Research use cases measuring the impact of COVID-19 on population health

Background

Wide variations in COVID-19 infection and outcomes exist across Europe and within countries. PHIRI will look at COVID-19 impacts in specific subgroups by conducting research through use cases of immediate relevance for public health policies focusing on indirect effects of the pandemic related to healthcare and other policies to contain the pandemic. Furthermore, the use cases represent pilot activities for the benefits and added value of a research infrastructure by bringing together data from different European countries.

Methods

Four research use cases will focus on selected aspects of vulnerable population groups and risk factors, delayed medical care in cancer, perinatal health outcomes, as well as mental health outcomes and are selected based on public health importance, geographic coverage, feasibility of producing actionable insights and relevance for the PHIRI infrastructure. The use cases will demonstrate how a broad variety of secondary data (e.g. administrative and survey data) can be pooled and/or reused in a distributed way across Europe.

Results

The outputs of the use cases will be processed by formalizing data models, data management processes and analytical pipelines in an interoperable way to feed in the federated research infrastructure. The use cases facilitate research by making scalable, reproducible methods available within PHIRI and by publishing the FAIRified use cases analysis results on the Health Information Portal. They will provide outcomes to guide policy makers in preparedness and response scenarios and will ensure the development of a format for the timely dissemination of use case results to the targeted groups.

Conclusions

PHIRI will provide insights in real life use cases to generate immediate results on key health impacts of COVID-19 on population health to underpin decision making and will drive the development of the federated research infrastructure that allows rapid cycle analysis.

Prioritising health information needs in Europe: a Policy Delphi survey

Background

Health information (HI) includes data on population health, health determinants, health care systems, and health-relevant policy developments. Duly prioritised HI is essential to inform decision-makers, researchers and the public. Little can be found in the literature on HI prioritisation methods and procedures in Europe. Our study aims to close this gap.

Methods

We designed a two-round online Policy Delphi and addressed 119 contacts, mainly public health and health information experts, in 33 InfAct partner countries. The first round included structured and full-text questions; in the ongoing second round, participants rank prioritisation approaches according to 'desirability', 'feasibility', 'importance' and 'confidence'.

Results

In the first round, 19 questionnaires were fully completed; the presented results also include replies from interrupted surveys and drop-outs. 58% of the participants reported the existence of structured national HI prioritisation processes; 65% indicated stakeholder involvement, and 54% the application of defined criteria. National health targets or strategies played a major role in HI prioritisation. 17 respondents from 13 countries agreed to participate in the second round. Based on analysis of the first round, participants rank approaches to HI prioritisation, preferences for stakeholder involvement and coordination, partners and methods for criteria development, the role of national and international frameworks and options for good-practices in HI development. The expected outcome of our study is not one single recommendation for HI prioritisation, but a list of good practice-approaches.

Conclusions

Health systems in Europe are heterogeneous, and so are health information systems. Mapping, sharing and ranking HI prioritisation approaches will facilitate knowledge exchange in the context of building a sustainable EU HI-system and may inform relevant EU processes.

Developing recommendations for good practice in national health reporting

Background

Health reporting should deliver up-to-date data and information on the population's health status, its determinants and on national (or regional) healthcare services. Establishing an information or discussion base for health policy is an important objective ('data for action'), but health reporting also addresses other target groups like scientists, the media or the general public. Depending on the needs and competencies of the respective target groups, requirements for health reporting formats will differ. At the same time, heterogeneity of health reporting practices in Member States causes, next to occasional language barriers, difficulties in facilitating access to EU-comparable information. To allow for alignment and identification of good practices, our study aims to provide a comprehensive overview of the health reporting formats in the EU.

Methods

A web-based desk research of health reporting formats and their target groups was conducted among EU Member States and associated InfAct partner countries. Good practice examples were identified on the basis of quality criteria derived from 'Good Practice in Health Reporting' for Germany and the Eva PHR (Evaluation of National and Regional Public Health Reports) project. Based on the findings of the desk research, a guidance document for health reports will be drafted in close cooperation with InfAct partner countries.

Results

The guidance should accommodate the heterogeneity of reporting practices at EU level while defining desirable and feasible good practice standards. Although the focus is on public health reports, recommendations for other formats of health reporting will also be included. It will facilitate the preparation, dissemination and access to EU-comparable and high-quality health information.

Conclusions

The guidance is expected to be a useful tool for making health information adequately available to the targeted groups while reducing inequalities in health reporting across the EU.

Gender equity in scientific publishing: Analysis of publications in the Journal of Health Monitoring

Background

The importance of gender- and sex-sensitive reporting and communication in science has been widely acknowledged in the past years. At the same time, a 'gendered system' of scientific publishing is increasingly discussed, given the underrepresentation of women as first and last authors, reviewers, on editorial boards and in editorial key positions. Against this background, the Journal of Health Monitoring (JoHM) - a scientific online journal published by the Federal Health Reporting at the Robert Koch Institute, Germany's national public health institute - took stock of the proportion of women among authors and reviewers.

Methods

Articles published in the JoHM between its founding in 2016 and the last issue in 2019 were included. Descriptive analysis was performed on the proportion of women in first and last authorship, stratified by publication format, and the proportion of peer reviews performed by women.

Results

A total of 145 articles were included in the analysis, comprising the categories Focus, Fact sheet, Concepts & Methods, Proceedings, Abstract and Editorial. The percentage of articles with first authorship by women was 66% (95/145), ranging from 53% for Focus articles (n = 16/30) to all of the Editorials (n = 6/6). 49% of last authors were female (n = 66/135). Overall, 42% of all reviews were performed by women (n = 96/233).

Conclusions

With almost two third of the publications analysed, first authorship of women in the JoHM is high. However, the proportion of female last authors and reviewers is lower in comparison. Next to professional qualification, gender should be taken into account when editors select reviewers. Overall, discussion should be stimulated on adequate representation of women in all areas of scientific publishing, given the relevance of visible merits in publishing for the building of scientific careers.

Key messages

Publications in the Journal of Health Monitoring have a high percentage of female first authors; in comparison, the percentage of last authorship and peer reviews by women is lower. An adequate representation of women in all areas of scientific publishing is essential, given the significance of publishing for merit in science and research.

Resistance to thyroid hormones. A disorder frequently confused with Graves' disease

Five patients from two unrelated families were found to have goiter and elevated serum concentrations of thyroxine (T4) and triiodothyronine (T3) without symptoms or signs of hyperthyroidism. All had measurable concentrations of thyroid stimulating hormone (TSH), and in four who were tested, there was an increase in TSH concentration following thyrotropin releasing hormone (TRH) administration. We believe these five patients have general resistance to the effects of thyroid hormones and need elevated concentrations of T4 and T3 to maintain a eumetabolic state. Study of nuclear T3 receptors from cultured fibroblasts of one patient disclosed a normal equilibrium association constant and a maximal binding capacity that was greater than normal control values. These findings suggest that thyroid hormone resistance in this patient is not due to a decrease in either the affinity or the number of specific nuclear T3 receptors. This disorder can easily be confused with Graves' disease and result in inappropriate treatment for hyperthyroidism, as was the case in three of our patients.