inpatient stays). RESULTS: We observed a 44% decrease in the number of inpatient stays with a principal diagnosis of AD or AD dementia from 2007 (46,313 inpatient stays) to 2017 (25,856 inpatient stays) in France. Over the same period, we observed a 49% increase in the number of inpatient stays with a principal diagnosis of related dementias (other organic mental disorders or other degenerative disorders). Overall, the number of inpatient stays for dementia remained stable despite the increase in the total number of inpatient stays: 95,377 in 2007 (0.409% of inpatient stays) and 99,190 in 2017 (0.344%). CONCLUSION: We therefore note a shift from AD and AD dementia to other dementia diagnoses since 2007. This study suggests a more accurate use of AD related ICD-10 codes since the revised criteria in 2007.

@article{rochoy_factors_2019-1,
	title = {Factors {Associated} with {Alzheimer}'s {Disease}: {An} {Overview} of {Reviews}},
	volume = {6},
	issn = {2426-0266},
	shorttitle = {Factors {Associated} with {Alzheimer}'s {Disease}},
	doi = {10.14283/jpad.2019.7},
	abstract = {Alzheimer's disease (AD) is a frequent pathology, with a poor prognosis, for which no curative treatment is available in 2018. AD prevention is an important issue, and is an important research topic. In this manuscript, we have synthesized the literature reviews and meta-analyses relating to modifiable risk factors associated with AD. Smoking, diabetes, high blood pressure, obesity, hypercholesterolemia, physical inactivity, depression, head trauma, heart failure, bleeding and ischemic strokes, sleep apnea syndrome appeared to be associated with an increased risk of AD. In addition to these well-known associations, we highlight here the existence of associated factors less described: hyperhomocysteinemia, hearing loss, essential tremor, occupational exposure to magnetic fields. On the contrary, some oral antidiabetic drugs, education and intellectual activity, a Mediterranean-type diet or using Healthy Diet Indicator, consumption of unsaturated fatty acids seemed to have a protective effect. Better knowledge of risk factors for AD allows for better identification of patients at risk. This may contribute to the emergence of prevention policies to delay or prevent the onset of AD.},
	language = {eng},
	number = {2},
	journal = {The Journal of Prevention of Alzheimer's Disease},
	author = {Rochoy, M. and Rivas, V. and Chazard, E. and Decarpentry, E. and Saudemont, G. and Hazard, P.-A. and Puisieux, F. and Gautier, S. and Bordet, R.},
	year = {2019},
	pmid = {30756119},
	keywords = {Alzheimer’s disease, early intervention, prevention, risk factors},
	pages = {121--134},
}

Alzheimer's disease (AD) is a frequent pathology, with a poor prognosis, for which no curative treatment is available in 2018. AD prevention is an important issue, and is an important research topic. In this manuscript, we have synthesized the literature reviews and meta-analyses relating to modifiable risk factors associated with AD. Smoking, diabetes, high blood pressure, obesity, hypercholesterolemia, physical inactivity, depression, head trauma, heart failure, bleeding and ischemic strokes, sleep apnea syndrome appeared to be associated with an increased risk of AD. In addition to these well-known associations, we highlight here the existence of associated factors less described: hyperhomocysteinemia, hearing loss, essential tremor, occupational exposure to magnetic fields. On the contrary, some oral antidiabetic drugs, education and intellectual activity, a Mediterranean-type diet or using Healthy Diet Indicator, consumption of unsaturated fatty acids seemed to have a protective effect. Better knowledge of risk factors for AD allows for better identification of patients at risk. This may contribute to the emergence of prevention policies to delay or prevent the onset of AD.

@article{rochoy_evolution_2018,
	title = {Evolution of {Dementia} {Related} to the {Use} of {Alcohol} in the {French} {Nationwide} {Discharge} {Summary} {Database} {Between} 2007 and 2017},
	issn = {1938-2731},
	doi = {10.1177/1533317518822043},
	abstract = {BACKGROUND:: The French nationwide exhaustive hospital discharge database (PMSI) is used for activity-based payment of hospital services. We hypothesized that the release of articles about alcohol and dementia could influence the identification of these diagnoses in PMSI.
METHODS:: We analyzed temporal evolution of coding for dementia and other persistent or late-onset cognitive impairment (OPLOCI) due to alcohol and other psychoactive substances in the PMSI database from 2007 to 2017 (285 748 938 inpatient stays). These codings use the International Classification of Diseases, 10th revision (ICD-10).
RESULTS:: The number of inpatient stays with dementia and OPLOCI due to alcohol increased from 34 to 1704 from 2007 to 2017. While the number of diagnosed dementias remained stable at around 400 from 2013, the number of OPLOCIs increased 10-fold from 2013 to 2017. This increase was not found with dementia or OPLOCI due to other psychoactive substances than alcohol.
CONCLUSION:: Notoriety of a diagnosis in the literature seems to have an impact on the coding.},
	language = {eng},
	journal = {American Journal of Alzheimer's Disease and Other Dementias},
	author = {Rochoy, Michaël and Gautier, Sophie and Béné, Johana and Bordet, Régis and Chazard, Emmanuel},
	month = dec,
	year = {2018},
	pmid = {30595024},
	keywords = {alcoholism, clinical coding, data reuse, database, dementia},
	pages = {1533317518822043},
}

BACKGROUND:: The French nationwide exhaustive hospital discharge database (PMSI) is used for activity-based payment of hospital services. We hypothesized that the release of articles about alcohol and dementia could influence the identification of these diagnoses in PMSI. METHODS:: We analyzed temporal evolution of coding for dementia and other persistent or late-onset cognitive impairment (OPLOCI) due to alcohol and other psychoactive substances in the PMSI database from 2007 to 2017 (285 748 938 inpatient stays). These codings use the International Classification of Diseases, 10th revision (ICD-10). RESULTS:: The number of inpatient stays with dementia and OPLOCI due to alcohol increased from 34 to 1704 from 2007 to 2017. While the number of diagnosed dementias remained stable at around 400 from 2013, the number of OPLOCIs increased 10-fold from 2013 to 2017. This increase was not found with dementia or OPLOCI due to other psychoactive substances than alcohol. CONCLUSION:: Notoriety of a diagnosis in the literature seems to have an impact on the coding.

@article{poirier_real_2018,
	title = {Real {Time} {Influenza} {Monitoring} {Using} {Hospital} {Big} {Data} in {Combination} with {Machine} {Learning} {Methods}: {Comparison} {Study}},
	volume = {4},
	issn = {2369-2960},
	shorttitle = {Real {Time} {Influenza} {Monitoring} {Using} {Hospital} {Big} {Data} in {Combination} with {Machine} {Learning} {Methods}},
	doi = {10.2196/11361},
	abstract = {BACKGROUND: Traditional surveillance systems produce estimates of influenza-like illness (ILI) incidence rates, but with 1- to 3-week delay. Accurate real-time monitoring systems for influenza outbreaks could be useful for making public health decisions. Several studies have investigated the possibility of using internet users' activity data and different statistical models to predict influenza epidemics in near real time. However, very few studies have investigated hospital big data.
OBJECTIVE: Here, we compared internet and electronic health records (EHRs) data and different statistical models to identify the best approach (data type and statistical model) for ILI estimates in real time.
METHODS: We used Google data for internet data and the clinical data warehouse eHOP, which included all EHRs from Rennes University Hospital (France), for hospital data. We compared 3 statistical models-random forest, elastic net, and support vector machine (SVM).
RESULTS: For national ILI incidence rate, the best correlation was 0.98 and the mean squared error (MSE) was 866 obtained with hospital data and the SVM model. For the Brittany region, the best correlation was 0.923 and MSE was 2364 obtained with hospital data and the SVM model.
CONCLUSIONS: We found that EHR data together with historical epidemiological information (French Sentinelles network) allowed for accurately predicting ILI incidence rates for the entire France as well as for the Brittany region and outperformed the internet data whatever was the statistical model used. Moreover, the performance of the two statistical models, elastic net and SVM, was comparable.},
	language = {eng},
	number = {4},
	journal = {JMIR public health and surveillance},
	author = {Poirier, Canelle and Lavenu, Audrey and Bertaud, Valérie and Campillo-Gimenez, Boris and Chazard, Emmanuel and Cuggia, Marc and Bouzillé, Guillaume},
	month = dec,
	year = {2018},
	pmid = {30578212},
	keywords = {Sentinelles network, big data, electronic health records, influenza, infodemiology, infoveillance, machine learning},
	pages = {e11361},
}

BACKGROUND: Traditional surveillance systems produce estimates of influenza-like illness (ILI) incidence rates, but with 1- to 3-week delay. Accurate real-time monitoring systems for influenza outbreaks could be useful for making public health decisions. Several studies have investigated the possibility of using internet users' activity data and different statistical models to predict influenza epidemics in near real time. However, very few studies have investigated hospital big data. OBJECTIVE: Here, we compared internet and electronic health records (EHRs) data and different statistical models to identify the best approach (data type and statistical model) for ILI estimates in real time. METHODS: We used Google data for internet data and the clinical data warehouse eHOP, which included all EHRs from Rennes University Hospital (France), for hospital data. We compared 3 statistical models-random forest, elastic net, and support vector machine (SVM). RESULTS: For national ILI incidence rate, the best correlation was 0.98 and the mean squared error (MSE) was 866 obtained with hospital data and the SVM model. For the Brittany region, the best correlation was 0.923 and MSE was 2364 obtained with hospital data and the SVM model. CONCLUSIONS: We found that EHR data together with historical epidemiological information (French Sentinelles network) allowed for accurately predicting ILI incidence rates for the entire France as well as for the Brittany region and outperformed the internet data whatever was the statistical model used. Moreover, the performance of the two statistical models, elastic net and SVM, was comparable.

@article{bray_increased_2018,
	title = {Increased incidence of cholecystectomy related to gallbladder disease in {France}: {Analysis} of 807,307 cholecystectomy procedures over a period of seven years},
	issn = {1878-7886},
	shorttitle = {Increased incidence of cholecystectomy related to gallbladder disease in {France}},
	doi = {10.1016/j.jviscsurg.2018.12.003},
	abstract = {PURPOSE: Gallstones are one of the most common abdominal reasons for admission to hospital. The aim of this study was to analyze trends and outcomes in patients undergoing cholecystectomy with gallbladder related disease in France from 2008 to 2014.
PATIENTS AND METHODS: We carried out a population-based, retrospective cohort study using data extracted from the French nationwide hospital discharge database (PMSI). We included all patients having a cholecystectomy related to gallbladder disease from January 2008 to December 2014. Patients' demographics, primary diagnosis, procedure type, length of stay (LOS), admission in an intensive care unit, discharge disposition, complications, and in-hospital mortality were analyzed.
RESULTS: Overall, 807,307 cholecystectomies were performed in France over the study period, with an increase in the national incidence rate from 167.5 (95\%CI [166.5; 168.5]) to 182.6 (95\%CI [181.6; 183.6]) per 100,000 inhabitants. Females accounted for 66.5\% of procedures (P{\textless}0.001). The mean age was lower for females than for males: 52.1 versus 60.2 (P{\textless}0.001). The ratio of laparoscopic cholecystectomy significantly increased from 90\% in 2008 to 94\% in 2014 (P{\textless}0.001). Average inpatient LOS decreased significantly from 6.5 days in 2008 to 4.7 days in 2014 (P{\textless}0.001). Most common complication type was intra-abdominal (23.1\%) for laparoscopic procedure (95\%CI [22.7; 23.5]), and in-hospital mortality significantly decreased over time from 0.45\% in 2008 to 0.38\% in 2014 (P{\textless}0.005).
CONCLUSION: Our results showed that the national incidence rate of cholecystectomy related to gallbladder disease increased from 2008 to 2014.},
	language = {eng},
	journal = {Journal of Visceral Surgery},
	author = {Bray, F. and Balcaen, T. and Baro, E. and Gandon, A. and Ficheur, G. and Chazard, E.},
	month = dec,
	year = {2018},
	pmid = {30573436},
	keywords = {Cholecystectomy, Epidemiology, Laparoscopic cholecystectomy, Nationwide database, Open cholecystectomy},
}

PURPOSE: Gallstones are one of the most common abdominal reasons for admission to hospital. The aim of this study was to analyze trends and outcomes in patients undergoing cholecystectomy with gallbladder related disease in France from 2008 to 2014. PATIENTS AND METHODS: We carried out a population-based, retrospective cohort study using data extracted from the French nationwide hospital discharge database (PMSI). We included all patients having a cholecystectomy related to gallbladder disease from January 2008 to December 2014. Patients' demographics, primary diagnosis, procedure type, length of stay (LOS), admission in an intensive care unit, discharge disposition, complications, and in-hospital mortality were analyzed. RESULTS: Overall, 807,307 cholecystectomies were performed in France over the study period, with an increase in the national incidence rate from 167.5 (95%CI [166.5; 168.5]) to 182.6 (95%CI [181.6; 183.6]) per 100,000 inhabitants. Females accounted for 66.5% of procedures (P\textless0.001). The mean age was lower for females than for males: 52.1 versus 60.2 (P\textless0.001). The ratio of laparoscopic cholecystectomy significantly increased from 90% in 2008 to 94% in 2014 (P\textless0.001). Average inpatient LOS decreased significantly from 6.5 days in 2008 to 4.7 days in 2014 (P\textless0.001). Most common complication type was intra-abdominal (23.1%) for laparoscopic procedure (95%CI [22.7; 23.5]), and in-hospital mortality significantly decreased over time from 0.45% in 2008 to 0.38% in 2014 (P\textless0.005). CONCLUSION: Our results showed that the national incidence rate of cholecystectomy related to gallbladder disease increased from 2008 to 2014.

@article{rochoy_vascular_2018,
	title = {Vascular dementia encoding in the {French} nationwide discharge summary database ({PMSI}): {Variability} over the 2007-2017 period},
	issn = {1768-3181},
	shorttitle = {Vascular dementia encoding in the {French} nationwide discharge summary database ({PMSI})},
	doi = {10.1016/j.ancard.2018.10.011},
	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.},
	language = {eng},
	journal = {Annales De Cardiologie Et D'angeiologie},
	author = {Rochoy, M. and Chazard, E. and Gautier, S. and Bordet, R.},
	month = nov,
	year = {2018},
	pmid = {30409382},
	keywords = {Base de données, Clinical coding, Codage clinique, Database, Dementia, Diagnosis, Diagnostic, Démence vasculaire, Vascular},
}

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.

@article{robert_hospital-acquired_2018,
	title = {Hospital-acquired hyperkalemia events in older patients are mostly due to avoidable, multifactorial, adverse drug reactions},
	issn = {1532-6535},
	doi = {10.1002/cpt.1239},
	abstract = {Drug-induced hyperkalemia is a frequent and severe complication in hospital setting. Other risk factors may also induce hyperkalemia but the combination of drugs and precipitating factors has not been extensively studied. The aim was to identify drug-induced hyperkalemia events in hospitalized older patients and to describe their combinations with precipitating factors. Two experts analyzed independently retrospective data of patients aged 75 years or more. Experts identified 471 hyperkalemia events and concluded that 379 (80.5\%) were induced by drugs. The cause was multifactorial (i.e. at least one drug with a precipitating factor) in 300 (79.2\%) of the 379 drug-induced hyperkalemia. Most of the drug-induced hyperkalemia events were avoidable (79.9\%) - mainly because of the multifactorial cause (e.g. dosage adaptation during acute kidney injury). Drug-induced hyperkalemia events are frequently combined with precipitating factors in hospitalized older patients and their prevention should focus on these combinations. This article is protected by copyright. All rights reserved.},
	language = {eng},
	journal = {Clinical Pharmacology and Therapeutics},
	author = {Robert, Laurine and Ficheur, Grégoire and Décaudin, Bertrand and Gellens, Juliette and Luyckx, Michel and Perichon, Renaud and Gautier, Sophie and Puisieux, François and Chazard, Emmanuel and Beuscart, Jean-Baptiste},
	month = sep,
	year = {2018},
	pmid = {30242829},
	keywords = {Adverse drug reactions, Elderly, Prevention},
}

Drug-induced hyperkalemia is a frequent and severe complication in hospital setting. Other risk factors may also induce hyperkalemia but the combination of drugs and precipitating factors has not been extensively studied. The aim was to identify drug-induced hyperkalemia events in hospitalized older patients and to describe their combinations with precipitating factors. Two experts analyzed independently retrospective data of patients aged 75 years or more. Experts identified 471 hyperkalemia events and concluded that 379 (80.5%) were induced by drugs. The cause was multifactorial (i.e. at least one drug with a precipitating factor) in 300 (79.2%) of the 379 drug-induced hyperkalemia. Most of the drug-induced hyperkalemia events were avoidable (79.9%) - mainly because of the multifactorial cause (e.g. dosage adaptation during acute kidney injury). Drug-induced hyperkalemia events are frequently combined with precipitating factors in hospitalized older patients and their prevention should focus on these combinations. This article is protected by copyright. All rights reserved.

@article{bensmaine_irisin_2018,
	title = {Irisin levels in {LMNA}-associated partial lipodystrophies},
	issn = {1878-1780},
	doi = {10.1016/j.diabet.2018.08.003},
	abstract = {AIM: The adipo-myokine irisin regulates energy expenditure and fat metabolism. LMNA-associated familial partial lipodystrophy (FPLD2) comprises insulin resistance, muscle hypertrophy and lipoatrophy. The aim of this study was to investigate whether irisin could be a biomarker of FPLD2.
PATIENTS AND METHODS: This case control study included 19 FPLD2 subjects, 13 obese non-diabetic (OND) patients and 19 healthy controls (HC) of normal weight (median BMI: 26, 39 and 22 kg/m2, respectively). Serum irisin and leptin levels, body composition (DXA/MRI) and metabolic/inflammatory parameters were compared in these three groups.
RESULTS: BMI and MRI intra-abdominal fat significantly differed among these three groups, whereas DXA total fat mass and leptin levels were higher in the OND group, but did not differ between HC and FPLD2. Lipodystrophy patients had higher intra-abdominal/total abdominal fat ratios than the other two groups. Irisin levels were higher in FPLD2 and OND patients than in HC (medians: 944, 934 and 804 ng/mL, respectively). However, irisin/leptin ratios and lean body mass percentages were strikingly higher, and lean mass indices lower, in FPLD2 and HC than in the OND (median irisin/leptin ratios: 137, 166 and 21, respectively). In the entire study group, irisin levels positively correlated with BMI, lean body mass and index, intra-abdominal/total abdominal fat ratio, triglyceride, cholesterol, insulin, glucose and HbA1c levels. Also, intra-abdominal/total abdominal fat ratio and lean body mass better differentiated the three groups only in female patients.
CONCLUSION: Circulating irisin is similarly increased in FPLD2 and OND patients, who are characterized by higher lean body mass regardless of their clearly different fat mass. However, irisin/leptin ratios, strikingly higher in FPLD2 than in OND patients, could help to make the diagnosis and prompt genetic testing in clinically atypical cases.},
	language = {eng},
	journal = {Diabetes \& Metabolism},
	author = {Bensmaïne, F. and Benomar, K. and Espiard, S. and Vahe, C. and Le Mapihan, K. and Lion, G. and Lemdani, M. and Chazard, E. and Ernst, O. and Vigouroux, C. and Pigny, P. and Vantyghem, M.-C.},
	month = aug,
	year = {2018},
	pmid = {30165155},
	keywords = {Fat mass, Irisin, Lamin A, Lean mass, Leptin, Lipodystrophy, Muscle, Obesity},
}

AIM: The adipo-myokine irisin regulates energy expenditure and fat metabolism. LMNA-associated familial partial lipodystrophy (FPLD2) comprises insulin resistance, muscle hypertrophy and lipoatrophy. The aim of this study was to investigate whether irisin could be a biomarker of FPLD2. PATIENTS AND METHODS: This case control study included 19 FPLD2 subjects, 13 obese non-diabetic (OND) patients and 19 healthy controls (HC) of normal weight (median BMI: 26, 39 and 22 kg/m2, respectively). Serum irisin and leptin levels, body composition (DXA/MRI) and metabolic/inflammatory parameters were compared in these three groups. RESULTS: BMI and MRI intra-abdominal fat significantly differed among these three groups, whereas DXA total fat mass and leptin levels were higher in the OND group, but did not differ between HC and FPLD2. Lipodystrophy patients had higher intra-abdominal/total abdominal fat ratios than the other two groups. Irisin levels were higher in FPLD2 and OND patients than in HC (medians: 944, 934 and 804 ng/mL, respectively). However, irisin/leptin ratios and lean body mass percentages were strikingly higher, and lean mass indices lower, in FPLD2 and HC than in the OND (median irisin/leptin ratios: 137, 166 and 21, respectively). In the entire study group, irisin levels positively correlated with BMI, lean body mass and index, intra-abdominal/total abdominal fat ratio, triglyceride, cholesterol, insulin, glucose and HbA1c levels. Also, intra-abdominal/total abdominal fat ratio and lean body mass better differentiated the three groups only in female patients. CONCLUSION: Circulating irisin is similarly increased in FPLD2 and OND patients, who are characterized by higher lean body mass regardless of their clearly different fat mass. However, irisin/leptin ratios, strikingly higher in FPLD2 than in OND patients, could help to make the diagnosis and prompt genetic testing in clinically atypical cases.

@article{bouzille_drug_2018,
	title = {Drug safety and big clinical data: {Detection} of drug-induced anaphylactic shock events},
	issn = {1365-2753},
	shorttitle = {Drug safety and big clinical data},
	url = {https://hal-univ-rennes1.archives-ouvertes.fr/hal-01833093/document},
	doi = {10.1111/jep.12908},
	abstract = {RATIONALE, AIMS, AND OBJECTIVES: The spontaneous reporting system currently used in pharmacovigilance is not sufficiently exhaustive to detect all adverse drug reactions (ADRs). With the widespread use of electronic health records, biomedical data collected during the clinical care process can be reused and analysed to better detect ADRs. The aim of this study was to assess whether querying a Clinical Data Warehouse (CDW) could increase the detection of drug-induced anaphylaxis.
METHODS: All known cases of drug-induced anaphylaxis that occurred or required hospitalization at Rennes Academic Hospital in 2011 (n = 19) were retrieved from the French pharmacovigilance database, which contains all reported ADR events. Then, from the Rennes Academic Hospital CDW, a training set (all patients hospitalized in 2011) and a test set (all patients hospitalized in 2012) were extracted. The training set was used to define an optimized query, by building a set of keywords (based on the known cases) and exclusion criteria to search structured and unstructured data within the CDW in order to identify at least all known cases of drug-induced anaphylaxis for 2011. Then, the real performance of the optimized query was tested in the test set.
RESULTS: Using the optimized query, 59 cases of drug-induced anaphylaxis were identified among the 253 patient records extracted from the test set as possible anaphylaxis cases. Specifically, the optimal query identified 41 drug-induced anaphylaxis cases that were not detected by searching the French pharmacovigilance database but missed 7 cases detected only by spontaneous reporting.
DISCUSSION: We proposed an information retrieval-based method for detecting drug-induced anaphylaxis, by querying structured and unstructured data in a CDW. CDW queries are less specific than spontaneous reporting and Diagnosis-related Groups queries, although their sensitivity is much higher. CDW queries can facilitate monitoring by pharmacovigilance experts. Our method could be easily incorporated in the routine practice.},
	language = {eng},
	journal = {Journal of Evaluation in Clinical Practice},
	author = {Bouzillé, Guillaume and Osmont, Marie-Noëlle and Triquet, Louise and Grabar, Natalia and Rochefort-Morel, Cécile and Chazard, Emmanuel and Polard, Elisabeth and Cuggia, Marc},
	month = mar,
	year = {2018},
	pmid = {29532572},
	keywords = {adverse drug reaction reporting systems, drug-related side effects and adverse reactions, electronic health records, information storage and retrieval},
}

RATIONALE, AIMS, AND OBJECTIVES: The spontaneous reporting system currently used in pharmacovigilance is not sufficiently exhaustive to detect all adverse drug reactions (ADRs). With the widespread use of electronic health records, biomedical data collected during the clinical care process can be reused and analysed to better detect ADRs. The aim of this study was to assess whether querying a Clinical Data Warehouse (CDW) could increase the detection of drug-induced anaphylaxis. METHODS: All known cases of drug-induced anaphylaxis that occurred or required hospitalization at Rennes Academic Hospital in 2011 (n = 19) were retrieved from the French pharmacovigilance database, which contains all reported ADR events. Then, from the Rennes Academic Hospital CDW, a training set (all patients hospitalized in 2011) and a test set (all patients hospitalized in 2012) were extracted. The training set was used to define an optimized query, by building a set of keywords (based on the known cases) and exclusion criteria to search structured and unstructured data within the CDW in order to identify at least all known cases of drug-induced anaphylaxis for 2011. Then, the real performance of the optimized query was tested in the test set. RESULTS: Using the optimized query, 59 cases of drug-induced anaphylaxis were identified among the 253 patient records extracted from the test set as possible anaphylaxis cases. Specifically, the optimal query identified 41 drug-induced anaphylaxis cases that were not detected by searching the French pharmacovigilance database but missed 7 cases detected only by spontaneous reporting. DISCUSSION: We proposed an information retrieval-based method for detecting drug-induced anaphylaxis, by querying structured and unstructured data in a CDW. CDW queries are less specific than spontaneous reporting and Diagnosis-related Groups queries, although their sensitivity is much higher. CDW queries can facilitate monitoring by pharmacovigilance experts. Our method could be easily incorporated in the routine practice.

@article{bouzille_leveraging_2018,
	title = {Leveraging hospital big data to monitor flu epidemics},
	volume = {154},
	copyright = {All rights reserved},
	issn = {1872-7565},
	doi = {10.1016/j.cmpb.2017.11.012},
	abstract = {BACKGROUND AND OBJECTIVE: Influenza epidemics are a major public health concern and require a costly and time-consuming surveillance system at different geographical scales. The main challenge is being able to predict epidemics. Besides traditional surveillance systems, such as the French Sentinel network, several studies proposed prediction models based on internet-user activity. Here, we assessed the potential of hospital big data to monitor influenza epidemics.
METHODS: We used the clinical data warehouse of the Academic Hospital of Rennes (France) and then built different queries to retrieve relevant information from electronic health records to gather weekly influenza-like illness activity.
RESULTS: We found that the query most highly correlated with Sentinel network estimates was based on emergency reports concerning discharged patients with a final diagnosis of influenza (Pearson's correlation coefficient (PCC) of 0.931). The other tested queries were based on structured data (ICD-10 codes of influenza in Diagnosis-related Groups, and influenza PCR tests) and performed best (PCC of 0.981 and 0.953, respectively) during the flu season 2014-15. This suggests that both ICD-10 codes and PCR results are associated with severe epidemics. Finally, our approach allowed us to obtain additional patients' characteristics, such as the sex ratio or age groups, comparable with those from the Sentinel network.
CONCLUSIONS: Conclusions: Hospital big data seem to have a great potential for monitoring influenza epidemics in near real-time. Such a method could constitute a complementary tool to standard surveillance systems by providing additional characteristics on the concerned population or by providing information earlier. This system could also be easily extended to other diseases with possible activity changes. Additional work is needed to assess the real efficacy of predictive models based on hospital big data to predict flu epidemics.},
	language = {eng},
	journal = {Computer Methods and Programs in Biomedicine},
	author = {Bouzillé, Guillaume and Poirier, Canelle and Campillo-Gimenez, Boris and Aubert, Marie-Laure and Chabot, Mélanie and Chazard, Emmanuel and Lavenu, Audrey and Cuggia, Marc},
	month = feb,
	year = {2018},
	pmid = {29249339},
	keywords = {Clinical data warehouse, Health Information Systems, Health big data, Influenza, Information retrieval system, Sentinel Surveillance, Sentinel surveillance},
	pages = {153--160},
}

BACKGROUND AND OBJECTIVE: Influenza epidemics are a major public health concern and require a costly and time-consuming surveillance system at different geographical scales. The main challenge is being able to predict epidemics. Besides traditional surveillance systems, such as the French Sentinel network, several studies proposed prediction models based on internet-user activity. Here, we assessed the potential of hospital big data to monitor influenza epidemics. METHODS: We used the clinical data warehouse of the Academic Hospital of Rennes (France) and then built different queries to retrieve relevant information from electronic health records to gather weekly influenza-like illness activity. RESULTS: We found that the query most highly correlated with Sentinel network estimates was based on emergency reports concerning discharged patients with a final diagnosis of influenza (Pearson's correlation coefficient (PCC) of 0.931). The other tested queries were based on structured data (ICD-10 codes of influenza in Diagnosis-related Groups, and influenza PCR tests) and performed best (PCC of 0.981 and 0.953, respectively) during the flu season 2014-15. This suggests that both ICD-10 codes and PCR results are associated with severe epidemics. Finally, our approach allowed us to obtain additional patients' characteristics, such as the sex ratio or age groups, comparable with those from the Sentinel network. CONCLUSIONS: Conclusions: Hospital big data seem to have a great potential for monitoring influenza epidemics in near real-time. Such a method could constitute a complementary tool to standard surveillance systems by providing additional characteristics on the concerned population or by providing information earlier. This system could also be easily extended to other diseases with possible activity changes. Additional work is needed to assess the real efficacy of predictive models based on hospital big data to predict flu epidemics.

@article{dhaenens_clinmine:_2018,
	title = {{ClinMine}: {Optimizing} the {Management} of {Patients} in {Hospital}},
	issn = {1959-0318},
	shorttitle = {{ClinMine}},
	url = {https://hal.inria.fr/hal-01692197/document},
	doi = {10.1016/j.irbm.2017.12.002},
	abstract = {Context
A better understanding of “patient pathway” thanks to data analysis can lead to better treatments for patients. The ClinMine project, supported by the French National Research Agency (ANR), aims at proposing, from various case studies, algorithmic and statistical models able to handle this type of pathway data, focusing primarily on hospital data.
Methods
This article presents two of these case studies, focusing on the integration of temporal data within analysis. First, the hypothesis that some aspects of the patient pathway can be described, even predicted, from the management process of the hospital medical mail is studied. Therefore a specific functional data analysis is driven, and several types of patients have been detected. The second case study deals with the detection of profiles through a biclustering of the patients. The difficulty to simultaneously deal with heterogeneous data, including temporal data is exposed and a method is proposed.
Results
Experiments are driven on real data coming from a hospital. Results on these data show the effectiveness of the two proposed methods.
Conclusion
The project ClinMine aimed at dealing with hospital data in order to provide a better understanding of “patient pathway”. The two methods proposed here show their ability to simultaneously deal with heterogeneous data, including temporal aspects, and manages to give information for the understanding of “patient pathway” (identification of interesting clusters of patients).},
	journal = {IRBM},
	author = {Dhaenens, C. and Jacques, J. and Vandewalle, V. and Vandromme, M. and Chazard, E. and Preda, C. and Amarioarei, A. and Chaiwuttisak, P. and Cozma, C. and Ficheur, G. and Kessaci, M. -E. and Perichon, R. and Taillard, J. and Bordet, R. and Lansiaux, A. and Jourdan, L. and Delerue, D. and Hansske, A.},
	month = jan,
	year = {2018},
	keywords = {Electronic Health Records, Heterogeneous data, Hospital information system, Optimization algorithms, Patient pathway, Temporal data, statistical analysis},
}

Context A better understanding of “patient pathway” thanks to data analysis can lead to better treatments for patients. The ClinMine project, supported by the French National Research Agency (ANR), aims at proposing, from various case studies, algorithmic and statistical models able to handle this type of pathway data, focusing primarily on hospital data. Methods This article presents two of these case studies, focusing on the integration of temporal data within analysis. First, the hypothesis that some aspects of the patient pathway can be described, even predicted, from the management process of the hospital medical mail is studied. Therefore a specific functional data analysis is driven, and several types of patients have been detected. The second case study deals with the detection of profiles through a biclustering of the patients. The difficulty to simultaneously deal with heterogeneous data, including temporal data is exposed and a method is proposed. Results Experiments are driven on real data coming from a hospital. Results on these data show the effectiveness of the two proposed methods. Conclusion The project ClinMine aimed at dealing with hospital data in order to provide a better understanding of “patient pathway”. The two methods proposed here show their ability to simultaneously deal with heterogeneous data, including temporal aspects, and manages to give information for the understanding of “patient pathway” (identification of interesting clusters of patients).

@article{engelmann_comparison_2018,
	title = {Comparison of two commercial quantitative {PCR} assays and correlation with the first {WHO} {International} {Standard} for human {CMV}},
	issn = {1879-0070},
	doi = {10.1016/j.diagmicrobio.2017.12.021},
	abstract = {Comparability between CMV assays could be facilitated by the first WHO International Standard for human CMV (standard). Standard dilutions were submitted to nucleic acid extraction with Versant kPCR Molecular systems SP or MagNA Pure LC System followed by the kPCR PLX™ CMV DNA (kPCR) or the CMV R-gene™ assay (R-gene), respectively; 139 clinical specimens were tested. Both assays correlated well with the standard (R2{\textgreater} 0.96) and a matrix effect was observed. Quantitative results correlated reasonably between both assays for whole blood (R2= 0.79) and well for other specimen types (R2= 0.93). Quantification differences were within one log10of the averaged log10results for 25/27 blood specimens and for 32/33 other specimens. Calibration to the standard did not increase this percentage. In conclusion, results of both assays showed reasonable correlation with each other and good correlation with the standard. Calibration to the standard did not improve comparability of quantitative results.},
	language = {eng},
	journal = {Diagnostic Microbiology and Infectious Disease},
	author = {Engelmann, Ilka and Alidjinou, Enagnon Kazali and Lazrek, Mouna and Ogiez, Judith and Pouillaude, Jean-Marie and Chazard, Emmanuel and Dewilde, Anny and Hober, Didier},
	month = jan,
	year = {2018},
	pmid = {29463426},
	keywords = {CMV, Molecular testing, PCR, Viral load, WHO standard, molecular testing, viral load},
}

Comparability between CMV assays could be facilitated by the first WHO International Standard for human CMV (standard). Standard dilutions were submitted to nucleic acid extraction with Versant kPCR Molecular systems SP or MagNA Pure LC System followed by the kPCR PLX™ CMV DNA (kPCR) or the CMV R-gene™ assay (R-gene), respectively; 139 clinical specimens were tested. Both assays correlated well with the standard (R2\textgreater 0.96) and a matrix effect was observed. Quantitative results correlated reasonably between both assays for whole blood (R2= 0.79) and well for other specimen types (R2= 0.93). Quantification differences were within one log10of the averaged log10results for 25/27 blood specimens and for 32/33 other specimens. Calibration to the standard did not increase this percentage. In conclusion, results of both assays showed reasonable correlation with each other and good correlation with the standard. Calibration to the standard did not improve comparability of quantitative results.

@article{sylvestre_combining_2018,
	title = {Combining information from a clinical data warehouse and a pharmaceutical database to generate a framework to detect comorbidities in electronic health records},
	volume = {18},
	issn = {1472-6947},
	url = {https://hal-univ-rennes1.archives-ouvertes.fr/hal-01709604/document},
	doi = {10.1186/s12911-018-0586-x},
	abstract = {BACKGROUND: Medical coding is used for a variety of activities, from observational studies to hospital billing. However, comorbidities tend to be under-reported by medical coders. The aim of this study was to develop an algorithm to detect comorbidities in electronic health records (EHR) by using a clinical data warehouse (CDW) and a knowledge database.
METHODS: We enriched the Theriaque pharmaceutical database with the French national Comorbidities List to identify drugs associated with at least one major comorbid condition and diagnoses associated with a drug indication. Then, we compared the drug indications in the Theriaque database with the ICD-10 billing codes in EHR to detect potentially missing comorbidities based on drug prescriptions. Finally, we improved comorbidity detection by matching drug prescriptions and laboratory test results. We tested the obtained algorithm by using two retrospective datasets extracted from the Rennes University Hospital (RUH) CDW. The first dataset included all adult patients hospitalized in the ear, nose, throat (ENT) surgical ward between October and December 2014 (ENT dataset). The second included all adult patients hospitalized at RUH between January and February 2015 (general dataset). We reviewed medical records to find written evidence of the suggested comorbidities in current or past stays.
RESULTS: Among the 22,132 Common Units of Dispensation (CUD) codes present in the Theriaque database, 19,970 drugs (90.2\%) were associated with one or several ICD-10 diagnoses, based on their indication, and 11,162 (50.4\%) with at least one of the 4878 comorbidities from the comorbidity list. Among the 122 patients of the ENT dataset, 75.4\% had at least one drug prescription without corresponding ICD-10 code. The comorbidity diagnoses suggested by the algorithm were confirmed in 44.6\% of the cases. Among the 4312 patients of the general dataset, 68.4\% had at least one drug prescription without corresponding ICD-10 code. The comorbidity diagnoses suggested by the algorithm were confirmed in 20.3\% of reviewed cases.
CONCLUSIONS: This simple algorithm based on combining accessible and immediately reusable data from knowledge databases, drug prescriptions and laboratory test results can detect comorbidities.},
	language = {eng},
	number = {1},
	journal = {BMC medical informatics and decision making},
	author = {Sylvestre, Emmanuelle and Bouzillé, Guillaume and Chazard, Emmanuel and His-Mahier, Cécil and Riou, Christine and Cuggia, Marc},
	year = {2018},
	pmid = {29368609},
	pmcid = {PMC5784648},
	keywords = {Billing codes, Clinical data warehouse, Comorbidity, Databases, Drug prescriptions, Laboratory test results, Pharmaceutical},
	pages = {9},
}

BACKGROUND: Medical coding is used for a variety of activities, from observational studies to hospital billing. However, comorbidities tend to be under-reported by medical coders. The aim of this study was to develop an algorithm to detect comorbidities in electronic health records (EHR) by using a clinical data warehouse (CDW) and a knowledge database. METHODS: We enriched the Theriaque pharmaceutical database with the French national Comorbidities List to identify drugs associated with at least one major comorbid condition and diagnoses associated with a drug indication. Then, we compared the drug indications in the Theriaque database with the ICD-10 billing codes in EHR to detect potentially missing comorbidities based on drug prescriptions. Finally, we improved comorbidity detection by matching drug prescriptions and laboratory test results. We tested the obtained algorithm by using two retrospective datasets extracted from the Rennes University Hospital (RUH) CDW. The first dataset included all adult patients hospitalized in the ear, nose, throat (ENT) surgical ward between October and December 2014 (ENT dataset). The second included all adult patients hospitalized at RUH between January and February 2015 (general dataset). We reviewed medical records to find written evidence of the suggested comorbidities in current or past stays. RESULTS: Among the 22,132 Common Units of Dispensation (CUD) codes present in the Theriaque database, 19,970 drugs (90.2%) were associated with one or several ICD-10 diagnoses, based on their indication, and 11,162 (50.4%) with at least one of the 4878 comorbidities from the comorbidity list. Among the 122 patients of the ENT dataset, 75.4% had at least one drug prescription without corresponding ICD-10 code. The comorbidity diagnoses suggested by the algorithm were confirmed in 44.6% of the cases. Among the 4312 patients of the general dataset, 68.4% had at least one drug prescription without corresponding ICD-10 code. The comorbidity diagnoses suggested by the algorithm were confirmed in 20.3% of reviewed cases. CONCLUSIONS: This simple algorithm based on combining accessible and immediately reusable data from knowledge databases, drug prescriptions and laboratory test results can detect comorbidities.

@article{berkhout_randomized_2018,
	title = {Randomized controlled trial on promoting influenza vaccination in general practice waiting rooms},
	volume = {13},
	issn = {1932-6203},
	doi = {10.1371/journal.pone.0192155},
	abstract = {BACKGROUND: Most of general practitioners (GPs) use advertising in their waiting rooms for patient's education purposes. Patients vaccinated against seasonal influenza have been gradually lessening. The objective of this trial was to assess the effect of an advertising campaign for influenza vaccination using posters and pamphlets in GPs' waiting rooms.
METHODS AND FINDINGS: Registry based 2/1 cluster randomized controlled trial, a cluster gathering the enlisted patients of 75 GPs aged over 16 years. The trial, run during the 2014-2015 influenza vaccination campaign, compared patient's awareness from being in 50 GPs' standard waiting rooms (control group) versus that of waiting in 25 rooms from GPs who had received and exposed pamphlets and one poster on influenza vaccine (intervention group), in addition to standard mandatory information. The main outcome was the number of vaccination units delivered in pharmacies. Data were extracted from the SIAM-ERASME claim database of the Health Insurance Fund of Lille-Douai (France). The association between the intervention (yes/no) and the main outcome was assessed through a generalized estimating equation. Seventy-five GPs enrolled 10,597 patients over 65 years or suffering from long lasting diseases (intervention/control as of 3781/6816 patients) from October 15, 2014 to February 28, 2015. No difference was found regarding the number of influenza vaccination units delivered (Relative Risk (RR) = 1.01; 95\% Confidence interval: 0.97 to 1.05; p = 0.561).
CONCLUSION: Effects of the monothematic campaign promoting vaccination against influenza using a poster and pamphlets exposed in GPs' waiting rooms could not be demonstrated.},
	language = {eng},
	number = {2},
	journal = {PloS One},
	author = {Berkhout, Christophe and Willefert-Bouche, Amy and Chazard, Emmanuel and Zgorska-Maynard-Moussa, Suzanna and Favre, Jonathan and Peremans, Lieve and Ficheur, Grégoire and Van Royen, Paul},
	year = {2018},
	pmid = {29425226},
	pages = {e0192155},
}

BACKGROUND: Most of general practitioners (GPs) use advertising in their waiting rooms for patient's education purposes. Patients vaccinated against seasonal influenza have been gradually lessening. The objective of this trial was to assess the effect of an advertising campaign for influenza vaccination using posters and pamphlets in GPs' waiting rooms. METHODS AND FINDINGS: Registry based 2/1 cluster randomized controlled trial, a cluster gathering the enlisted patients of 75 GPs aged over 16 years. The trial, run during the 2014-2015 influenza vaccination campaign, compared patient's awareness from being in 50 GPs' standard waiting rooms (control group) versus that of waiting in 25 rooms from GPs who had received and exposed pamphlets and one poster on influenza vaccine (intervention group), in addition to standard mandatory information. The main outcome was the number of vaccination units delivered in pharmacies. Data were extracted from the SIAM-ERASME claim database of the Health Insurance Fund of Lille-Douai (France). The association between the intervention (yes/no) and the main outcome was assessed through a generalized estimating equation. Seventy-five GPs enrolled 10,597 patients over 65 years or suffering from long lasting diseases (intervention/control as of 3781/6816 patients) from October 15, 2014 to February 28, 2015. No difference was found regarding the number of influenza vaccination units delivered (Relative Risk (RR) = 1.01; 95% Confidence interval: 0.97 to 1.05; p = 0.561). CONCLUSION: Effects of the monothematic campaign promoting vaccination against influenza using a poster and pamphlets exposed in GPs' waiting rooms could not be demonstrated.

@article{chazard_secondary_2018,
	title = {Secondary {Use} of {Healthcare} {Structured} {Data}: {The} {Challenge} of {Domain}-{Knowledge} {Based} {Extraction} of {Features}},
	volume = {255},
	issn = {0926-9630},
	shorttitle = {Secondary {Use} of {Healthcare} {Structured} {Data}},
	abstract = {Secondary use of clinical structured data takes an important place in healthcare research. It was first described by Fayyad as "knowledge discovery in databases". Feature extraction is an important phase but received little attention. The objectives of this paper are: 1) to propose an updated representation of data reuse in healthcare, 2) to illustrate methods and objectives of feature extraction, and 3) to discuss the place of domain-specific knowledge.
MATERIAL AND METHODS: an updated representation is proposed. Then, a case study consists of automatically identifying acute renal failure and discovering risk factors, by secondary use of structured data. Finally, a literature review published par Meystre et al. is analyzed.
RESULTS: 1) we propose a description of data reuse in 5 phases. Phase 1 is data preprocessing (cleansing, linkage, terminological alignment, unit conversions, deidentification), it enables to construct a data warehouse. Phase 2 is feature extraction. Phase 3 is statistical and graphical mining. Phase 4 consists of expert filtering and reorganization of statistical results. Phase 5 is decision making. 2) The case study illustrates how time-dependent features can be extracted from laboratory results and drug administrations, using domain-specific knowledge. 3) Among the 200 papers cited by Meystre et al., the first and last authors were affiliated to health institutions in 74\% (68\% for methodological papers, and 79\% for applied papers).
DISCUSSION: features extraction has a major impact on success of data reuse. Specific knowledge-based reasoning takes an important place in feature extraction, which requires tight collaboration between computer scientists, statisticians, and health professionals.},
	language = {eng},
	journal = {Studies in Health Technology and Informatics},
	author = {Chazard, Emmanuel and Ficheur, Grégoire and Caron, Alexandre and Lamer, Antoine and Labreuche, Julien and Cuggia, Marc and Genin, Michaël and Bouzille, Guillaume and Duhamel, Alain},
	year = {2018},
	pmid = {30306898},
	keywords = {Data reuse, data transformation, feature extraction},
	pages = {15--19},
}

Secondary use of clinical structured data takes an important place in healthcare research. It was first described by Fayyad as "knowledge discovery in databases". Feature extraction is an important phase but received little attention. The objectives of this paper are: 1) to propose an updated representation of data reuse in healthcare, 2) to illustrate methods and objectives of feature extraction, and 3) to discuss the place of domain-specific knowledge. MATERIAL AND METHODS: an updated representation is proposed. Then, a case study consists of automatically identifying acute renal failure and discovering risk factors, by secondary use of structured data. Finally, a literature review published par Meystre et al. is analyzed. RESULTS: 1) we propose a description of data reuse in 5 phases. Phase 1 is data preprocessing (cleansing, linkage, terminological alignment, unit conversions, deidentification), it enables to construct a data warehouse. Phase 2 is feature extraction. Phase 3 is statistical and graphical mining. Phase 4 consists of expert filtering and reorganization of statistical results. Phase 5 is decision making. 2) The case study illustrates how time-dependent features can be extracted from laboratory results and drug administrations, using domain-specific knowledge. 3) Among the 200 papers cited by Meystre et al., the first and last authors were affiliated to health institutions in 74% (68% for methodological papers, and 79% for applied papers). DISCUSSION: features extraction has a major impact on success of data reuse. Specific knowledge-based reasoning takes an important place in feature extraction, which requires tight collaboration between computer scientists, statisticians, and health professionals.

@article{lamer_data_2018,
	title = {From {Data} {Extraction} to {Analysis}: {Proposal} of a {Methodology} to {Optimize} {Hospital} {Data} {Reuse} {Process}},
	volume = {247},
	issn = {0926-9630},
	shorttitle = {From {Data} {Extraction} to {Analysis}},
	abstract = {In the Lille University Hospital (North of France), data from the Anesthesia Information Management System (Diane® are linked to the Hospital Information System and stored in a dedicated data warehouse since 2010. These electronic medical records need to be reused and analyzed for observational studies. The aim of this paper is to describe the framework developed to structure the operation of that anesthesia data warehouse for research purposes. The presented framework is structured around three meetings between clinicians, computer scientists, and statisticians. The data scientist acts as a coordinator, leads meetings, and checks each milestone. Reuse of anesthesia-related electronic medical record for research purposes is only allowed through this framework. The aim of the first meeting is to decide the primary and secondary objectives of the study. The aim of the second meeting is to validate the statistical protocol. The data are extracted and the statistical analyses are performed. Finally, the results are presented, explained and discussed during the third meeting. During a 6 months period, 27 projects were included in the framework leading to 5 scientific communications. As a result, case studies with extraction and/or analysis situations are presented. This collaboration led to an empowerment process between all three actors, which increased efficiency of the workflow. Implementation of this framework will keep encouraging collaborative publication in order to provide reproducible research evidence.},
	language = {eng},
	journal = {Studies in Health Technology and Informatics},
	author = {Lamer, Antoine and Ficheur, Grégoire and Rousselet, Louis and van Berleere, Marine and Chazard, Emmanuel and Caron, Alexandre},
	year = {2018},
	pmid = {29677919},
	keywords = {Data Science, Electronic Medical Records, Healthcare Data Reuse, Reproducible Research, Statistical Analysis},
	pages = {41--45},
}

In the Lille University Hospital (North of France), data from the Anesthesia Information Management System (Diane® are linked to the Hospital Information System and stored in a dedicated data warehouse since 2010. These electronic medical records need to be reused and analyzed for observational studies. The aim of this paper is to describe the framework developed to structure the operation of that anesthesia data warehouse for research purposes. The presented framework is structured around three meetings between clinicians, computer scientists, and statisticians. The data scientist acts as a coordinator, leads meetings, and checks each milestone. Reuse of anesthesia-related electronic medical record for research purposes is only allowed through this framework. The aim of the first meeting is to decide the primary and secondary objectives of the study. The aim of the second meeting is to validate the statistical protocol. The data are extracted and the statistical analyses are performed. Finally, the results are presented, explained and discussed during the third meeting. During a 6 months period, 27 projects were included in the framework leading to 5 scientific communications. As a result, case studies with extraction and/or analysis situations are presented. This collaboration led to an empowerment process between all three actors, which increased efficiency of the workflow. Implementation of this framework will keep encouraging collaborative publication in order to provide reproducible research evidence.

@article{georges_enhancing_2018,
	title = {Enhancing {Nationwide} {Medico}-{Administrative} {Databases} {Analysis} with {SAF4SUHAD}: {A} {Statistical} {Analysis} {Framework} for {Secondary} {Use} of {Healthcare} {Administrative} {Databases}},
	volume = {255},
	issn = {0926-9630},
	shorttitle = {Enhancing {Nationwide} {Medico}-{Administrative} {Databases} {Analysis} with {SAF4SUHAD}},
	abstract = {Many epidemiological studies now rely on the reuse of large healthcare administrative databases. In those studies, most of the time is consumed in managing data and performing basic statistical analyses and is not available anymore for complex statistical and medical analysis, therefore the potential of such databases is sometimes underexploited. The objective of this work is to build SAF4SUHAD, a statistical analysis framework for secondary use of healthcare administrative databases, using literature-based specifications. A literature review was performed on PubMed in four different medical domains: caesarian deliveries, cholecystectomies, hip replacement surgeries and bariatric surgeries. We identified 22 papers relating analyses of large databases. They reported epidemiological indicators (e.g. mean age), that were abstracted to features (e.g. univariate description of a quantitative variable), and then were implemented through 32 functions available for the user in R programming language. For instance, a function will draw a histogram, compute the mean with confidence interval, quantiles, etc. Those functions comprehend 4 functions for data management, 9 for univariate analysis, 8 for bivariate analysis, 11 for multivariate analysis, and many other intermediate functions. Those functions were successfully used to analyze a French database of 250 million discharge summaries. The set of R ready-to-use functions defined in this work could enable to secure repetitive tasks, and to refocus efforts on expert analysis.},
	language = {eng},
	journal = {Studies in Health Technology and Informatics},
	author = {Georges, Alexandre and Balcaen, Thibaut and Caron, Alexandre and Ficheur, Gregoire and Chazard, Emmanuel},
	year = {2018},
	pmid = {30306900},
	keywords = {Healthcare epidemiology, Medico-administrative databases, Statistics},
	pages = {25--29},
}

Many epidemiological studies now rely on the reuse of large healthcare administrative databases. In those studies, most of the time is consumed in managing data and performing basic statistical analyses and is not available anymore for complex statistical and medical analysis, therefore the potential of such databases is sometimes underexploited. The objective of this work is to build SAF4SUHAD, a statistical analysis framework for secondary use of healthcare administrative databases, using literature-based specifications. A literature review was performed on PubMed in four different medical domains: caesarian deliveries, cholecystectomies, hip replacement surgeries and bariatric surgeries. We identified 22 papers relating analyses of large databases. They reported epidemiological indicators (e.g. mean age), that were abstracted to features (e.g. univariate description of a quantitative variable), and then were implemented through 32 functions available for the user in R programming language. For instance, a function will draw a histogram, compute the mean with confidence interval, quantiles, etc. Those functions comprehend 4 functions for data management, 9 for univariate analysis, 8 for bivariate analysis, 11 for multivariate analysis, and many other intermediate functions. Those functions were successfully used to analyze a French database of 250 million discharge summaries. The set of R ready-to-use functions defined in this work could enable to secure repetitive tasks, and to refocus efforts on expert analysis.

@article{dezetree_comparison_2018,
	title = {Comparison of {Changes} in the {Number} of {Included} {Patients} {Between} {Interventional} {Trials} and {Observational} {Studies} {Published} from 1995 to 2014 in {Three} {Leading} {Journals}},
	volume = {255},
	issn = {0926-9630},
	abstract = {INTRODUCTION: Since the late 1990s, research and administrative institutions have been developing health data warehouses and increasingly reusing claims data. The impact of these changes is not yet completely quantified. Our objective was to compare the change in the number of patients included per study between observational and interventional studies over a 20-year period starting in 1995.
MATERIALS AND METHODS: We extracted all abstracts from studies published in three leading medical journals over the period 1995-2014 (18,107 studies). Then, we divided our study into two steps. First, we constructed an SVM-based predictive model to categorize each abstract into "observational", "interventional" or "other" studies. In a second step, we built an algorithm based on regular expressions to automatically extract the number of included patients.
RESULTS: During the investigated period, the median number of enrolled patients per study increased for interventional studies, from 282 in 1995-1999 to 629 in 2010-2014. In the same time, the median number of patients increased more for observational studies, from 368 in 1995-1999 to 2078 in 2010-2014.
DISCUSSION: The routine storage of an increasing amount of data (from data warehouses or claims data) has had an impact in recent years on the number of patients included in observational studies. The recent development of "randomized registry trials" combining, on the one hand, an intervention and, on the other hand, the identification of the outcome through data reuse, may also have an impact, over the next decade, on the number of patients included in randomized clinical trials.},
	language = {eng},
	journal = {Studies in Health Technology and Informatics},
	author = {Dezetree, Arnaud and Chazard, Emmanuel and Schlegel, Daniel R. and Sakilay, Sylvester and Elkin, Peter L. and Ficheur, Grégoire},
	year = {2018},
	pmid = {30306905},
	keywords = {Data reuse, claims data, data warehouse, support vector machine},
	pages = {50--54},
}

INTRODUCTION: Since the late 1990s, research and administrative institutions have been developing health data warehouses and increasingly reusing claims data. The impact of these changes is not yet completely quantified. Our objective was to compare the change in the number of patients included per study between observational and interventional studies over a 20-year period starting in 1995. MATERIALS AND METHODS: We extracted all abstracts from studies published in three leading medical journals over the period 1995-2014 (18,107 studies). Then, we divided our study into two steps. First, we constructed an SVM-based predictive model to categorize each abstract into "observational", "interventional" or "other" studies. In a second step, we built an algorithm based on regular expressions to automatically extract the number of included patients. RESULTS: During the investigated period, the median number of enrolled patients per study increased for interventional studies, from 282 in 1995-1999 to 629 in 2010-2014. In the same time, the median number of patients increased more for observational studies, from 368 in 1995-1999 to 2078 in 2010-2014. DISCUSSION: The routine storage of an increasing amount of data (from data warehouses or claims data) has had an impact in recent years on the number of patients included in observational studies. The recent development of "randomized registry trials" combining, on the one hand, an intervention and, on the other hand, the identification of the outcome through data reuse, may also have an impact, over the next decade, on the number of patients included in randomized clinical trials.

@phdthesis{chazard_reutilisation_2017,
	address = {Lille, France},
	type = {Habilitation à {Diriger} des {Recherches}},
	title = {Réutilisation et fouille de données massives de santé produites en routine au cours du soin},
	url = {http://www.chazard.org/emmanuel/pdf_articles/thesis_HDR_2017_chazard.pdf},
	language = {Fr},
	school = {Université de Lille},
	author = {Chazard, Emmanuel},
	month = dec,
	year = {2017},
}

@article{ferret_inappropriate_2017,
	title = {Inappropriate anticholinergic drugs prescriptions in older patients: analysing a hospital database},
	copyright = {All rights reserved},
	issn = {2210-7703, 2210-7711},
	shorttitle = {Inappropriate anticholinergic drugs prescriptions in older patients},
	url = {https://link.springer.com/article/10.1007/s11096-017-0554-z},
	doi = {10.1007/s11096-017-0554-z},
	abstract = {Background Although many anticholinergics are inappropriate in older patients, the prescription of these drugs in a hospital setting has not been extensively studied. Objective To describe prescriptions of anticholinergic drugs in terms of frequency, at risk situations and constipation in hospitalized, older adults. Setting Using a database from a French general hospital (period 2009–2013), we extracted information on 14,090 hospital stays by patients aged 75 and over. Methods Anticholinergic drug prescriptions were automatically detected, with a focus on prescriptions in three well-known at-risk situations: falls, dementia, and benign prostatic hyperplasia. Cases of constipation that might have been causally related to the administration of anticholinergic drugs were screened for and reviewed. Main outcome measure Prescriptions with a high associated risk of anticholinergic related adverse reactions. Results Administration of an anticholinergic drug was detected in 1412 (10.0\%) of the hospital stays by older patients. At-risk situations were identified in 413 (36.5\%) of these stays: 137 (9.7\%) for falls, 243 (17.2\%) for dementia, and 114 (8.1\%) for benign prostatic hyperplasia; 78 (18.9\%) of these 413 stays featured a combination of two or three at-risk situations. Cases of constipation induced by anticholinergic drug administration were identified in 188 (13.3\%) patient stays by using validated adjudication rules for adverse drug reactions: 85 and 103 cases were respectively evaluated as “possible” or “probable” adverse drug reactions. Conclusions Anticholinergic drugs prescription was found in 10.0\% of hospitalized, older patients. More than one third of these prescriptions occurred in at-risk situations and more than one in ten prescriptions induced constipation.},
	language = {en},
	urldate = {2017-11-17},
	journal = {International Journal of Clinical Pharmacy},
	author = {Ferret, Laurie and Ficheur, Gregoire and Delaviez, Emeline and Luyckx, Michel and Quenton, Sophie and Beuscart, Regis and Chazard, Emmanuel and Beuscart, Jean-Baptiste},
	month = nov,
	year = {2017},
	pages = {1--7},
}

Background Although many anticholinergics are inappropriate in older patients, the prescription of these drugs in a hospital setting has not been extensively studied. Objective To describe prescriptions of anticholinergic drugs in terms of frequency, at risk situations and constipation in hospitalized, older adults. Setting Using a database from a French general hospital (period 2009–2013), we extracted information on 14,090 hospital stays by patients aged 75 and over. Methods Anticholinergic drug prescriptions were automatically detected, with a focus on prescriptions in three well-known at-risk situations: falls, dementia, and benign prostatic hyperplasia. Cases of constipation that might have been causally related to the administration of anticholinergic drugs were screened for and reviewed. Main outcome measure Prescriptions with a high associated risk of anticholinergic related adverse reactions. Results Administration of an anticholinergic drug was detected in 1412 (10.0%) of the hospital stays by older patients. At-risk situations were identified in 413 (36.5%) of these stays: 137 (9.7%) for falls, 243 (17.2%) for dementia, and 114 (8.1%) for benign prostatic hyperplasia; 78 (18.9%) of these 413 stays featured a combination of two or three at-risk situations. Cases of constipation induced by anticholinergic drug administration were identified in 188 (13.3%) patient stays by using validated adjudication rules for adverse drug reactions: 85 and 103 cases were respectively evaluated as “possible” or “probable” adverse drug reactions. Conclusions Anticholinergic drugs prescription was found in 10.0% of hospitalized, older patients. More than one third of these prescriptions occurred in at-risk situations and more than one in ten prescriptions induced constipation.

@article{putman_epidemiologie_2017,
	series = {92e {Réunion} annuelle de la {SOFCOT}},
	title = {Épidémiologie des prothèses de hanche en {France} : analyse de la base nationale du {PMSI} de 2008 à 2014},
	volume = {103},
	issn = {1877-0517},
	shorttitle = {Épidémiologie des prothèses de hanche en {France}},
	url = {http://www.sciencedirect.com/science/article/pii/S1877051717304525},
	doi = {10.1016/j.rcot.2017.09.158},
	abstract = {Introduction
L’incidence des arthroplasties de hanche est en augmentation en France. L’objectif de ce travail était d’étudier l’épidémiologie de la pose de prothèses de hanche en France de 2008 à 2014.
Matériel et méthodes
En utilisant la base de données hospitalière nationale du Programme de médicalisation des systèmes d’information (PMSI) pour les années 2008 à 2014, nous avons identifié tous les patients opérés d’une pose de prothèse de hanche en utilisant la Classification commune des actes médicaux (CCAM). Nous avons analysé les données démographiques des patients, la durée de séjour, le diagnostic principal, le type d’hôpital, le type de prothèse et la mortalité hospitalière.
Résultats
De 2008 à 2014, il y a eu 1 049 637 arthroplasties de hanche (incluant les arthroplasties primaires par prothèse totale, les hémiarthroplasties primaires, et les arthroplasties de remplacement). Le taux d’incidence annuel est passé de 222 en 2008 à 241 pour 100 000 habitants en 2014. L’âge moyen des patients était de 72,8 ans. Soixante pour cent des arthroplasties de la hanche ont été effectuées chez des femmes. Les principales causes de pose de prothèses de hanche étaient l’arthrose (62 \%), les fractures (23,8 \%) et les complications mécaniques des prothèses (8,3 \%). Il y a eu 72,1 \% d’arthroplasties primaires par prothèses totales de la hanche, 16,7 \% d’hémiarthroplasties primaires et 11,6 \% d’arthroplasties de révision. La durée moyenne de séjour des patients hospitalisés était de 11,2jours et 1,28 \% des patients a passé au moins une journée dans une unité de soins intensifs. Dans l’ensemble, 45,6 \% des arthroplasties de hanche ont été effectuées dans des hôpitaux sans but lucratif. La mortalité intrahospitalière est passée de 1,26 \% en 2008 à 0,96 \% en 2014.
Discussion
L’incidence des prothèses de hanche, bien qu’en augmentation en France, reste inférieur aux États-unis et en Angleterre. L’augmentation de l’incidence des prothèses de hanche était principalement le résultat de l’augmentation des arthroplasties de hanches.
Conclusion
L’incidence des prothèses de hanche est en augmentation, avec une diminution de la durée de séjour et une diminution de la mortalité hospitalière.},
	number = {7, Supplement},
	journal = {Revue de Chirurgie Orthopédique et Traumatologique},
	author = {Putman, Sophie and Girier, Nicolas and Girard, Julien and Pasquier, Gilles and Migaud, Henri and Chazard, Emmanuel},
	month = nov,
	year = {2017},
	pages = {S90},
}

Introduction L’incidence des arthroplasties de hanche est en augmentation en France. L’objectif de ce travail était d’étudier l’épidémiologie de la pose de prothèses de hanche en France de 2008 à 2014. Matériel et méthodes En utilisant la base de données hospitalière nationale du Programme de médicalisation des systèmes d’information (PMSI) pour les années 2008 à 2014, nous avons identifié tous les patients opérés d’une pose de prothèse de hanche en utilisant la Classification commune des actes médicaux (CCAM). Nous avons analysé les données démographiques des patients, la durée de séjour, le diagnostic principal, le type d’hôpital, le type de prothèse et la mortalité hospitalière. Résultats De 2008 à 2014, il y a eu 1 049 637 arthroplasties de hanche (incluant les arthroplasties primaires par prothèse totale, les hémiarthroplasties primaires, et les arthroplasties de remplacement). Le taux d’incidence annuel est passé de 222 en 2008 à 241 pour 100 000 habitants en 2014. L’âge moyen des patients était de 72,8 ans. Soixante pour cent des arthroplasties de la hanche ont été effectuées chez des femmes. Les principales causes de pose de prothèses de hanche étaient l’arthrose (62 %), les fractures (23,8 %) et les complications mécaniques des prothèses (8,3 %). Il y a eu 72,1 % d’arthroplasties primaires par prothèses totales de la hanche, 16,7 % d’hémiarthroplasties primaires et 11,6 % d’arthroplasties de révision. La durée moyenne de séjour des patients hospitalisés était de 11,2jours et 1,28 % des patients a passé au moins une journée dans une unité de soins intensifs. Dans l’ensemble, 45,6 % des arthroplasties de hanche ont été effectuées dans des hôpitaux sans but lucratif. La mortalité intrahospitalière est passée de 1,26 % en 2008 à 0,96 % en 2014. Discussion L’incidence des prothèses de hanche, bien qu’en augmentation en France, reste inférieur aux États-unis et en Angleterre. L’augmentation de l’incidence des prothèses de hanche était principalement le résultat de l’augmentation des arthroplasties de hanches. Conclusion L’incidence des prothèses de hanche est en augmentation, avec une diminution de la durée de séjour et une diminution de la mortalité hospitalière.

@article{ghenassia_generic_2017,
	title = {A generic method for improving the spatial interoperability of medical and ecological databases},
	volume = {16},
	copyright = {All rights reserved},
	issn = {1476-072X},
	doi = {10.1186/s12942-017-0109-5},
	abstract = {BACKGROUND: The availability of big data in healthcare and the intensive development of data reuse and georeferencing have opened up perspectives for health spatial analysis. However, fine-scale spatial studies of ecological and medical databases are limited by the change of support problem and thus a lack of spatial unit interoperability. The use of spatial disaggregation methods to solve this problem introduces errors into the spatial estimations. Here, we present a generic, two-step method for merging medical and ecological databases that avoids the use of spatial disaggregation methods, while maximizing the spatial resolution.
METHODS: Firstly, a mapping table is created after one or more transition matrices have been defined. The latter link the spatial units of the original databases to the spatial units of the final database. Secondly, the mapping table is validated by (1) comparing the covariates contained in the two original databases, and (2) checking the spatial validity with a spatial continuity criterion and a spatial resolution index.
RESULTS: We used our novel method to merge a medical database (the French national diagnosis-related group database, containing 5644 spatial units) with an ecological database (produced by the French National Institute of Statistics and Economic Studies, and containing with 36,594 spatial units). The mapping table yielded 5632 final spatial units. The mapping table's validity was evaluated by comparing the number of births in the medical database and the ecological databases in each final spatial unit. The median [interquartile range] relative difference was 2.3\% [0; 5.7]. The spatial continuity criterion was low (2.4\%), and the spatial resolution index was greater than for most French administrative areas.
CONCLUSIONS: Our innovative approach improves interoperability between medical and ecological databases and facilitates fine-scale spatial analyses. We have shown that disaggregation models and large aggregation techniques are not necessarily the best ways to tackle the change of support problem.},
	language = {eng},
	number = {1},
	journal = {International Journal of Health Geographics},
	author = {Ghenassia, A. and Beuscart, J. B. and Ficheur, G. and Occelli, F. and Babykina, E. and Chazard, E. and Genin, M.},
	month = oct,
	year = {2017},
	pmid = {28974262},
	keywords = {Change-of-support problem, Data reuse, Interoperability, Spatial analysis},
	pages = {36},
}

BACKGROUND: The availability of big data in healthcare and the intensive development of data reuse and georeferencing have opened up perspectives for health spatial analysis. However, fine-scale spatial studies of ecological and medical databases are limited by the change of support problem and thus a lack of spatial unit interoperability. The use of spatial disaggregation methods to solve this problem introduces errors into the spatial estimations. Here, we present a generic, two-step method for merging medical and ecological databases that avoids the use of spatial disaggregation methods, while maximizing the spatial resolution. METHODS: Firstly, a mapping table is created after one or more transition matrices have been defined. The latter link the spatial units of the original databases to the spatial units of the final database. Secondly, the mapping table is validated by (1) comparing the covariates contained in the two original databases, and (2) checking the spatial validity with a spatial continuity criterion and a spatial resolution index. RESULTS: We used our novel method to merge a medical database (the French national diagnosis-related group database, containing 5644 spatial units) with an ecological database (produced by the French National Institute of Statistics and Economic Studies, and containing with 36,594 spatial units). The mapping table yielded 5632 final spatial units. The mapping table's validity was evaluated by comparing the number of births in the medical database and the ecological databases in each final spatial unit. The median [interquartile range] relative difference was 2.3% [0; 5.7]. The spatial continuity criterion was low (2.4%), and the spatial resolution index was greater than for most French administrative areas. CONCLUSIONS: Our innovative approach improves interoperability between medical and ecological databases and facilitates fine-scale spatial analyses. We have shown that disaggregation models and large aggregation techniques are not necessarily the best ways to tackle the change of support problem.

@article{baclet_explicit_2017,
	title = {Explicit definitions of potentially inappropriate prescriptions of antibiotics in older patients: a compilation derived from a systematic review},
	copyright = {All rights reserved},
	issn = {1872-7913},
	shorttitle = {Explicit definitions of potentially inappropriate prescriptions of antibiotics in older patients},
	doi = {10.1016/j.ijantimicag.2017.08.011},
	abstract = {CONTEXT: Potentially inappropriate prescriptions (PIPs) of antibiotics (antibiotic-PIPs) are generally detected by applying implicit definitions based on expert opinion. Explicit definitions are less frequently used, even though this approach would enable the automated detection of antibiotic-PIPs in electronic health records. Here, we systematically reviewed explicit definitions of antibiotic-PIPs used in studies of older adults.
METHOD: We searched the MEDLINE(®), Scopus(®) and Web of Science(TM) core collection databases with a combination of three terms and their synonyms: "potentially inappropriate prescription" AND "antibiotic treatment" AND "older patients". After the standardized selection of publications, explicit definitions of antibiotic-PIPs were extracted and classified into infectious disease domains and sub-domains.
RESULTS: A total of 600 search queries identified 4,270 records, 93 of which were selected for review. We found 160 mentions of antibiotic-PIPs, corresponding to 62 distinct definitions in 19 infectious disease domains. Nearly half of the definitions were related to upper respiratory tract infections (n=11 definitions; 17.7\%), lower respiratory tract infections (n=8; 12.9\%) and drug-drug interactions (n=11; 17.7\%). Almost 75\% of the definitions (n=46) were mentioned in a single study only. Only three definitions concerned critically important antibiotics, such as third-generation cephalosporins and fluoroquinolones.
CONCLUSION: Our systematic review identified 62 explicit definitions of antibiotic-PIPs. Most of the definitions were not found in more than one study, and they varied in the degree of precision. We advocate the implementation of an expert consensus on explicit definitions of antibiotic-PIPs that correspond to today's challenges in public health.},
	language = {eng},
	journal = {International Journal of Antimicrobial Agents},
	author = {Baclet, Nicolas and Ficheur, Grégoire and Alfandari, Serge and Ferret, Laurie and Senneville, Eric and Chazard, Emmanuel and Beuscart, Jean-Baptiste},
	month = aug,
	year = {2017},
	pmid = {28803931},
	keywords = {Antibiotics, Elderly, Potentially Inappropriate Prescription},
}

CONTEXT: Potentially inappropriate prescriptions (PIPs) of antibiotics (antibiotic-PIPs) are generally detected by applying implicit definitions based on expert opinion. Explicit definitions are less frequently used, even though this approach would enable the automated detection of antibiotic-PIPs in electronic health records. Here, we systematically reviewed explicit definitions of antibiotic-PIPs used in studies of older adults. METHOD: We searched the MEDLINE(®), Scopus(®) and Web of Science(TM) core collection databases with a combination of three terms and their synonyms: "potentially inappropriate prescription" AND "antibiotic treatment" AND "older patients". After the standardized selection of publications, explicit definitions of antibiotic-PIPs were extracted and classified into infectious disease domains and sub-domains. RESULTS: A total of 600 search queries identified 4,270 records, 93 of which were selected for review. We found 160 mentions of antibiotic-PIPs, corresponding to 62 distinct definitions in 19 infectious disease domains. Nearly half of the definitions were related to upper respiratory tract infections (n=11 definitions; 17.7%), lower respiratory tract infections (n=8; 12.9%) and drug-drug interactions (n=11; 17.7%). Almost 75% of the definitions (n=46) were mentioned in a single study only. Only three definitions concerned critically important antibiotics, such as third-generation cephalosporins and fluoroquinolones. CONCLUSION: Our systematic review identified 62 explicit definitions of antibiotic-PIPs. Most of the definitions were not found in more than one study, and they varied in the degree of precision. We advocate the implementation of an expert consensus on explicit definitions of antibiotic-PIPs that correspond to today's challenges in public health.

@article{chazard_how_2017,
	title = {How to {Compare} the {Length} of {Stay} of {Two} {Samples} of {Inpatients}? {A} {Simulation} {Study} to {Compare} {Type} {I} and {Type} {II} {Errors} of 12 {Statistical} {Tests}},
	volume = {20},
	copyright = {All rights reserved},
	issn = {1524-4733},
	shorttitle = {How to {Compare} the {Length} of {Stay} of {Two} {Samples} of {Inpatients}?},
	doi = {10.1016/j.jval.2017.02.009},
	abstract = {BACKGROUND: Although many researchers in the field of health economics and quality of care compare the length of stay (LOS) in two inpatient samples, they often fail to check whether the sample meets the assumptions made by their chosen statistical test. In fact, LOS data show a highly right-skewed, discrete distribution in which most of the observations are tied; this violates the assumptions of most statistical tests.
OBJECTIVES: To estimate the type I and type II errors associated with the application of 12 different statistical tests to a series of LOS samples.
METHODS: The LOS distribution was extracted from an exhaustive French national database of inpatient stays. The type I error was estimated using 19 sample sizes and 1,000,000 simulations per sample. The type II error was estimated in three alternative scenarios. For each test, the type I and type II errors were plotted as a function of the sample size.
RESULTS: Gamma regression with log link, the log rank test, median regression, Poisson regression, and Weibull survival analysis presented an unacceptably high type I error. In contrast, the Student standard t test, linear regression with log link, and the Cox models had an acceptable type I error but low power.
CONCLUSIONS: When comparing the LOS for two balanced inpatient samples, the Student t test with logarithmic or rank transformation, the Wilcoxon test, and the Kruskal-Wallis test are the only methods with an acceptable type I error and high power.},
	language = {eng},
	number = {7},
	journal = {Value in Health: The Journal of the International Society for Pharmacoeconomics and Outcomes Research},
	author = {Chazard, Emmanuel and Ficheur, Grégoire and Beuscart, Jean-Baptiste and Preda, Cristian},
	month = aug,
	year = {2017},
	pmid = {28712630},
	keywords = {Length of Stay, METHODOLOGY, Statistics, length of stay, methodology, outcome measurement, statistics},
	pages = {992--998},
}

BACKGROUND: Although many researchers in the field of health economics and quality of care compare the length of stay (LOS) in two inpatient samples, they often fail to check whether the sample meets the assumptions made by their chosen statistical test. In fact, LOS data show a highly right-skewed, discrete distribution in which most of the observations are tied; this violates the assumptions of most statistical tests. OBJECTIVES: To estimate the type I and type II errors associated with the application of 12 different statistical tests to a series of LOS samples. METHODS: The LOS distribution was extracted from an exhaustive French national database of inpatient stays. The type I error was estimated using 19 sample sizes and 1,000,000 simulations per sample. The type II error was estimated in three alternative scenarios. For each test, the type I and type II errors were plotted as a function of the sample size. RESULTS: Gamma regression with log link, the log rank test, median regression, Poisson regression, and Weibull survival analysis presented an unacceptably high type I error. In contrast, the Student standard t test, linear regression with log link, and the Cox models had an acceptable type I error but low power. CONCLUSIONS: When comparing the LOS for two balanced inpatient samples, the Student t test with logarithmic or rank transformation, the Wilcoxon test, and the Kruskal-Wallis test are the only methods with an acceptable type I error and high power.

@article{averlant_underuse_2017,
	title = {Underuse of {Oral} {Anticoagulants} and {Inappropriate} {Prescription} of {Antiplatelet} {Therapy} in {Older} {Inpatients} with {Atrial} {Fibrillation}},
	copyright = {All rights reserved},
	issn = {1179-1969},
	doi = {10.1007/s40266-017-0477-3},
	abstract = {BACKGROUND: Several studies have shown that the prescription of antiplatelet therapy (APT) is associated with an increased risk of oral anticoagulant (OAC) underuse in patients aged 75 years and over with atrial fibrillation (AF). An associated atheromatous disease may be the underlying reason for APT prescription. The objective of the study was to determine whether the association between underuse of OAC and APT prescription was explained by the presence of an atheromatous disease.
METHODS AND RESULTS: We performed a retrospective, observational, single-centre study between 2009 and 2013 based on administrative data. Patients aged 75 years and over with non-valvular AF were identified in a database of 72,090 hospital stays. Prescriptions of anti-thrombotic medications and their association with the presence of atheromatous disease were evaluated by the mean of a logistic regression. A total of 2034 hospital stays were included (mean age 84.3 ± 5.2 years). The overall prevalence of known atheromatous disease was 25.9\%. OAC underuse was observed in 58.5\% of the stays. In multivariable analysis, the prescription of an APT was associated with an increased risk of OAC underuse [odds ratio (OR) 6.85; 95\% confidence interval (CI) 5.50-8.58], independently of the presence of a concomitant known atheromatous disease (OR 0.78; 95\% CI 0.60-1.01). Among the 692 stays with APT monotherapy (34.0\%), 232 (33.5\%) displayed an atheromatous disease.
CONCLUSIONS: The underuse of OAC is associated with the prescription of APT in older patients with AF, regardless of the presence or absence of known atheromatous disease. Our results suggest that APT is often inappropriately prescribed instead of OAC.},
	language = {eng},
	journal = {Drugs \& Aging},
	author = {Averlant, Lorette and Ficheur, Grégoire and Ferret, Laurie and Boulé, Stéphane and Puisieux, François and Luyckx, Michel and Soula, Julien and Georges, Alexandre and Beuscart, Régis and Chazard, Emmanuel and Beuscart, Jean-Baptiste},
	month = jul,
	year = {2017},
	pmid = {28702928},
}

BACKGROUND: Several studies have shown that the prescription of antiplatelet therapy (APT) is associated with an increased risk of oral anticoagulant (OAC) underuse in patients aged 75 years and over with atrial fibrillation (AF). An associated atheromatous disease may be the underlying reason for APT prescription. The objective of the study was to determine whether the association between underuse of OAC and APT prescription was explained by the presence of an atheromatous disease. METHODS AND RESULTS: We performed a retrospective, observational, single-centre study between 2009 and 2013 based on administrative data. Patients aged 75 years and over with non-valvular AF were identified in a database of 72,090 hospital stays. Prescriptions of anti-thrombotic medications and their association with the presence of atheromatous disease were evaluated by the mean of a logistic regression. A total of 2034 hospital stays were included (mean age 84.3 ± 5.2 years). The overall prevalence of known atheromatous disease was 25.9%. OAC underuse was observed in 58.5% of the stays. In multivariable analysis, the prescription of an APT was associated with an increased risk of OAC underuse [odds ratio (OR) 6.85; 95% confidence interval (CI) 5.50-8.58], independently of the presence of a concomitant known atheromatous disease (OR 0.78; 95% CI 0.60-1.01). Among the 692 stays with APT monotherapy (34.0%), 232 (33.5%) displayed an atheromatous disease. CONCLUSIONS: The underuse of OAC is associated with the prescription of APT in older patients with AF, regardless of the presence or absence of known atheromatous disease. Our results suggest that APT is often inappropriately prescribed instead of OAC.

@article{caron_it-cares:_2017,
	title = {{IT}-{CARES}: an interactive tool for case-crossover analyses of electronic medical records for patient safety},
	volume = {24},
	issn = {1527-974X},
	shorttitle = {{IT}-{CARES}},
	doi = {10.1093/jamia/ocw132},
	abstract = {Background: The significant risk of adverse events following medical procedures supports a clinical epidemiological approach based on the analyses of collections of electronic medical records. Data analytical tools might help clinical epidemiologists develop more appropriate case-crossover designs for monitoring patient safety.
Objective: To develop and assess the methodological quality of an interactive tool for use by clinical epidemiologists to systematically design case-crossover analyses of large electronic medical records databases.
Material and Methods: We developed IT-CARES, an analytical tool implementing case-crossover design, to explore the association between exposures and outcomes. The exposures and outcomes are defined by clinical epidemiologists via lists of codes entered via a user interface screen. We tested IT-CARES on data from the French national inpatient stay database, which documents diagnoses and medical procedures for 170 million inpatient stays between 2007 and 2013. We compared the results of our analysis with reference data from the literature on thromboembolic risk after delivery and bleeding risk after total hip replacement.
Results: IT-CARES provides a user interface with 3 columns: (i) the outcome criteria in the left-hand column, (ii) the exposure criteria in the right-hand column, and (iii) the estimated risk (odds ratios, presented in both graphical and tabular formats) in the middle column. The estimated odds ratios were consistent with the reference literature data.
Discussion: IT-CARES may enhance patient safety by facilitating clinical epidemiological studies of adverse events following medical procedures. The tool's usability must be evaluated and improved in further research.},
	language = {eng},
	number = {2},
	journal = {Journal of the American Medical Informatics Association: JAMIA},
	author = {Caron, Alexandre and Chazard, Emmanuel and Muller, Joris and Perichon, Renaud and Ferret, Laurie and Koutkias, Vassilis and Beuscart, Régis and Beuscart, Jean-Baptiste and Ficheur, Grégoire},
	month = mar,
	year = {2017},
	pmid = {27678461},
	pmcid = {PMC5391728},
	keywords = {Cross-Over Studies, Databases, Factual, Electronic Health Records, Epidemiologic Methods, Hemorrhage, Humans, Medical Informatics, Patient Safety, Patient safety, Risk, Software, Thromboembolism, adverse event, big data, clinical epidemiology, data analytics, medical informatics},
	pages = {323--330},
}

Background: The significant risk of adverse events following medical procedures supports a clinical epidemiological approach based on the analyses of collections of electronic medical records. Data analytical tools might help clinical epidemiologists develop more appropriate case-crossover designs for monitoring patient safety. Objective: To develop and assess the methodological quality of an interactive tool for use by clinical epidemiologists to systematically design case-crossover analyses of large electronic medical records databases. Material and Methods: We developed IT-CARES, an analytical tool implementing case-crossover design, to explore the association between exposures and outcomes. The exposures and outcomes are defined by clinical epidemiologists via lists of codes entered via a user interface screen. We tested IT-CARES on data from the French national inpatient stay database, which documents diagnoses and medical procedures for 170 million inpatient stays between 2007 and 2013. We compared the results of our analysis with reference data from the literature on thromboembolic risk after delivery and bleeding risk after total hip replacement. Results: IT-CARES provides a user interface with 3 columns: (i) the outcome criteria in the left-hand column, (ii) the exposure criteria in the right-hand column, and (iii) the estimated risk (odds ratios, presented in both graphical and tabular formats) in the middle column. The estimated odds ratios were consistent with the reference literature data. Discussion: IT-CARES may enhance patient safety by facilitating clinical epidemiological studies of adverse events following medical procedures. The tool's usability must be evaluated and improved in further research.

@article{balcaen_validite_2017,
	series = {{XXXe} {Congrès} national Émois, {Nancy}, 23 et 24 mars 2017},
	title = {Validité de la mesure de l’incidence des cancers en {France} à partir de la base de données du {Programme} de médicalisation des systèmes d’information : revue systématique de la littérature de 2001 à 2015},
	volume = {65, Supplement 1},
	issn = {0398-7620},
	shorttitle = {Validité de la mesure de l’incidence des cancers en {France} à partir de la base de données du {Programme} de médicalisation des systèmes d’information},
	url = {http://www.sciencedirect.com/science/article/pii/S039876201730069X},
	doi = {10.1016/j.respe.2017.01.066},
	abstract = {Introduction
L’incidence des cancers est estimée à partir des données des registres des cancers qui couvrent environ 20 \% de la population. La base de données du Programme de médicalisation des systèmes d’information (PMSI) contient des données médico-administratives liées aux hospitalisations pour cancer. Le PMSI est potentiellement exploitable pour mesurer leur incidence. L’objectif de ce travail est de réaliser une revue systématique de la littérature sur l’utilisation de la base PMSI pour mesurer l’incidence des cancers en France.
Méthodes
=Une recherche bibliographique systématique, selon les recommandations PRISMA, a été faite à partir des thèmes « incidence », « cancer » et « pmsi ». Nous avons exploré plusieurs bases de données bibliographiques, dont Pubmed, Web of science, Springer Link, Science Direct. Nous avons retenu les articles qui comparaient la mesure de l’incidence des cancers à partir du PMSI à une mesure de référence. Les critères d’inclusion étaient : une année de production de la base PMSI postérieure à 2000, la nature du cancer (primitif uniquement) et des données issues de la base nationale du PMSI. Une synthèse qualitative des articles inclus a été réalisée.
Résultats
Sur 1428 références analysées, 12 études originales ont été retenues. L’année médiane de production des bases était 2004, une seule étude a analysé les bases postérieures à 2007. Les résultats des études montrent une fiabilité satisfaisante du PMSI, surtout pour les années de production les plus récentes.
Discussion/conclusion
Ceci est en faveur de l’exploitation des données PMSI dans un cadre de recherche épidémiologique destiné à documenter les incidences de cancers. Toutefois, il est important de prendre en compte les contraintes inhérentes à la production de ces données dans les analyses. Il sera nécessaire de compléter ce travail avec des données plus récentes afin de confirmer cette fiabilité. Le développement d’algorithmes utilisant l’ensemble des informations disponibles (les diagnostics, les actes et le croisement des données des différents séjours d’un même patient) améliorerait certainement la détection des cas.},
	journal = {Revue d'Épidémiologie et de Santé Publique},
	author = {Balcaen, T. and Chazard, E. and Ganry, O. and Caillet, P.},
	month = mar,
	year = {2017},
	keywords = {Epidémiologie, PMSI, ésCancer},
	pages = {S28},
}

Introduction L’incidence des cancers est estimée à partir des données des registres des cancers qui couvrent environ 20 % de la population. La base de données du Programme de médicalisation des systèmes d’information (PMSI) contient des données médico-administratives liées aux hospitalisations pour cancer. Le PMSI est potentiellement exploitable pour mesurer leur incidence. L’objectif de ce travail est de réaliser une revue systématique de la littérature sur l’utilisation de la base PMSI pour mesurer l’incidence des cancers en France. Méthodes =Une recherche bibliographique systématique, selon les recommandations PRISMA, a été faite à partir des thèmes « incidence », « cancer » et « pmsi ». Nous avons exploré plusieurs bases de données bibliographiques, dont Pubmed, Web of science, Springer Link, Science Direct. Nous avons retenu les articles qui comparaient la mesure de l’incidence des cancers à partir du PMSI à une mesure de référence. Les critères d’inclusion étaient : une année de production de la base PMSI postérieure à 2000, la nature du cancer (primitif uniquement) et des données issues de la base nationale du PMSI. Une synthèse qualitative des articles inclus a été réalisée. Résultats Sur 1428 références analysées, 12 études originales ont été retenues. L’année médiane de production des bases était 2004, une seule étude a analysé les bases postérieures à 2007. Les résultats des études montrent une fiabilité satisfaisante du PMSI, surtout pour les années de production les plus récentes. Discussion/conclusion Ceci est en faveur de l’exploitation des données PMSI dans un cadre de recherche épidémiologique destiné à documenter les incidences de cancers. Toutefois, il est important de prendre en compte les contraintes inhérentes à la production de ces données dans les analyses. Il sera nécessaire de compléter ce travail avec des données plus récentes afin de confirmer cette fiabilité. Le développement d’algorithmes utilisant l’ensemble des informations disponibles (les diagnostics, les actes et le croisement des données des différents séjours d’un même patient) améliorerait certainement la détection des cas.

@article{martincic_chirurgie_2017,
	series = {{XXXe} {Congrès} national Émois, {Nancy}, 23 et 24 mars 2017},
	title = {La chirurgie bariatrique en {France} de 2008 à 2014 : triplement de l’activité et fort recul de l’anneau gastrique},
	volume = {65, Supplement 1},
	issn = {0398-7620},
	shorttitle = {La chirurgie bariatrique en {France} de 2008 à 2014},
	url = {http://www.sciencedirect.com/science/article/pii/S0398762017300470},
	doi = {10.1016/j.respe.2017.01.044},
	abstract = {Introduction
La chirurgie de l’obésité augmente sans cesse en France. Les techniques chirurgicales évoluent. L’objectif est de décrire les patients et les interventions.
Méthodes
La base nationale du PMSI de 2008 à 2014 est analysée à l’aide du langage de programmation en statistiques R. Les séjours d’un même patient sont chaînés. Des analyses descriptives et multivariées sont réalisées (Cox, régressions logistiques et arbres de décision).
Résultats
Le nombre d’intervention passe de 17 659 en 2008 à 47 544 à 2014. Les interventions sont des sleeve gastrectomies (45,2 \%), des bypass gastriques (29,8 \%), des anneaux gastriques (23,0 \%) et des dérivations biliopancréatiques (0,81 \%) ; 66 \% sont réalisées en établissement lucratif (diminue, p = 0). Les patients sont pour 83 \% des femmes, l’âge moyen est de 40 ans L’IMC est compris entre 40 et 50 kg/m2 dans au moins 59,1 \% des cas, mais diminue régulièrement (p = 0). Les patients sont hospitalisés en médiane six journées consécutives. L’hospitalisation ambulatoire passe de 1 \% en 2008 à 3,4 \% en 2014 (p = 0), principalement dans le secteur lucratif (p = 0) et pour les anneaux gastriques (p = 0) ; 4,5 \% des patients passent en réanimation ou soins intensif, mais cette proportion diminue (p = 0) ; 98,2 \% rentrent directement à domicile. L’anneau gastrique passe de 55,4 \% en 2008 à 9,2 \% en 2014, tandis que la sleeve gastrectomie passe de 16,9 à 60,7 \%. En 2014, 25,7 \% des patients opérés en lucratif, âgés de moins de 30 ans et d’IMC \< 40 ont bénéficié d’un anneau, contre 8,3 \% chez les autres. En 2014, 41 \% des patients âgés de plus de 40 ans et diabétiques ont reçu une technique créant une malabsorption, contre 28,5 \% chez les autres. Les réhospitalisations sont fréquentes et se répartissent ainsi : complications mécaniques d’anneaux (27,1 \%), occlusions (22,6 \%), hernies ou éventrations (15,3 \%), fistules (12,7 \%), infections (9,6 \%), saignements (7,6 \%) et abdominoplasties (5,7 \%). La mortalité observée en court séjour est de 0,18 \% à 1 an et 0,55 \% à 5 ans.
Discussion/conclusion
L’accès direct aux bases nationales à l’aide d’outils d’analyse choisis par les chercheurs eux-mêmes est dans l’intérêt général.},
	journal = {Revue d'Épidémiologie et de Santé Publique},
	author = {Martincic, C. and Balcaen, T. and Georges, A. and Baro, E. and Ficheur, G. and Chazard, E.},
	month = mar,
	year = {2017},
	keywords = {Base nationale du PMSI, big data, ésChirurgie bariatrique},
	pages = {S20},
}

Introduction La chirurgie de l’obésité augmente sans cesse en France. Les techniques chirurgicales évoluent. L’objectif est de décrire les patients et les interventions. Méthodes La base nationale du PMSI de 2008 à 2014 est analysée à l’aide du langage de programmation en statistiques R. Les séjours d’un même patient sont chaînés. Des analyses descriptives et multivariées sont réalisées (Cox, régressions logistiques et arbres de décision). Résultats Le nombre d’intervention passe de 17 659 en 2008 à 47 544 à 2014. Les interventions sont des sleeve gastrectomies (45,2 %), des bypass gastriques (29,8 %), des anneaux gastriques (23,0 %) et des dérivations biliopancréatiques (0,81 %) ; 66 % sont réalisées en établissement lucratif (diminue, p = 0). Les patients sont pour 83 % des femmes, l’âge moyen est de 40 ans L’IMC est compris entre 40 et 50 kg/m2 dans au moins 59,1 % des cas, mais diminue régulièrement (p = 0). Les patients sont hospitalisés en médiane six journées consécutives. L’hospitalisation ambulatoire passe de 1 % en 2008 à 3,4 % en 2014 (p = 0), principalement dans le secteur lucratif (p = 0) et pour les anneaux gastriques (p = 0) ; 4,5 % des patients passent en réanimation ou soins intensif, mais cette proportion diminue (p = 0) ; 98,2 % rentrent directement à domicile. L’anneau gastrique passe de 55,4 % en 2008 à 9,2 % en 2014, tandis que la sleeve gastrectomie passe de 16,9 à 60,7 %. En 2014, 25,7 % des patients opérés en lucratif, âgés de moins de 30 ans et d’IMC < 40 ont bénéficié d’un anneau, contre 8,3 % chez les autres. En 2014, 41 % des patients âgés de plus de 40 ans et diabétiques ont reçu une technique créant une malabsorption, contre 28,5 % chez les autres. Les réhospitalisations sont fréquentes et se répartissent ainsi : complications mécaniques d’anneaux (27,1 %), occlusions (22,6 %), hernies ou éventrations (15,3 %), fistules (12,7 %), infections (9,6 %), saignements (7,6 %) et abdominoplasties (5,7 %). La mortalité observée en court séjour est de 0,18 % à 1 an et 0,55 % à 5 ans. Discussion/conclusion L’accès direct aux bases nationales à l’aide d’outils d’analyse choisis par les chercheurs eux-mêmes est dans l’intérêt général.

@article{beuscart_co-prescriptions_2017,
	title = {Co-prescriptions of psychotropic drugs to older patients in a general hospital},
	volume = {8},
	issn = {1878-7649},
	url = {http://www.sciencedirect.com/science/article/pii/S1878764916301917},
	doi = {10.1016/j.eurger.2016.11.012},
	abstract = {Introduction
The prescription of psychotropic drugs to older patients in a hospital setting has not been extensively characterized. The objective was to describe the inappropriate co-prescriptions of psychotropic drugs in hospitalized patients aged 75 and over.
Methods
By analysing the medical database from 222-bed general hospital in France, we reviewed a total of 11,929 stays of at least 3 days by patients aged 75 and over. Prescriptions and co-prescriptions of psychotropic drugs were identified automatically. Anticholinergic drugs with sedative effects were considered as psychotropic drugs. An expert review was performed for stays with the co-prescription of three or more psychotropic drugs to identify inappropriate co-prescriptions.
Results
Administration of a psychotropic drug was identified in 5475 stays (45.9\% of the total number of stays), of which 1526 (12.8\% of the total) featured at least one co-prescription. Co-prescriptions of three or more psychotropic drugs for at least 3 days were identified in 374 stays (3.1\% of the total). Most of these co-prescriptions (n = 334; 89.2\%) were considered inappropriate because of the combination of at least two drugs from the same psychotropic class (n = 269), the absence of a clear indication for a psychotropic drug (n = 173) and a history of falls (n = 86). However, the co-prescriptions were maintained after hospital discharge in 77.4\% of cases.
Conclusion
The co-prescriptions of psychotropic drugs should be re-evaluated in older hospitalized patients.},
	number = {1},
	journal = {European Geriatric Medicine},
	author = {Beuscart, J. -B. and Ficheur, G. and Miqueu, M. and Luyckx, M. and Perichon, R. and Puisieux, F. and Beuscart, R. and Chazard, E. and Ferret, L.},
	month = feb,
	year = {2017},
	keywords = {Data reuse, Inappropriate prescribing, Psychotropic Drugs},
	pages = {84--89},
}

Introduction The prescription of psychotropic drugs to older patients in a hospital setting has not been extensively characterized. The objective was to describe the inappropriate co-prescriptions of psychotropic drugs in hospitalized patients aged 75 and over. Methods By analysing the medical database from 222-bed general hospital in France, we reviewed a total of 11,929 stays of at least 3 days by patients aged 75 and over. Prescriptions and co-prescriptions of psychotropic drugs were identified automatically. Anticholinergic drugs with sedative effects were considered as psychotropic drugs. An expert review was performed for stays with the co-prescription of three or more psychotropic drugs to identify inappropriate co-prescriptions. Results Administration of a psychotropic drug was identified in 5475 stays (45.9% of the total number of stays), of which 1526 (12.8% of the total) featured at least one co-prescription. Co-prescriptions of three or more psychotropic drugs for at least 3 days were identified in 374 stays (3.1% of the total). Most of these co-prescriptions (n = 334; 89.2%) were considered inappropriate because of the combination of at least two drugs from the same psychotropic class (n = 269), the absence of a clear indication for a psychotropic drug (n = 173) and a history of falls (n = 86). However, the co-prescriptions were maintained after hospital discharge in 77.4% of cases. Conclusion The co-prescriptions of psychotropic drugs should be re-evaluated in older hospitalized patients.

@article{ficheur_case-crossover_2017,
	title = {Case-crossover study to examine the change in postpartum risk of pulmonary embolism over time},
	volume = {17},
	issn = {1471-2393},
	doi = {10.1186/s12884-017-1283-y},
	abstract = {BACKGROUND: Although the current guidelines recommend anticoagulation up until 6 weeks after delivery in women at high risk of venous thromboembolism (VTE), the risk of VTE may extend beyond 6 weeks. Our objective was to estimate the risk of a pulmonary embolism in successive 2-week intervals during the postpartum period.
METHODS: In a population-based, case-crossover study, we analyzed the French national inpatient database from 2007 to 2013 (n = 5,517,680 singleton deliveries). Using ICD-10 codes, we identified women who were diagnosed with a postpartum pulmonary embolism between July 1st, 2008, and December 31st, 2013. Deliveries were identified during a case "period" immediately before the pulmonary embolism, and five different control periods one year before the pulmonary embolism. Using conditional logistic regression, Odds ratios (ORs) and 95\% confidential intervals (CIs) were estimated for ten successive 2-week intervals that preceded the diagnosis of pulmonary embolism.
RESULTS: We identified 167,103 cases with a pulmonary embolism during the inclusion period. After delivery, the risk of pulmonary embolism declined progressively over time, with an OR [95\%CI] of 17.2 [14.0-21.3] in postpartum weeks 1 to 2 and 1.9 [1.4-2.7] in postpartum weeks 11 to 12. The OR [95\%CI] in postpartum weeks 13 to 14 was 1.4 [0.9-2.0], and the OR did not fall significantly after postpartum week 14.
CONCLUSIONS: Our findings indicate that women are at risk of a pulmonary embolism up to 12 weeks after delivery. The shape of the risk curve suggests that the risk decreases exponentially over time. Future research is needed to establish whether the duration of postpartum anticoagulation should be extended beyond 6 weeks.},
	language = {eng},
	number = {1},
	journal = {BMC pregnancy and childbirth},
	author = {Ficheur, Grégoire and Caron, Alexandre and Beuscart, Jean-Baptiste and Ferret, Laurie and Jung, Yu-Jin and Garabedian, Charles and Beuscart, Régis and Chazard, Emmanuel},
	year = {2017},
	pmid = {28410584},
	pmcid = {PMC5391590},
	keywords = {Adult, Case-Control Studies, Female, France, Humans, Odds Ratio, Population Surveillance, Pregnancy, Pregnancy Complications, Cardiovascular, Puerperal Disorders, Pulmonary Embolism, Risk Factors, Young Adult},
	pages = {119},
}

BACKGROUND: Although the current guidelines recommend anticoagulation up until 6 weeks after delivery in women at high risk of venous thromboembolism (VTE), the risk of VTE may extend beyond 6 weeks. Our objective was to estimate the risk of a pulmonary embolism in successive 2-week intervals during the postpartum period. METHODS: In a population-based, case-crossover study, we analyzed the French national inpatient database from 2007 to 2013 (n = 5,517,680 singleton deliveries). Using ICD-10 codes, we identified women who were diagnosed with a postpartum pulmonary embolism between July 1st, 2008, and December 31st, 2013. Deliveries were identified during a case "period" immediately before the pulmonary embolism, and five different control periods one year before the pulmonary embolism. Using conditional logistic regression, Odds ratios (ORs) and 95% confidential intervals (CIs) were estimated for ten successive 2-week intervals that preceded the diagnosis of pulmonary embolism. RESULTS: We identified 167,103 cases with a pulmonary embolism during the inclusion period. After delivery, the risk of pulmonary embolism declined progressively over time, with an OR [95%CI] of 17.2 [14.0-21.3] in postpartum weeks 1 to 2 and 1.9 [1.4-2.7] in postpartum weeks 11 to 12. The OR [95%CI] in postpartum weeks 13 to 14 was 1.4 [0.9-2.0], and the OR did not fall significantly after postpartum week 14. CONCLUSIONS: Our findings indicate that women are at risk of a pulmonary embolism up to 12 weeks after delivery. The shape of the risk curve suggests that the risk decreases exponentially over time. Future research is needed to establish whether the duration of postpartum anticoagulation should be extended beyond 6 weeks.

@article{joly_success_2017,
	title = {Success rates in smoking cessation: {Psychological} preparation plays a critical role and interacts with other factors such as psychoactive substances},
	volume = {12},
	copyright = {All rights reserved},
	issn = {1932-6203},
	shorttitle = {Success rates in smoking cessation},
	url = {https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0184800&type=printable},
	doi = {10.1371/journal.pone.0184800},
	abstract = {INTRODUCTION: The aim of this study was to identify factors associated with the results of smoking cessation attempts.
METHODS: Data were collected in Clermont-Ferrand from a smoking cessation clinic between 1999 and 2009 (1,361 patients). Smoking cessation was considered a success when patients were abstinent 6 months after the beginning of cessation. Multivariate logistic regression was used to investigate the association between abstinence and different factors.
RESULTS: The significant factors were a history of depression (ORadjusted = 0.57, p = 0.003), state of depression at the initial consultation (ORa = 0.64, p = 0.005), other psychoactive substances (ORa = 0.52, p{\textless}0.0001), heart, lung and Ear-Nose-Throat diseases (ORa = 0.65, p = 0.005), age (ORa = 1.04, p{\textless}0.0001), the Richmond test (p{\textless}0.0001; when the patient's motivation went from insufficient to moderate, the frequency of abstinence was twice as high) and the Prochaska algorithm (p{\textless}0.0001; when the patient went from the 'pre-contemplation' to the 'contemplation' level, the frequency of success was four times higher). A high score in the Richmond test had a greater impact on success with increasing age (significant interaction: p = 0.01). In exclusive smokers, the contemplation level in the Prochaska algorithm was enough to obtain a satisfactory abstinence rate (65.5\%) whereas among consumers of other psychoactive substances, it was necessary to reach the preparation level in the Prochaska algorithm to achieve a success rate greater than 50\% (significant interaction: p = 0.02).
CONCLUSION: The psychological preparation of the smoker plays a critical role. The management of smoking cessation must be personalized, especially for consumers of other psychoactive substances and/or smokers with a history of depression.},
	language = {eng},
	number = {10},
	journal = {PloS One},
	author = {Joly, Bertrand and Perriot, Jean and d'Athis, Philippe and Chazard, Emmanuel and Brousse, Georges and Quantin, Catherine},
	year = {2017},
	pmid = {29020085},
	keywords = {Algorithms, Anxiety, Depression, Female, Heart, Humans, Male, Multivariate Analysis, Nicotine replacement therapy, Patients, Psychotropic Drugs, Smoking Cessation, Smoking habits, Smoking related disorders},
	pages = {e0184800},
}

INTRODUCTION: The aim of this study was to identify factors associated with the results of smoking cessation attempts. METHODS: Data were collected in Clermont-Ferrand from a smoking cessation clinic between 1999 and 2009 (1,361 patients). Smoking cessation was considered a success when patients were abstinent 6 months after the beginning of cessation. Multivariate logistic regression was used to investigate the association between abstinence and different factors. RESULTS: The significant factors were a history of depression (ORadjusted = 0.57, p = 0.003), state of depression at the initial consultation (ORa = 0.64, p = 0.005), other psychoactive substances (ORa = 0.52, p\textless0.0001), heart, lung and Ear-Nose-Throat diseases (ORa = 0.65, p = 0.005), age (ORa = 1.04, p\textless0.0001), the Richmond test (p\textless0.0001; when the patient's motivation went from insufficient to moderate, the frequency of abstinence was twice as high) and the Prochaska algorithm (p\textless0.0001; when the patient went from the 'pre-contemplation' to the 'contemplation' level, the frequency of success was four times higher). A high score in the Richmond test had a greater impact on success with increasing age (significant interaction: p = 0.01). In exclusive smokers, the contemplation level in the Prochaska algorithm was enough to obtain a satisfactory abstinence rate (65.5%) whereas among consumers of other psychoactive substances, it was necessary to reach the preparation level in the Prochaska algorithm to achieve a success rate greater than 50% (significant interaction: p = 0.02). CONCLUSION: The psychological preparation of the smoker plays a critical role. The management of smoking cessation must be personalized, especially for consumers of other psychoactive substances and/or smokers with a history of depression.

@article{ficheur_risks_2016,
	title = {The risks of pulmonary embolism and upper gastrointestinal bleeding beyond 35days after total hip replacement for coxarthrosis among middle-aged patients: {A} cross-over cohort},
	volume = {93},
	issn = {1096-0260},
	shorttitle = {The risks of pulmonary embolism and upper gastrointestinal bleeding beyond 35days after total hip replacement for coxarthrosis among middle-aged patients},
	doi = {10.1016/j.ypmed.2016.09.010},
	abstract = {Prophylactic anticoagulation is recommended up to 35days after total hip replacement (THR). Although several observational studies have assessed the incidence of thrombotic events or bleeding events after THR, the corresponding measures of association have never been studied concomitantly. Here, we evaluated the duration of the elevated risks (relative to the baseline risk) of both venous thromboembolic events and bleeding events after THR for coxarthrosis among middle-aged patients. This was a population-based, cross-over cohort study of data extracted from the French national inpatient database between 2007 and 2013. We included middle-aged patients (aged 45 to 69) having undergone THR for coxarthrosis. We compared the numbers of pulmonary embolisms (PEs) (respectively upper gastrointestinal bleedings (UGIBs)) following the THR with the numbers occurring during three unexposed periods one year later. This enabled us to estimate the odds ratio (OR) [95\% confidence interval (CI)] for each of six successive 35-day intervals. The study included 108,099 patients. The ORs for PE were respectively 12.4 (95\% CI, 8.6-17.8) (absolute risk difference rate per 100,000 (ARD/100,000)=130) and 5.0 (95\% CI, 3.4-7.4) (ARD/100,000=52) for the first two 35-day intervals, and the risk was close to 1 thereafter. The risk of UGIB fell quickly, with an OR of 6.5 (95\% CI, 4.6-9.1) (ARD/100,000=83) and 0.8 (95\% CI, 0.4-1.6) for the first two 35-day intervals, respectively. The majority of UGIBs occurred during the inpatient stay for THR. Among middle-aged patients, the risk of a PE remains elevated beyond 35days after THR for coxarthrosis, whereas the risk of a UGIB remains elevated for the first 35days only.},
	language = {eng},
	journal = {Preventive Medicine},
	author = {Ficheur, Grégoire and Caron, Alexandre and Beuscart, Jean-Baptiste and Ferret, Laurie and Putman, Sophie and Beuscart, Régis and Chazard, Emmanuel},
	month = dec,
	year = {2016},
	pmid = {27612575},
	keywords = {Arthroplasty, Replacement, Hip, Bleeding event, Cohort Studies, Cross-Over Studies, Female, Hemorrhage, Humans, Incidence, Male, Middle Aged, Osteoarthritis, Hip, Patient Safety, Patient safety, Postoperative Complications, Pulmonary Embolism, Risk Factors, Time Factors, Total hip arthroplasty, Total hip replacement, United States, Venous Thromboembolism, Venous thromboembolic event},
	pages = {121--127},
}

Prophylactic anticoagulation is recommended up to 35days after total hip replacement (THR). Although several observational studies have assessed the incidence of thrombotic events or bleeding events after THR, the corresponding measures of association have never been studied concomitantly. Here, we evaluated the duration of the elevated risks (relative to the baseline risk) of both venous thromboembolic events and bleeding events after THR for coxarthrosis among middle-aged patients. This was a population-based, cross-over cohort study of data extracted from the French national inpatient database between 2007 and 2013. We included middle-aged patients (aged 45 to 69) having undergone THR for coxarthrosis. We compared the numbers of pulmonary embolisms (PEs) (respectively upper gastrointestinal bleedings (UGIBs)) following the THR with the numbers occurring during three unexposed periods one year later. This enabled us to estimate the odds ratio (OR) [95% confidence interval (CI)] for each of six successive 35-day intervals. The study included 108,099 patients. The ORs for PE were respectively 12.4 (95% CI, 8.6-17.8) (absolute risk difference rate per 100,000 (ARD/100,000)=130) and 5.0 (95% CI, 3.4-7.4) (ARD/100,000=52) for the first two 35-day intervals, and the risk was close to 1 thereafter. The risk of UGIB fell quickly, with an OR of 6.5 (95% CI, 4.6-9.1) (ARD/100,000=83) and 0.8 (95% CI, 0.4-1.6) for the first two 35-day intervals, respectively. The majority of UGIBs occurred during the inpatient stay for THR. Among middle-aged patients, the risk of a PE remains elevated beyond 35days after THR for coxarthrosis, whereas the risk of a UGIB remains elevated for the first 35days only.