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Chen-Xu J, Varga O, Mahrouseh N, Eikemo TA, Grad DA, Wyper GMA, Badache A, Balaj M, Charalampous P, Economou M, Haagsma JA, Haneef R, Mechili EA, Unim B, von der Lippe E, Baravelli CM. Subnational inequalities in years of life lost and associations with socioeconomic factors in pre-pandemic Europe, 2009-19: an ecological study. Lancet Public Health 2024; 9:e166-e177. [PMID: 38429016 DOI: 10.1016/s2468-2667(24)00004-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Health inequalities have been associated with shorter lifespans. We aimed to investigate subnational geographical inequalities in all-cause years of life lost (YLLs) and the association between YLLs and socioeconomic factors, such as household income, risk of poverty, and educational attainment, in countries within the European Economic Area (EEA) before the COVID-19 pandemic. METHODS In this ecological study, we extracted demographic and socioeconomic data from Eurostat for 1390 small regions and 285 basic regions for 32 countries in the EEA, which was complemented by a time-trend analysis of subnational regions within the EEA. Age-standardised YLL rates per 100 000 population were estimated from 2009 to 2019 based on methods from the Global Burden of Disease study. Geographical inequalities were assessed using the Gini coefficient and slope index of inequality. Socioeconomic inequalities were assessed by investigating the association between socioeconomic factors (educational attainment, household income, and risk of poverty) and YLLs in 2019 using negative binomial mixed models. FINDINGS Between Jan 1, 2009, and Dec 31, 2019, YLLs lowered in almost all subnational regions. The Gini coefficient of YLLs across all EEA regions was 14·2% (95% CI 13·6-14·8) for females and 17·0% (16·3 to 17·7) for males. Relative geographical inequalities in YLLs among women were highest in the UK (Gini coefficient 11·2% [95% CI 10·1-12·3]) and among men were highest in Belgium (10·8% [9·3-12·2]). The highest YLLs were observed in subnational regions with the lowest levels of educational attainment (incident rate ratio [IRR] 1·19 [1·13-1·26] for females; 1·22 [1·16-1·28] for males), household income (1·35 [95% CI 1·19-1·53]), and the highest poverty risk (1·25 [1·18-1·34]). INTERPRETATION Differences in YLLs remain within, and between, EEA countries and are associated with socioeconomic factors. This evidence can assist stakeholders in addressing health inequities to improve overall disease burden within the EEA. FUNDING Research Council of Norway; Development, and Innovation Fund of Hungary; Norwegian Institute of Public Medicine; and COST Action 18218 European Burden of Disease Network.
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Affiliation(s)
- José Chen-Xu
- Comprehensive Health Research Centre, Public Health Research Centre, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal; Public Health Unit, Local Health Unit Baixo Mondego, Figueira da Foz, Portugal
| | - Orsolya Varga
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Syreon Research Institute, Budapest, Hungary
| | - Nour Mahrouseh
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Terje Andreas Eikemo
- Department of Sociology and Political Science, Centre for Global Health Inequalities Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Diana A Grad
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Grant M A Wyper
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK; Population Health and Wellbeing, Public Health Scotland, Glasgow, Scotland
| | - Andreea Badache
- Swedish Institute of Disability Research, School of Health Sciences, Örebro University, Örebro, Sweden; School of Health Sciences, Örebro University, Örebro, Sweden
| | - Mirza Balaj
- Department of Sociology and Political Science, Centre for Global Health Inequalities Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Periklis Charalampous
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Mary Economou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Romana Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - Enkeleint A Mechili
- Department of Healthcare, Faculty of Health, University of Vlora, Vlora, Albania; School of Medicine, University of Crete, Crete, Greece
| | - Brigid Unim
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Italian National Institute of Health, Rome, Italy
| | - Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Makovski TT, Ghattas J, Monnier-Besnard S, Cavillot L, Ambrožová M, Vašinová B, Feteira-Santos R, Bezzegh P, Bollmann FP, Cottam J, Haneef R, Devleesschauwer B, Speybroeck N, Nogueira PJ, Forjaz MJ, Coste J, Carcaillon-Bentata L. Multimorbidity and frailty are associated with poorer SARS-CoV-2-related outcomes: systematic review of population-based studies. Aging Clin Exp Res 2024; 36:40. [PMID: 38353841 PMCID: PMC10866755 DOI: 10.1007/s40520-023-02685-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 11/29/2023] [Indexed: 02/16/2024]
Abstract
BACKGROUND Estimating the risks and impacts of COVID-19 for different health groups at the population level is essential for orienting public health measures. Adopting a population-based approach, we conducted a systematic review to explore: (1) the etiological role of multimorbidity and frailty in developing SARS-CoV-2 infection and COVID-19-related short-term outcomes; and (2) the prognostic role of multimorbidity and frailty in developing short- and long-term outcomes. This review presents the state of the evidence in the early years of the pandemic. It was conducted within the European Union Horizon 2020 program (No: 101018317); Prospero registration: CRD42021249444. METHODS PubMed, Embase, World Health Organisation COVID-19 Global literature on coronavirus disease, and PsycINFO were searched between January 2020 and 7 April 2021 for multimorbidity and 1 February 2022 for frailty. Quantitative peer-reviewed studies published in English with population-representative samples and validated multimorbidity and frailty tools were considered. RESULTS Overall, 9,701 records were screened by title/abstract and 267 with full text. Finally, 14 studies were retained for multimorbidity (etiological role, n = 2; prognostic, n = 13) and 5 for frailty (etiological role, n = 2; prognostic, n = 4). Only short-term outcomes, mainly mortality, were identified. An elevated likelihood of poorer outcomes was associated with an increasing number of diseases, a higher Charlson Comorbidity Index, different disease combinations, and an increasing frailty level. DISCUSSION Future studies, which include the effects of recent virus variants, repeated exposure and vaccination, will be useful for comparing the possible evolution of the associations observed in the earlier waves.
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Affiliation(s)
- Tatjana T Makovski
- Department of Non-Communicable Diseases and Injuries, French Public Health Agency (Santé publique France), Saint-Maurice, France.
| | - Jinane Ghattas
- Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Stéphanie Monnier-Besnard
- Department of Non-Communicable Diseases and Injuries, French Public Health Agency (Santé publique France), Saint-Maurice, France
| | - Lisa Cavillot
- Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Monika Ambrožová
- National screening centre, Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Barbora Vašinová
- National screening centre, Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Rodrigo Feteira-Santos
- Área Disciplinar Autónoma de Bioestatística, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Laboratório Associado TERRA, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Peter Bezzegh
- Directorate for Project Management, National Directorate General for Hospitals, Budapest, Hungary
| | | | - James Cottam
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Romana Haneef
- Department of Non-Communicable Diseases and Injuries, French Public Health Agency (Santé publique France), Saint-Maurice, France
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Niko Speybroeck
- Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium
| | - Paulo Jorge Nogueira
- Área Disciplinar Autónoma de Bioestatística, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Laboratório Associado TERRA, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Centro de Investigação Em Saúde Pública, Escola Nacional de Saúde Pública, ENSP, CISP, Comprehensive Health Research Center, CHRC, Universidade NOVA de Lisboa, Lisbon, Portugal
- CIDNUR-Centro de Investigação, Inovação e Desenvolvimento Em Enfermagem de Lisboa Escola Superior de Enfermagem de Lisboa, Avenida Professor Egas Moniz, 1600-190, Lisbon, Portugal
| | - Maria João Forjaz
- National Center of Epidemiology, Instituto de Salud Carlos III, RICAPPS, Madrid, Spain
| | - Joël Coste
- Department of Non-Communicable Diseases and Injuries, French Public Health Agency (Santé publique France), Saint-Maurice, France
| | - Laure Carcaillon-Bentata
- Department of Non-Communicable Diseases and Injuries, French Public Health Agency (Santé publique France), Saint-Maurice, France
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Andrade CAS, Mahrouseh N, Gabrani J, Charalampous P, Cuschieri S, Grad DA, Unim B, Mechili EA, Chen-Xu J, Devleesschauwer B, Isola G, von der Lippe E, Baravelli CM, Fischer F, Weye N, Balaj M, Haneef R, Economou M, Haagsma JA, Varga O. Inequalities in the burden of non-communicable diseases across European countries: a systematic analysis of the Global Burden of Disease 2019 study. Int J Equity Health 2023; 22:140. [PMID: 37507733 PMCID: PMC10375608 DOI: 10.1186/s12939-023-01958-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Although overall health status in the last decades improved, health inequalities due to non-communicable diseases (NCDs) persist between and within European countries. There is a lack of studies giving insights into health inequalities related to NCDs in the European Economic Area (EEA) countries. Therefore, the aim of the present study was to quantify health inequalities in age-standardized disability adjusted life years (DALY) rates for NCDs overall and 12 specific NCDs across 30 EEA countries between 1990 and 2019. Also, this study aimed to determine trends in health inequalities and to identify those NCDs where the inequalities were the highest. METHODS DALY rate ratios were calculated to determine and compare inequalities between the 30 EEA countries, by sex, and across time. Annual rate of change was used to determine the differences in DALY rate between 1990 and 2019 for males and females. The Gini Coefficient (GC) was used to measure the DALY rate inequalities across countries, and the Slope Index of Inequality (SII) to estimate the average absolute difference in DALY rate across countries. RESULTS Between 1990 and 2019, there was an overall declining trend in DALY rate, with larger declines among females compared to males. Among EEA countries, in 2019 the highest NCD DALY rate for both sexes were observed for Bulgaria. For the whole period, the highest DALY rate ratios were identified for digestive diseases, diabetes and kidney diseases, substance use disorders, cardiovascular diseases (CVD), and chronic respiratory diseases - representing the highest inequality between countries. In 2019, the highest DALY rate ratio was found between Bulgaria and Iceland for males. GC and SII indicated that the highest inequalities were due to CVD for most of the study period - however, overall levels of inequality were low. CONCLUSIONS The inequality in level 1 NCDs DALYs rate is relatively low among all the countries. CVDs, digestive diseases, diabetes and kidney diseases, substance use disorders, and chronic respiratory diseases are the NCDs that exhibit higher levels of inequality across countries in the EEA. This might be mitigated by applying tailored preventive measures and enabling healthcare access.
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Affiliation(s)
- Carlos Alexandre Soares Andrade
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 26 Kassai Street, 4028, Debrecen, Hungary
| | - Nour Mahrouseh
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 26 Kassai Street, 4028, Debrecen, Hungary
| | - Jonila Gabrani
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Periklis Charalampous
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Sarah Cuschieri
- Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Diana Alecsandra Grad
- Department of Public Health, Babes-Bolyai University, Cluj-Napoca-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca-Napoca, Romania
| | - Brigid Unim
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore Di Sanità, Rome, Italy
| | - Enkeleint A Mechili
- Department of Healthcare, Faculty of Health, University of Vlora, Vlora, Albania
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece
| | - José Chen-Xu
- Public Health Unit, Primary Healthcare Cluster Baixo Mondego, Coimbra, Portugal
- National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Gaetano Isola
- Department of General Surgery and Surgical Medical Specialties, University of Catania, Catania, Italy
| | - Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | | | - Florian Fischer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nanna Weye
- Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Mirza Balaj
- Department of Sociology and Political Science, Centre for Global Health Inequalities Research (CHAIN), Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Romana Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - Mary Economou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Orsolya Varga
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 26 Kassai Street, 4028, Debrecen, Hungary.
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Haneef R, Fayad M, Fouillet A, Sommen C, Bonaldi C, Wyper GMA, Pires SM, Devleesschauwer B, Rachas A, Constantinou P, Levy-Bruhl D, Beltzer N, Gallay A. Direct impact of COVID-19 by estimating disability-adjusted life years at national level in France in 2020. PLoS One 2023; 18:e0280990. [PMID: 36693071 PMCID: PMC9873186 DOI: 10.1371/journal.pone.0280990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 01/13/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The World Health Organization declared a pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on March 11, 2020. The standardized approach of disability-adjusted life years (DALYs) allows for quantifying the combined impact of morbidity and mortality of diseases and injuries. The main objective of this study was to estimate the direct impact of COVID-19 in France in 2020, using DALYs to combine the population health impact of infection fatalities, acute symptomatic infections and their post-acute consequences, in 28 days (baseline) up to 140 days, following the initial infection. METHODS National mortality, COVID-19 screening, and hospital admission data were used to calculate DALYs based on the European Burden of Disease Network consensus disease model. Scenario analyses were performed by varying the number of symptomatic cases and duration of symptoms up to a maximum of 140 days, defining COVID-19 deaths using the underlying, and associated, cause of death. RESULTS In 2020, the estimated DALYs due to COVID-19 in France were 990 710 (1472 per 100 000), with 99% of burden due to mortality (982 531 years of life lost, YLL) and 1% due to morbidity (8179 years lived with disability, YLD), following the initial infection. The contribution of YLD reached 375%, assuming the duration of 140 days of post-acute consequences of COVID-19. Post-acute consequences contributed to 49% of the total morbidity burden. The contribution of YLD due to acute symptomatic infections among people younger than 70 years was higher (67%) than among people aged 70 years and above (33%). YLL among people aged 70 years and above, contributed to 74% of the total YLL. CONCLUSIONS COVID-19 had a substantial impact on population health in France in 2020. The majority of population health loss was due to mortality. Men had higher population health loss due to COVID-19 than women. Post-acute consequences of COVID-19 had a large contribution to the YLD component of the disease burden, even when we assume the shortest duration of 28 days, long COVID burden is large. Further research is recommended to assess the impact of health inequalities associated with these estimates.
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Affiliation(s)
- Romana Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
- * E-mail:
| | - Myriam Fayad
- Department of Data science, Santé Publique France, Saint-Maurice, France
| | - Anne Fouillet
- Department of Data science, Santé Publique France, Saint-Maurice, France
| | - Cécile Sommen
- Department of Data science, Santé Publique France, Saint-Maurice, France
| | - Christophe Bonaldi
- Department of Data science, Santé Publique France, Saint-Maurice, France
| | - Grant M. A. Wyper
- School of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | | | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Antoine Rachas
- Department of Strategy, Studies and Statistics, French National Health Insurance: Caisse nationale de l’assurance maladie (Cnam), Paris, France
| | - Panayotis Constantinou
- Department of Strategy, Studies and Statistics, French National Health Insurance: Caisse nationale de l’assurance maladie (Cnam), Paris, France
| | - Daniel Levy-Bruhl
- Department of Infectious Diseases, Santé Publique France, Saint-Maurice, France
| | - Nathalie Beltzer
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - Anne Gallay
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
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Makovski TT, Ghattas J, Monnier Besnard S, Ambrozova M, Vasinova B, Feteira-Santos R, Bezzegh P, Ponce Bollmann F, Cottam J, Haneef R, Devleesschauwer B, Speybroeck N, Nogueira P, Forjaz MJ, Coste J, Carcaillon-Bentata L. Aetiological and prognostic roles of frailty, multimorbidity and socioeconomic characteristics in the development of SARS-CoV-2 health outcomes: protocol for systematic reviews of population-based studies. BMJ Open 2022; 12:e063573. [PMID: 36414309 PMCID: PMC9684277 DOI: 10.1136/bmjopen-2022-063573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 10/27/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION There is growing evidence that the impact of COVID-19 crisis may be stronger for individuals with multimorbidity, frailty and lower socioeconomic status. Existing reviews focus on few, mainly short-term effects of COVID-19 illness and patients with single chronic disease. Information is also largely missing for population representative samples.Applying population-based approach, the systematic reviews will have two objectives: (1) to evaluate the aetiological roles of frailty, multimorbidity and socioeconomic status on SARS-CoV-2 infection probability, hospitalisation, intensive care unit (ICU) admission, mechanical ventilation and COVID-19 related mortality among general population and (2) to investigate the prognostic roles of frailty, multimorbidity and socioeconomic characteristics on the risk of hospitalisation, ICU admission, mechanical ventilation, COVID-19 mortality, functioning, quality of life, disability, mental health and work absence. METHODS AND ANALYSIS For this ongoing work, four databases were searched: PubMed, Embase, WHO COVID-19 Global literature on coronavirus disease and PsycINFO, for the period between January 2020 and April 7 2021. Peer-reviewed published literature in English and all types of population-based studies will be considered. Studies using standard tools to assess multimorbidity such as disease count, comorbidity indices or disease combinations will be retained, as well as studies with standard scales and scores for frailty or measurement of a socioeconomic gradient. Initial search included 10 139 articles, 411 for full-text reading. Results will be summarised by risk factor, objective and outcome. The feasibility of meta-analysis will be determined by the findings and will aim to better understand uncertainties of the results. Quality of studies will be assessed using standardised scales. ETHICS AND DISSEMINATION The study will be based on published evidence, and it is exempt from the ethical approval. This work is part of the Population Health Information Research Infrastructure (PHIRI) project. Dissemination of the results will imply conference presentation, submission for scientific publication and PHIRI project report. PROSPERO REGISTRATION NUMBER CRD42021249444.
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Affiliation(s)
- Tatjana T Makovski
- Department of non-communicable diseases and injuries, Santé publique France, Saint-Maurice, Île-de-France, France
| | - Jinane Ghattas
- Institut de recherche santé et société (IRSS), Université catholique de Louvain, Woluwe-Saint-Lambert, Brussels, Belgium
| | - Stephanie Monnier Besnard
- Department of non-communicable diseases and injuries, Santé publique France, Saint-Maurice, Île-de-France, France
| | - Monika Ambrozova
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Barbora Vasinova
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Rodrigo Feteira-Santos
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Área Disciplinar Autónoma de Bioestatística, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Peter Bezzegh
- Directorate for Project Management, National Directorate General for Hospitals, Budapest, Hungary
| | | | - James Cottam
- Department of Epidemiology and Public Health, Sciensano, Brussel, Belgium
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Romana Haneef
- Department of non-communicable diseases and injuries, Santé publique France, Saint-Maurice, Île-de-France, France
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussel, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Niko Speybroeck
- Institut de recherche santé et société (IRSS), Université catholique de Louvain, Woluwe-Saint-Lambert, Brussels, Belgium
| | - Paulo Nogueira
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Área Disciplinar Autónoma de Bioestatística, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Maria João Forjaz
- National Center of Epidemiology, Instituto de Salud Carlos III, REDISSEC and RICAPPS, Madrid, Spain
| | - Joel Coste
- Department of non-communicable diseases and injuries, Santé publique France, Saint-Maurice, Île-de-France, France
| | - Laure Carcaillon-Bentata
- Department of non-communicable diseases and injuries, Santé publique France, Saint-Maurice, Île-de-France, France
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Pires SM, Wyper GMA, Wengler A, Peñalvo JL, Haneef R, Moran D, Cuschieri S, Redondo HG, De Pauw R, McDonald SA, Moon L, Shedrawy J, Pallari E, Charalampous P, Devleesschauwer B, Von Der Lippe E. Burden of Disease of COVID-19: Strengthening the Collaboration for National Studies. Front Public Health 2022; 10:907012. [PMID: 35734754 PMCID: PMC9208200 DOI: 10.3389/fpubh.2022.907012] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/10/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives Quantifying the combined impact of morbidity and mortality is a key enabler to assessing the impact of COVID-19 across countries and within countries relative to other diseases, regions, or demographics. Differences in methods, data sources, and definitions of mortality due to COVID-19 may hamper comparisons. We describe efforts to support countries in estimating the national-level burden of COVID-19 using disability-adjusted life years. Methods The European Burden of Disease Network developed a consensus methodology, as well as a range of capacity-building activities to support burden of COVID-19 studies. These activities have supported 11 national studies so far, with study periods between January 2020 and December 2021. Results National studies dealt with various data gaps and different assumptions were made to face knowledge gaps. Still, they delivered broadly comparable results that allow for interpretation of consistencies, as well as differences in the quantified direct health impact of the pandemic. Discussion Harmonized efforts and methodologies have allowed for comparable estimates and communication of results. Future studies should evaluate the impact of interventions, and unravel the indirect health impact of the COVID-19 crisis.
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Affiliation(s)
- Sara Monteiro Pires
- National Food Institute, Technical University of Denmark, Kgs Lyngby, Denmark
- *Correspondence: Sara Monteiro Pires
| | - Grant M. A. Wyper
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, United Kingdom
| | - Annelene Wengler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute (RKI), Berlin, Germany
| | - José L. Peñalvo
- Unit of Non-Communicable Diseases, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Romana Haneef
- Département des Maladies Infectieuses, Santé Publique France, Saint-Maurice, France
| | - Declan Moran
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Sarah Cuschieri
- Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Hernan G. Redondo
- National Food Institute, Technical University of Denmark, Kgs Lyngby, Denmark
| | - Robby De Pauw
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Scott A. McDonald
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Lynelle Moon
- Health Group, Australian Institute of Health and Welfare, Canberra, ACT, Australia
| | - Jad Shedrawy
- Department of Global Public Health, Karolinska Institutet (KI), Stockholm, Sweden
| | | | | | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Ghent, Belgium
| | - Elena Von Der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute (RKI), Berlin, Germany
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7
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Sarmiento-Suárez R, Padron-Monedero A, Bogaert P, Abboud L, Van Oyen H, Tolonen H, Tijhuis M, Seeling S, Haneef R, Zaletel M, Palmieri L, Gallay A, Lapão LV, Nogueira P, Ziese T, Vukovic J, Beja A, Saso M, Noguer-Zambrano I. The InfAct proposal for a sustainable European health information infrastructure on population health: the Distributed Infrastructure on Population Health (DIPoH). Arch Public Health 2022; 80:139. [PMID: 35581661 PMCID: PMC9113621 DOI: 10.1186/s13690-022-00844-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 03/08/2022] [Indexed: 11/20/2022] Open
Abstract
Background In Europe, data on population health is fragmented, difficult to access, project-based and prone to health information inequalities in terms of availability, accessibility and especially in quality between and within countries. This situation is further exacerbated and exposed by the recent COVID-19 pandemic. The Joint Action on Health Information (InfAct) that builds on previous works of the BRIDGE Health project, carried out collaborative action to set up a sustainable infrastructure for health information in the European Union (EU). The aim of this paper is to present InfAct’s proposal for a sustainable research infrastructure, the Distributed Infrastructure on Population Health (DIPoH), which includes the setup of a Health Information Portal on population health to be maintained beyond InfAct’s time span. Methods The strategy for the proposal was based on three components: scientific initiatives and proposals to improve Health Information Systems (HIS), exploration of technical acceptability and feasibility, and finally obtaining high-level political support.. The technical exploration (Technical Dialogues—TD) was assumed by technical experts proposed by the countries, and political guidance was provided by the Assembly of Members (AoM), which gathered representatives from Ministries of Health and Science of EU/EEA countries. The results from the AoM and the TD were integrated in the sustainability plan compiling all the major outputs of InfAct. Results The InfAct sustainability plan was organized in three main sections: a proposal of a new research infrastructure on population health (the DIPoH), new health information tools and innovative proposals for HIS, and a comprehensive capacity building programme. These activities were carried out in InfAct and are being further developed in the Population Health Information Research Infrastructure (PHIRI). PHIRI is a practical rollout of DIPoH facilitating and generating the best available evidence for research on health and wellbeing of populations as impacted by COVID-19. Conclusions The sustainability plan received wide support from Member States and was recognized to have an added value at EU level. Nevertheless, there were several aspects which still need to be considered for the near future such as: (i) a commitment of stable financial and political support by Member States (MSs), (ii) the availability of resources at regional, national and European level to deal with innovations, and (iii) a more direct involvement from EU and international institutions such as the European Centre for Disease Prevention and Control (ECDC), the World Health Organization (WHO) and the Organisation for Economic Cooperation and Development OECD for providing support and sustainable contributions.
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Affiliation(s)
- Rodrigo Sarmiento-Suárez
- National School of Public Health. Instituto de Salud Carlos III, Avenida Monforte de Lemos 5, 28029, Madrid, Spain. .,Medicine School, University of Applied and Environmental Sciences, Calle 222 #55-37, Bogota, Colombia.
| | - Alicia Padron-Monedero
- National School of Public Health. Instituto de Salud Carlos III, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
| | - Petronille Bogaert
- Scientific Institute of Public Health, SciensanoRue Juliette, Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Linda Abboud
- Scientific Institute of Public Health, SciensanoRue Juliette, Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Herman Van Oyen
- Scientific Institute of Public Health, SciensanoRue Juliette, Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Hanna Tolonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Mannerheimintie 166, 00271, Helsinki, Finland
| | - Mariken Tijhuis
- National Institute for Public Health and the Environment RIVM, 3720 BA, Bilthoven, Netherlands
| | - Stefanie Seeling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, Berlin, Germany
| | - Romana Haneef
- Santé Publique France, 12 Rue du Val d'Osne, Allée Vacassy, 94410, Saint-Maurice, France
| | - Metka Zaletel
- National Institute of Public Health, Trubarjeva 2, 1000, Ljubljana, Slovenia
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore Di Sanità (ISS), Via Giano della Bella, 34, 00161, Rome, Italy
| | - Anne Gallay
- Santé Publique France, 12 Rue du Val d'Osne, Allée Vacassy, 94410, Saint-Maurice, France
| | - Luís Velez Lapão
- Instituto de Higiene E Medicina Tropical, Universidade NOVA de Lisboa, R. da Junqueira 100, 1349-008, Lisboa, Portugal
| | - Paulo Nogueira
- Instituto de Medicina Preventiva E Saúde Pública, Faculdade de Medicina da Universidade de Lisboa, 1649-028, Lisboa, Portugal
| | - Thomas Ziese
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, Berlin, Germany
| | - Jakov Vukovic
- Croatian Institute of Public Health, Rockefeller str 7, 10000, Zagreb, Croatia
| | - André Beja
- Instituto de Higiene E Medicina Tropical, Universidade NOVA de Lisboa, R. da Junqueira 100, 1349-008, Lisboa, Portugal
| | - Miriam Saso
- Scientific Institute of Public Health, SciensanoRue Juliette, Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Isabel Noguer-Zambrano
- National School of Public Health. Instituto de Salud Carlos III, Avenida Monforte de Lemos 5, 28029, Madrid, Spain
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8
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Haneef R, Tijhuis M, Thiébaut R, Májek O, Pristaš I, Tolonen H, Gallay A. Correction to: Methodological guidelines to estimate population-based health indicators using linked data and/or machine learning techniques. Arch Public Health 2022; 80:67. [PMID: 35193664 PMCID: PMC8864790 DOI: 10.1186/s13690-022-00831-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Romana Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France.
| | - Mariken Tijhuis
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Rodolphe Thiébaut
- Bordeaux University, Bordeaux School of Public Health, Bordeaux, France.,INSERM / INRIA SISTM team, Bordeaux Population Health, Bordeaux, France.,Medical Information Department, Bordeaux University Hospital, Bordeaux, France
| | - Ondřej Májek
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic.,Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Ivan Pristaš
- National Institute of Public Health, Division of Health Informatics and Biostatistics, Zagreb, Croatia
| | - Hanna Tolonen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Anne Gallay
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
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9
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Unim B, Mattei E, Carle F, Tolonen H, Bernal-Delgado E, Achterberg P, Zaletel M, Seeling S, Haneef R, Lorcy AC, Van Oyen H, Palmieri L. Correction to: Health data collection methods and procedures across EU member states: findings from the InfAct Joint Action on health information. Arch Public Health 2022; 80:51. [PMID: 35164869 PMCID: PMC8842969 DOI: 10.1186/s13690-022-00806-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Brigid Unim
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Via Giano della Bella 34, 00162, Rome, Italy.
| | - Eugenio Mattei
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Via Giano della Bella 34, 00162, Rome, Italy
| | - Flavia Carle
- Center of Epidemiology, Biostatistics and Medical Information, Marche Polytechnic University, Ancona, Italy
| | - Hanna Tolonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Enrique Bernal-Delgado
- Data Sciences for Health Services and Policy Research Group, Institute for Health Sciences in Aragon (IACS), Zaragoza, Spain
| | - Peter Achterberg
- Centre for Health Knowledge Integration, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Metka Zaletel
- Health Data Centre, National Institute of Public Health, Ljubljana, Slovenia
| | - Stefanie Seeling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Romana Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 94415, Saint-Maurice, France
| | | | - Herman Van Oyen
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Via Giano della Bella 34, 00162, Rome, Italy
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10
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Mathis-Edenhofer S, Röthlin F, Wachabauer D, Haneef R, Ventura I, Fülöp G. Regional health care profiles - an improved method for generating case studies on the catchment areas of envisaged primary health care units in Austria: a report to the InfAct Joint Action. Arch Public Health 2022; 80:50. [PMID: 35164880 PMCID: PMC8842556 DOI: 10.1186/s13690-022-00821-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 02/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background The recent Austrian Primary Care Act established new primary health care units (PHCUs) and obliged them to draw up a “care strategy” specifying their focal care tasks and objectives and emphasizing the health care needs of the population in their catchment area with its specific local health and epidemiological profile. The main purpose of these care strategies is thus to ensure that care-providers meet the local needs, but they also provide a rationale for evaluation and organizational development. To assist new PHCUs in establishing care strategies it was necessary to develop a method for automatically generating comprehensive local case studies for any freely definable location in Austria. Results We designed an interactive report generator capable of producing location-specific regional health care profiles for a PHCU located in any of Austria’s 2122 municipalities and of calculating the radius of its catchment area (defined by different levels of maximum car-travelling times). The reports so generated, called “regional health care profiles for primary health care” (RHCPs/PHC), are in comprehensive PDF report format. The core of each report is a set of 35 indicators, classified under five health and health service domains. The reports include an introductory text, definitions, a map, a graphic and tabular presentation of all indicator values, including information on local, supra-regional and national value distribution, a ranking, and numbers of service providers (e.g. pharmacies, surgeries, nursing homes) located within the catchment area. Conclusions The RHCPs/PHC support primary health care planning, efforts to improve care-effectiveness, and strategic organizational development by providing comprehensive information on the health of the population, the utilization of health services and the health care structures within the catchment area. In addition to revealing the scope and nature of the health care needed, they also provide information on what public health approaches are necessary. RHCPs/PHC for different locations have already been distributed to numerous stakeholders and primary health care providers in Austria.
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Affiliation(s)
- Stefan Mathis-Edenhofer
- The Austrian National Public Health Institute (Gesundheit Österreich GmbH, GÖG), Stubenring 6, 1010, Vienna, Austria.
| | - Florian Röthlin
- The Austrian National Public Health Institute (Gesundheit Österreich GmbH, GÖG), Stubenring 6, 1010, Vienna, Austria
| | - David Wachabauer
- The Austrian National Public Health Institute (Gesundheit Österreich GmbH, GÖG), Stubenring 6, 1010, Vienna, Austria
| | - Romana Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 12 rue du Val d'Osne, 94415, Saint-Maurice, France
| | - Ilana Ventura
- Federal Ministry of Social Affairs, Health, Care and Consumer Protection, Vienna, Austria
| | - Gerhard Fülöp
- The Austrian National Public Health Institute (Gesundheit Österreich GmbH, GÖG), Stubenring 6, 1010, Vienna, Austria
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11
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Padron-Monedero A, Suárez RS, Bogaert P, Abboud L, Van Oyen H, Tolonen H, Tijhuis MJ, Palmieri L, Haneef R, Gallay A, Lapao L, Nogueira PJ, Ziese T, Seeling S, Vukovic J, Noguer-Zambrano I. Integrating technical and political views for a sustainable European Distributed Infrastructure on Population Health. Arch Public Health 2022; 80:29. [PMID: 35039082 PMCID: PMC8761966 DOI: 10.1186/s13690-022-00790-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 01/07/2022] [Indexed: 11/22/2022] Open
Abstract
Background Non-Communicable diseases (NCD) are the main contributors to mortality and burden of disease. There is no infrastructure in Europe that could provide health information (HI) on Public Health monitoring and Health Systems Performance (HSP) for research and evidence-informed decision-making. Moreover, there was no EU and European Economic Area Member States (EU/EEA MSs) general consensus, on developing this initiative and guarantee its sustainability. The aim of this study is to analyze the integration of technical and political views made by the Joint Action on Health Information (InfAct; Information for Action) and the results obtained from those activities, in terms of advice and national and institutional support to develop an integrated and sustainable European Distributed Infrastructure on Population Health (DIPoH) for research and evidence-informed policy-making. Methods InfAct established two main boards, the Technical Dialogues (TDs) and the Assembly of Members (AoM), to provide a platform for discussion with EU/EEA MSs to establish a sustainable infrastructure for HI: 1) The TDs were composed by national technical experts (NTE) with the aim to discuss and provide feedback about scientific aspects, feasibility and EU-added value of the infrastructure proposed by InfAct. 2) The AoM gathered country representatives from Ministries of Health and Research at the highest political level, with the aim of providing policy-oriented advice for the future political acceptance, support, implementation, and development of InfAct’s outcomes including DIPoH. The documentation provided for the meetings consisted in Fact-Sheets, where the main results, new methods and proposals were clearly exposed for discussion and assessment; altogether with more extended information of the DIPoH. The documentation was provided to national representatives within one more before each TD and AoM meeting. The Agenda and methodological approaches for each TD and AoM meeting consisted in the presentations of the InfAct outcomes extending the information provided in the Fact-Sheets; followed by a non-structured interaction, exchange of information, discussion and suggestions by the MSs representatives. The outcomes of the non-structured discussions were collected in Minutes of the TD and AoM meetings, and the final version was obtained with the consensus of all participants. Additionally, structured letters of political support were provided to the AoM representatives, for them to consider providing their MS written support for DIPoH. Results NTE, within the TDs, considered that DIPoH was useful for technical mutual learning and cooperation among and within countries; although they considered that the technical feasibility to uptake InfAct deliverables at the national and EU level was complex. The AoM focused on political support, resources, and expected MSs returns. The AoM representatives agreed in the interest of setting up an integrated and sustainable HI infrastructure and they considered DIPoH to be well-articulated and defined; although, some of them, expressed some barriers for providing DIPoH political support. The AoM representatives stated that the AoM is the most suitable way to inform EU MSs/ACs about future advances of DIPoH. Both boards provided valuable feedback to develop this infrastructure. Eleven countries and sixteen institutions supported the proposal, either by letters of political support or by signing the Memorandum of Understandings (MoU) and three countries, additionally, provided expression of financial commitment, for DIPoH to be added to the ESFRI 2021 roadmap. Conclusions TDs and AoM were key forums to develop, advise, advocate and provide support for a sustainable European research infrastructure for Population Health.
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Affiliation(s)
- Alicia Padron-Monedero
- National School of Public Health, Instituto de Salud Carlos III. Av/ Monforte de Lemos 5, 28029, Madrid, Spain.
| | - Rodrigo Sarmiento Suárez
- National School of Public Health, Instituto de Salud Carlos III. Av/ Monforte de Lemos 5, 28029, Madrid, Spain
| | - Petronille Bogaert
- Department of Epidemiology and Public Health, Scientific Institute of Public Health. Sciensano, Brussels, Belgium
| | - Linda Abboud
- Department of Epidemiology and Public Health, Scientific Institute of Public Health. Sciensano, Brussels, Belgium
| | - Herman Van Oyen
- Department of Epidemiology and Public Health, Scientific Institute of Public Health. Sciensano, Brussels, Belgium.,Department of Public Health and Primary Care, Faculty of Medicine, Ghent University, Ghent, Belgium
| | - Hanna Tolonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Mannerheimintie 166, 00271, Helsinki, Finland
| | - Mariken J Tijhuis
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità (ISS), Via Giano della Bella, 34, 00161, Rome, Italy
| | | | - Anne Gallay
- Santé Publique France, Saint-Maurice, France
| | - Luis Lapao
- Institute of Hygiene and Tropical Medicine, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Paulo Jorge Nogueira
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina da Universidade de Lisboa, 1649-028, Lisbon, Portugal
| | | | | | - Jakov Vukovic
- Croatian Institute of Public Health (CIPH), Zagreb, Croatia
| | - Isabel Noguer-Zambrano
- National School of Public Health, Instituto de Salud Carlos III. Av/ Monforte de Lemos 5, 28029, Madrid, Spain
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12
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Unim B, Mattei E, Carle F, Tolonen H, Bernal-Delgado E, Achterberg P, Zaletel M, Seeling S, Haneef R, Lorcy AC, Van Oyen H, Palmieri L. Health data collection methods and procedures across EU member states: findings from the InfAct Joint Action on health information. Arch Public Health 2022; 80:17. [PMID: 34986889 PMCID: PMC8728985 DOI: 10.1186/s13690-021-00780-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 12/23/2021] [Indexed: 11/15/2022] Open
Abstract
Background Health-related data are collected from a variety of sources for different purposes, including secondary use for population health monitoring (HM) and health system performance assessment (HSPA). Most of these data sources are not included in databases of international organizations (e.g., WHO, OECD, Eurostat), limiting their use for research activities and policy making. This study aims at identifying and describing collection methods, quality assessment procedures, availability and accessibility of health data across EU Member States (MS) for HM and HSPA. Methods A structured questionnaire was developed and administered through an online platform to partners of the InfAct consortium form EU MS to investigate data collections applied in HM and HSPA projects, as well as their methods and procedures. A descriptive analysis of the questionnaire results was performed. Results Information on 91 projects from 18 EU MS was collected. In these projects, data were mainly collected through administrative sources, population health interview or health examination surveys and from electronic medical records. Tools and methods used for data collection were mostly mandatory reports, self-administered questionnaires, or record linkage of various data sources. One-third of the projects shared data with EU research networks and less than one-third performed quality assessment of their data collection procedures using international standardized criteria. Macrodata were accessible via open access and reusable in 22 projects. Microdata were accessible upon specific request and reusable in 15 projects based on data usage licenses. Metadata was available for the majority of the projects, but followed reporting standards only in 29 projects. Overall, compliance to FAIR Data principles (Findable, Accessible, Interoperable, and Reusable) was not optimal across the EU projects. Conclusions Data collection and exchange procedures differ across EU MS and research data are not always available, accessible, comparable or reusable for further research and evidence-based policy making. There is a need for an EU-level health information infrastructure and governance to promote and facilitate sharing and dissemination of standardized and comparable health data, following FAIR Data principles, across the EU. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00780-4.
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Affiliation(s)
- Brigid Unim
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Via Giano della Bella 34, 00162, Rome, Italy.
| | - Eugenio Mattei
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Via Giano della Bella 34, 00162, Rome, Italy
| | - Flavia Carle
- Center of Epidemiology, Biostatistics and Medical Information, Marche Polytechnic University, Ancona, Italy
| | - Hanna Tolonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Enrique Bernal-Delgado
- Data Sciences for Health Services and Policy Research Group, Institute for Health Sciences in Aragon (IACS), Zaragoza, Spain
| | - Peter Achterberg
- Centre for Health Knowledge Integration, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Metka Zaletel
- Health Data Centre, National Institute of Public Health, Ljubljana, Slovenia
| | - Stefanie Seeling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Romana Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 94415, Saint-Maurice, France
| | | | - Herman Van Oyen
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Via Giano della Bella 34, 00162, Rome, Italy
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13
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Haneef R, Tijhuis M, Thiébaut R, Májek O, Pristaš I, Tolenan H, Gallay A. Methodological guidelines to estimate population-based health indicators using linked data and/or machine learning techniques. Arch Public Health 2022; 80:9. [PMID: 34983651 PMCID: PMC8725299 DOI: 10.1186/s13690-021-00770-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 12/17/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The capacity to use data linkage and artificial intelligence to estimate and predict health indicators varies across European countries. However, the estimation of health indicators from linked administrative data is challenging due to several reasons such as variability in data sources and data collection methods resulting in reduced interoperability at various levels and timeliness, availability of a large number of variables, lack of skills and capacity to link and analyze big data. The main objective of this study is to develop the methodological guidelines calculating population-based health indicators to guide European countries using linked data and/or machine learning (ML) techniques with new methods. METHOD We have performed the following step-wise approach systematically to develop the methodological guidelines: i. Scientific literature review, ii. Identification of inspiring examples from European countries, and iii. Developing the checklist of guidelines contents. RESULTS We have developed the methodological guidelines, which provide a systematic approach for studies using linked data and/or ML-techniques to produce population-based health indicators. These guidelines include a detailed checklist of the following items: rationale and objective of the study (i.e., research question), study design, linked data sources, study population/sample size, study outcomes, data preparation, data analysis (i.e., statistical techniques, sensitivity analysis and potential issues during data analysis) and study limitations. CONCLUSIONS This is the first study to develop the methodological guidelines for studies focused on population health using linked data and/or machine learning techniques. These guidelines would support researchers to adopt and develop a systematic approach for high-quality research methods. There is a need for high-quality research methodologies using more linked data and ML-techniques to develop a structured cross-disciplinary approach for improving the population health information and thereby the population health.
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Affiliation(s)
- Romana Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France.
| | - Mariken Tijhuis
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Rodolphe Thiébaut
- Bordeaux University, Bordeaux School of Public Health, Bordeaux, France.,INSERM / INRIA SISTM team, Bordeaux Population health, Bordeaux, France.,Medical Information Department, Bordeaux University Hospital, Bordeaux, France
| | - Ondřej Májek
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic.,Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Ivan Pristaš
- National Institute of public health, division of health informatics and biostatistics, Zagreb, Croatia
| | - Hanna Tolenan
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Anne Gallay
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
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14
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Vasco Santos J, Padron Monedero A, Bikbov B, Grad DA, Plass D, Mechili EA, Gazzelloni F, Fischer F, Sulo G, Ngwa CH, Noguer-Zambrano I, Peñalvo J, Haagsma JA, Kissimova-Skarbek K, Monasta L, Ghith N, Sarmiento-Suarez R, Hrzic R, Haneef R, O'Caoimh R, Cuschieri S, Mondello S, Kabir Z, Devleesschauwer B. The state of health in the European Union in 2019. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The European Union (EU) faces many health-related challenges. Accurate and timely data on mortality and morbidity from diseases and injuries and their trends over time are essential for health planning and priority setting.
Methods
We use the GBD 2019 study estimates and 95% uncertainty intervals for the whole EU and each country to evaluate age-standardized death, YLL, YLD and DALY rates for Level 2 causes. We evaluate trends by comparing estimates for the year 2019 with those for the year 2010.
Results
In 2019, the age-standardized death and DALY rates in the EU were 465.8 and 20 251.0 per 100 000 inhabitants, respectively. Between 2010 and 2019, there were significant decreases for age-standardized, death and YLL rates across EU countries. However, YLD rates remained mainly unchanged, with increases in the Netherlands and the ‘. The largest decreases in age-standardized DALY rates were observed for HIV/AIDS and sexually transmitted diseases and transport injuries (both -19%). On the other hand, only diabetes and kidney diseases showed a significant increase for age-standardized DALY rates in the EU (3.5%). Mental disorders showed an increasing age-standardized YLD rate, as well.
Conclusions
Overall, there was a visible trend of improvement in the health status in the EU with substantial differences between countries. EU health policy makers need to tackle incidence of diseases and injuries, with specific attention to causes such as mental disorders. There are many opportunities for mutual learning among otherwise similar countries with different patterns of disease.
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Affiliation(s)
- J Vasco Santos
- European Burden of Disease Network (COST Action CA18218)
| | | | - B Bikbov
- European Burden of Disease Network (COST Action CA18218)
| | - DA Grad
- European Burden of Disease Network (COST Action CA18218)
| | - D Plass
- European Burden of Disease Network (COST Action CA18218)
| | - E-A Mechili
- European Burden of Disease Network (COST Action CA18218)
| | - F Gazzelloni
- European Burden of Disease Network (COST Action CA18218)
| | - F Fischer
- European Burden of Disease Network (COST Action CA18218)
| | - G Sulo
- European Burden of Disease Network (COST Action CA18218)
| | - CH Ngwa
- European Burden of Disease Network (COST Action CA18218)
| | | | - J Peñalvo
- European Burden of Disease Network (COST Action CA18218)
| | - JA Haagsma
- European Burden of Disease Network (COST Action CA18218)
| | | | - L Monasta
- European Burden of Disease Network (COST Action CA18218)
| | - N Ghith
- European Burden of Disease Network (COST Action CA18218)
| | | | - R Hrzic
- European Burden of Disease Network (COST Action CA18218)
| | - R Haneef
- European Burden of Disease Network (COST Action CA18218)
| | - R O'Caoimh
- European Burden of Disease Network (COST Action CA18218)
| | - S Cuschieri
- European Burden of Disease Network (COST Action CA18218)
| | - S Mondello
- European Burden of Disease Network (COST Action CA18218)
| | - Z Kabir
- European Burden of Disease Network (COST Action CA18218)
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15
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Haneef R, Constantinou P, Rachas A, Ghosn W, Kudjawu Y, Grave C, Torres M, Fayad M, Ung A, Bonaldi C. Quantifying the burden of premature mortality at national level in France in 2016. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Efforts to accurately measure premature mortality are important to monitor the impact of diseases and injuries on population health and to set policy priorities. This is an ongoing study with a strong collaboration between Santé Publique France and the French National Health Insurance, whose main objective is to provide the first national estimates of Years of Life Lost (YLLs) for all causes of death in France.
Methods
The French national health data system (SNDS) contains detailed nationwide causes of death data, reported using ICD-10 codes. We used the underlying cause, as defined by the Center for Epidemiology on Medical Causes of deaths, of all deaths for year 2016 (the last year available). For this preliminary study without redistribution of ill-defined deaths (IDDs), national sex-specific life expectancy tables were used to estimate YLLs by age class, sex, and cause of death categories at national level. We identified and quantified IDDs and also compared YLLs to crude mortality.
Results
In 2016, we estimated approximately 7.3 million YLLs (586,519 registered deaths), of which 35.1% were due to neoplasms, 17.8% to cardiovascular diseases (respectively 34.5% and 17.3% in men; 35.8% and 18.4% in women) and 10.3% to injuries (4.9% among people aged 65 or more at time of death; 34.5% among people aged 25-44). Approximately 27% of the deaths registered were IDDs, representing approximately 1.8 million YLLs.
Conclusions
These preliminary results confirm the importance of YLLs as a metric to target preventive strategies according to age. Moreover, by quantifying IDDs, we highlight that data gaps are important even in settings with highly developed health information systems. Next steps include applying an IDD redistribution methodology, aspirational life table and computing subnational YLLs. The French collaborative initiative should address those gaps and propose national and subnational burden metrics in the following months.
Key messages
Methodological and data requirements to compute YLLs constitute a challenge even in settings with developed health information systems, highlighting the need of national institutional collaborations. Highlight data gaps in terms of ill-defined deaths in mortality database.
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Affiliation(s)
- R Haneef
- Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - P Constantinou
- Department of Strategy, Studies and Statistics, French National Health Insurance, Paris, France
| | - A Rachas
- Department of Strategy, Studies and Statistics, French National Health Insurance, Paris, France
| | - W Ghosn
- INSERM, CépiDc, Epidemiological Center of Medical Causes of Death, Le Kremlin-Bicêtre, France
| | - Y Kudjawu
- Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - C Grave
- Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - M Torres
- Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - M Fayad
- Department of Strategy, Studies and Statistics, Santé Publique France, Saint-Maurice, France
| | - A Ung
- Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - C Bonaldi
- Department of Strategy, Studies and Statistics, Santé Publique France, Saint-Maurice, France
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16
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Vasco Santos J, Padron Monedero A, Kocbach Bolling A, Bikbov B, Unim B, Grad DA, Plass D, Fischer F, Violante FS, Sulo G, Ngwa CH, Noguer-Zambrano I, Peñalvo J, Haagsma JA, Kissimova-Skarbek K, Monasta L, Ghith N, Sigurvinsdóttir R, Sarmiento-Suarez R, Haneef R, Mondello S, Breitner S, Kabir Z, Devleesschauwer B. Burden of diseases and injuries attributable to risk factors in the European Union in 2019. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In addition to information on mortality and morbidity from diseases and injuries, it is important to identify the attributable burden of risk factors to allow for health planning and prioritization.
Methods
For the whole EU and each country, using estimates and 95% uncertainty intervals from the GBD 2019 study, we report attributable (all-cause and by level 2 risk factors) age-standardized death and DALY rates, as well as summary exposure values (SEV). We evaluate trends by comparing estimates for the year 2019 with those for the year 2010.
Results
Age-standardized death and DALY rates attributable to risk factors declined by 10.7% (95%UI 13.8%-7.6%) and 9.1% (95%UI 12.0%-6.3%), between 2010 and 2019 in the EU. While there was a decreasing trend for both age-standardized death and DALY rates for almost all risk factors, some showed an increasing trend on SEV, including low physical activity and intimate partner violence.
Conclusions
Despite the improvement of health metrics attributable to risk factors, several modifiable behavioral and metabolic risk factors remain unchanged over the years. It is crucial to ensure a swift implementation of evidence-based policies and interventions in EU member states to achieve the targets of the Sustainable Development Goals.
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Affiliation(s)
- J Vasco Santos
- European Burden of Disease Network (COST Action CA18218)
| | | | | | - B Bikbov
- European Burden of Disease Network (COST Action CA18218)
| | - B Unim
- European Burden of Disease Network (COST Action CA18218)
| | - DA Grad
- European Burden of Disease Network (COST Action CA18218)
| | - D Plass
- European Burden of Disease Network (COST Action CA18218)
| | - F Fischer
- European Burden of Disease Network (COST Action CA18218)
| | - FS Violante
- European Burden of Disease Network (COST Action CA18218)
| | - G Sulo
- European Burden of Disease Network (COST Action CA18218)
| | - CH Ngwa
- European Burden of Disease Network (COST Action CA18218)
| | | | - J Peñalvo
- European Burden of Disease Network (COST Action CA18218)
| | - JA Haagsma
- European Burden of Disease Network (COST Action CA18218)
| | | | - L Monasta
- European Burden of Disease Network (COST Action CA18218)
| | - N Ghith
- European Burden of Disease Network (COST Action CA18218)
| | | | | | - R Haneef
- European Burden of Disease Network (COST Action CA18218)
| | - S Mondello
- European Burden of Disease Network (COST Action CA18218)
| | - S Breitner
- European Burden of Disease Network (COST Action CA18218)
| | - Z Kabir
- European Burden of Disease Network (COST Action CA18218)
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17
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Haneef R, Kab S, Hrzic R, Fuentes S, Fosse-Edorh S, Cosson E, Gallay A. Use of artificial intelligence for public health surveillance: a case study to develop a machine Learning-algorithm to estimate the incidence of diabetes mellitus in France. ACTA ACUST UNITED AC 2021; 79:168. [PMID: 34551816 PMCID: PMC8456679 DOI: 10.1186/s13690-021-00687-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 09/02/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The use of machine learning techniques is increasing in healthcare which allows to estimate and predict health outcomes from large administrative data sets more efficiently. The main objective of this study was to develop a generic machine learning (ML) algorithm to estimate the incidence of diabetes based on the number of reimbursements over the last 2 years. METHODS We selected a final data set from a population-based epidemiological cohort (i.e., CONSTANCES) linked with French National Health Database (i.e., SNDS). To develop this algorithm, we adopted a supervised ML approach. Following steps were performed: i. selection of final data set, ii. target definition, iii. Coding variables for a given window of time, iv. split final data into training and test data sets, v. variables selection, vi. training model, vii. Validation of model with test data set and viii. Selection of the model. We used the area under the receiver operating characteristic curve (AUC) to select the best algorithm. RESULTS The final data set used to develop the algorithm included 44,659 participants from CONSTANCES. Out of 3468 variables from SNDS linked to CONSTANCES cohort were coded, 23 variables were selected to train different algorithms. The final algorithm to estimate the incidence of diabetes was a Linear Discriminant Analysis model based on number of reimbursements of selected variables related to biological tests, drugs, medical acts and hospitalization without a procedure over the last 2 years. This algorithm has a sensitivity of 62%, a specificity of 67% and an accuracy of 67% [95% CI: 0.66-0.68]. CONCLUSIONS Supervised ML is an innovative tool for the development of new methods to exploit large health administrative databases. In context of InfAct project, we have developed and applied the first time a generic ML-algorithm to estimate the incidence of diabetes for public health surveillance. The ML-algorithm we have developed, has a moderate performance. The next step is to apply this algorithm on SNDS to estimate the incidence of type 2 diabetes cases. More research is needed to apply various MLTs to estimate the incidence of various health conditions.
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Affiliation(s)
- Romana Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 12 rue du Val d'Onse, 94415, Saint-Maurice, France.
| | - Sofiane Kab
- Population-Based Epidemiological Cohorts Unit, INSERM UMS 011, Villejuif, France
| | - Rok Hrzic
- Department of International Health, Care and Public Health Research Institute - CAPHRI, University of Maastricht University, Maastricht, The Netherlands
| | - Sonsoles Fuentes
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 12 rue du Val d'Onse, 94415, Saint-Maurice, France
| | - Sandrine Fosse-Edorh
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 12 rue du Val d'Onse, 94415, Saint-Maurice, France
| | - Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France.,Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
| | - Anne Gallay
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 12 rue du Val d'Onse, 94415, Saint-Maurice, France
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18
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Haneef R, Schmidt J, Gallay A, Devleesschauwer B, Grant I, Rommel A, Wyper GM, Van Oyen H, Hilderink H, Ziese T, Newton J. Recommendations to plan a national burden of disease study. ACTA ACUST UNITED AC 2021; 79:126. [PMID: 34233754 PMCID: PMC8262070 DOI: 10.1186/s13690-021-00652-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/27/2021] [Indexed: 11/17/2022]
Abstract
Background The InfAct (Information for Action) project is a European Commission Joint Action on Health Information which has promoted the potential role of burden of disease (BoD) approaches to improve the current European Union-Health Information System (EU-HIS). It has done so by raising awareness of the concept, the methods used to calculate estimates and their potential implications and uses in policymaking. The BoD approach is a systematic and scientific effort to quantify and compare the magnitude of health loss due to different diseases, injuries, and risk factors with estimates produced by demographic characteristics and geographies for specific points in time. Not all countries have the resources to undertake such work, and may therefore start with a more restricted objective, e.g., a limited number of diseases, or the use of simple measures of population health such as disease prevalence or life expectancy. The main objective to develop these recommendations was to facilitate those countries planning to start a national burden of disease study. Results These recommendations could be considered as minimum requirements for those countries planning to start a BoD study and includes following elements: (1) Define the objectives of a burden of disease study within the context of your country, (2) Identify, communicate and secure the benefits of performing national burden of disease studies, (3) Secure access to the minimum required data sources, (4) Ensure the minimum required capacity and capability is available to carry out burden of disease study, (5) Establish a clear governance structure for the burden of disease study and stakeholder engagement/involvement, (6) Choose the appropriate methodological approaches and (7) Knowledge translation. These were guided by the results from our survey performed to identify the needs of European countries for BoD studies, a narrative overview from four European countries (Belgium, Germany, The Netherlands and Scotland) and the summary of a comparative study of country health profiles with national health statistics. Conclusions These recommendations as minimum requirements would facilitate efforts by those European countries who intend to perform national BoD studies. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00652-x.
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Affiliation(s)
- Romana Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 12 rue du Val d'Osne, 94415, Saint-Maurice Cedex, France.
| | | | - Anne Gallay
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 12 rue du Val d'Osne, 94415, Saint-Maurice Cedex, France
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.,Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
| | - Ian Grant
- Public Health Scotland, Edinburgh, Scotland, UK
| | - Alexander Rommel
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | | | - Herman Van Oyen
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.,Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
| | - Henk Hilderink
- Centre for Public Health Forecasting, National Institute for Public Health and the Environment (RIVM), Bilthoven Utrecht, Utrecht, The Netherlands
| | - Thomas Ziese
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - John Newton
- Health Improvement, Public Health England, London, UK
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19
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Thißen M, Seeling S, Achterberg P, Fehr A, Haneef R, Palmieri L, Tijhuis M, Unim B, Ziese T. Developing recommendations for good practice in national health reporting. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
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.
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Affiliation(s)
- M Thißen
- Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - S Seeling
- Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - P Achterberg
- Centre for Health Knowledge Integration, RIVM, Bilthoven, Netherlands
| | - A Fehr
- Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - R Haneef
- Non-Communicable Diseases and Injuries, Santé Publique France, Paris, France
| | - L Palmieri
- Cardiovascular Endocrine-metabolic Diseases and Aging, National Institute of Health, Rome, Italy
| | - M Tijhuis
- Centre for Health Knowledge Integration, RIVM, Bilthoven, Netherlands
| | - B Unim
- Cardiovascular Endocrine-metabolic Diseases and Aging, National Institute of Health, Rome, Italy
| | - T Ziese
- Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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20
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Haneef R, Fuentes S, Hrzic R, Fosse-Edorh S, Kab S, Gallay A, Cosson E. Use of artificial intelligence to estimate population health indicators in France. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The use of artificial intelligence is increasing to estimate and predict health outcomes from large data sets. The main objectives were to develop two algorithms using machine learning techniques to identify new cases of diabetes (case study I) and to classify type 1 and type 2 (case study II) in France.
Methods
We selected the training data set from a cohort study linked with French national Health database (i.e., SNDS). Two final datasets were used to achieve each objective. A supervised machine learning method including eight following steps was developed: the selection of the data set, case definition, coding and standardization of variables, split data into training and test data sets, variable selection, training, validation and selection of the model. We planned to apply the trained models on the SNDS to estimate the incidence of diabetes and the prevalence of type 1/2 diabetes.
Results
For the case study I, 23/3468 and for case study II, 14/3481 SNDS variables were selected based on an optimal balance between variance explained and using the ReliefExp algorithm. We trained four models using different classification algorithms on the training data set. The Linear Discriminant Analysis model performed best in both case studies. The models were assessed on the test datasets and achieved a specificity of 67% and a sensitivity of 62% in case study I, and a specificity of 97 % and sensitivity of 100% in case study II. The case study II model was applied to the SNDS and estimated the prevalence of type 1 diabetes in 2016 in France of 0.3% and for type 2, 4.4%. The case study model I was not applied to the SNDS.
Conclusions
The case study II model to estimate the prevalence of type 1/2 diabetes has good performance and will be used in routine surveillance. The case study I model to identify new cases of diabetes showed a poor performance due to missing necessary information on determinants of diabetes and will need to be improved for further research.
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Affiliation(s)
- R Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint Maurice, France
| | - S Fuentes
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint Maurice, France
| | - R Hrzic
- Faculty of Health, Medicine and Life Sciences, International Health, School for Public Health and Prim Care, Maastricht University, Maastricht, Netherlands
| | - S Fosse-Edorh
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint Maurice, France
| | - S Kab
- Population-Based Epidemiological Cohorts Unit, Inserm UMS 011, Villejuif, France
| | - A Gallay
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint Maurice, France
| | - E Cosson
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
- UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Sorbonne Paris Cité, Bobigny, France
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21
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Haneef R, Delnord M, Vernay M, Bauchet E, Gaidelyte R, Van Oyen H, Or Z, Pérez-Gómez B, Palmieri L, Achterberg P, Tijhuis M, Zaletel M, Mathis-Edenhofer S, Májek O, Haaheim H, Tolonen H, Gallay A. Innovative use of data sources: a cross-sectional study of data linkage and artificial intelligence practices across European countries. ACTA ACUST UNITED AC 2020; 78:55. [PMID: 32537143 PMCID: PMC7288525 DOI: 10.1186/s13690-020-00436-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 06/02/2020] [Indexed: 11/10/2022]
Abstract
Background The availability of data generated from different sources is increasing with the possibility to link these data sources with each other. However, linked administrative data can be complex to use and may require advanced expertise and skills in statistical analysis. The main objectives of this study were to describe the current use of data linkage at the individual level and artificial intelligence (AI) in routine public health activities, to identify the related estimated health indicators (i.e., outcome and intervention indicators) and health determinants of non-communicable diseases and the obstacles to linking different data sources. Method We performed a survey across European countries to explore the current practices applied by national institutes of public health, health information and statistics for innovative use of data sources (i.e., the use of data linkage and/or AI). Results The use of data linkage and AI at national institutes of public health, health information and statistics in Europe varies. The majority of European countries use data linkage in routine by applying a deterministic method or a combination of two types of linkages (i.e., deterministic & probabilistic) for public health surveillance and research purposes. The use of AI to estimate health indicators is not frequent at national institutes of public health, health information and statistics. Using linked data, 46 health outcome indicators, 34 health determinants and 23 health intervention indicators were estimated in routine. The complex data regulation laws, lack of human resources, skills and problems with data governance, were reported by European countries as obstacles to routine data linkage for public health surveillance and research. Conclusions Our results highlight that the majority of European countries have integrated data linkage in their routine public health activities but only a few use AI. A sustainable national health information system and a robust data governance framework allowing to link different data sources are essential to support evidence-informed health policy development. Building analytical capacity and raising awareness of the added value of data linkage in national institutes is necessary for improving the use of linked data in order to improve the quality of public health surveillance and monitoring activities.
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Affiliation(s)
- Romana Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 12 rue du Val d'Osne, 94415 Saint-Maurice, France
| | - Marie Delnord
- Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Michel Vernay
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 12 rue du Val d'Osne, 94415 Saint-Maurice, France
| | - Emmanuelle Bauchet
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 12 rue du Val d'Osne, 94415 Saint-Maurice, France
| | - Rita Gaidelyte
- Health information centre, Institute of hygiene, Vilnius, Lithuania
| | - Herman Van Oyen
- Epidemiology and public health, Sciensano, Brussels, Belgium.,Department of public health, Ghent University, Ghent, Belgium
| | - Zeynep Or
- Institute of research and information for health economics, Paris, France
| | - Beatriz Pérez-Gómez
- National Centre for Epidemiology & CIBERESP, Carlos III Institute of Health, Madrid, Spain
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, National Institute of Health, Rome, Italy
| | - Peter Achterberg
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Mariken Tijhuis
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Metka Zaletel
- National Institute of Public Health (NIJZ), Ljubljana, Slovenia
| | - Stefan Mathis-Edenhofer
- The Austrian National Public Health Institute (Gesundheit Österreich GmbH, GÖG), Vienna, Austria
| | - Ondřej Májek
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic.,Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | | | - Hanna Tolonen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Anne Gallay
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 12 rue du Val d'Osne, 94415 Saint-Maurice, France
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22
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Haneef R, Gallay A, Hilderink H, Devleesschauwer B, Ziese T, Schmidt J, Newton J. Development of composite indicators to monitor burden of disease across Member States. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The burden of disease (BoD) methods are not part of routine public health activities and policy development process across all Member States (MSs). The main reasons for this are varying levels of knowledge, experience, and capability to apply and use BoD methods. Therefore, MSs need support, guidance and training to adopt and integrate BoD approaches in their public health systems. In this context, two workshops have been organised by InfAct. The main objectives of the workshops are to raise awareness, share knowledge and experience, and to provide mutual support to to integrate BoD indicators in the public health policies across Europe.
Methods
The workshops were about the BoD concept and methodologies, and the use of BoD data in public health policy. These workshops were supported by technical presentations describing methods and the use of BoD data in health policy with various case studies, followed by expert exchange with facilitated discussions and group work. The case studies included national BoD studies from Belgium, Germany, Netherland, and Scotland.
Results
Two workshops were held at Santé Publique France, and attended by 16 BoD experts and 40 participants from 25 MSs. The workshops were well received by the participants particularly with regards to the diversity of the group and the possibility to share knowledge and experience from various perspectives. Three areas of action were highlighted: 1. the need for methodological trainings to strengthen skills in interpreting and calculating BoD estimates; 2. the encouragement of more collaborations across MSs to share or exchange good practices on BoD; and 3. the importance of the implications of BoD data to guide policies across MSs.
Conclusions
The workshops highlighted the need for capacity building activities to implement BoD approaches across MSs in routine public health activities and to use BoD data to guide health policy. More collaborations among MSs on BoD activities are needed in the future.
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Affiliation(s)
- R Haneef
- Departement of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - A Gallay
- Departement of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - H Hilderink
- Centre for Public Health Forecasting, RIVM, Bilthoven, Netherlands
| | - B Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
| | - T Ziese
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - J Schmidt
- Health Improvement, Public Health England, London, UK
| | - J Newton
- Health Improvement, Public Health England, London, UK
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23
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Haneef R, Oyen HV, Gaidelyte R, Zeynep O, Pérez-Gomez B, Haaheim H, Palmieri L, Mathis-Edenhofer S, Majek O, Gallay A. The innovative use of health information in public health policy across EU-Member States. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Health information systems both at the national and international level play a key role in ensuring that timely and reliable evidence is used for operational and strategic decision making inside and outside the health sector. The availability of data generated from different sources is increasing with the possibility to link these data sources together. However, more efficient data generation processes are required to use data collected for different purposes initially, as well as advanced statistical techniques to generate comparable and timely health information. The main objective is to explore the innovative use of health information for better public health policy across the Member States.
Methods
As part of InfAct, we have conducted as survey among EU-MS to describe the innovative use of data sources. We are collecting inspiring examples on the innovative use of health information based on national or European data networks involved with health policy-making at national, regional or local level. We are further developing generic methods to estimate health indicators using machine learning techniques and mathematical modelling.
Results
These approaches will generate a roadmap on the innovative use of health information across Member States, enlarge the existing list of health indicators estimated from linked data and/or advanced statistical techniques, inform on the implications of these indicators in health policy with inspiring examples from Member States, and provide methodological guidelines for using linked data and advanced statistics to estimate health indicators, and composite outcome measures.
Conclusions
This work will highlight the gaps in the innovative use of data sources, and improve the comparability of health indicators and the capacity of EU-Member states to apply innovation for increased relevance and timeliness of health information for public health policy-making.
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Affiliation(s)
- R Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint Maurice, France
| | - H Van Oyen
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - R Gaidelyte
- Health Information Centre, Institute of Hygiene, Vilnius, Slovenia
| | - O Zeynep
- Institute of Research and Information for Health Economics, Paris, France
| | | | - H Haaheim
- The Norwegian Directorate of Health, Oslo, Norway
| | - L Palmieri
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, National Institute of Health, Rome, Italy
| | - S Mathis-Edenhofer
- Federal Ministry of Labour, Social Affairs, Health and Consumer Protection, Vienna, Austria
| | - O Majek
- Institute of Health Information and Statistics, Prague, Czech Republic
| | - A Gallay
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint Maurice, France
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24
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Boutron I, Haneef R, Yavchitz A, Baron G, Novack J, Oransky I, Schwitzer G, Ravaud P. Correction to: Three randomized controlled trials evaluating the impact of "spin" in health news stories reporting studies of pharmacologic treatments on patients'/caregivers' interpretation of treatment benefit. BMC Med 2019; 17:147. [PMID: 31349847 PMCID: PMC6660928 DOI: 10.1186/s12916-019-1388-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 07/11/2019] [Indexed: 11/16/2022] Open
Abstract
Figure 3 in the original article [1] is incorrect; labels for secondary outcomes have been shifted and do not correspond to the numbers reported in the table (Additional file 8). The corrected version can be seen ahead. This figure should be used over the figure 3 seen in the original article. This error does not affect the results, interpretation, or conclusion.
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Affiliation(s)
- Isabelle Boutron
- INSERM, UMR 1153, Epidemiology and Biostatistics Research Center (CRESS), Methods Team, Paris, France. .,Faculté de Médecine, Paris Descartes University, Paris, France. .,Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, 1, Place du parvis Notre Dame, 75004, Paris Cedex 4, France.
| | - Romana Haneef
- INSERM, UMR 1153, Epidemiology and Biostatistics Research Center (CRESS), Methods Team, Paris, France.,Faculté de Médecine, Paris Descartes University, Paris, France.,Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, 1, Place du parvis Notre Dame, 75004, Paris Cedex 4, France
| | - Amélie Yavchitz
- INSERM, UMR 1153, Epidemiology and Biostatistics Research Center (CRESS), Methods Team, Paris, France.,Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, 1, Place du parvis Notre Dame, 75004, Paris Cedex 4, France
| | - Gabriel Baron
- Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, 1, Place du parvis Notre Dame, 75004, Paris Cedex 4, France
| | | | - Ivan Oransky
- New York University's Arthur Carter Journalism Institute, New York, USA
| | - Gary Schwitzer
- HealthNewsReview.org, University of Minnesota, School of Public Health, Minneapolis, MN, USA
| | - Philippe Ravaud
- INSERM, UMR 1153, Epidemiology and Biostatistics Research Center (CRESS), Methods Team, Paris, France.,Faculté de Médecine, Paris Descartes University, Paris, France.,Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, 1, Place du parvis Notre Dame, 75004, Paris Cedex 4, France.,Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
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25
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Boutron I, Haneef R, Yavchitz A, Baron G, Novack J, Oransky I, Schwitzer G, Ravaud P. Three randomized controlled trials evaluating the impact of "spin" in health news stories reporting studies of pharmacologic treatments on patients'/caregivers' interpretation of treatment benefit. BMC Med 2019; 17:105. [PMID: 31159786 PMCID: PMC6547451 DOI: 10.1186/s12916-019-1330-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/25/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND News stories represent an important source of information. We aimed to evaluate the impact of "spin" (i.e., misrepresentation of study results) in health news stories reporting studies of pharmacologic treatments on patients'/caregivers' interpretation of treatment benefit. METHODS We conducted three two-arm, parallel-group, Internet-based randomized trials (RCTs) comparing the interpretation of news stories reported with or without spin. Each RCT considered news stories reporting a different type of study: (1) pre-clinical study, (2) phase I/II non-RCT, and (3) phase III/IV RCT. For each type of study, we identified news stories reported with spin that had earned mention in the press. Two versions of the news stories were used: the version with spin and a version rewritten without spin. Participants were patients/caregivers involved in Inspire, a large online community of more than one million patients/caregivers. The primary outcome was participants' interpretation assessed by one specific question "What do you think is the probability that 'treatment X' would be beneficial to patients?" (scale, 0 [very unlikely] to 10 [very likely]). RESULTS For each RCT, 300 participants were randomly assigned to assess a news story with spin (n = 150) or without spin (n = 150), and 900 participants assessed a news story. Participants were more likely to consider that the treatment would be beneficial to patients when the news story was reported with spin. The mean (SD) score for the primary outcome for abstracts reported with and without spin for pre-clinical studies was 7.5 (2.2) versus 5.8 (2.8) (mean difference [95% CI] 1.7 [1.0-2.3], p < 0.001); for phase I/II non-randomized trials, 7.6 (2.2) versus 5.8 (2.7) (mean difference 1.8 [1.0-2.5], p < 0.001); and for phase III/IV RCTs, 7.2 (2.3) versus 4.9 (2.8) (mean difference 2.3 [1.4-3.2], p < 0.001). CONCLUSIONS Spin in health news stories reporting studies of pharmacologic treatments affects patients'/caregivers' interpretation. TRIAL REGISTRATION ClinicalTrials.gov, NCT03094078 , NCT03094104 , NCT03095586.
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Affiliation(s)
- Isabelle Boutron
- INSERM, UMR 1153, Epidemiology and Biostatistics Research Center (CRESS), Methods Team, Paris, France. .,Faculté de Médecine, Paris Descartes University, Paris, France. .,Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, 1, Place du parvis Notre Dame, 75004, Paris Cedex 4, France.
| | - Romana Haneef
- INSERM, UMR 1153, Epidemiology and Biostatistics Research Center (CRESS), Methods Team, Paris, France.,Faculté de Médecine, Paris Descartes University, Paris, France.,Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, 1, Place du parvis Notre Dame, 75004, Paris Cedex 4, France
| | - Amélie Yavchitz
- INSERM, UMR 1153, Epidemiology and Biostatistics Research Center (CRESS), Methods Team, Paris, France.,Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, 1, Place du parvis Notre Dame, 75004, Paris Cedex 4, France
| | - Gabriel Baron
- Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, 1, Place du parvis Notre Dame, 75004, Paris Cedex 4, France
| | | | - Ivan Oransky
- New York University's Arthur Carter Journalism Institute, New York, USA
| | - Gary Schwitzer
- HealthNewsReview.org, University of Minnesota, School of Public Health, Minneapolis, MN, USA
| | - Philippe Ravaud
- INSERM, UMR 1153, Epidemiology and Biostatistics Research Center (CRESS), Methods Team, Paris, France.,Faculté de Médecine, Paris Descartes University, Paris, France.,Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, 1, Place du parvis Notre Dame, 75004, Paris Cedex 4, France.,Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
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26
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Haneef R, Yavchitz A, Ravaud P, Baron G, Oranksy I, Schwitzer G, Boutron I. Interpretation of health news items reported with or without spin: protocol for a prospective meta-analysis of 16 randomised controlled trials. BMJ Open 2017; 7:e017425. [PMID: 29151047 PMCID: PMC5702017 DOI: 10.1136/bmjopen-2017-017425] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 09/09/2017] [Accepted: 09/22/2017] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION We aim to compare the interpretation of health news items reported with or without spin. 'Spin' is defined as a misrepresentation of study results, regardless of motive (intentionally or unintentionally) that overemphasises the beneficial effects of the intervention and overstates safety compared with that shown by the results. METHODS AND ANALYSIS We have planned a series of 16 randomised controlled trials (RCTs) to perform a prospective meta-analysis. We will select a sample of health news items reporting the results of four types of study designs, evaluating the effect of pharmacological treatment and containing the highest amount of spin in the headline and text. News items reporting four types of studies will be included: (1) preclinical studies; (2) phase I/II (non-randomised) trials; (3) RCTs and (4) observational studies. We will rewrite the selected news items and remove the spin. The original news and rewritten news will be appraised by four types of populations: (1) French-speaking patients; (2) French-speaking general public; (3) English-speaking patients and (4) English-speaking general public. Each RCT will explore the interpretation of news items reporting one of the four study designs by each type of population and will include a sample size of 300 participants. The primary outcome will be participants' interpretation of the benefit of treatment after reading the news items: (What do you think is the probability that treatment X would be beneficial to patients? (scale, 0 (very unlikely) to 10 (very likely)).This study will evaluate the impact of spin on the interpretation of health news reporting results of studies by patients and the general public. ETHICS AND DISSEMINATION This study has obtained ethics approval from the Institutional Review Board of the Institut national de la santé et de la recherche médicale (INSERM) (registration no: IRB00003888). The description of all the steps and the results of this prospective meta-analysis will be available online and will be disseminated as a published article. On the completion of this study, the results will be sent to all participants. PROSPERO REGISTRATION NUMBER CRD42017058941.
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Affiliation(s)
- Romana Haneef
- METHODS team, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), UMR 1153, INSERM, Paris, France
- Faculté de Médecine, Sorbonne Paris Cité, Paris Descartes University, Paris, France
- Centre d’Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Paris, France
| | - Amélie Yavchitz
- METHODS team, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), UMR 1153, INSERM, Paris, France
- Centre d’Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Paris, France
- Cochrane France, Cochrane, Paris, France
| | - Philippe Ravaud
- METHODS team, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), UMR 1153, INSERM, Paris, France
- Faculté de Médecine, Sorbonne Paris Cité, Paris Descartes University, Paris, France
- Centre d’Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Paris, France
- Cochrane France, Cochrane, Paris, France
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Gabriel Baron
- Centre d’Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Paris, France
| | - Ivan Oranksy
- Arthur Carter Journalism Institute, New York University, New York, USA
| | - Gary Schwitzer
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Isabelle Boutron
- METHODS team, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), UMR 1153, INSERM, Paris, France
- Faculté de Médecine, Sorbonne Paris Cité, Paris Descartes University, Paris, France
- Centre d’Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Paris, France
- Cochrane France, Cochrane, Paris, France
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27
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Abstract
OBJECTIVE To explore how the results from the 2014 dual antiplatelet therapy (DAPT) trial were disseminated to the scientific community and online media. DESIGN A a systematic review of scholarly and public attention surrounding the DAPT study. SETTINGS Data were collected from the ISI Web of Knowledge, Google Scholar, PubMed Commons, EurekAlert, the DAPT study website (www.daptstudy.org) and the New England Journal of Medicine website (for scholarly attention) and Altmetric Explorer, Snap Bird, YouTube (for public attention) citing DAPT study results appearing from 16 November 2014 to 10 June 2015. PARTICIPANTS No participants were involved in this study. MAIN OUTCOME MEASURE Proportion of contents highlighting the increased risk of mortality and critical to the author's interpretation of the results. RESULTS We identified 425 items reported by seven sources; 164 (39%) disseminated the authors' interpretation via an electronic link or a reference, with no additional text. Among 81 items (19 %), the message favoured prolonged treatment and consequently overstated the article conclusions. Among 119 items (28 %), the text was uncertain about the benefit of prolonged treatment but was reported with no or inappropriate mention of increased risk of mortality. Only 34 items (8 %) were uncertain about the benefit of prolonged treatment and mentioned increased risk of mortality. In all, 27 items (6 %) did not favour prolonged treatment, and only 12 of these (3 %) clearly raised some concerns about the reporting of increased risk of death. CONCLUSION Dissemination of the DAPT study results to the scientific community and on different media sources rarely criticised the interpretation of the study results.
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Affiliation(s)
- Melissa K Sharp
- Mailman School of Public Health, Columbia University, New York, USA
- METHODS Team, Center of Research in Epidemiology and Statistics Sorbonne Paris Cité INSERM UMR 1153, Paris, France
- University of Paris Descartes, Paris, France
| | - Romana Haneef
- METHODS Team, Center of Research in Epidemiology and Statistics Sorbonne Paris Cité INSERM UMR 1153, Paris, France
- University of Paris Descartes, Paris, France
- Centre d'épidémiologie clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Philippe Ravaud
- Mailman School of Public Health, Columbia University, New York, USA
- METHODS Team, Center of Research in Epidemiology and Statistics Sorbonne Paris Cité INSERM UMR 1153, Paris, France
- University of Paris Descartes, Paris, France
- Centre d'épidémiologie clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
- Cochrane France, Paris, France
| | - Isabelle Boutron
- METHODS Team, Center of Research in Epidemiology and Statistics Sorbonne Paris Cité INSERM UMR 1153, Paris, France
- University of Paris Descartes, Paris, France
- Centre d'épidémiologie clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
- Cochrane France, Paris, France
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Haneef R, Ravaud P, Baron G, Ghosn L, Boutron I. Factors associated with online media attention to research: a cohort study of articles evaluating cancer treatments. Res Integr Peer Rev 2017; 2:9. [PMID: 29451556 PMCID: PMC5803628 DOI: 10.1186/s41073-017-0033-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 05/05/2017] [Indexed: 11/22/2022] Open
Abstract
Background New metrics have been developed to assess the impact of research and provide an indication of online media attention and data dissemination. We aimed to describe online media attention of articles evaluating cancer treatments and identify the factors associated with high online media attention. Methods We systematically searched MEDLINE via PubMed on March 1, 2015 for articles published during the first 6 months of 2014 in oncology and medical journals with a diverse range of impact factors, from 3.9 to 54.4, and selected a sample of articles evaluating a cancer treatment regardless of study design. Altmetric Explorer was used to identify online media attention of selected articles. The primary outcome was media attention an article received online as measured by Altmetric score (i.e., number of mentions in online news outlets, science blogs and social media). Regression analysis was performed to investigate the factors associated with high media attention, and regression coefficients represent the logarithm of ratio of mean (RoM) values of Altmetric score per unit change in the covariate. Results Among 792 articles, 218 (27.5%) received no online media attention (Altmetric score = 0). The median [Q1–Q3] Altmetric score was 2.0 [0.0–8.0], range 0.0–428.0. On multivariate analysis, factors associated with high Altmetric score were presence of a press release (RoM = 10.14, 95%CI [4.91–20.96]), open access to the article (RoM = 1.48, 95%CI [1.02–2.16]), and journal impact factor (RoM = 1.10, 95%CI [1.07–1.12]. As compared with observational studies, systematic reviews were not associated with high Altmetric score (RoM = 1.46, 95%CI [0.74–2.86]; P = 0.27), nor were RCTs (RoM = 0.65, 95%CI [0.41–1.02]; P = 0.059) and phase I/II non-RCTs (RoM = 0.58, 95%CI [0.33–1.05]; P = 0.07). The articles with abstract conclusions favouring study treatments were not associated with high Altmetric score (RoM = 0.97, 95%CI [0.60–1.58]; P = 0.91). Conclusions Most important factors associated with high online media attention were the presence of a press release and the journal impact factor. There was no evidence that study design with high level of evidence and type of abstract conclusion were associated with high online media attention. Electronic supplementary material The online version of this article (doi:10.1186/s41073-017-0033-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Romana Haneef
- INSERM, UMR 1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS team, University of Paris Descartes, Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Paris, France.,2Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Paris, France
| | - Philippe Ravaud
- INSERM, UMR 1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS team, University of Paris Descartes, Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Paris, France.,2Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Paris, France.,French Cochrane Center, Paris, France.,5Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY USA
| | - Gabriel Baron
- Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Paris, France
| | - Lina Ghosn
- 2Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Isabelle Boutron
- INSERM, UMR 1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS team, University of Paris Descartes, Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Paris, France.,2Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Paris, France.,French Cochrane Center, Paris, France
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Lazarus C, Haneef R, Ravaud P, Hopewell S, Altman DG, Boutron I. Peer reviewers identified spin in manuscripts of nonrandomized studies assessing therapeutic interventions, but their impact on spin in abstract conclusions was limited. J Clin Epidemiol 2016; 77:44-51. [PMID: 27164274 DOI: 10.1016/j.jclinepi.2016.04.012] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 02/26/2016] [Accepted: 04/29/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To describe the impact of peer reviewers on spin in reports of nonrandomized studies assessing a therapeutic intervention. STUDY DESIGN AND SETTING This is a systematic review and retrospective before-after study. The sample consists of primary reports (n = 128) published in BioMed Central Medical Series journals between January 1, 2011, and December 31, 2013. The main outcome measures are the following: number and type of spin examples identified, deleted, or added by peer reviewers in the whole manuscript; number of reports with spin in abstract conclusions not detected by peer reviewers; the level of spin (i.e., no, low, moderate, and high level of spin) in the abstract conclusions before and after the peer review. RESULTS For 70 (55%) submitted manuscripts, peer reviewers identified at least one example of spin. Of 123 unique examples of spin identified by peer reviewers, 82 (67%) were completely deleted by the authors. For 19 articles (15%), peer reviewers requested adding some spin, and for 11 (9%), the spin was added by the authors. Peer reviewers failed to identify spin in abstract conclusions of 97 (76%) reports. CONCLUSION Peer reviewers identified many examples of spin in submitted manuscripts. However, their influence on changing spin in the abstract conclusions was low.
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Affiliation(s)
- Clément Lazarus
- INSERM, UMR 1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS Team 1 place du Parvis Notre Dame 75004, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine, 1 place du Parvis Notre Dame 75004, Paris, France; Centre d'Epidémiologie Clinique, AP-HP (Assistance Publique-Hôpitaux de Paris), 1 place du Parvis Notre Dame 75004, Paris, France
| | - Romana Haneef
- INSERM, UMR 1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS Team 1 place du Parvis Notre Dame 75004, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine, 1 place du Parvis Notre Dame 75004, Paris, France
| | - Philippe Ravaud
- INSERM, UMR 1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS Team 1 place du Parvis Notre Dame 75004, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine, 1 place du Parvis Notre Dame 75004, Paris, France; Centre d'Epidémiologie Clinique, AP-HP (Assistance Publique-Hôpitaux de Paris), 1 place du Parvis Notre Dame 75004, Paris, France; Department of Epidemiology, Columbia University Mailman School of Public Health, 22 W 168th Street, New York, NY 10032, USA
| | - Sally Hopewell
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Windmill Road, Oxford OX3 7LD, UK
| | - Douglas G Altman
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Windmill Road, Oxford OX3 7LD, UK
| | - Isabelle Boutron
- INSERM, UMR 1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS Team 1 place du Parvis Notre Dame 75004, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine, 1 place du Parvis Notre Dame 75004, Paris, France; Centre d'Epidémiologie Clinique, AP-HP (Assistance Publique-Hôpitaux de Paris), 1 place du Parvis Notre Dame 75004, Paris, France.
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Baudart M, Ravaud P, Baron G, Dechartres A, Haneef R, Boutron I. Public availability of results of observational studies evaluating an intervention registered at ClinicalTrials.gov. BMC Med 2016; 14:7. [PMID: 26819213 PMCID: PMC4730754 DOI: 10.1186/s12916-016-0551-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 01/05/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Observational studies are essential for assessing safety. The aims of this study were to evaluate whether results of observational studies evaluating an intervention with safety outcome(s) registered at ClinicalTrials.gov were published and, if not, whether they were available through posting on ClinicalTrials.gov or the sponsor website. METHODS We identified a cohort of observational studies with safety outcome(s) registered on ClinicalTrials.gov after October 1, 2007, and completed between October 1, 2007, and December 31, 2011. We systematically searched PubMed for a publication, as well as ClinicalTrials.gov and the sponsor website for results. The main outcomes were the time to the first publication in journals and to the first public availability of the study results (i.e. published or posted on ClinicalTrials.gov or the sponsor website). For all studies with results publicly available, we evaluated the completeness of reporting (i.e. reported with the number of events per arm) of safety outcomes. RESULTS We identified 489 studies; 334 (68%) were partially or completely funded by industry. Results for only 189 (39%, i.e. 65% of the total target number of participants) were published at least 30 months after the study completion. When searching other data sources, we obtained the results for 53% (n = 158; i.e. 93% of the total target number of participants) of unpublished studies; 31% (n = 94) were posted on ClinicalTrials.gov and 21% (n = 64) on the sponsor website. As compared with non-industry-funded studies, industry-funded study results were less likely to be published but not less likely to be publicly available. Of the 242 studies with a primary outcome recorded as a safety issue, all these outcomes were adequately reported in 86% (114/133) when available in a publication, 91% (62/68) when available on ClinicalTrials.gov, and 80% (33/41) when available on the sponsor website. CONCLUSIONS Only 39% of observational studies evaluating an intervention with safety outcome(s) registered at ClinicalTrials.gov had their results published at least 30 months after study completion. The registration of these observational studies allowed searching other sources (results posted at ClinicalTrials.gov and sponsor website) and obtaining results for half of unpublished studies and 93% of the total target number of participants.
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Affiliation(s)
- Marie Baudart
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, 1, Place du parvis Notre Dame, 75181, Paris, Cedex 4, France.,Paris Descartes University, Paris, France
| | - Philippe Ravaud
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, 1, Place du parvis Notre Dame, 75181, Paris, Cedex 4, France.,Paris Descartes University, Paris, France.,METHODS Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, UMR 1153, INSERM, Paris, France.,French Cochrane Center, Paris, France.,Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Gabriel Baron
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, 1, Place du parvis Notre Dame, 75181, Paris, Cedex 4, France.,Paris Descartes University, Paris, France.,METHODS Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, UMR 1153, INSERM, Paris, France
| | - Agnes Dechartres
- Paris Descartes University, Paris, France.,METHODS Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, UMR 1153, INSERM, Paris, France
| | - Romana Haneef
- Paris Descartes University, Paris, France.,METHODS Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, UMR 1153, INSERM, Paris, France
| | - Isabelle Boutron
- Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, 1, Place du parvis Notre Dame, 75181, Paris, Cedex 4, France. .,Paris Descartes University, Paris, France. .,METHODS Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, UMR 1153, INSERM, Paris, France. .,French Cochrane Center, Paris, France.
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Haneef R, Lazarus C, Ravaud P, Yavchitz A, Boutron I. Interpretation of Results of Studies Evaluating an Intervention Highlighted in Google Health News: A Cross-Sectional Study of News. PLoS One 2015; 10:e0140889. [PMID: 26473725 PMCID: PMC4608738 DOI: 10.1371/journal.pone.0140889] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 10/01/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mass media through the Internet is a powerful means of disseminating medical research. We aimed to determine whether and how the interpretation of research results is misrepresented by the use of "spin" in the health section of Google News. Spin was defined as specific way of reporting, from whatever motive (intentional or unintentional), to emphasize that the beneficial effect of the intervention is greater than that shown by the results. METHODS We conducted a cross-sectional study of news highlighted in the health section of US, UK and Canada editions of Google News between July 2013 and January 2014. We searched for news items for 3 days a week (i.e., Monday, Wednesday, and Friday) during 6 months and selected a sample of 130 news items reporting a scientific article evaluating the effect of an intervention on human health. RESULTS In total, 78% of the news did not provide a full reference or electronic link to the scientific article. We found at least one spin in 114 (88%) news items and 18 different types of spin in news. These spin were mainly related to misleading reporting (59%) such as not reporting adverse events that were reported in the scientific article (25%), misleading interpretation (69%) such as claiming a causal effect despite non-randomized study design (49%) and overgeneralization/misleading extrapolation (41%) of the results such as extrapolating a beneficial effect from an animal study to humans (21%). We also identified some new types of spin such as highlighting a single patient experience for the success of a new treatment instead of focusing on the group results. CONCLUSIONS Interpretation of research results was frequently misrepresented in the health section of Google News. However, we do not know whether these spin were from the scientific articles themselves or added in the news.
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Affiliation(s)
- Romana Haneef
- INSERM, UMR 1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS team, Paris, France
- Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
- Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Paris, France
| | - Clement Lazarus
- INSERM, UMR 1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS team, Paris, France
- Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
- Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Paris, France
| | - Philippe Ravaud
- INSERM, UMR 1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS team, Paris, France
- Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
- Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Paris, France
- French Cochrane Center, Paris, France
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, United States of America
| | - Amélie Yavchitz
- INSERM, UMR 1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS team, Paris, France
- Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
- Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Paris, France
- French Cochrane Center, Paris, France
| | - Isabelle Boutron
- INSERM, UMR 1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS team, Paris, France
- Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
- Centre d'Épidémiologie Clinique, AP-HP (Assistance Publique des Hôpitaux de Paris), Hôpital Hôtel Dieu, Paris, France
- French Cochrane Center, Paris, France
- * E-mail:
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Lazarus C, Haneef R, Ravaud P, Boutron I. Classification and prevalence of spin in abstracts of non-randomized studies evaluating an intervention. BMC Med Res Methodol 2015; 15:85. [PMID: 26462565 PMCID: PMC4604617 DOI: 10.1186/s12874-015-0079-x] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 10/05/2015] [Indexed: 11/10/2022] Open
Abstract
Background Spin represents specific reporting strategies, either intentional or unintentional, to convince the reader that the beneficial effect of the experimental intervention in terms of efficacy and safety is greater than that shown by the results. The objectives of this study were to 1) develop a classification of spin specific to non-randomized studies assessing an intervention and 2) estimate the prevalence of spin in abstracts of reports of such studies. Methods In a first step, we developed a specific classification of spin for non-randomized studies by a literature review and pilot study. In a second step, 2 researchers trained in the field of methodology evaluated the prevalence of spin in the abstract of all non-randomized studies assessing an intervention published in the BioMed Central Medical Series journals between January 1, 2011 and December 31, 2013. All disagreements were resolved by consensus. We also determined whether the level of spin in abstract conclusions was high (spin reported without uncertainty or recommendations for further trials), moderate (spin reported with some uncertainty or recommendations for further trials) or low (spin reported with uncertainty and recommendations for further trials). Results Among the 128 assessed articles assessed, 107 (84 %) had at least one example of spin in their abstract. The most prevalent strategy of spin was the use of causal language, identified in 68 (53 %) abstracts. Other frequent strategies were linguistic spin, inadequate implications for clinical practice, and lack of focus on harm, identified in 33 (26 %), 25 (20 %), and 34 (27 %) abstracts respectively. Abstract conclusions of 61 (48 %) articles featured a high level of spin. Conclusion Abstract of reports of non-randomized studies assessing an intervention frequently includes spin. Efforts to reduce the prevalence of spin in abstract for such studies are needed. Electronic supplementary material The online version of this article (doi:10.1186/s12874-015-0079-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Clément Lazarus
- METHODS Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), UMR 1153, INSERM, Paris, France. .,Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine de Paris, Paris, France. .,Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, 1, place du Parvis Notre-Dame, 75181, Paris, France.
| | - Romana Haneef
- METHODS Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), UMR 1153, INSERM, Paris, France. .,Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine de Paris, Paris, France.
| | - Philippe Ravaud
- METHODS Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), UMR 1153, INSERM, Paris, France. .,Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine de Paris, Paris, France. .,Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, 1, place du Parvis Notre-Dame, 75181, Paris, France. .,French Cochrane Center, Paris, France. .,Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Isabelle Boutron
- METHODS Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), UMR 1153, INSERM, Paris, France. .,Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine de Paris, Paris, France. .,Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, 1, place du Parvis Notre-Dame, 75181, Paris, France. .,French Cochrane Center, Paris, France.
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Dechartres A, Riveros C, Perrodeau E, Haneef R, Boutron I, Ravaud P. Intérêt de ClinicalTrials.gov pour évaluer les résultats d’essais contrôlés randomisés. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Riveros C, Dechartres A, Perrodeau E, Haneef R, Boutron I, Ravaud P. Timing and completeness of trial results posted at ClinicalTrials.gov and published in journals. PLoS Med 2013; 10:e1001566; discussion e1001566. [PMID: 24311990 PMCID: PMC3849189 DOI: 10.1371/journal.pmed.1001566] [Citation(s) in RCA: 163] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 10/23/2013] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The US Food and Drug Administration Amendments Act requires results from clinical trials of Food and Drug Administration-approved drugs to be posted at ClinicalTrials.gov within 1 y after trial completion. We compared the timing and completeness of results of drug trials posted at ClinicalTrials.gov and published in journals. METHODS AND FINDINGS We searched ClinicalTrials.gov on March 27, 2012, for randomized controlled trials of drugs with posted results. For a random sample of these trials, we searched PubMed for corresponding publications. Data were extracted independently from ClinicalTrials.gov and from the published articles for trials with results both posted and published. We assessed the time to first public posting or publishing of results and compared the completeness of results posted at ClinicalTrials.gov versus published in journal articles. Completeness was defined as the reporting of all key elements, according to three experts, for the flow of participants, efficacy results, adverse events, and serious adverse events (e.g., for adverse events, reporting of the number of adverse events per arm, without restriction to statistically significant differences between arms for all randomized patients or for those who received at least one treatment dose). From the 600 trials with results posted at ClinicalTrials.gov, we randomly sampled 50% (n = 297) had no corresponding published article. For trials with both posted and published results (n = 202), the median time between primary completion date and first results publicly posted was 19 mo (first quartile = 14, third quartile = 30 mo), and the median time between primary completion date and journal publication was 21 mo (first quartile = 14, third quartile = 28 mo). Reporting was significantly more complete at ClinicalTrials.gov than in the published article for the flow of participants (64% versus 48% of trials, p<0.001), efficacy results (79% versus 69%, p = 0.02), adverse events (73% versus 45%, p<0.001), and serious adverse events (99% versus 63%, p<0.001). The main study limitation was that we considered only the publication describing the results for the primary outcomes. CONCLUSIONS Our results highlight the need to search ClinicalTrials.gov for both unpublished and published trials. Trial results, especially serious adverse events, are more completely reported at ClinicalTrials.gov than in the published article.
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Affiliation(s)
- Carolina Riveros
- INSERM U738, Paris, France
- Université Paris Descartes—Sorbonne Paris Cité, Paris, France
- Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Agnes Dechartres
- INSERM U738, Paris, France
- Université Paris Descartes—Sorbonne Paris Cité, Paris, France
- Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
- * E-mail:
| | - Elodie Perrodeau
- INSERM U738, Paris, France
- Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Romana Haneef
- INSERM U738, Paris, France
- Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Isabelle Boutron
- INSERM U738, Paris, France
- Université Paris Descartes—Sorbonne Paris Cité, Paris, France
- Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
- French Cochrane Centre, Paris, France
| | - Philippe Ravaud
- INSERM U738, Paris, France
- Université Paris Descartes—Sorbonne Paris Cité, Paris, France
- Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
- French Cochrane Centre, Paris, France
- Mailman School of Public Health, Columbia University, New York, New York, United States of America
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Obadia T, Haneef R, Boëlle PY. The R0 package: a toolbox to estimate reproduction numbers for epidemic outbreaks. BMC Med Inform Decis Mak 2012; 12:147. [PMID: 23249562 PMCID: PMC3582628 DOI: 10.1186/1472-6947-12-147] [Citation(s) in RCA: 199] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 12/04/2012] [Indexed: 11/28/2022] Open
Abstract
Background Several generic methods have been proposed to estimate transmission parameters during an outbreak, especially the reproduction number. However, as of today, no dedicated software exists that implements these methods and allow comparisons. Results A review of generic methods used to estimate transmissibility parameters during outbreaks was carried out. Most methods used the epidemic curve and the generation time distribution. Two categories of methods were available: those estimating the initial reproduction number, and those estimating a time dependent reproduction number. We implemented five methods as an R library, developed sensitivity analysis tools for each method and provided numerical illustrations of their use. A comparison of the performance of the different methods on simulated datasets is reported. Conclusions This software package allows a standardized and extensible approach to the estimation of the reproduction number and generation interval distribution from epidemic curves.
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Abstract
OBJECTIVE To investigate free alpha-human chorionic gonadotropin (hCG) as a marker of preeclampsia. METHODS Four groups of patients were studied: normal pregnancies, preeclampsia, eclampsia and normal pregnant women <20 weeks' gestation. Patients were further divided according to parity and gestational age (< or =20, 21-30, 31-40 weeks). An immunoradiometric assay employing monoclonal antibodies specific for free alpha-hCG was used. RESULTS A total of 313 patients were analyzed. Thirty-four patients < or =20 weeks' gestation were followed until delivery: five (14.7%) developed preeclampsia; none had abnormal alpha-hCG levels before onset of preeclampsia. Patients with preeclampsia (21-30 weeks' gestation) demonstrated a mean alpha-hCG level greater than that of normotensive controls but this was not statistically significant. Between 31 and 40 weeks' gestation, mean alpha-hCG levels in the hypertensive and control groups were 210.8 ng/ml and 115.8 ng/ml, respectively (P < 0.001). A stronger association was observed between alpha-hCG and preeclampsia with increasing gestational age (relative risk [RR] 2.07, 21-30 weeks; RR 3.02, 31-40 weeks) and severity (RR 4.51, mild; RR 12.15, severe; RR 16.88, eclampsia). CONCLUSION There is a strong association between alpha-hCG and preeclampsia, nevertheless this test is unsuitable for predicting preeclampsia.
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Affiliation(s)
- D Moodley
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Natal, Durban, South Africa
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Mahabeer S, Naidoo C, Norman RJ, Jialal I, Govender T, Haneef R, Dunn R, Joubert SM. 125I-insulin binding to circulating erythrocytes, monocytes and cultured fibroblasts in non-obese patients with polycystic ovarian disease. Diabetes Res 1990; 13:139-44. [PMID: 2128692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The insulin receptor status of circulating erythrocytes, monocytes and cultured fibroblasts were studied in non-obese Indian women with polycystic ovarian disease (PCOD) with no clinical evidence of acanthosis nigricans and age, height and weight matched reference subjects. The women with polycystic ovaries had decreased mean maximum specific binding to erythrocytes (PCOD 7.4 +/- 0.6%, normal women 11.5 +/- 0.3%; p less than 0.0001) and monocytes (PCOD 2.4 +/- 0.3%, normal women 4.1 +/- 0.4%; p less than 0.003) when compared to the normal women. This decreased binding was attributed to a change in both receptor number and affinity. 125I-insulin binding to cultured fibroblasts revealed similar mean maximum specific binding and affinity values in both groups studied. Although further work is necessary to exclude genetic or post-receptor defects, it is likely that an environmental factor is implicated in the decreased 125I-insulin binding to erythrocytes and monocytes.
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Affiliation(s)
- S Mahabeer
- Department of Chemical Pathology, University of Natal Medical School, Durban, RSA
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Norman RJ, Haneef R, Buck RH, Joubert SM. Measurement of the free alpha subunit of human glycoprotein hormones by a monoclonal antibody-based immunoradiometric assay, and further exploration of antigenic sites on the choriogonadotropin molecule. Clin Chem 1987; 33:1147-51. [PMID: 2439237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Three monoclonal antibodies were raised against the free alpha subunit of choriogonadotropin (hCG); each recognized a different antigenic site on the molecule. One (antibody 42) preferentially bound to the alpha subunit when it was coupled to the beta subunit as dimeric choriogonadotropin (hCG), thyrotropin (TSH), lutropin (LH), or follitropin (FSH). Antibody 71 showed some cross-reaction with intact FSH; antibody 75 was more specific for the alpha subunit. All were of low affinity (10(-7) to 10(-8) mol/L), but when combined in immunoradiometric assays (IRMAS) they proved to be as sensitive as current radioimmunoassays involving polyclonal antibodies. Advantages of the combination of antibody 75 bound to the solid phase and antibody 71 as the radiolabeled antibody were: detection limit of at least 0.1 micrograms/L; linear dilution of serum and urine; insignificant cross-reaction with intact hCG, allowing direct assay in pregnancy fluids; and a coefficient of variation less than 3% over the reference interval for nonpregnant women. There was 4% cross-reaction with intact FSH, suggesting that the epitopes recognized by nos. 71 and 75 are more exposed in FSH and that perhaps there is less folding in this molecule than in intact hCG.
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Norman RJ, Haneef R, Buck RH, Joubert SM. Measurement of the free alpha subunit of human glycoprotein hormones by a monoclonal antibody-based immunoradiometric assay, and further exploration of antigenic sites on the choriogonadotropin molecule. Clin Chem 1987. [DOI: 10.1093/clinchem/33.7.1147] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Three monoclonal antibodies were raised against the free alpha subunit of choriogonadotropin (hCG); each recognized a different antigenic site on the molecule. One (antibody 42) preferentially bound to the alpha subunit when it was coupled to the beta subunit as dimeric choriogonadotropin (hCG), thyrotropin (TSH), lutropin (LH), or follitropin (FSH). Antibody 71 showed some cross-reaction with intact FSH; antibody 75 was more specific for the alpha subunit. All were of low affinity (10(-7) to 10(-8) mol/L), but when combined in immunoradiometric assays (IRMAS) they proved to be as sensitive as current radioimmunoassays involving polyclonal antibodies. Advantages of the combination of antibody 75 bound to the solid phase and antibody 71 as the radiolabeled antibody were: detection limit of at least 0.1 micrograms/L; linear dilution of serum and urine; insignificant cross-reaction with intact hCG, allowing direct assay in pregnancy fluids; and a coefficient of variation less than 3% over the reference interval for nonpregnant women. There was 4% cross-reaction with intact FSH, suggesting that the epitopes recognized by nos. 71 and 75 are more exposed in FSH and that perhaps there is less folding in this molecule than in intact hCG.
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Naidoo C, Jialal I, Haneef R, Joubert SM. 125 I-insulin binding to cultured fibroblasts in non-insulin-dependent diabetes in the young. Diabete Metab 1987; 13:222-4. [PMID: 3609424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
125 I-insulin binding to circulating monocytes was found to be decreased in Indian patients with non-insulin-dependent diabetes in the young, when compared to controls. To determine whether this was due to an inherent defect in the insulin receptor, fibroblasts from diabetics and controls were grown in an environment free from the diabetic milieu. Under these conditions 125 I-insulin binding to fibroblasts in patients with non-insulin-dependent diabetes in the young was similar to that obtained in controls. (1.5 +/- 0.4% and 1.3 +/- 0.3% per 10(6) cells, p greater than 0.5). It thus appears that the receptor defect manifest on circulating monocytes is unlikely to be a primary defect.
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