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Loyeau A, Benamer H, Caussin C, Garot P, Teiger E, Moiteaux B, Bataille S. [Registry CARDIO-ARSIF - Database on coronary angiography and percutaneous coronary invasive performed in Île-de-France]. Ann Cardiol Angeiol (Paris) 2023; 72:101685. [PMID: 37918329 DOI: 10.1016/j.ancard.2023.101685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/09/2023] [Indexed: 11/04/2023]
Abstract
The CARDIO-ARSIF registry has been continuously collecting comprehensive data on coronary angiography and percutaneous coronary interventions (PCI) performed in the 36 catheterization laboratories across the Île-de-France region since 2000. Over the period from 2003 to 2022, this registry has recorded information from more than 330,000 patients, encompassing more than one million procedures. Among these procedures, 58% consisted of coronary angiography, 13% were percutaneous coronary interventions (PCI), and the remaining 28% were PCI performed on an ad-hoc basis. This extensive dataset serves as a valuable resource for both qualitative and quantitative assessments of practices and the relevance of procedures in the field of coronary invasive cardiology. The results of these analyses undergo annual validation by a dedicated scientific committee and are shared with the teams of investigators. The exploitation of this data has led to scientific publications, with one notable finding being a consistent reduction in the radiation doses received by patients, regardless of the type of procedure.
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Affiliation(s)
- Aurélie Loyeau
- Département Traitement de l'information, GIP SESAN, 6-8 rue Firmin Gillot, 75015 Paris, France.
| | - Hakim Benamer
- Institut Cardiovasculaire Paris Sud, 6 Av. du Noyer Lambert, 91300 Massy, France.
| | | | - Philippe Garot
- ICPS Claude Galien, 20 Rte de Boussy-Saint-Antoine, 91480 Quincy-sous-Sénart, France.
| | - Emmanuel Teiger
- Hôpital Henri Mondor APHP, 1 Rue Gustave Eiffel, 94000 Créteil, France.
| | - Brice Moiteaux
- Département Traitement de l'information, GIP SESAN, 6-8 rue Firmin Gillot, 75015 Paris, France.
| | - Sophie Bataille
- Département de l'Offre de soin, Agence Régionale de Santé d'Île-de-France, Immeuble Le Curve, 13 Rue du Landy, 93200 Saint-Denis, France.
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Lesaine E, Francis-Oliviero F, Domecq S, Bijon M, Cetran L, Coste P, Lhuaire Q, Miganeh-Hadi S, Pradeau C, Rouanet F, Sevin F, Sibon I, Saillour-Glenisson F. Effects of healthcare system transformations spurred by the COVID-19 pandemic on management of stroke and STEMI: a registry-based cohort study in France. BMJ Open 2022; 12:e061025. [PMID: 36130741 PMCID: PMC9494013 DOI: 10.1136/bmjopen-2022-061025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To assess the impact of changes in use of care and implementation of hospital reorganisations spurred by the COVID-19 pandemic (first wave) on the acute management times of patients who had a stroke and ST-segment elevation myocardial infarction (STEMI). DESIGN Two cohorts of patients who had an STEMI and stroke in the Aquitaine Cardio-Neuro-Vascular (CNV) registry. SETTING 6 emergency medical services, 30 emergency units (EUs), 14 hospitalisation units and 11 cathlabs in the Aquitaine region. PARTICIPANTS This study involved 9218 patients (6436 patients who had a stroke and 2782 patients who had an STEMI) in the CNV Registry from January 2019 to August 2020. METHOD Hospital reorganisations, retrieved in a scoping review, were collected from heads of hospital departments. Other data were from the CNV Registry. Associations between reorganisations, use of care and care management times were analysed using multivariate linear regression mixed models. Interaction terms between use-of-care variables and period (pre-wave, per-wave and post-wave) were introduced. MAIN OUTCOME MEASURES STEMI cohort, first medical contact-to-procedure time; stroke cohort, EU admission-to-imaging time. RESULTS Per-wave period management times deteriorated for stroke but were maintained for STEMI. Per-wave changes in use of care did not affect STEMI management. No association was found between reorganisations and stroke management times. In the STEMI cohort, the implementation of systematic testing at admission was associated with a 41% increase in care management time (exp=1.409, 95% CI 1.075 to 1.848, p=0.013). Implementation of plan blanc, which concentrated resources in emergency activities, was associated with a 19% decrease in management time (exp=0.801, 95% CI 0.639 to 1.023, p=0.077). CONCLUSIONS The pandemic did not markedly alter the functioning of the emergency network. Although stroke patient management deteriorated, the resilience of the STEMI pathway was linked to its stronger structuring. Transversal reorganisations, aiming at concentrating resources on emergency care, contributed to maintenance of the quality of care. TRIAL REGISTRATION NUMBER NCT04979208.
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Affiliation(s)
- Emilie Lesaine
- CIC-EC 14-01, CHU de Bordeaux, Bordeaux, France
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
| | - Florence Francis-Oliviero
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
- Pôle de santé publique, Service d'Information Médicale, CHU de Bordeaux, Bordeaux, France
| | - Sandrine Domecq
- CIC-EC 14-01, CHU de Bordeaux, Bordeaux, France
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
| | - Marine Bijon
- Pôle de santé publique, Service d'Information Médicale, CHU de Bordeaux, Bordeaux, France
| | - Laura Cetran
- Coronary Care Unit, CHU de Bordeaux Hôpital Cardiologique, Pessac, France
| | - Pierre Coste
- Coronary Care Unit, CHU de Bordeaux Hôpital Cardiologique, Pessac, France
- University of Bordeaux, Talence, France
| | - Quentin Lhuaire
- Pôle de santé publique, Service d'Information Médicale, CHU de Bordeaux, Bordeaux, France
| | - Sahal Miganeh-Hadi
- CIC-EC 14-01, CHU de Bordeaux, Bordeaux, France
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
| | | | | | - Floriane Sevin
- CIC-EC 14-01, CHU de Bordeaux, Bordeaux, France
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
| | - Igor Sibon
- Neurology, Stroke Unit, CHU de Bordeaux, Bordeaux, France
- INCIA CNRS UMR 5287, University of Bordeaux, Talence, France
| | - Florence Saillour-Glenisson
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
- Pôle de santé publique, Service d'Information Médicale, CHU de Bordeaux, Bordeaux, France
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Francis-Oliviero F, Coste P, Lesaine E, Perez C, Casteigt F, Clerc JM, Delarche N, Hassan A, Larnaudie B, Leymarie JL, Salmi LR, Saillour-Glenisson F. Development and evaluation of the accuracy of an indicator of the appropriateness of interventional cardiology generated from a French registry. Arch Public Health 2022; 80:132. [PMID: 35524321 PMCID: PMC9077814 DOI: 10.1186/s13690-022-00885-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Development of appropriateness indicators of medical interventions has become a major quality-of-care issue, especially in the domain of interventional cardiology (IC). The objective of this study was to develop and evaluate the accuracy of an indicator of the appropriateness of interventional cardiology acts (invasive coronary angiographies (ICA) and percutaneous coronary interventions (PCI)) in patients with coronary stable disease and silent ischemia, automated from a French registry. Methods All ICA and PCI recorded in a Regional IC Registry (ACIRA) and operated for a stable coronary artery disease or silent ischemia from January 1st to December 31th 2013 in eight IC hospitals of Aquitaine, southwestern France, were included. The indicator was developed to reflect European guidelines. Classification of appropriateness by the indicator, measured on the registry database, was compared to the classification of a reference standard (expert judgment applied through complete record review) on a random sample of 300 interventions. Accuracy parameters were estimated. A second version of the indicator was defined, based on the analysis of false negative and positive results, and its accuracy estimated. Results The second indicator accuracy was: sensitivity 63.5% (95% confidence interval CI [51.7–75.3]), specificity 76.0% (95%CI [70.4–81.6]), PPV 43.0% (95% CI [33.0–53.0]) and NPV 88.0% (95% CI [83.4–92.6]). When stratified on the type of act, parameters were better for ICA alone than for PCI. Conclusions Accuracy of the indicator should raise with improvement of database quality. Despite its average accuracy, it is already used as a benchmark indicator for cardiologists. It is sent annually to each IC center with value of the indicator at the region level to allow a comparison.
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Affiliation(s)
- Florence Francis-Oliviero
- Inserm Bordeaux Population Health, U1219, ISPED, Univ Bordeaux, Bordeaux, France. .,Medical Information Department, Bordeaux University Hospital, Bordeaux, France.
| | - Pierre Coste
- Hôpital Cardiologique-CHU de Bordeaux, Université de Bordeaux, Pessac, France
| | - Emilie Lesaine
- Inserm Bordeaux Population Health, U1219, ISPED, Univ Bordeaux, Bordeaux, France
| | - Corinne Perez
- Inserm Bordeaux Population Health, U1219, ISPED, Univ Bordeaux, Bordeaux, France
| | | | | | | | - Akil Hassan
- Centre Hospitalier de Mont de Marsan, Mont de Marsan, France
| | | | | | - Louis-Rachid Salmi
- Inserm Bordeaux Population Health, U1219, ISPED, Univ Bordeaux, Bordeaux, France.,Medical Information Department, Bordeaux University Hospital, Bordeaux, France
| | - Florence Saillour-Glenisson
- Inserm Bordeaux Population Health, U1219, ISPED, Univ Bordeaux, Bordeaux, France.,Medical Information Department, Bordeaux University Hospital, Bordeaux, France
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Lesaine E, Belhamri NM, Legrand JP, Domecq S, Coste P, Lacroix A, Saillour-Glenisson F. [Linking Interventional Cardiology clinical registry data with French hospital administrative data: Development and validation of deterministic record linkage]. Rev Epidemiol Sante Publique 2021; 69:78-87. [PMID: 33707007 DOI: 10.1016/j.respe.2021.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 01/22/2021] [Accepted: 01/27/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND To recreate the in-hospital healthcare pathway for patients treated with coronary angiography or percutaneous coronary intervention, we linked the interventional cardiology registry (ACIRA) and the pseudonymized French hospital medical information system database (PMSI) in the Aquitaine region. The objective of this study was to develop and validate a deterministic merging algorithm between these exhaustive and complementary databases. METHODS After a pre-treatment phase of the databases to standardize the 11 identified linking variables, a deterministic linking algorithm was developed on ACIRA hospital stays between December 2011 and December 2014 in nine interventional cardiology centers as well as the data from the consolidated PMSI databases of the Aquitaine region from 2011 to 2014. Merging was carried out through 12 successive steps, the first consisting in strict linking of the 11 variables. The performance of the algorithm was analyzed in terms of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Strategies complementary to the initial algorithm (change in the order of variables and base preprocessing) were tested. Comparative analysis of merged/unmerged patients explored potential causes of mismatch. RESULTS The algorithm found 97.2% of the 31,621 ACIRA stays to have sensitivity of 99.9% (95% CI [99.9; 99.9]), specificity of 97.9% (95% CI [97.7; 98.1]), PPV of 99.9% (95% CI [99.9; 99.9]) and NPV of 96.9% (95% CI [96.7; 97.1]). Complementary strategies did not yield better results. The unmerged patients were older, and hospitalized mostly in 2012 in two interventional cardiology centers. CONCLUSION This study underscored the feasibility and validity of an indirect deterministic pairing to routinely link a registry of practices using hospital data to pseudonymized medico-administrative databases. This method, which can be extrapolated to other health events leading to hospitalization, renders it possible to effectively reconstruct patients' hospital healthcare pathway.
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Affiliation(s)
- E Lesaine
- University Bordeaux, ISPED, Centre Inserm U1219-Bordeaux Population Health, 33000 Bordeaux, France; Service d'information médicale, CHU de Bordeaux, pôle de santé publique, 33000 Bordeaux, France; Inserm, ISPED, Centre Inserm U1219-Bordeaux Population Health, 33000 Bordeaux, France.
| | - N-M Belhamri
- University Bordeaux, ISPED, Centre Inserm U1219-Bordeaux Population Health, 33000 Bordeaux, France
| | - J-P Legrand
- University Bordeaux, ISPED, Centre Inserm U1219-Bordeaux Population Health, 33000 Bordeaux, France; Service d'information médicale, CHU de Bordeaux, pôle de santé publique, 33000 Bordeaux, France; Inserm, ISPED, Centre Inserm U1219-Bordeaux Population Health, 33000 Bordeaux, France
| | - S Domecq
- University Bordeaux, ISPED, Centre Inserm U1219-Bordeaux Population Health, 33000 Bordeaux, France; Service d'information médicale, CHU de Bordeaux, pôle de santé publique, 33000 Bordeaux, France; Inserm, ISPED, Centre Inserm U1219-Bordeaux Population Health, 33000 Bordeaux, France
| | - P Coste
- CHU de Bordeaux Hôpital Cardiologique, Coronary Care Unit, 33600 Pessac, France; University Bordeaux, Collège sciences de la santé, Cardiology Bordeaux, Aquitaine, 33000 Bordeaux, France
| | - A Lacroix
- Agence régionale de santé Nouvelle-Aquitaine, Direction du pilotage de la stratégie et des parcours, 33000 Bordeaux, France
| | - F Saillour-Glenisson
- University Bordeaux, ISPED, Centre Inserm U1219-Bordeaux Population Health, 33000 Bordeaux, France; Service d'information médicale, CHU de Bordeaux, pôle de santé publique, 33000 Bordeaux, France; Inserm, ISPED, Centre Inserm U1219-Bordeaux Population Health, 33000 Bordeaux, France
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