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\n\n \n \n 2018\n \n \n (5)\n \n \n
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\n \n \n\n \n \n \n \n \n \n Inappropriate anticholinergic drugs prescriptions in older patients: analysing a hospital database.\n \n \n \n \n\n\n \n Ferret, L.; Ficheur, G.; Delaviez, E.; Luyckx, M.; Quenton, S.; Beuscart, R.; Chazard, E.; and Beuscart, J.\n\n\n \n\n\n\n International Journal of Clinical Pharmacy, 40(1): 94–100. February 2018.\n \n\n\n\n
\n\n\n\n \n \n![\"Inappropriate](\"//bibbase.org/img/filetypes/link.svg\"\n\t "\\"Paper\\"\n\t")
Paper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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\n\n\n@article{ferret_inappropriate_2018,\n\ttitle = {Inappropriate anticholinergic drugs prescriptions in older patients: analysing a hospital database},\n\tvolume = {40},\n\tissn = {2210-7711},\n\tshorttitle = {Inappropriate anticholinergic drugs prescriptions in older patients},\n\turl = {https://nextcloud.univ-lille.fr/index.php/s/9QkCictkez6WF3p},\n\tdoi = {10.1007/s11096-017-0554-z},\n\tabstract = {Background Although many anticholinergics are inappropriate in older patients, the prescription of these drugs in a hospital setting has not been extensively studied. Objective To describe prescriptions of anticholinergic drugs in terms of frequency, at risk situations and constipation in hospitalized, older adults. Setting Using a database from a French general hospital (period 2009-2013), we extracted information on 14,090 hospital stays by patients aged 75 and over. Methods Anticholinergic drug prescriptions were automatically detected, with a focus on prescriptions in three well-known at-risk situations: falls, dementia, and benign prostatic hyperplasia. Cases of constipation that might have been causally related to the administration of anticholinergic drugs were screened for and reviewed. Main outcome measure Prescriptions with a high associated risk of anticholinergic related adverse reactions. Results Administration of an anticholinergic drug was detected in 1412 (10.0\\%) of the hospital stays by older patients. At-risk situations were identified in 413 (36.5\\%) of these stays: 137 (9.7\\%) for falls, 243 (17.2\\%) for dementia, and 114 (8.1\\%) for benign prostatic hyperplasia; 78 (18.9\\%) of these 413 stays featured a combination of two or three at-risk situations. Cases of constipation induced by anticholinergic drug administration were identified in 188 (13.3\\%) patient stays by using validated adjudication rules for adverse drug reactions: 85 and 103 cases were respectively evaluated as "possible" or "probable" adverse drug reactions. Conclusions Anticholinergic drugs prescription was found in 10.0\\% of hospitalized, older patients. More than one third of these prescriptions occurred in at-risk situations and more than one in ten prescriptions induced constipation.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {International Journal of Clinical Pharmacy},\n\tauthor = {Ferret, Laurie and Ficheur, Gregoire and Delaviez, Emeline and Luyckx, Michel and Quenton, Sophie and Beuscart, Regis and Chazard, Emmanuel and Beuscart, Jean-Baptiste},\n\tmonth = feb,\n\tyear = {2018},\n\tpmid = {29147963},\n\tkeywords = {Anticholinergic drugs, Elderly, France, Hospital pharmacy, Inappropriate prescribing},\n\tpages = {94--100},\n}\n\n\n\n Background Although many anticholinergics are inappropriate in older patients, the prescription of these drugs in a hospital setting has not been extensively studied. Objective To describe prescriptions of anticholinergic drugs in terms of frequency, at risk situations and constipation in hospitalized, older adults. Setting Using a database from a French general hospital (period 2009-2013), we extracted information on 14,090 hospital stays by patients aged 75 and over. Methods Anticholinergic drug prescriptions were automatically detected, with a focus on prescriptions in three well-known at-risk situations: falls, dementia, and benign prostatic hyperplasia. Cases of constipation that might have been causally related to the administration of anticholinergic drugs were screened for and reviewed. Main outcome measure Prescriptions with a high associated risk of anticholinergic related adverse reactions. Results Administration of an anticholinergic drug was detected in 1412 (10.0%) of the hospital stays by older patients. At-risk situations were identified in 413 (36.5%) of these stays: 137 (9.7%) for falls, 243 (17.2%) for dementia, and 114 (8.1%) for benign prostatic hyperplasia; 78 (18.9%) of these 413 stays featured a combination of two or three at-risk situations. Cases of constipation induced by anticholinergic drug administration were identified in 188 (13.3%) patient stays by using validated adjudication rules for adverse drug reactions: 85 and 103 cases were respectively evaluated as \"possible\" or \"probable\" adverse drug reactions. Conclusions Anticholinergic drugs prescription was found in 10.0% of hospitalized, older patients. More than one third of these prescriptions occurred in at-risk situations and more than one in ten prescriptions induced constipation.\n
\n\n\n\n \n\n \n \n \n \n \n \n Hospital-acquired hyperkalemia events in older patients are mostly due to avoidable, multifactorial, adverse drug reactions.\n \n \n \n \n\n\n \n Robert, L.; Ficheur, G.; Décaudin, B.; Gellens, J.; Luyckx, M.; Perichon, R.; Gautier, S.; Puisieux, F.; Chazard, E.; and Beuscart, J.\n\n\n \n\n\n\n Clinical Pharmacology and Therapeutics. September 2018.\n \n\n\n\n
\n\n\n\n \n \nPaper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n \n \n 1 download\n \n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n\n\n\n
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\n\n\n@article{robert_hospital-acquired_2018,\n\ttitle = {Hospital-acquired hyperkalemia events in older patients are mostly due to avoidable, multifactorial, adverse drug reactions},\n\tissn = {1532-6535},\n\turl = {https://nextcloud.univ-lille.fr/index.php/s/4w5DGNTxMimaQAz},\n\tdoi = {10.1002/cpt.1239},\n\tabstract = {Drug-induced hyperkalemia is a frequent and severe complication in hospital setting. Other risk factors may also induce hyperkalemia but the combination of drugs and precipitating factors has not been extensively studied. The aim was to identify drug-induced hyperkalemia events in hospitalized older patients and to describe their combinations with precipitating factors. Two experts analyzed independently retrospective data of patients aged 75 years or more. Experts identified 471 hyperkalemia events and concluded that 379 (80.5\\%) were induced by drugs. The cause was multifactorial (i.e. at least one drug with a precipitating factor) in 300 (79.2\\%) of the 379 drug-induced hyperkalemia. Most of the drug-induced hyperkalemia events were avoidable (79.9\\%) - mainly because of the multifactorial cause (e.g. dosage adaptation during acute kidney injury). Drug-induced hyperkalemia events are frequently combined with precipitating factors in hospitalized older patients and their prevention should focus on these combinations. This article is protected by copyright. All rights reserved.},\n\tlanguage = {eng},\n\tjournal = {Clinical Pharmacology and Therapeutics},\n\tauthor = {Robert, Laurine and Ficheur, Grégoire and Décaudin, Bertrand and Gellens, Juliette and Luyckx, Michel and Perichon, Renaud and Gautier, Sophie and Puisieux, François and Chazard, Emmanuel and Beuscart, Jean-Baptiste},\n\tmonth = sep,\n\tyear = {2018},\n\tpmid = {30242829},\n\tkeywords = {Adverse drug reactions, Elderly, Prevention},\n}\n\n\n\n Drug-induced hyperkalemia is a frequent and severe complication in hospital setting. Other risk factors may also induce hyperkalemia but the combination of drugs and precipitating factors has not been extensively studied. The aim was to identify drug-induced hyperkalemia events in hospitalized older patients and to describe their combinations with precipitating factors. Two experts analyzed independently retrospective data of patients aged 75 years or more. Experts identified 471 hyperkalemia events and concluded that 379 (80.5%) were induced by drugs. The cause was multifactorial (i.e. at least one drug with a precipitating factor) in 300 (79.2%) of the 379 drug-induced hyperkalemia. Most of the drug-induced hyperkalemia events were avoidable (79.9%) - mainly because of the multifactorial cause (e.g. dosage adaptation during acute kidney injury). Drug-induced hyperkalemia events are frequently combined with precipitating factors in hospitalized older patients and their prevention should focus on these combinations. This article is protected by copyright. All rights reserved.\n
\n\n\n\n \n\n \n \n \n \n \n \n International core outcome set for clinical trials of medication review in multi-morbid older patients with polypharmacy.\n \n \n \n \n\n\n \n Beuscart, J.; Knol, W.; Cullinan, S.; Schneider, C.; Dalleur, O.; Boland, B.; Thevelin, S.; Jansen, P. A. F.; O’Mahony, D.; Rodondi, N.; and Spinewine, A.\n\n\n \n\n\n\n BMC Medicine, 16(1): 21. February 2018.\n \n\n\n\n
\n\n\n\n \n \nPaper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n
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\n\n\n@article{beuscart_international_2018,\n\ttitle = {International core outcome set for clinical trials of medication review in multi-morbid older patients with polypharmacy},\n\tvolume = {16},\n\tissn = {1741-7015},\n\turl = {https://doi.org/10.1186/s12916-018-1007-9},\n\tdoi = {10.1186/s12916-018-1007-9},\n\tabstract = {Comparisons of clinical trial findings in systematic reviews can be hindered by the heterogeneity of the outcomes reported. Moreover, the outcomes that matter most to patients might be underreported. A core outcome set can address these issues, as it defines a minimum set of outcomes that should be reported in all clinical trials in a particular area of research. The objective in this study was to develop a core outcome set for clinical trials of medication review in multi-morbid older patients with polypharmacy.},\n\tnumber = {1},\n\turldate = {2019-03-07},\n\tjournal = {BMC Medicine},\n\tauthor = {Beuscart, Jean-Baptiste and Knol, Wilma and Cullinan, Shane and Schneider, Claudio and Dalleur, Olivia and Boland, Benoit and Thevelin, Stefanie and Jansen, Paul A. F. and O’Mahony, Denis and Rodondi, Nicolas and Spinewine, Anne},\n\tmonth = feb,\n\tyear = {2018},\n\tpages = {21},\n}\n\n\n\n Comparisons of clinical trial findings in systematic reviews can be hindered by the heterogeneity of the outcomes reported. Moreover, the outcomes that matter most to patients might be underreported. A core outcome set can address these issues, as it defines a minimum set of outcomes that should be reported in all clinical trials in a particular area of research. The objective in this study was to develop a core outcome set for clinical trials of medication review in multi-morbid older patients with polypharmacy.\n
\n\n\n\n \n\n \n \n \n \n \n Native aortic valve endocarditis due to Pseudomonas stutzeri in a 91-year-old woman.\n \n \n \n\n\n \n Héquette-Ruz, R.; Charpentier, A.; Delabriere, I.; Loiez, C.; Guery, B.; Puisieux, F.; and Beuscart, J.\n\n\n \n\n\n\n Medecine Et Maladies Infectieuses, 48(7): 492–494. October 2018.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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\n\n\n\n@article{hequette-ruz_native_2018,\n\ttitle = {Native aortic valve endocarditis due to {Pseudomonas} stutzeri in a 91-year-old woman},\n\tvolume = {48},\n\tissn = {1769-6690},\n\tdoi = {10.1016/j.medmal.2018.04.399},\n\tlanguage = {eng},\n\tnumber = {7},\n\tjournal = {Medecine Et Maladies Infectieuses},\n\tauthor = {Héquette-Ruz, R. and Charpentier, A. and Delabriere, I. and Loiez, C. and Guery, B. and Puisieux, F. and Beuscart, J.-B.},\n\tmonth = oct,\n\tyear = {2018},\n\tpmid = {29807689},\n\tkeywords = {Elderly, Endocardite, Endocarditis, Personnes âgées, Pseudomonas stutzeri},\n\tpages = {492--494},\n}\n\n\n\n \n\n \n \n \n \n \n Development of a standardized chart review method to identify drug-related hospital admissions in older people.\n \n \n \n\n\n \n Thevelin, S.; Spinewine, A.; Beuscart, J.; Boland, B.; Marien, S.; Vaillant, F.; Wilting, I.; Vondeling, A.; Floriani, C.; Schneider, C.; Donzé, J.; Rodondi, N.; Cullinan, S.; O'Mahony, D.; and Dalleur, O.\n\n\n \n\n\n\n British Journal of Clinical Pharmacology. July 2018.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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\n\n\n@article{thevelin_development_2018,\n\ttitle = {Development of a standardized chart review method to identify drug-related hospital admissions in older people},\n\tissn = {1365-2125},\n\tdoi = {10.1111/bcp.13716},\n\tabstract = {AIMS: We aimed to develop a standardized chart review method to identify drug-related hospital admissions (DRA) in older people caused by non-preventable adverse drug reactions and preventable medication errors including overuse, underuse and misuse of medications: the DRA adjudication guide.\nMETHODS: The DRA adjudication guide was developed based on design and test iterations with international and multidisciplinary input in four subsequent steps: literature review; evaluation of content validity using a Delphi consensus technique; a pilot test; and a reliability study.\nRESULTS: The DRA adjudication guide provides definitions, examples and step-by-step instructions to measure DRA. A three-step standardized chart review method was elaborated including: (i) data abstraction; (ii) explicit screening with a newly developed trigger tool for DRA in older people; and (iii) consensus adjudication for causality by a pharmacist and a physician using the World Health Organization-Uppsala Monitoring Centre and Hallas criteria. A 15-member international Delphi panel reached consensus agreement on 26 triggers for DRA in older people. The DRA adjudication guide showed good feasibility of use and achieved moderate inter-rater reliability for the evaluation of 16 cases by four European adjudication pairs (71\\% agreement, κ = 0.41). Disagreements arose mainly for cases with potential underuse.\nCONCLUSIONS: The DRA adjudication guide is the first standardized chart review method to identify DRA in older persons. Content validity, feasibility of use and inter-rater reliability were found to be satisfactory. The method can be used as an outcome measure for interventions targeted at improving quality and safety of medication use in older people.},\n\tlanguage = {eng},\n\tjournal = {British Journal of Clinical Pharmacology},\n\tauthor = {Thevelin, Stefanie and Spinewine, Anne and Beuscart, Jean-Baptiste and Boland, Benoit and Marien, Sophie and Vaillant, Fanny and Wilting, Ingeborg and Vondeling, Ariel and Floriani, Carmen and Schneider, Claudio and Donzé, Jacques and Rodondi, Nicolas and Cullinan, Shane and O'Mahony, Denis and Dalleur, Olivia},\n\tmonth = jul,\n\tyear = {2018},\n\tpmid = {30007041},\n\tkeywords = {adverse drug reactions, elderly, medication errors, medication safety, patient safety},\n}\n\n\n\n AIMS: We aimed to develop a standardized chart review method to identify drug-related hospital admissions (DRA) in older people caused by non-preventable adverse drug reactions and preventable medication errors including overuse, underuse and misuse of medications: the DRA adjudication guide. METHODS: The DRA adjudication guide was developed based on design and test iterations with international and multidisciplinary input in four subsequent steps: literature review; evaluation of content validity using a Delphi consensus technique; a pilot test; and a reliability study. RESULTS: The DRA adjudication guide provides definitions, examples and step-by-step instructions to measure DRA. A three-step standardized chart review method was elaborated including: (i) data abstraction; (ii) explicit screening with a newly developed trigger tool for DRA in older people; and (iii) consensus adjudication for causality by a pharmacist and a physician using the World Health Organization-Uppsala Monitoring Centre and Hallas criteria. A 15-member international Delphi panel reached consensus agreement on 26 triggers for DRA in older people. The DRA adjudication guide showed good feasibility of use and achieved moderate inter-rater reliability for the evaluation of 16 cases by four European adjudication pairs (71% agreement, κ = 0.41). Disagreements arose mainly for cases with potential underuse. CONCLUSIONS: The DRA adjudication guide is the first standardized chart review method to identify DRA in older persons. Content validity, feasibility of use and inter-rater reliability were found to be satisfactory. The method can be used as an outcome measure for interventions targeted at improving quality and safety of medication use in older people.\n
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\n\n \n \n 2017\n \n \n (12)\n \n \n
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\n \n \n\n \n \n \n \n \n \n Development of a core outcome set for medication review in older patients with multimorbidity and polypharmacy: a study protocol.\n \n \n \n \n\n\n \n Beuscart, J.; Dalleur, O.; Boland, B.; Thevelin, S.; Knol, W.; Cullinan, S.; Schneider, C.; O'Mahony, D.; Rodondi, N.; and Spinewine, A.\n\n\n \n\n\n\n Clinical Interventions in Aging, 12: 1379–1389. 2017.\n \n\n\n\n
\n\n\n\n \n \nPaper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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Paper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n\n\n\n\n
\n\n\n@article{beuscart_development_2017,\n\ttitle = {Development of a core outcome set for medication review in older patients with multimorbidity and polypharmacy: a study protocol},\n\tvolume = {12},\n\tissn = {1178-1998},\n\tshorttitle = {Development of a core outcome set for medication review in older patients with multimorbidity and polypharmacy},\n\turl = {https://www.dovepress.com/development-of-a-core-outcome-set-for-medication-review-in-older-patie-peer-reviewed-article-CIA},\n\tdoi = {10.2147/CIA.S135481},\n\tabstract = {BACKGROUND: Medication review has been advocated to address the challenge of polypharmacy in older patients, yet there is no consensus on how best to evaluate its efficacy. Heterogeneity of outcomes reported in clinical trials can hinder the comparison of clinical trial findings in systematic reviews. Moreover, the outcomes that matter most to older patients might be under-reported or disregarded altogether. A core outcome set can address this issue as it defines a minimum set of outcomes that should be reported in all clinical trials in any particular field of research. As part of the European Commission-funded project, called OPtimising thERapy to prevent Avoidable hospital admissions in the Multimorbid elderly, this paper describes the methods used to develop a core outcome set for clinical trials of medication review in older patients with multimorbidity.\nMETHODS/DESIGN: The study was designed in several steps. First, a systematic review established which outcomes were measured in published and ongoing clinical trials of medication review in older patients. Second, we undertook semistructured interviews with older patients and carers aimed at identifying additional relevant outcomes. Then, a multilanguage European Delphi survey adapted to older patients was designed. The international Delphi survey was conducted with older patients, health care professionals, researchers, and clinical experts in geriatric pharmacotherapy to validate outcomes to be included in the core outcome set. Consensus meetings were conducted to validate the results.\nDISCUSSION: We present the method for developing a core outcome set for medication review in older patients with multimorbidity. This study protocol could be used as a basis to develop core outcome sets in other fields of geriatric research.},\n\tlanguage = {eng},\n\tjournal = {Clinical Interventions in Aging},\n\tauthor = {Beuscart, Jean-Baptiste and Dalleur, Olivia and Boland, Benoit and Thevelin, Stefanie and Knol, Wilma and Cullinan, Shane and Schneider, Claudio and O'Mahony, Denis and Rodondi, Nicolas and Spinewine, Anne},\n\tyear = {2017},\n\tpmid = {28919724},\n\tpmcid = {PMC5586980},\n\tkeywords = {core outcome set, multimorbidity, polypharmacy, study protocol},\n\tpages = {1379--1389},\n}\n\n\n\n BACKGROUND: Medication review has been advocated to address the challenge of polypharmacy in older patients, yet there is no consensus on how best to evaluate its efficacy. Heterogeneity of outcomes reported in clinical trials can hinder the comparison of clinical trial findings in systematic reviews. Moreover, the outcomes that matter most to older patients might be under-reported or disregarded altogether. A core outcome set can address this issue as it defines a minimum set of outcomes that should be reported in all clinical trials in any particular field of research. As part of the European Commission-funded project, called OPtimising thERapy to prevent Avoidable hospital admissions in the Multimorbid elderly, this paper describes the methods used to develop a core outcome set for clinical trials of medication review in older patients with multimorbidity. METHODS/DESIGN: The study was designed in several steps. First, a systematic review established which outcomes were measured in published and ongoing clinical trials of medication review in older patients. Second, we undertook semistructured interviews with older patients and carers aimed at identifying additional relevant outcomes. Then, a multilanguage European Delphi survey adapted to older patients was designed. The international Delphi survey was conducted with older patients, health care professionals, researchers, and clinical experts in geriatric pharmacotherapy to validate outcomes to be included in the core outcome set. Consensus meetings were conducted to validate the results. DISCUSSION: We present the method for developing a core outcome set for medication review in older patients with multimorbidity. This study protocol could be used as a basis to develop core outcome sets in other fields of geriatric research.\n
\n\n\n\n \n\n \n \n \n \n \n \n Explicit definitions of potentially inappropriate prescriptions of antibiotics in older patients: a compilation derived from a systematic review.\n \n \n \n \n\n\n \n Baclet, N.; Ficheur, G.; Alfandari, S.; Ferret, L.; Senneville, E.; Chazard, E.; and Beuscart, J.\n\n\n \n\n\n\n International Journal of Antimicrobial Agents. August 2017.\n \n\n\n\n
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\n\n\n@article{baclet_explicit_2017,\n\ttitle = {Explicit definitions of potentially inappropriate prescriptions of antibiotics in older patients: a compilation derived from a systematic review},\n\tissn = {1872-7913},\n\tshorttitle = {Explicit definitions of potentially inappropriate prescriptions of antibiotics in older patients},\n\turl = {https://nextcloud.univ-lille.fr/index.php/s/qr4PSf9eqC9DGKM},\n\tdoi = {10.1016/j.ijantimicag.2017.08.011},\n\tabstract = {CONTEXT: Potentially inappropriate prescriptions (PIPs) of antibiotics (antibiotic-PIPs) are generally detected by applying implicit definitions based on expert opinion. Explicit definitions are less frequently used, even though this approach would enable the automated detection of antibiotic-PIPs in electronic health records. Here, we systematically reviewed explicit definitions of antibiotic-PIPs used in studies of older adults.\nMETHOD: We searched the MEDLINE(®), Scopus(®) and Web of Science(TM) core collection databases with a combination of three terms and their synonyms: "potentially inappropriate prescription" AND "antibiotic treatment" AND "older patients". After the standardized selection of publications, explicit definitions of antibiotic-PIPs were extracted and classified into infectious disease domains and sub-domains.\nRESULTS: A total of 600 search queries identified 4,270 records, 93 of which were selected for review. We found 160 mentions of antibiotic-PIPs, corresponding to 62 distinct definitions in 19 infectious disease domains. Nearly half of the definitions were related to upper respiratory tract infections (n=11 definitions; 17.7\\%), lower respiratory tract infections (n=8; 12.9\\%) and drug-drug interactions (n=11; 17.7\\%). Almost 75\\% of the definitions (n=46) were mentioned in a single study only. Only three definitions concerned critically important antibiotics, such as third-generation cephalosporins and fluoroquinolones.\nCONCLUSION: Our systematic review identified 62 explicit definitions of antibiotic-PIPs. Most of the definitions were not found in more than one study, and they varied in the degree of precision. We advocate the implementation of an expert consensus on explicit definitions of antibiotic-PIPs that correspond to today's challenges in public health.},\n\tlanguage = {eng},\n\tjournal = {International Journal of Antimicrobial Agents},\n\tauthor = {Baclet, Nicolas and Ficheur, Grégoire and Alfandari, Serge and Ferret, Laurie and Senneville, Eric and Chazard, Emmanuel and Beuscart, Jean-Baptiste},\n\tmonth = aug,\n\tyear = {2017},\n\tpmid = {28803931},\n\tkeywords = {Antibiotics, Elderly, Potentially Inappropriate Prescription},\n}\n\n\n\n CONTEXT: Potentially inappropriate prescriptions (PIPs) of antibiotics (antibiotic-PIPs) are generally detected by applying implicit definitions based on expert opinion. Explicit definitions are less frequently used, even though this approach would enable the automated detection of antibiotic-PIPs in electronic health records. Here, we systematically reviewed explicit definitions of antibiotic-PIPs used in studies of older adults. METHOD: We searched the MEDLINE(®), Scopus(®) and Web of Science(TM) core collection databases with a combination of three terms and their synonyms: \"potentially inappropriate prescription\" AND \"antibiotic treatment\" AND \"older patients\". After the standardized selection of publications, explicit definitions of antibiotic-PIPs were extracted and classified into infectious disease domains and sub-domains. RESULTS: A total of 600 search queries identified 4,270 records, 93 of which were selected for review. We found 160 mentions of antibiotic-PIPs, corresponding to 62 distinct definitions in 19 infectious disease domains. Nearly half of the definitions were related to upper respiratory tract infections (n=11 definitions; 17.7%), lower respiratory tract infections (n=8; 12.9%) and drug-drug interactions (n=11; 17.7%). Almost 75% of the definitions (n=46) were mentioned in a single study only. Only three definitions concerned critically important antibiotics, such as third-generation cephalosporins and fluoroquinolones. CONCLUSION: Our systematic review identified 62 explicit definitions of antibiotic-PIPs. Most of the definitions were not found in more than one study, and they varied in the degree of precision. We advocate the implementation of an expert consensus on explicit definitions of antibiotic-PIPs that correspond to today's challenges in public health.\n
\n\n\n\n \n\n \n \n \n \n \n \n Underuse of Oral Anticoagulants and Inappropriate Prescription of Antiplatelet Therapy in Older Inpatients with Atrial Fibrillation.\n \n \n \n \n\n\n \n Averlant, L.; Ficheur, G.; Ferret, L.; Boulé, S.; Puisieux, F.; Luyckx, M.; Soula, J.; Georges, A.; Beuscart, R.; Chazard, E.; and Beuscart, J.\n\n\n \n\n\n\n Drugs & Aging. July 2017.\n \n\n\n\n
\n\n\n\n \n \nPaper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n \n \n 1 download\n \n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n
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\n\n\n@article{averlant_underuse_2017,\n\ttitle = {Underuse of {Oral} {Anticoagulants} and {Inappropriate} {Prescription} of {Antiplatelet} {Therapy} in {Older} {Inpatients} with {Atrial} {Fibrillation}},\n\tissn = {1179-1969},\n\turl = {https://nextcloud.univ-lille.fr/index.php/s/E64mqC4yePRP653},\n\tdoi = {10.1007/s40266-017-0477-3},\n\tabstract = {BACKGROUND: Several studies have shown that the prescription of antiplatelet therapy (APT) is associated with an increased risk of oral anticoagulant (OAC) underuse in patients aged 75 years and over with atrial fibrillation (AF). An associated atheromatous disease may be the underlying reason for APT prescription. The objective of the study was to determine whether the association between underuse of OAC and APT prescription was explained by the presence of an atheromatous disease.\nMETHODS AND RESULTS: We performed a retrospective, observational, single-centre study between 2009 and 2013 based on administrative data. Patients aged 75 years and over with non-valvular AF were identified in a database of 72,090 hospital stays. Prescriptions of anti-thrombotic medications and their association with the presence of atheromatous disease were evaluated by the mean of a logistic regression. A total of 2034 hospital stays were included (mean age 84.3 ± 5.2 years). The overall prevalence of known atheromatous disease was 25.9\\%. OAC underuse was observed in 58.5\\% of the stays. In multivariable analysis, the prescription of an APT was associated with an increased risk of OAC underuse [odds ratio (OR) 6.85; 95\\% confidence interval (CI) 5.50-8.58], independently of the presence of a concomitant known atheromatous disease (OR 0.78; 95\\% CI 0.60-1.01). Among the 692 stays with APT monotherapy (34.0\\%), 232 (33.5\\%) displayed an atheromatous disease.\nCONCLUSIONS: The underuse of OAC is associated with the prescription of APT in older patients with AF, regardless of the presence or absence of known atheromatous disease. Our results suggest that APT is often inappropriately prescribed instead of OAC.},\n\tlanguage = {eng},\n\tjournal = {Drugs \\& Aging},\n\tauthor = {Averlant, Lorette and Ficheur, Grégoire and Ferret, Laurie and Boulé, Stéphane and Puisieux, François and Luyckx, Michel and Soula, Julien and Georges, Alexandre and Beuscart, Régis and Chazard, Emmanuel and Beuscart, Jean-Baptiste},\n\tmonth = jul,\n\tyear = {2017},\n\tpmid = {28702928},\n}\n\n\n\n BACKGROUND: Several studies have shown that the prescription of antiplatelet therapy (APT) is associated with an increased risk of oral anticoagulant (OAC) underuse in patients aged 75 years and over with atrial fibrillation (AF). An associated atheromatous disease may be the underlying reason for APT prescription. The objective of the study was to determine whether the association between underuse of OAC and APT prescription was explained by the presence of an atheromatous disease. METHODS AND RESULTS: We performed a retrospective, observational, single-centre study between 2009 and 2013 based on administrative data. Patients aged 75 years and over with non-valvular AF were identified in a database of 72,090 hospital stays. Prescriptions of anti-thrombotic medications and their association with the presence of atheromatous disease were evaluated by the mean of a logistic regression. A total of 2034 hospital stays were included (mean age 84.3 ± 5.2 years). The overall prevalence of known atheromatous disease was 25.9%. OAC underuse was observed in 58.5% of the stays. In multivariable analysis, the prescription of an APT was associated with an increased risk of OAC underuse [odds ratio (OR) 6.85; 95% confidence interval (CI) 5.50-8.58], independently of the presence of a concomitant known atheromatous disease (OR 0.78; 95% CI 0.60-1.01). Among the 692 stays with APT monotherapy (34.0%), 232 (33.5%) displayed an atheromatous disease. CONCLUSIONS: The underuse of OAC is associated with the prescription of APT in older patients with AF, regardless of the presence or absence of known atheromatous disease. Our results suggest that APT is often inappropriately prescribed instead of OAC.\n
\n\n\n\n \n\n \n \n \n \n \n \n A systematic review of the outcomes reported in trials of medication review in older patients: the need for a core outcome set.\n \n \n \n \n\n\n \n Beuscart, J.; Pont, L. G.; Thevelin, S.; Boland, B.; Dalleur, O.; Rutjes, A. W. S.; Westbrook, J. I.; and Spinewine, A.\n\n\n \n\n\n\n British Journal of Clinical Pharmacology, 83(5): 942–952. May 2017.\n \n\n\n\n
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\n\n\n@article{beuscart_systematic_2017,\n\ttitle = {A systematic review of the outcomes reported in trials of medication review in older patients: the need for a core outcome set},\n\tvolume = {83},\n\tissn = {1365-2125},\n\tshorttitle = {A systematic review of the outcomes reported in trials of medication review in older patients},\n\turl = {https://nextcloud.univ-lille.fr/index.php/s/onHQGgmAoFizk7w},\n\tdoi = {10.1111/bcp.13197},\n\tabstract = {AIM: Medication review has been advocated as one of the measures to tackle the challenge of polypharmacy in older patients, yet there is no consensus on how best to evaluate its efficacy. This study aimed to assess outcome reporting in trials of medication review in older patients.\nMETHODS: Randomized controlled trials (RCTs), prospective studies and RCT protocols involving medication review performed in patients aged 65 years or older in any setting of care were identified from: (1) a recent systematic review; (2) RCT registries of ongoing studies; (3) the Cochrane library. The type, definition, and frequency of all outcomes reported were extracted independently by two researchers.\nRESULTS: Forty-seven RCTs or prospective published studies and 32 RCT protocols were identified. A total of 327 distinct outcomes were identified in the 47 published studies. Only one fifth (21\\%) of the studies evaluated the impact of medication reviews on adverse events such as drug reactions or drug-related hospital admissions. Most of the outcomes were related to medication use (n = 114, 35\\%) and healthcare use (n = 74, 23\\%). Very few outcomes were patient-related (n = 24, 7\\%). A total of 248 distinct outcomes were identified in the 32 RCT protocols. Overall, the number of outcomes and the number and type of health domains covered by the outcomes varied largely.\nCONCLUSION: Outcome reporting from RCTs concerning medication review in older patients is heterogeneous. This review highlights the need for a standardized core outcome set for medication review in older patients, to improve outcome reporting and evidence synthesis.},\n\tlanguage = {eng},\n\tnumber = {5},\n\tjournal = {British Journal of Clinical Pharmacology},\n\tauthor = {Beuscart, Jean-Baptiste and Pont, Lisa G. and Thevelin, Stefanie and Boland, Benoit and Dalleur, Olivia and Rutjes, Anne W. S. and Westbrook, Johanna I. and Spinewine, Anne},\n\tmonth = may,\n\tyear = {2017},\n\tpmid = {27891666},\n\tkeywords = {elderly, medication review, outcomes assessment, randomized controlled trials, systematic review},\n\tpages = {942--952},\n}\n\n\n\n AIM: Medication review has been advocated as one of the measures to tackle the challenge of polypharmacy in older patients, yet there is no consensus on how best to evaluate its efficacy. This study aimed to assess outcome reporting in trials of medication review in older patients. METHODS: Randomized controlled trials (RCTs), prospective studies and RCT protocols involving medication review performed in patients aged 65 years or older in any setting of care were identified from: (1) a recent systematic review; (2) RCT registries of ongoing studies; (3) the Cochrane library. The type, definition, and frequency of all outcomes reported were extracted independently by two researchers. RESULTS: Forty-seven RCTs or prospective published studies and 32 RCT protocols were identified. A total of 327 distinct outcomes were identified in the 47 published studies. Only one fifth (21%) of the studies evaluated the impact of medication reviews on adverse events such as drug reactions or drug-related hospital admissions. Most of the outcomes were related to medication use (n = 114, 35%) and healthcare use (n = 74, 23%). Very few outcomes were patient-related (n = 24, 7%). A total of 248 distinct outcomes were identified in the 32 RCT protocols. Overall, the number of outcomes and the number and type of health domains covered by the outcomes varied largely. CONCLUSION: Outcome reporting from RCTs concerning medication review in older patients is heterogeneous. This review highlights the need for a standardized core outcome set for medication review in older patients, to improve outcome reporting and evidence synthesis.\n
\n\n\n\n \n\n \n \n \n \n \n Co-prescriptions of psychotropic drugs to older patients in a general hospital.\n \n \n \n\n\n \n Beuscart, J.; Ficheur, G.; Miqueu, M.; Luyckx, M.; Perichon, R.; Puisieux, F.; Beuscart, R.; Chazard, E.; and Ferret, L.\n\n\n \n\n\n\n European Geriatric Medicine, 8(1): 84–89. 2017.\n \n\n\n\n
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\n\n\n@article{beuscart_co-prescriptions_2017,\n\ttitle = {Co-prescriptions of psychotropic drugs to older patients in a general hospital},\n\tvolume = {8},\n\tdoi = {10.1016/j.eurger.2016.11.012},\n\tabstract = {Introduction The prescription of psychotropic drugs to older patients in a hospital setting has not been extensively characterized. The objective was to describe the inappropriate co-prescriptions of psychotropic drugs in hospitalized patients aged 75 and over. Methods By analysing the medical database from 222-bed general hospital in France, we reviewed a total of 11,929 stays of at least 3 days by patients aged 75 and over. Prescriptions and co-prescriptions of psychotropic drugs were identified automatically. Anticholinergic drugs with sedative effects were considered as psychotropic drugs. An expert review was performed for stays with the co-prescription of three or more psychotropic drugs to identify inappropriate co-prescriptions. Results Administration of a psychotropic drug was identified in 5475 stays (45.9\\% of the total number of stays), of which 1526 (12.8\\% of the total) featured at least one co-prescription. Co-prescriptions of three or more psychotropic drugs for at least 3 days were identified in 374 stays (3.1\\% of the total). Most of these co-prescriptions (n = 334; 89.2\\%) were considered inappropriate because of the combination of at least two drugs from the same psychotropic class (n = 269), the absence of a clear indication for a psychotropic drug (n = 173) and a history of falls (n = 86). However, the co-prescriptions were maintained after hospital discharge in 77.4\\% of cases. Conclusion The co-prescriptions of psychotropic drugs should be re-evaluated in older hospitalized patients. © 2016 Elsevier Masson SAS and European Union Geriatric Medicine Society},\n\tnumber = {1},\n\tjournal = {European Geriatric Medicine},\n\tauthor = {Beuscart, J.-B. and Ficheur, G. and Miqueu, M. and Luyckx, M. and Perichon, R. and Puisieux, F. and Beuscart, R. and Chazard, E. and Ferret, L.},\n\tyear = {2017},\n\tkeywords = {Data reuse, Inappropriate prescribing, Psychotropic drugs},\n\tpages = {84--89},\n}\n\n\n\n Introduction The prescription of psychotropic drugs to older patients in a hospital setting has not been extensively characterized. The objective was to describe the inappropriate co-prescriptions of psychotropic drugs in hospitalized patients aged 75 and over. Methods By analysing the medical database from 222-bed general hospital in France, we reviewed a total of 11,929 stays of at least 3 days by patients aged 75 and over. Prescriptions and co-prescriptions of psychotropic drugs were identified automatically. Anticholinergic drugs with sedative effects were considered as psychotropic drugs. An expert review was performed for stays with the co-prescription of three or more psychotropic drugs to identify inappropriate co-prescriptions. Results Administration of a psychotropic drug was identified in 5475 stays (45.9% of the total number of stays), of which 1526 (12.8% of the total) featured at least one co-prescription. Co-prescriptions of three or more psychotropic drugs for at least 3 days were identified in 374 stays (3.1% of the total). Most of these co-prescriptions (n = 334; 89.2%) were considered inappropriate because of the combination of at least two drugs from the same psychotropic class (n = 269), the absence of a clear indication for a psychotropic drug (n = 173) and a history of falls (n = 86). However, the co-prescriptions were maintained after hospital discharge in 77.4% of cases. Conclusion The co-prescriptions of psychotropic drugs should be re-evaluated in older hospitalized patients. © 2016 Elsevier Masson SAS and European Union Geriatric Medicine Society\n
\n\n\n\n \n\n \n \n \n \n \n IT-CARES: an interactive tool for case-crossover analyses of electronic medical records for patient safety.\n \n \n \n\n\n \n Caron, A.; Chazard, E.; Muller, J.; Perichon, R.; Ferret, L.; Koutkias, V.; Beuscart, R.; Beuscart, J.; and Ficheur, G.\n\n\n \n\n\n\n Journal of the American Medical Informatics Association: JAMIA, 24(2): 323–330. March 2017.\n \n\n\n\n
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\n\n\n@article{caron_it-cares:_2017,\n\ttitle = {{IT}-{CARES}: an interactive tool for case-crossover analyses of electronic medical records for patient safety},\n\tvolume = {24},\n\tissn = {1527-974X},\n\tshorttitle = {{IT}-{CARES}},\n\tdoi = {10.1093/jamia/ocw132},\n\tabstract = {Background: The significant risk of adverse events following medical procedures supports a clinical epidemiological approach based on the analyses of collections of electronic medical records. Data analytical tools might help clinical epidemiologists develop more appropriate case-crossover designs for monitoring patient safety.\nObjective: To develop and assess the methodological quality of an interactive tool for use by clinical epidemiologists to systematically design case-crossover analyses of large electronic medical records databases.\nMaterial and Methods: We developed IT-CARES, an analytical tool implementing case-crossover design, to explore the association between exposures and outcomes. The exposures and outcomes are defined by clinical epidemiologists via lists of codes entered via a user interface screen. We tested IT-CARES on data from the French national inpatient stay database, which documents diagnoses and medical procedures for 170 million inpatient stays between 2007 and 2013. We compared the results of our analysis with reference data from the literature on thromboembolic risk after delivery and bleeding risk after total hip replacement.\nResults: IT-CARES provides a user interface with 3 columns: (i) the outcome criteria in the left-hand column, (ii) the exposure criteria in the right-hand column, and (iii) the estimated risk (odds ratios, presented in both graphical and tabular formats) in the middle column. The estimated odds ratios were consistent with the reference literature data.\nDiscussion: IT-CARES may enhance patient safety by facilitating clinical epidemiological studies of adverse events following medical procedures. The tool's usability must be evaluated and improved in further research.},\n\tlanguage = {eng},\n\tnumber = {2},\n\tjournal = {Journal of the American Medical Informatics Association: JAMIA},\n\tauthor = {Caron, Alexandre and Chazard, Emmanuel and Muller, Joris and Perichon, Renaud and Ferret, Laurie and Koutkias, Vassilis and Beuscart, Régis and Beuscart, Jean-Baptiste and Ficheur, Grégoire},\n\tmonth = mar,\n\tyear = {2017},\n\tpmid = {27678461},\n\tpmcid = {PMC5391728},\n\tkeywords = {Patient safety, adverse event, big data, clinical epidemiology, data analytics, medical informatics},\n\tpages = {323--330},\n}\n\n\n\n Background: The significant risk of adverse events following medical procedures supports a clinical epidemiological approach based on the analyses of collections of electronic medical records. Data analytical tools might help clinical epidemiologists develop more appropriate case-crossover designs for monitoring patient safety. Objective: To develop and assess the methodological quality of an interactive tool for use by clinical epidemiologists to systematically design case-crossover analyses of large electronic medical records databases. Material and Methods: We developed IT-CARES, an analytical tool implementing case-crossover design, to explore the association between exposures and outcomes. The exposures and outcomes are defined by clinical epidemiologists via lists of codes entered via a user interface screen. We tested IT-CARES on data from the French national inpatient stay database, which documents diagnoses and medical procedures for 170 million inpatient stays between 2007 and 2013. We compared the results of our analysis with reference data from the literature on thromboembolic risk after delivery and bleeding risk after total hip replacement. Results: IT-CARES provides a user interface with 3 columns: (i) the outcome criteria in the left-hand column, (ii) the exposure criteria in the right-hand column, and (iii) the estimated risk (odds ratios, presented in both graphical and tabular formats) in the middle column. The estimated odds ratios were consistent with the reference literature data. Discussion: IT-CARES may enhance patient safety by facilitating clinical epidemiological studies of adverse events following medical procedures. The tool's usability must be evaluated and improved in further research.\n
\n\n\n\n \n\n \n \n \n \n \n Potentially inappropriate medication prescribing is associated with socioeconomic factors: a spatial analysis in the French Nord-Pas-de-Calais Region.\n \n \n \n\n\n \n Beuscart, J.; Genin, M.; Dupont, C.; Verloop, D.; Duhamel, A.; Defebvre, M.; and Puisieux, F.\n\n\n \n\n\n\n Age and Ageing, 46(4): 607–613. July 2017.\n \n\n\n\n
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\n\n\n@article{beuscart_potentially_2017,\n\ttitle = {Potentially inappropriate medication prescribing is associated with socioeconomic factors: a spatial analysis in the {French} {Nord}-{Pas}-de-{Calais} {Region}},\n\tvolume = {46},\n\tissn = {1468-2834},\n\tshorttitle = {Potentially inappropriate medication prescribing is associated with socioeconomic factors},\n\tdoi = {10.1093/ageing/afw245},\n\tabstract = {Background: potentially inappropriate medication (PIM) prescribing is common in older people and leads to adverse events and hospital admissions.\nObjective: to determine whether prevalence of PIM prescribing varies according to healthcare supply and socioeconomic status.\nMethods: all prescriptions dispensed at community pharmacies for patients aged 75 and older between 1 January and 31 March 2012 were retrieved from French Health Insurance Information System of the Nord-Pas-de-Calais Region for patients affiliated to the Social Security scheme. PIM was defined according to the French list of Laroche. The geographic distribution of PIM prescribing in this area was analysed using spatial scan statistics.\nResults: overall, 65.6\\% (n = 207,979) of people aged 75 years and over living in the Nord-Pas-de-Calais Region were included. Among them, 32.6\\% (n = 67,863) received at least one PIM. The spatial analysis identified 16 and 10 clusters of municipalities with a high and a low prevalence of PIM prescribing, respectively. Municipalities with a low prevalence of PIM were characterised by a high socioeconomic status whereas those with a high prevalence of PIM were mainly characterised by a low socioeconomic status, such as a high unemployment rate and low household incomes. Markers of healthcare supply were weakly associated with high or low prevalence clusters.\nConclusion: significant geographic variation in PIM prescribing was observed in the study territory and was mainly associated with socioeconomic factors.},\n\tlanguage = {eng},\n\tnumber = {4},\n\tjournal = {Age and Ageing},\n\tauthor = {Beuscart, Jean-Baptiste and Genin, Michael and Dupont, Corrine and Verloop, David and Duhamel, Alain and Defebvre, Marguerite-Marie and Puisieux, François},\n\tmonth = jul,\n\tyear = {2017},\n\tpmid = {28064169},\n\tkeywords = {inappropriate prescribing, older people, pharmacoepidemiology, scan statistics},\n\tpages = {607--613},\n}\n\n\n\n Background: potentially inappropriate medication (PIM) prescribing is common in older people and leads to adverse events and hospital admissions. Objective: to determine whether prevalence of PIM prescribing varies according to healthcare supply and socioeconomic status. Methods: all prescriptions dispensed at community pharmacies for patients aged 75 and older between 1 January and 31 March 2012 were retrieved from French Health Insurance Information System of the Nord-Pas-de-Calais Region for patients affiliated to the Social Security scheme. PIM was defined according to the French list of Laroche. The geographic distribution of PIM prescribing in this area was analysed using spatial scan statistics. Results: overall, 65.6% (n = 207,979) of people aged 75 years and over living in the Nord-Pas-de-Calais Region were included. Among them, 32.6% (n = 67,863) received at least one PIM. The spatial analysis identified 16 and 10 clusters of municipalities with a high and a low prevalence of PIM prescribing, respectively. Municipalities with a low prevalence of PIM were characterised by a high socioeconomic status whereas those with a high prevalence of PIM were mainly characterised by a low socioeconomic status, such as a high unemployment rate and low household incomes. Markers of healthcare supply were weakly associated with high or low prevalence clusters. Conclusion: significant geographic variation in PIM prescribing was observed in the study territory and was mainly associated with socioeconomic factors.\n
\n\n\n\n \n\n \n \n \n \n \n How to Compare the Length of Stay of Two Samples of Inpatients? A Simulation Study to Compare Type I and Type II Errors of 12 Statistical Tests.\n \n \n \n\n\n \n Chazard, E.; Ficheur, G.; Beuscart, J.; and Preda, C.\n\n\n \n\n\n\n Value in Health: The Journal of the International Society for Pharmacoeconomics and Outcomes Research, 20(7): 992–998. August 2017.\n \n\n\n\n
\n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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\n\n\n@article{chazard_how_2017,\n\ttitle = {How to {Compare} the {Length} of {Stay} of {Two} {Samples} of {Inpatients}? {A} {Simulation} {Study} to {Compare} {Type} {I} and {Type} {II} {Errors} of 12 {Statistical} {Tests}},\n\tvolume = {20},\n\tissn = {1524-4733},\n\tshorttitle = {How to {Compare} the {Length} of {Stay} of {Two} {Samples} of {Inpatients}?},\n\tdoi = {10.1016/j.jval.2017.02.009},\n\tabstract = {BACKGROUND: Although many researchers in the field of health economics and quality of care compare the length of stay (LOS) in two inpatient samples, they often fail to check whether the sample meets the assumptions made by their chosen statistical test. In fact, LOS data show a highly right-skewed, discrete distribution in which most of the observations are tied; this violates the assumptions of most statistical tests.\nOBJECTIVES: To estimate the type I and type II errors associated with the application of 12 different statistical tests to a series of LOS samples.\nMETHODS: The LOS distribution was extracted from an exhaustive French national database of inpatient stays. The type I error was estimated using 19 sample sizes and 1,000,000 simulations per sample. The type II error was estimated in three alternative scenarios. For each test, the type I and type II errors were plotted as a function of the sample size.\nRESULTS: Gamma regression with log link, the log rank test, median regression, Poisson regression, and Weibull survival analysis presented an unacceptably high type I error. In contrast, the Student standard t test, linear regression with log link, and the Cox models had an acceptable type I error but low power.\nCONCLUSIONS: When comparing the LOS for two balanced inpatient samples, the Student t test with logarithmic or rank transformation, the Wilcoxon test, and the Kruskal-Wallis test are the only methods with an acceptable type I error and high power.},\n\tlanguage = {eng},\n\tnumber = {7},\n\tjournal = {Value in Health: The Journal of the International Society for Pharmacoeconomics and Outcomes Research},\n\tauthor = {Chazard, Emmanuel and Ficheur, Grégoire and Beuscart, Jean-Baptiste and Preda, Cristian},\n\tmonth = aug,\n\tyear = {2017},\n\tpmid = {28712630},\n\tkeywords = {Computer Simulation, Data Interpretation, Statistical, Databases, Factual, France, Humans, Inpatients, Length of Stay, Outcome Assessment (Health Care), Poisson Distribution, Proportional Hazards Models, Regression Analysis, Sample Size, Statistics, Nonparametric, Survival Analysis, length of stay, methodology, outcome measurement, statistics},\n\tpages = {992--998},\n}\n\n\n\n BACKGROUND: Although many researchers in the field of health economics and quality of care compare the length of stay (LOS) in two inpatient samples, they often fail to check whether the sample meets the assumptions made by their chosen statistical test. In fact, LOS data show a highly right-skewed, discrete distribution in which most of the observations are tied; this violates the assumptions of most statistical tests. OBJECTIVES: To estimate the type I and type II errors associated with the application of 12 different statistical tests to a series of LOS samples. METHODS: The LOS distribution was extracted from an exhaustive French national database of inpatient stays. The type I error was estimated using 19 sample sizes and 1,000,000 simulations per sample. The type II error was estimated in three alternative scenarios. For each test, the type I and type II errors were plotted as a function of the sample size. RESULTS: Gamma regression with log link, the log rank test, median regression, Poisson regression, and Weibull survival analysis presented an unacceptably high type I error. In contrast, the Student standard t test, linear regression with log link, and the Cox models had an acceptable type I error but low power. CONCLUSIONS: When comparing the LOS for two balanced inpatient samples, the Student t test with logarithmic or rank transformation, the Wilcoxon test, and the Kruskal-Wallis test are the only methods with an acceptable type I error and high power.\n
\n\n\n\n \n\n \n \n \n \n \n No increase in small-solute transport in peritoneal dialysis patients treated without hypertonic glucose for fifty-four months.\n \n \n \n\n\n \n Pagniez, D.; Duhamel, A.; Boulanger, E.; Lessore de Sainte Foy, C.; and Beuscart, J.\n\n\n \n\n\n\n BMC nephrology, 18(1): 278. August 2017.\n \n\n\n\n
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\n\n\n@article{pagniez_no_2017,\n\ttitle = {No increase in small-solute transport in peritoneal dialysis patients treated without hypertonic glucose for fifty-four months},\n\tvolume = {18},\n\tissn = {1471-2369},\n\tdoi = {10.1186/s12882-017-0690-7},\n\tabstract = {BACKGROUND: Glucose is widely used as an osmotic agent in peritoneal dialysis (PD), but exerts untoward effects on the peritoneum. The potential protective effect of a reduced exposure to hypertonic glucose has never been investigated.\nMETHODS: The cohort of PD patients attending our center which tackled the challenge of a restricted use of hypertonic glucose solutions has been prospectively followed since 1992. Small-solute transport was assessed using an equivalent of the glucose peritoneal equilibration test after 6 months, and then every year. Study was stopped on July 1st, 2008, before use of biocompatible solutions. Repeated measures in patients treated with PD for 54 months were analyzed by using (1) the slopes of the linear regression for D4/D0 ratios over time computed for each individual, and (2) a linear mixed model.\nRESULTS: In the study period, 44 patients were treated for a total of 2376 months, 2058 without hypertonic glucose. There was one episode of peritoneal infection every 18 patient-months. The mean of slopes of the linear regression for D4/D0 ratios was found to be significantly positive (Student's test, p {\\textless} .001) and the results of the mixed model reflected a similar significant increase for D4/D0 ratios over time. These results reflected a significant decrease of small-solute transport.\nCONCLUSION: In this large series, minimizing the use of hypertonic glucose solutions was associated in patients on long term PD with an overall decrease of small-solute transport within 54 months, despite a high rate of peritoneal infection.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {BMC nephrology},\n\tauthor = {Pagniez, Dominique and Duhamel, Alain and Boulanger, Eric and Lessore de Sainte Foy, Celia and Beuscart, Jean-Baptiste},\n\tmonth = aug,\n\tyear = {2017},\n\tpmid = {28859606},\n\tpmcid = {PMC5580320},\n\tkeywords = {Glucose exposure, Glucose sparing, Peritoneal dialysis, Peritoneal equilibration test, Small-solute transport},\n\tpages = {278},\n}\n\n\n\n BACKGROUND: Glucose is widely used as an osmotic agent in peritoneal dialysis (PD), but exerts untoward effects on the peritoneum. The potential protective effect of a reduced exposure to hypertonic glucose has never been investigated. METHODS: The cohort of PD patients attending our center which tackled the challenge of a restricted use of hypertonic glucose solutions has been prospectively followed since 1992. Small-solute transport was assessed using an equivalent of the glucose peritoneal equilibration test after 6 months, and then every year. Study was stopped on July 1st, 2008, before use of biocompatible solutions. Repeated measures in patients treated with PD for 54 months were analyzed by using (1) the slopes of the linear regression for D4/D0 ratios over time computed for each individual, and (2) a linear mixed model. RESULTS: In the study period, 44 patients were treated for a total of 2376 months, 2058 without hypertonic glucose. There was one episode of peritoneal infection every 18 patient-months. The mean of slopes of the linear regression for D4/D0 ratios was found to be significantly positive (Student's test, p \\textless .001) and the results of the mixed model reflected a similar significant increase for D4/D0 ratios over time. These results reflected a significant decrease of small-solute transport. CONCLUSION: In this large series, minimizing the use of hypertonic glucose solutions was associated in patients on long term PD with an overall decrease of small-solute transport within 54 months, despite a high rate of peritoneal infection.\n
\n\n\n\n \n\n \n \n \n \n \n A generic method for improving the spatial interoperability of medical and ecological databases.\n \n \n \n\n\n \n Ghenassia, A.; Beuscart, J. B.; Ficheur, G.; Occelli, F.; Babykina, E.; Chazard, E.; and Genin, M.\n\n\n \n\n\n\n International Journal of Health Geographics, 16(1): 36. October 2017.\n \n\n\n\n
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\n\n\n \n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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\n\n\n@article{ghenassia_generic_2017,\n\ttitle = {A generic method for improving the spatial interoperability of medical and ecological databases},\n\tvolume = {16},\n\tissn = {1476-072X},\n\tdoi = {10.1186/s12942-017-0109-5},\n\tabstract = {BACKGROUND: The availability of big data in healthcare and the intensive development of data reuse and georeferencing have opened up perspectives for health spatial analysis. However, fine-scale spatial studies of ecological and medical databases are limited by the change of support problem and thus a lack of spatial unit interoperability. The use of spatial disaggregation methods to solve this problem introduces errors into the spatial estimations. Here, we present a generic, two-step method for merging medical and ecological databases that avoids the use of spatial disaggregation methods, while maximizing the spatial resolution.\nMETHODS: Firstly, a mapping table is created after one or more transition matrices have been defined. The latter link the spatial units of the original databases to the spatial units of the final database. Secondly, the mapping table is validated by (1) comparing the covariates contained in the two original databases, and (2) checking the spatial validity with a spatial continuity criterion and a spatial resolution index.\nRESULTS: We used our novel method to merge a medical database (the French national diagnosis-related group database, containing 5644 spatial units) with an ecological database (produced by the French National Institute of Statistics and Economic Studies, and containing with 36,594 spatial units). The mapping table yielded 5632 final spatial units. The mapping table's validity was evaluated by comparing the number of births in the medical database and the ecological databases in each final spatial unit. The median [interquartile range] relative difference was 2.3\\% [0; 5.7]. The spatial continuity criterion was low (2.4\\%), and the spatial resolution index was greater than for most French administrative areas.\nCONCLUSIONS: Our innovative approach improves interoperability between medical and ecological databases and facilitates fine-scale spatial analyses. We have shown that disaggregation models and large aggregation techniques are not necessarily the best ways to tackle the change of support problem.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {International Journal of Health Geographics},\n\tauthor = {Ghenassia, A. and Beuscart, J. B. and Ficheur, G. and Occelli, F. and Babykina, E. and Chazard, E. and Genin, M.},\n\tmonth = oct,\n\tyear = {2017},\n\tpmid = {28974262},\n\tkeywords = {Change-of-support problem, Data reuse, Interoperability, Spatial analysis},\n\tpages = {36},\n}\n\n\n\n BACKGROUND: The availability of big data in healthcare and the intensive development of data reuse and georeferencing have opened up perspectives for health spatial analysis. However, fine-scale spatial studies of ecological and medical databases are limited by the change of support problem and thus a lack of spatial unit interoperability. The use of spatial disaggregation methods to solve this problem introduces errors into the spatial estimations. Here, we present a generic, two-step method for merging medical and ecological databases that avoids the use of spatial disaggregation methods, while maximizing the spatial resolution. METHODS: Firstly, a mapping table is created after one or more transition matrices have been defined. The latter link the spatial units of the original databases to the spatial units of the final database. Secondly, the mapping table is validated by (1) comparing the covariates contained in the two original databases, and (2) checking the spatial validity with a spatial continuity criterion and a spatial resolution index. RESULTS: We used our novel method to merge a medical database (the French national diagnosis-related group database, containing 5644 spatial units) with an ecological database (produced by the French National Institute of Statistics and Economic Studies, and containing with 36,594 spatial units). The mapping table yielded 5632 final spatial units. The mapping table's validity was evaluated by comparing the number of births in the medical database and the ecological databases in each final spatial unit. The median [interquartile range] relative difference was 2.3% [0; 5.7]. The spatial continuity criterion was low (2.4%), and the spatial resolution index was greater than for most French administrative areas. CONCLUSIONS: Our innovative approach improves interoperability between medical and ecological databases and facilitates fine-scale spatial analyses. We have shown that disaggregation models and large aggregation techniques are not necessarily the best ways to tackle the change of support problem.\n
\n\n\n\n \n\n \n \n \n \n \n \n Co-prescriptions of psychotropic drugs to older patients in a general hospital.\n \n \n \n \n\n\n \n Beuscart, J.; Ficheur, G.; Miqueu, M.; Luyckx, M.; Perichon, R.; Puisieux, F.; Beuscart, R.; Chazard, E.; and Ferret, L.\n\n\n \n\n\n\n European Geriatric Medicine, 8(1): 84–89. February 2017.\n \n\n\n\n
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\n\n\n\n@article{beuscart_co-prescriptions_2017-1,\n\ttitle = {Co-prescriptions of psychotropic drugs to older patients in a general hospital},\n\tvolume = {8},\n\tissn = {1878-7649},\n\turl = {http://www.europeangeriaticmedicine.com/article/S1878-7649(16)30191-7/fulltext},\n\tdoi = {10.1016/j.eurger.2016.11.012},\n\tlanguage = {English},\n\tnumber = {1},\n\turldate = {2017-06-21},\n\tjournal = {European Geriatric Medicine},\n\tauthor = {Beuscart, J.-B. and Ficheur, G. and Miqueu, M. and Luyckx, M. and Perichon, R. and Puisieux, F. and Beuscart, R. and Chazard, E. and Ferret, L.},\n\tmonth = feb,\n\tyear = {2017},\n\tkeywords = {Data reuse, Inappropriate Prescribing, Psychotropic Drugs},\n\tpages = {84--89},\n}\n\n\n\n \n\n \n \n \n \n \n Case-crossover study to examine the change in postpartum risk of pulmonary embolism over time.\n \n \n \n\n\n \n Ficheur, G.; Caron, A.; Beuscart, J.; Ferret, L.; Jung, Y.; Garabedian, C.; Beuscart, R.; and Chazard, E.\n\n\n \n\n\n\n BMC pregnancy and childbirth, 17(1): 119. April 2017.\n \n\n\n\n
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\n\n\n@article{ficheur_case-crossover_2017,\n\ttitle = {Case-crossover study to examine the change in postpartum risk of pulmonary embolism over time},\n\tvolume = {17},\n\tissn = {1471-2393},\n\tdoi = {10.1186/s12884-017-1283-y},\n\tabstract = {BACKGROUND: Although the current guidelines recommend anticoagulation up until 6 weeks after delivery in women at high risk of venous thromboembolism (VTE), the risk of VTE may extend beyond 6 weeks. Our objective was to estimate the risk of a pulmonary embolism in successive 2-week intervals during the postpartum period.\nMETHODS: In a population-based, case-crossover study, we analyzed the French national inpatient database from 2007 to 2013 (n = 5,517,680 singleton deliveries). Using ICD-10 codes, we identified women who were diagnosed with a postpartum pulmonary embolism between July 1(st), 2008, and December 31(st), 2013. Deliveries were identified during a case "period" immediately before the pulmonary embolism, and five different control periods one year before the pulmonary embolism. Using conditional logistic regression, Odds ratios (ORs) and 95\\% confidential intervals (CIs) were estimated for ten successive 2-week intervals that preceded the diagnosis of pulmonary embolism.\nRESULTS: We identified 167,103 cases with a pulmonary embolism during the inclusion period. After delivery, the risk of pulmonary embolism declined progressively over time, with an OR [95\\%CI] of 17.2 [14.0-21.3] in postpartum weeks 1 to 2 and 1.9 [1.4-2.7] in postpartum weeks 11 to 12. The OR [95\\%CI] in postpartum weeks 13 to 14 was 1.4 [0.9-2.0], and the OR did not fall significantly after postpartum week 14.\nCONCLUSIONS: Our findings indicate that women are at risk of a pulmonary embolism up to 12 weeks after delivery. The shape of the risk curve suggests that the risk decreases exponentially over time. Future research is needed to establish whether the duration of postpartum anticoagulation should be extended beyond 6 weeks.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {BMC pregnancy and childbirth},\n\tauthor = {Ficheur, Grégoire and Caron, Alexandre and Beuscart, Jean-Baptiste and Ferret, Laurie and Jung, Yu-Jin and Garabedian, Charles and Beuscart, Régis and Chazard, Emmanuel},\n\tmonth = apr,\n\tyear = {2017},\n\tpmid = {28410584},\n\tpmcid = {PMC5391590},\n\tpages = {119},\n}\n\n\n\n BACKGROUND: Although the current guidelines recommend anticoagulation up until 6 weeks after delivery in women at high risk of venous thromboembolism (VTE), the risk of VTE may extend beyond 6 weeks. Our objective was to estimate the risk of a pulmonary embolism in successive 2-week intervals during the postpartum period. METHODS: In a population-based, case-crossover study, we analyzed the French national inpatient database from 2007 to 2013 (n = 5,517,680 singleton deliveries). Using ICD-10 codes, we identified women who were diagnosed with a postpartum pulmonary embolism between July 1(st), 2008, and December 31(st), 2013. Deliveries were identified during a case \"period\" immediately before the pulmonary embolism, and five different control periods one year before the pulmonary embolism. Using conditional logistic regression, Odds ratios (ORs) and 95% confidential intervals (CIs) were estimated for ten successive 2-week intervals that preceded the diagnosis of pulmonary embolism. RESULTS: We identified 167,103 cases with a pulmonary embolism during the inclusion period. After delivery, the risk of pulmonary embolism declined progressively over time, with an OR [95%CI] of 17.2 [14.0-21.3] in postpartum weeks 1 to 2 and 1.9 [1.4-2.7] in postpartum weeks 11 to 12. The OR [95%CI] in postpartum weeks 13 to 14 was 1.4 [0.9-2.0], and the OR did not fall significantly after postpartum week 14. CONCLUSIONS: Our findings indicate that women are at risk of a pulmonary embolism up to 12 weeks after delivery. The shape of the risk curve suggests that the risk decreases exponentially over time. Future research is needed to establish whether the duration of postpartum anticoagulation should be extended beyond 6 weeks.\n
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\n \n \n\n \n \n \n \n \n \n Incident delirium in acute geriatric medicine: Are iatrogenic causes really important?.\n \n \n \n \n\n\n \n Beuscart, J.; Convain, J.; Lemaitre, M.; Charpentier, A.; Perichon, R.; Gaxatte, C.; Boumbar, Y.; Boulanger, E.; and Puisieux, F.\n\n\n \n\n\n\n European Geriatric Medicine, 7(5): 492–496. 2016.\n \n\n\n\n
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\n\n\n@article{beuscart_incident_2016,\n\ttitle = {Incident delirium in acute geriatric medicine: {Are} iatrogenic causes really important?},\n\tvolume = {7},\n\tshorttitle = {Incident delirium in acute geriatric medicine},\n\turl = {https://nextcloud.univ-lille.fr/index.php/s/364SDHQQF4soHZT},\n\tdoi = {10.1016/j.eurger.2016.06.004},\n\tabstract = {Background The consequences of an incident delirium (ID) are multiple and severe among the hospitalized elderly patients. Many medications are recognized risk factors for delirium. The aim of this study was to determine the incidence of ID in an acute geriatric unit and to assess the role of iatrogenic factors among the precipitating factors of ID. Methods The study included 369 consecutive incident patients who were admitted in our Acute Geriatric Unit between January and April 2013. Delirium was diagnosed with the Confusion Assessment Method on a daily basis. The Naranjo criteria were used to determine iatrogenic causes of the ID. Results During the study, 34 (9.2\\%) patients exhibited 35 ID. A multifactorial origin was found in 26 (75\\%) of these ID. A therapeutic change likely to promote an ID was found for 11 of these ID. According to the criteria of Naranjo, seven (20\\%) of these ID were likely to have iatrogenic origins. Only one of these seven ID was caused exclusively by iatrogenic factors. Medication was less frequently implicated as a precipitating factor of ID than metabolic factors (n = 33; 94.4\\%), sources of discomfort (n = 29; 82.8\\%), or acute medical problems (n = 30; 85.7\\%). Conclusion The incidence of ID was about 10\\% in our acute geriatric unit. Iatrogenic factors were implicated in only one out of five ID and they were not among the three most common precipitating factors of ID. © 2016 Elsevier Masson SAS and European Union Geriatric Medicine Society},\n\tnumber = {5},\n\tjournal = {European Geriatric Medicine},\n\tauthor = {Beuscart, J.-B. and Convain, J. and Lemaitre, M. and Charpentier, A. and Perichon, R. and Gaxatte, C. and Boumbar, Y. and Boulanger, E. and Puisieux, F.},\n\tyear = {2016},\n\tkeywords = {Acute geriatric units, Adverse drug event, Delirium, Geriatric syndromes},\n\tpages = {492--496},\n}\n\n\n\n Background The consequences of an incident delirium (ID) are multiple and severe among the hospitalized elderly patients. Many medications are recognized risk factors for delirium. The aim of this study was to determine the incidence of ID in an acute geriatric unit and to assess the role of iatrogenic factors among the precipitating factors of ID. Methods The study included 369 consecutive incident patients who were admitted in our Acute Geriatric Unit between January and April 2013. Delirium was diagnosed with the Confusion Assessment Method on a daily basis. The Naranjo criteria were used to determine iatrogenic causes of the ID. Results During the study, 34 (9.2%) patients exhibited 35 ID. A multifactorial origin was found in 26 (75%) of these ID. A therapeutic change likely to promote an ID was found for 11 of these ID. According to the criteria of Naranjo, seven (20%) of these ID were likely to have iatrogenic origins. Only one of these seven ID was caused exclusively by iatrogenic factors. Medication was less frequently implicated as a precipitating factor of ID than metabolic factors (n = 33; 94.4%), sources of discomfort (n = 29; 82.8%), or acute medical problems (n = 30; 85.7%). Conclusion The incidence of ID was about 10% in our acute geriatric unit. Iatrogenic factors were implicated in only one out of five ID and they were not among the three most common precipitating factors of ID. © 2016 Elsevier Masson SAS and European Union Geriatric Medicine Society\n
\n\n\n\n \n\n \n \n \n \n \n \n Competing risk of death and end-stage renal disease in incident chronic kidney disease (stages 3 to 5): the EPIRAN community-based study.\n \n \n \n \n\n\n \n Ayav, C.; Beuscart, J.; Briançon, S.; Duhamel, A.; Frimat, L.; and Kessler, M.\n\n\n \n\n\n\n BMC nephrology, 17(1): 174. November 2016.\n \n\n\n\n
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\n\n\n@article{ayav_competing_2016,\n\ttitle = {Competing risk of death and end-stage renal disease in incident chronic kidney disease (stages 3 to 5): the {EPIRAN} community-based study},\n\tvolume = {17},\n\tissn = {1471-2369},\n\tshorttitle = {Competing risk of death and end-stage renal disease in incident chronic kidney disease (stages 3 to 5)},\n\turl = {https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-016-0379-3},\n\tdoi = {10.1186/s12882-016-0379-3},\n\tabstract = {BACKGROUND: Although chronic kidney disease (CKD) affects a growing number of people, epidemiologic data on incident CKD in the general population are scarce. Screening strategies to increase early CKD detection have been developed.\nMETHODS: From a community-based sample of 4,409 individuals residing in a well-defined geographical area, we determined the number of patients having a first serum creatinine value ≥1.7 mg/dL and present for at least 3 months that allowed us to calculate an annual incidence rate of CKD (stages 3 to 5). CKD (stages 3 to 5) was defined by estimated glomerular filtration rate (eGFR) {\\textless}60 mL/min/1.73 m(2). We also described the primary care, outcomes and risk factors associated with outcomes using competing risks analyses for these CKD patients.\nRESULTS: A total of 631 incident CKD patients (stages 3 to 5) were followed-up until the occurrence of death and dialysis initiation for more than 3 years. The annual incidence rate of CKD (stages 3 to 5) was estimated at 977.7 per million inhabitants. Analyses were performed on 514 patients with available medical data. During the study, 155 patients (30.2 \\%) were referred to a nephrologist, 193 (37.5 \\%) died and 58 (11.3 \\%) reached end-stage renal disease and initiated dialysis. A total of 139 patients (27.6 \\%) had a fast decline of their renal function, 92 (18.3 \\%) a moderate decline and the 272 remaining patients had a physiological decline (21.1 \\%) or a small improvement of their renal function (33.0 \\%). Predictors of death found in both Cox and Fine-Gray multivariable regression models included age at diagnosis, anemia, active neoplasia and chronic heart failure, but not a low glomerular filtration rate (GFR). Age at diagnosis, anemia and a low GFR were independently associated with dialysis initiation in Cox model, but anemia was not found to be a risk factor for dialysis initiation in Fine-Gray model.\nCONCLUSIONS: This large cohort study provided useful epidemiological data on incident CKD (stages 3 to 5) and stressed the need to improve the hands-on implementation of clinical practice guidelines for the evaluation and the management of CKD in primary care.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {BMC nephrology},\n\tauthor = {Ayav, Carole and Beuscart, Jean-Baptiste and Briançon, Serge and Duhamel, Alain and Frimat, Luc and Kessler, Michèle},\n\tmonth = nov,\n\tyear = {2016},\n\tpmid = {27846810},\n\tpmcid = {PMC5111196},\n\tkeywords = {Competing-risk analysis, Epidemiological study, Incidence, Outcomes, Risk Factors, chronic kidney disease},\n\tpages = {174},\n}\n\n\n\n BACKGROUND: Although chronic kidney disease (CKD) affects a growing number of people, epidemiologic data on incident CKD in the general population are scarce. Screening strategies to increase early CKD detection have been developed. METHODS: From a community-based sample of 4,409 individuals residing in a well-defined geographical area, we determined the number of patients having a first serum creatinine value ≥1.7 mg/dL and present for at least 3 months that allowed us to calculate an annual incidence rate of CKD (stages 3 to 5). CKD (stages 3 to 5) was defined by estimated glomerular filtration rate (eGFR) \\textless60 mL/min/1.73 m(2). We also described the primary care, outcomes and risk factors associated with outcomes using competing risks analyses for these CKD patients. RESULTS: A total of 631 incident CKD patients (stages 3 to 5) were followed-up until the occurrence of death and dialysis initiation for more than 3 years. The annual incidence rate of CKD (stages 3 to 5) was estimated at 977.7 per million inhabitants. Analyses were performed on 514 patients with available medical data. During the study, 155 patients (30.2 %) were referred to a nephrologist, 193 (37.5 %) died and 58 (11.3 %) reached end-stage renal disease and initiated dialysis. A total of 139 patients (27.6 %) had a fast decline of their renal function, 92 (18.3 %) a moderate decline and the 272 remaining patients had a physiological decline (21.1 %) or a small improvement of their renal function (33.0 %). Predictors of death found in both Cox and Fine-Gray multivariable regression models included age at diagnosis, anemia, active neoplasia and chronic heart failure, but not a low glomerular filtration rate (GFR). Age at diagnosis, anemia and a low GFR were independently associated with dialysis initiation in Cox model, but anemia was not found to be a risk factor for dialysis initiation in Fine-Gray model. CONCLUSIONS: This large cohort study provided useful epidemiological data on incident CKD (stages 3 to 5) and stressed the need to improve the hands-on implementation of clinical practice guidelines for the evaluation and the management of CKD in primary care.\n
\n\n\n\n \n\n \n \n \n \n \n Impact of acute geriatric care in elderly patients according to the Screening Tool of Older Persons' Prescriptions/Screening Tool to Alert doctors to Right Treatment criteria in northern France.\n \n \n \n\n\n \n Frély, A.; Chazard, E.; Pansu, A.; Beuscart, J.; and Puisieux, F.\n\n\n \n\n\n\n Geriatrics & Gerontology International, 16(2): 272–278. February 2016.\n \n\n\n\n
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\n\n\n@article{frely_impact_2016,\n\ttitle = {Impact of acute geriatric care in elderly patients according to the {Screening} {Tool} of {Older} {Persons}' {Prescriptions}/{Screening} {Tool} to {Alert} doctors to {Right} {Treatment} criteria in northern {France}},\n\tvolume = {16},\n\tissn = {1447-0594},\n\tdoi = {10.1111/ggi.12474},\n\tabstract = {INTRODUCTION: In France, over 20\\% of hospitalizations of elderly people are a result of adverse drug events, of which 50\\% are considered preventable. Tools have been developed to detect inappropriate prescriptions. The Screening Tool of Older Persons' Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) criteria are innovative and adapted to French prescriptions. This is one of the first French prospective studies to evaluate the impact of acute geriatric care on prescriptions at discharge in elderly patients using the STOPP/START criteria.\nMETHOD: The evaluation of prescriptions according to STOPP/START was carried out on admission and at discharge of patients in acute geriatric units at three hospitals in the Nord-Pas de Calais region, France. A total of 202 elderly hospitalized patients were included during the 4.5 months of the study (1.5 months per center).\nRESULTS: The mean number of drugs was seven on admission and at discharge. Over half of the prescriptions at admission contained at least one potentially inappropriate medication or one potential prescription omission. The prescriptions at discharge contained significantly fewer potentially inappropriate medications than prescriptions on admission (P {\\textless} 0.001). In contrast, there was no difference between prescriptions at discharge in terms of potential prescription omissions.\nCONCLUSION: Acute geriatric hospitalization in France improves prescriptions in terms of potentially inappropriate medication, but has no impact on potential prescription omissions. Further studies must be carried out to see if STOPP/START could be used as a tool in French prescription.},\n\tlanguage = {eng},\n\tnumber = {2},\n\tjournal = {Geriatrics \\& Gerontology International},\n\tauthor = {Frély, Anne and Chazard, Emmanuel and Pansu, Aymeric and Beuscart, Jean-Baptiste and Puisieux, François},\n\tmonth = feb,\n\tyear = {2016},\n\tpmid = {25809727},\n\tkeywords = {Aged, Aged, 80 and over, Female, France, Geriatrics, Hospitalization, Humans, Inappropriate Prescribing, Male, Older patients, Polypharmacy, Prospective Studies, Screening Tool of Older Persons' Prescriptions/Screening Tool to Alert doctors to Right Treatment criteria, screening tools},\n\tpages = {272--278},\n}\n\n\n\n INTRODUCTION: In France, over 20% of hospitalizations of elderly people are a result of adverse drug events, of which 50% are considered preventable. Tools have been developed to detect inappropriate prescriptions. The Screening Tool of Older Persons' Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) criteria are innovative and adapted to French prescriptions. This is one of the first French prospective studies to evaluate the impact of acute geriatric care on prescriptions at discharge in elderly patients using the STOPP/START criteria. METHOD: The evaluation of prescriptions according to STOPP/START was carried out on admission and at discharge of patients in acute geriatric units at three hospitals in the Nord-Pas de Calais region, France. A total of 202 elderly hospitalized patients were included during the 4.5 months of the study (1.5 months per center). RESULTS: The mean number of drugs was seven on admission and at discharge. Over half of the prescriptions at admission contained at least one potentially inappropriate medication or one potential prescription omission. The prescriptions at discharge contained significantly fewer potentially inappropriate medications than prescriptions on admission (P \\textless 0.001). In contrast, there was no difference between prescriptions at discharge in terms of potential prescription omissions. CONCLUSION: Acute geriatric hospitalization in France improves prescriptions in terms of potentially inappropriate medication, but has no impact on potential prescription omissions. Further studies must be carried out to see if STOPP/START could be used as a tool in French prescription.\n
\n\n\n\n \n\n \n \n \n \n \n The risks of pulmonary embolism and upper gastrointestinal bleeding beyond 35days after total hip replacement for coxarthrosis among middle-aged patients: A cross-over cohort.\n \n \n \n\n\n \n Ficheur, G.; Caron, A.; Beuscart, J.; Ferret, L.; Putman, S.; Beuscart, R.; and Chazard, E.\n\n\n \n\n\n\n Preventive Medicine, 93: 121–127. September 2016.\n \n\n\n\n
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\n\n\n@article{ficheur_risks_2016,\n\ttitle = {The risks of pulmonary embolism and upper gastrointestinal bleeding beyond 35days after total hip replacement for coxarthrosis among middle-aged patients: {A} cross-over cohort},\n\tvolume = {93},\n\tissn = {1096-0260},\n\tshorttitle = {The risks of pulmonary embolism and upper gastrointestinal bleeding beyond 35days after total hip replacement for coxarthrosis among middle-aged patients},\n\tdoi = {10.1016/j.ypmed.2016.09.010},\n\tabstract = {Prophylactic anticoagulation is recommended up to 35days after total hip replacement (THR). Although several observational studies have assessed the incidence of thrombotic events or bleeding events after THR, the corresponding measures of association have never been studied concomitantly. Here, we evaluated the duration of the elevated risks (relative to the baseline risk) of both venous thromboembolic events and bleeding events after THR for coxarthrosis among middle-aged patients. This was a population-based, cross-over cohort study of data extracted from the French national inpatient database between 2007 and 2013. We included middle-aged patients (aged 45 to 69) having undergone THR for coxarthrosis. We compared the numbers of pulmonary embolisms (PEs) (respectively upper gastrointestinal bleedings (UGIBs)) following the THR with the numbers occurring during three unexposed periods one year later. This enabled us to estimate the odds ratio (OR) [95\\% confidence interval (CI)] for each of six successive 35-day intervals. The study included 108,099 patients. The ORs for PE were respectively 12.4 (95\\% CI, 8.6-17.8) (absolute risk difference rate per 100,000 (ARD/100,000)=130) and 5.0 (95\\% CI, 3.4-7.4) (ARD/100,000=52) for the first two 35-day intervals, and the risk was close to 1 thereafter. The risk of UGIB fell quickly, with an OR of 6.5 (95\\% CI, 4.6-9.1) (ARD/100,000=83) and 0.8 (95\\% CI, 0.4-1.6) for the first two 35-day intervals, respectively. The majority of UGIBs occurred during the inpatient stay for THR. Among middle-aged patients, the risk of a PE remains elevated beyond 35days after THR for coxarthrosis, whereas the risk of a UGIB remains elevated for the first 35days only.},\n\tlanguage = {ENG},\n\tjournal = {Preventive Medicine},\n\tauthor = {Ficheur, Grégoire and Caron, Alexandre and Beuscart, Jean-Baptiste and Ferret, Laurie and Putman, Sophie and Beuscart, Régis and Chazard, Emmanuel},\n\tmonth = sep,\n\tyear = {2016},\n\tpmid = {27612575},\n\tkeywords = {Bleeding event, Total hip arthroplasty, Total hip replacement, Venous thromboembolic event, patient safety},\n\tpages = {121--127},\n}\n\n\n\n Prophylactic anticoagulation is recommended up to 35days after total hip replacement (THR). Although several observational studies have assessed the incidence of thrombotic events or bleeding events after THR, the corresponding measures of association have never been studied concomitantly. Here, we evaluated the duration of the elevated risks (relative to the baseline risk) of both venous thromboembolic events and bleeding events after THR for coxarthrosis among middle-aged patients. This was a population-based, cross-over cohort study of data extracted from the French national inpatient database between 2007 and 2013. We included middle-aged patients (aged 45 to 69) having undergone THR for coxarthrosis. We compared the numbers of pulmonary embolisms (PEs) (respectively upper gastrointestinal bleedings (UGIBs)) following the THR with the numbers occurring during three unexposed periods one year later. This enabled us to estimate the odds ratio (OR) [95% confidence interval (CI)] for each of six successive 35-day intervals. The study included 108,099 patients. The ORs for PE were respectively 12.4 (95% CI, 8.6-17.8) (absolute risk difference rate per 100,000 (ARD/100,000)=130) and 5.0 (95% CI, 3.4-7.4) (ARD/100,000=52) for the first two 35-day intervals, and the risk was close to 1 thereafter. The risk of UGIB fell quickly, with an OR of 6.5 (95% CI, 4.6-9.1) (ARD/100,000=83) and 0.8 (95% CI, 0.4-1.6) for the first two 35-day intervals, respectively. The majority of UGIBs occurred during the inpatient stay for THR. Among middle-aged patients, the risk of a PE remains elevated beyond 35days after THR for coxarthrosis, whereas the risk of a UGIB remains elevated for the first 35days only.\n
\n\n\n\n \n\n \n \n \n \n \n Elderly Surgical Patients: Automated Computation of Healthcare Quality Indicators by Data Reuse of EHR.\n \n \n \n\n\n \n Ficheur, G.; Schaffar, A.; Caron, A.; Balcaen, T.; Beuscart, J.; and Chazard, E.\n\n\n \n\n\n\n Studies in Health Technology and Informatics, 221: 92–96. 2016.\n \n\n\n\n
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\n\n\n@article{ficheur_elderly_2016,\n\ttitle = {Elderly {Surgical} {Patients}: {Automated} {Computation} of {Healthcare} {Quality} {Indicators} by {Data} {Reuse} of {EHR}},\n\tvolume = {221},\n\tissn = {0926-9630},\n\tshorttitle = {Elderly {Surgical} {Patients}},\n\tabstract = {The objective of the work is to implement and evaluate the automated computation of 9 healthcare quality indicators, by data reuse of electronic health records, in the field of elderly surgical patients.\nMETHODS: Data are extracted from EHR, including administrative data, ICD10 diagnoses, laboratory results, procedures, administered drugs, and free-text letters. The indicators are implemented by a medical data reuse specialist. The conformity rate is automatically computed (3.5 minutes for 15,000 inpatient stays and 9 indicators). A medical expert reviews 45 stays per indicator. The precision is the proportion of non-conform inpatient stays among the cases detected as non-conform by the algorithms.\nRESULTS: the paper describes the implemented algorithms, the conformity rates and the precisions. Two indicators have a precision of 0\\%, 3 indicators have a precision of 40 to 60\\%, and four indicators have a precision from 80 to 100\\% (for 2 of them, the conformity rate is lower than 2.5\\%!). This demonstrates that automated quality screening is possible and enables to detect threatening situations. The implementation of the indicators requires special skills in medicine, medical information sciences, and algorithmics. Failures of precision are mainly due to defaults of information quality (missing codes), and could benefit from text analysis.},\n\tlanguage = {ENG},\n\tjournal = {Studies in Health Technology and Informatics},\n\tauthor = {Ficheur, Grégoire and Schaffar, Aurélien and Caron, Alexandre and Balcaen, Thibaut and Beuscart, Jean-Baptiste and Chazard, Emmanuel},\n\tyear = {2016},\n\tpmid = {27071884},\n\tpages = {92--96},\n}\n\n\n\n The objective of the work is to implement and evaluate the automated computation of 9 healthcare quality indicators, by data reuse of electronic health records, in the field of elderly surgical patients. METHODS: Data are extracted from EHR, including administrative data, ICD10 diagnoses, laboratory results, procedures, administered drugs, and free-text letters. The indicators are implemented by a medical data reuse specialist. The conformity rate is automatically computed (3.5 minutes for 15,000 inpatient stays and 9 indicators). A medical expert reviews 45 stays per indicator. The precision is the proportion of non-conform inpatient stays among the cases detected as non-conform by the algorithms. RESULTS: the paper describes the implemented algorithms, the conformity rates and the precisions. Two indicators have a precision of 0%, 3 indicators have a precision of 40 to 60%, and four indicators have a precision from 80 to 100% (for 2 of them, the conformity rate is lower than 2.5%!). This demonstrates that automated quality screening is possible and enables to detect threatening situations. The implementation of the indicators requires special skills in medicine, medical information sciences, and algorithmics. Failures of precision are mainly due to defaults of information quality (missing codes), and could benefit from text analysis.\n
\n\n\n\n \n\n \n \n \n \n \n When French Adult Grandchildren Become the Primary Caregivers of Their Grandparents with Dementia: A Desperate or an Overlooked Generation?.\n \n \n \n\n\n \n Huvent-Grelle, D.; Boulanger, E.; Beuscart, J. B.; Delannoy, L.; Delabriere, I.; François, V.; and Puisieux, F.\n\n\n \n\n\n\n Journal of the American Geriatrics Society, 64(9): 1920–1922. September 2016.\n \n\n\n\n
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\n\n\n\n@article{huvent-grelle_when_2016,\n\ttitle = {When {French} {Adult} {Grandchildren} {Become} the {Primary} {Caregivers} of {Their} {Grandparents} with {Dementia}: {A} {Desperate} or an {Overlooked} {Generation}?},\n\tvolume = {64},\n\tissn = {1532-5415},\n\tshorttitle = {When {French} {Adult} {Grandchildren} {Become} the {Primary} {Caregivers} of {Their} {Grandparents} with {Dementia}},\n\tdoi = {10.1111/jgs.14328},\n\tlanguage = {ENG},\n\tnumber = {9},\n\tjournal = {Journal of the American Geriatrics Society},\n\tauthor = {Huvent-Grelle, Dominique and Boulanger, Eric and Beuscart, Jean Baptiste and Delannoy, Laurie and Delabriere, Isabelle and François, Valérie and Puisieux, François},\n\tmonth = sep,\n\tyear = {2016},\n\tpmid = {27459329},\n\tpages = {1920--1922},\n}\n\n\n\n \n\n \n \n \n \n \n Measuring senescence rates of patients with end-stage renal disease while accounting for population heterogeneity: an analysis of data from the ERA-EDTA Registry.\n \n \n \n\n\n \n Koopman, J. J. E.; Kramer, A.; van Heemst, D.; Åsberg, A.; Beuscart, J.; Buturović-Ponikvar, J.; Collart, F.; Couchoud, C. G.; Finne, P.; Heaf, J. G.; Massy, Z. A.; De Meester, J. M. J.; Palsson, R.; Steenkamp, R.; Traynor, J. P.; Jager, K. J.; and Putter, H.\n\n\n \n\n\n\n Annals of Epidemiology. August 2016.\n \n\n\n\n
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\n\n\n@article{koopman_measuring_2016,\n\ttitle = {Measuring senescence rates of patients with end-stage renal disease while accounting for population heterogeneity: an analysis of data from the {ERA}-{EDTA} {Registry}},\n\tissn = {1873-2585},\n\tshorttitle = {Measuring senescence rates of patients with end-stage renal disease while accounting for population heterogeneity},\n\tdoi = {10.1016/j.annepidem.2016.08.010},\n\tabstract = {PURPOSE: Although a population's senescence rate is classically measured as the increase in mortality rate with age on a logarithmic scale, it may be more accurately measured as the increase on a linear scale. Patients on dialysis, who suffer from accelerated senescence, exhibit a smaller increase in their mortality rate on a logarithmic scale, but a larger increase on a linear scale than patients with a functioning kidney transplant. However, this comparison may be biased by population heterogeneity.\nMETHODS: Follow-up data on 323,308 patients on dialysis and 91,679 patients with a functioning kidney transplant were derived from the ERA-EDTA Registry. We measured the increases in their mortality rates using Gompertz frailty models that allow individual variation in this increase.\nRESULTS: According to these models, the senescence rate measured as the increase in mortality rate on a logarithmic scale was smaller in patients on dialysis, while the senescence rate measured as the increase on a linear scale was larger in patients on dialysis than patients with a functioning kidney transplant.\nCONCLUSIONS: Also when accounting for population heterogeneity, a population's senescence rate is more accurately measured as the increase in mortality rate on a linear scale than a logarithmic scale.},\n\tlanguage = {ENG},\n\tjournal = {Annals of Epidemiology},\n\tauthor = {Koopman, Jacob J. E. and Kramer, Anneke and van Heemst, Diana and Åsberg, Anders and Beuscart, Jean-Baptiste and Buturović-Ponikvar, Jadranka and Collart, Frederic and Couchoud, Cécile G. and Finne, Patrik and Heaf, James G. and Massy, Ziad A. and De Meester, Johan M. J. and Palsson, Runolfur and Steenkamp, Retha and Traynor, Jamie P. and Jager, Kitty J. and Putter, Hein},\n\tmonth = aug,\n\tyear = {2016},\n\tpmid = {27665405},\n\tkeywords = {Aging, Dialysis, End-stage renal disease, Gompertz model, Kidney Transplantation, Mortality rate, Population heterogeneity, Senescence, Senescence rate, frailty},\n}\n\n\n\n PURPOSE: Although a population's senescence rate is classically measured as the increase in mortality rate with age on a logarithmic scale, it may be more accurately measured as the increase on a linear scale. Patients on dialysis, who suffer from accelerated senescence, exhibit a smaller increase in their mortality rate on a logarithmic scale, but a larger increase on a linear scale than patients with a functioning kidney transplant. However, this comparison may be biased by population heterogeneity. METHODS: Follow-up data on 323,308 patients on dialysis and 91,679 patients with a functioning kidney transplant were derived from the ERA-EDTA Registry. We measured the increases in their mortality rates using Gompertz frailty models that allow individual variation in this increase. RESULTS: According to these models, the senescence rate measured as the increase in mortality rate on a logarithmic scale was smaller in patients on dialysis, while the senescence rate measured as the increase on a linear scale was larger in patients on dialysis than patients with a functioning kidney transplant. CONCLUSIONS: Also when accounting for population heterogeneity, a population's senescence rate is more accurately measured as the increase in mortality rate on a linear scale than a logarithmic scale.\n
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\n \n \n\n \n \n \n \n \n Women in the middle: An observational study of a generation story in Alzheimer disease in France.\n \n \n \n\n\n \n Huvent-Grelle, D.; Boulanger, E.; Beuscart, J.; Martin, T.; Podvin, J.; and Puisieux, F.\n\n\n \n\n\n\n European Geriatric Medicine, 6(2): 124–127. 2015.\n \n\n\n\n
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\n\n\n \n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n\n\n\n
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\n\n\n@article{huvent-grelle_women_2015,\n\ttitle = {Women in the middle: {An} observational study of a generation story in {Alzheimer} disease in {France}},\n\tvolume = {6},\n\tshorttitle = {Women in the middle},\n\tdoi = {10.1016/j.eurger.2014.10.001},\n\tabstract = {Background: It is well known that informal care giving for Alzheimer patients can be a burden and may result in caregivers' distress and stress. Caring for a person with Alzheimer's disease (AD) is a difficult task, which can become overwhelming. Their caregivers need attention as well. Objectives: The present study examines the socio-demographic characteristics and the quality of health and life of the sandwich grandparent generation (SGP) caregivers defined as providing care to both old demented parents and young grandchildren. Study design: Multicentric, prospective and observational study over a one-year period. Setting: Eleven voluntary Memory Clinics across the North of France. Participants: Voluntary SGP caregivers recruited in Memory Clinics who completed an oral questionnaire, during an interview one to one with a physician. Results: A vast majority of our SGP caregivers were women, mean age 59 years, married, retired, described in the literature as "women in the middle", felling stressed and not sleeping well in more than half of the cases. They had three grandchildren, mean age 7 years. The AD patient, mean age 86-yearsold, was most frequently the caregiver's mother. Many SGPs had been providing their help for 5 years or even longer. Nevertheless, the SGPs considered themselves satisfied about their health, and said they had a good quality of life. Conclusion: Although SGP women caregivers reported high levels of perceived burden, they considered that their health and quality of life were good. © 2015 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.},\n\tnumber = {2},\n\tjournal = {European Geriatric Medicine},\n\tauthor = {Huvent-Grelle, D. and Boulanger, E. and Beuscart, J.B. and Martin, T. and Podvin, J. and Puisieux, F.},\n\tyear = {2015},\n\tkeywords = {Alzheimer disease, Caregiver burden, Caregiving},\n\tpages = {124--127},\n}\n\n\n\n Background: It is well known that informal care giving for Alzheimer patients can be a burden and may result in caregivers' distress and stress. Caring for a person with Alzheimer's disease (AD) is a difficult task, which can become overwhelming. Their caregivers need attention as well. Objectives: The present study examines the socio-demographic characteristics and the quality of health and life of the sandwich grandparent generation (SGP) caregivers defined as providing care to both old demented parents and young grandchildren. Study design: Multicentric, prospective and observational study over a one-year period. Setting: Eleven voluntary Memory Clinics across the North of France. Participants: Voluntary SGP caregivers recruited in Memory Clinics who completed an oral questionnaire, during an interview one to one with a physician. Results: A vast majority of our SGP caregivers were women, mean age 59 years, married, retired, described in the literature as \"women in the middle\", felling stressed and not sleeping well in more than half of the cases. They had three grandchildren, mean age 7 years. The AD patient, mean age 86-yearsold, was most frequently the caregiver's mother. Many SGPs had been providing their help for 5 years or even longer. Nevertheless, the SGPs considered themselves satisfied about their health, and said they had a good quality of life. Conclusion: Although SGP women caregivers reported high levels of perceived burden, they considered that their health and quality of life were good. © 2015 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.\n
\n\n\n\n \n\n \n \n \n \n \n Management of recurrent falls in hypertensive elderly.\n \n \n \n\n\n \n Puisieux, F.; Boulanger, E.; and Beuscart, J.\n\n\n \n\n\n\n Archives des Maladies du Coeur et des Vaisseaux - Pratique, 2015(242): 8–13. 2015.\n \n\n\n\n
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\n\n\n@article{puisieux_management_2015,\n\ttitle = {Management of recurrent falls in hypertensive elderly},\n\tvolume = {2015},\n\tshorttitle = {Prise en charge des chutes répétées chez l'hypertendu âgé},\n\tdoi = {10.1038/jhh.2013.82},\n\tabstract = {Among people aged 65 years or over, two thirds have hypertension (HTA) and one third fall each year. These conditions frequently coexist in the same patient, and each carries a risk for functional decline or mortality. The majority of falls result from interactions between multiple predisposing and precipitating factors. Orthostatic hypotension is recognized as a risk factor of falling. Although antihypertensive treatment may contribute to orthostatic hypotension, data from studies suggest that the link between HTA, antihypertensive medication, orthostatic hypotension and falls is more complex than expected. The treatment of HTA is crucial for the prevention of stroke and heart failure even in the frail old person at high risk for falling, but represents in this group of patients a challenge in terms of safety and quality of life. Confirmation of the diagnosis with 24-hour ambulatory blood pressure monitoring or BP monitoring at home is important. Cautious drug prescription, with adapted blood pressure targets, avoiding too intensive treatments, is important for treatment adequacy and safety. Cardiologists must pay greater attention to fall risk in older adults with HTA in an effort to prevent falls and injurious falls. © 2015 Elsevier Masson SAS. All rights reserved.},\n\tnumber = {242},\n\tjournal = {Archives des Maladies du Coeur et des Vaisseaux - Pratique},\n\tauthor = {Puisieux, F. and Boulanger, E. and Beuscart, J.-B.},\n\tyear = {2015},\n\tpages = {8--13},\n}\n\n\n\n Among people aged 65 years or over, two thirds have hypertension (HTA) and one third fall each year. These conditions frequently coexist in the same patient, and each carries a risk for functional decline or mortality. The majority of falls result from interactions between multiple predisposing and precipitating factors. Orthostatic hypotension is recognized as a risk factor of falling. Although antihypertensive treatment may contribute to orthostatic hypotension, data from studies suggest that the link between HTA, antihypertensive medication, orthostatic hypotension and falls is more complex than expected. The treatment of HTA is crucial for the prevention of stroke and heart failure even in the frail old person at high risk for falling, but represents in this group of patients a challenge in terms of safety and quality of life. Confirmation of the diagnosis with 24-hour ambulatory blood pressure monitoring or BP monitoring at home is important. Cautious drug prescription, with adapted blood pressure targets, avoiding too intensive treatments, is important for treatment adequacy and safety. Cardiologists must pay greater attention to fall risk in older adults with HTA in an effort to prevent falls and injurious falls. © 2015 Elsevier Masson SAS. All rights reserved.\n
\n\n\n\n \n\n \n \n \n \n \n Evaluation of compliance with recommendations of prevention of thromboembolism in atrial fibrillation in the elderly, by data reuse of electronic health records.\n \n \n \n\n\n \n Ferret, L.; Beuscart, J.; Ficheur, G.; Beuscart, R.; Luyckx, M.; and Chazard, E.\n\n\n \n\n\n\n Studies in Health Technology and Informatics, 210: 394–398. 2015.\n \n\n\n\n
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\n\n\n@article{ferret_evaluation_2015,\n\ttitle = {Evaluation of compliance with recommendations of prevention of thromboembolism in atrial fibrillation in the elderly, by data reuse of electronic health records},\n\tvolume = {210},\n\tissn = {0926-9630},\n\tabstract = {Under-prescription of anticoagulants in the elderly with atrial fibrillation (AF) has been described in several studies, showing that only 15 to 44\\% of them receive anticoagulants. However, the European Society of Cardiology recommendations state that anticoagulants should be systematically prescribed. In case of refusal of the treatment by the patient, a platelet aggregation inhibitor should be prescribed in monotherapy or bitherapy according to the HAS-BLED bleeding risk score. In all the cases the patient should receive an antithrombotic treatment. In this work we observe the adequacy of prescription practices to the recommendations for AF in the elderly by data reuse on a monocentric observational retrospective cohort. Data of a 222 beds French community hospital were extracted for the year 2013. The patients aged over 75 years and presenting AF were selected. The HAS-BLED score was calculated and the consistency of the prescriptions with the recommendations of the European Society of Cardiology was verified. Then the compliance rate to the recommendations was calculated. The rules detected 433 patients with AF and aged over 75 years. From those patients, 45\\% received an anticoagulant, 32.1\\% received platelet aggregation inhibitors and 22.9\\% did not receive any antithrombotic treatment. When a platelet aggregation inhibitor was prescribed the recommendation for bitherapy was not followed in 97\\% of the cases. The compliance rate to the recommendations was 47.8\\%. This work highlights a major problem of quality of the prescriptions in the hospital field and shows how data reuse can help describing this type of issues.},\n\tlanguage = {eng},\n\tjournal = {Studies in Health Technology and Informatics},\n\tauthor = {Ferret, Laurie and Beuscart, Jean-Baptiste and Ficheur, Grégoire and Beuscart, Régis and Luyckx, Michel and Chazard, Emmanuel},\n\tyear = {2015},\n\tpmid = {25991173},\n\tpages = {394--398},\n}\n\n\n\n Under-prescription of anticoagulants in the elderly with atrial fibrillation (AF) has been described in several studies, showing that only 15 to 44% of them receive anticoagulants. However, the European Society of Cardiology recommendations state that anticoagulants should be systematically prescribed. In case of refusal of the treatment by the patient, a platelet aggregation inhibitor should be prescribed in monotherapy or bitherapy according to the HAS-BLED bleeding risk score. In all the cases the patient should receive an antithrombotic treatment. In this work we observe the adequacy of prescription practices to the recommendations for AF in the elderly by data reuse on a monocentric observational retrospective cohort. Data of a 222 beds French community hospital were extracted for the year 2013. The patients aged over 75 years and presenting AF were selected. The HAS-BLED score was calculated and the consistency of the prescriptions with the recommendations of the European Society of Cardiology was verified. Then the compliance rate to the recommendations was calculated. The rules detected 433 patients with AF and aged over 75 years. From those patients, 45% received an anticoagulant, 32.1% received platelet aggregation inhibitors and 22.9% did not receive any antithrombotic treatment. When a platelet aggregation inhibitor was prescribed the recommendation for bitherapy was not followed in 97% of the cases. The compliance rate to the recommendations was 47.8%. This work highlights a major problem of quality of the prescriptions in the hospital field and shows how data reuse can help describing this type of issues.\n
\n\n\n\n \n\n \n \n \n \n \n Acrylamide induces accelerated endothelial aging in a human cell model.\n \n \n \n\n\n \n Sellier, C.; Boulanger, E.; Maladry, F.; Tessier, F. J.; Lorenzi, R.; Nevière, R.; Desreumaux, P.; Beuscart, J.; Puisieux, F.; and Grossin, N.\n\n\n \n\n\n\n Food and Chemical Toxicology: An International Journal Published for the British Industrial Biological Research Association, 83: 140–145. September 2015.\n \n\n\n\n
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\n\n\n@article{sellier_acrylamide_2015,\n\ttitle = {Acrylamide induces accelerated endothelial aging in a human cell model},\n\tvolume = {83},\n\tissn = {1873-6351},\n\tdoi = {10.1016/j.fct.2015.05.021},\n\tabstract = {Acrylamide (AAM) has been recently discovered in food as a Maillard reaction product. AAM and glycidamide (GA), its metabolite, have been described as probably carcinogenic to humans. It is widely established that senescence and carcinogenicity are closely related. In vitro, endothelial aging is characterized by replicative senescence in which primary cells in culture lose their ability to divide. Our objective was to assess the effects of AAM and GA on human endothelial cell senescence. Human umbilical vein endothelial cells (HUVECs) cultured in vitro were used as model. HUVECs were cultured over 3 months with AAM or GA (1, 10 or 100 μM) until growth arrest. To analyze senescence, β-galactosidase activity and telomere length of HUVECs were measured by cytometry and semi-quantitative PCR, respectively. At all tested concentrations, AAM or GA reduced cell population doubling compared to the control condition (p {\\textless} 0.001). β-galactosidase activity in endothelial cells was increased when exposed to AAM (≥10 μM) or GA (≥1 μM) (p {\\textless} 0.05). AAM (≥10 μM) or GA (100 μM) accelerated telomere shortening in HUVECs (p {\\textless} 0.05). In conclusion, in vitro chronic exposure to AAM or GA at low concentrations induces accelerated senescence. This result suggests that an exposure to AAM might contribute to endothelial aging.},\n\tlanguage = {eng},\n\tjournal = {Food and Chemical Toxicology: An International Journal Published for the British Industrial Biological Research Association},\n\tauthor = {Sellier, Cyril and Boulanger, Eric and Maladry, François and Tessier, Frédéric J. and Lorenzi, Rodrigo and Nevière, Rémi and Desreumaux, Pierre and Beuscart, Jean-Baptiste and Puisieux, François and Grossin, Nicolas},\n\tmonth = sep,\n\tyear = {2015},\n\tpmid = {26070502},\n\tkeywords = {Acrylamide, Endothelial cell, Hayflick's limit, Senescence, Telomere length shortening},\n\tpages = {140--145},\n}\n\n\n\n Acrylamide (AAM) has been recently discovered in food as a Maillard reaction product. AAM and glycidamide (GA), its metabolite, have been described as probably carcinogenic to humans. It is widely established that senescence and carcinogenicity are closely related. In vitro, endothelial aging is characterized by replicative senescence in which primary cells in culture lose their ability to divide. Our objective was to assess the effects of AAM and GA on human endothelial cell senescence. Human umbilical vein endothelial cells (HUVECs) cultured in vitro were used as model. HUVECs were cultured over 3 months with AAM or GA (1, 10 or 100 μM) until growth arrest. To analyze senescence, β-galactosidase activity and telomere length of HUVECs were measured by cytometry and semi-quantitative PCR, respectively. At all tested concentrations, AAM or GA reduced cell population doubling compared to the control condition (p \\textless 0.001). β-galactosidase activity in endothelial cells was increased when exposed to AAM (≥10 μM) or GA (≥1 μM) (p \\textless 0.05). AAM (≥10 μM) or GA (100 μM) accelerated telomere shortening in HUVECs (p \\textless 0.05). In conclusion, in vitro chronic exposure to AAM or GA at low concentrations induces accelerated senescence. This result suggests that an exposure to AAM might contribute to endothelial aging.\n
\n\n\n\n \n\n \n \n \n \n \n Development of a risk stratification algorithm to improve patient-centered care and decision making for incident elderly patients with end-stage renal disease.\n \n \n \n\n\n \n Couchoud, C. G.; Beuscart, J. R.; Aldigier, J.; Brunet, P. J.; Moranne, O. P.; and REIN registry\n\n\n \n\n\n\n Kidney International, 88(5): 1178–1186. November 2015.\n \n\n\n\n
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\n\n\n@article{couchoud_development_2015,\n\ttitle = {Development of a risk stratification algorithm to improve patient-centered care and decision making for incident elderly patients with end-stage renal disease},\n\tvolume = {88},\n\tissn = {1523-1755},\n\tdoi = {10.1038/ki.2015.245},\n\tabstract = {A significant number of elderly patients die during their first 3 months of dialysis. Because dialysis can impair the quality of both life and death, a personalized care plan based on both early prognosis and patient choices is required. We developed a prognostic screening tool to identify older patients in need of specific care based on a multidisciplinary approach. Our study included 24,348 patients aged 75 years and older from the French national renal epidemiology and information network (REIN) registry who began dialysis between 1 January 2005 and 30 September 2012. Our primary outcome was overall mortality during the first 3 months of renal replacement therapy. Multivariate logistic regression was used to construct a scoring system in a random half of the cohort (training set). This score, which included age, gender, specific comorbidities, albumin levels, and mobility, was then applied to the other half (validation set). In all, 2548 patients died during the first 3 months after dialysis initiation, 22\\% after dialysis withdrawal. Three risk groups were identified: low risk (score under 12 points, 3-month expected mortality under 20\\%), intermediate risk (score from 12 to 16, mortality between 20 and 40\\%, 9.5\\% of patients) and high risk (score 17 or more, mortality over 40\\%, 2.5\\% of patients). We developed a decision-making process that classifies patients according to their risk of early death in view of their potentially imminent need for supportive care or treatment.},\n\tlanguage = {eng},\n\tnumber = {5},\n\tjournal = {Kidney International},\n\tauthor = {Couchoud, Cécile G. and Beuscart, Jean-Baptiste R. and Aldigier, Jean-Claude and Brunet, Philippe J. and Moranne, Olivier P. and {REIN registry}},\n\tmonth = nov,\n\tyear = {2015},\n\tpmid = {26331408},\n\tpages = {1178--1186},\n}\n\n\n\n A significant number of elderly patients die during their first 3 months of dialysis. Because dialysis can impair the quality of both life and death, a personalized care plan based on both early prognosis and patient choices is required. We developed a prognostic screening tool to identify older patients in need of specific care based on a multidisciplinary approach. Our study included 24,348 patients aged 75 years and older from the French national renal epidemiology and information network (REIN) registry who began dialysis between 1 January 2005 and 30 September 2012. Our primary outcome was overall mortality during the first 3 months of renal replacement therapy. Multivariate logistic regression was used to construct a scoring system in a random half of the cohort (training set). This score, which included age, gender, specific comorbidities, albumin levels, and mobility, was then applied to the other half (validation set). In all, 2548 patients died during the first 3 months after dialysis initiation, 22% after dialysis withdrawal. Three risk groups were identified: low risk (score under 12 points, 3-month expected mortality under 20%), intermediate risk (score from 12 to 16, mortality between 20 and 40%, 9.5% of patients) and high risk (score 17 or more, mortality over 40%, 2.5% of patients). We developed a decision-making process that classifies patients according to their risk of early death in view of their potentially imminent need for supportive care or treatment.\n
\n\n\n\n \n\n \n \n \n \n \n \n “Women in the middle”: An observational study of a generation story in Alzheimer disease in France.\n \n \n \n \n\n\n \n Huvent-Grelle, D.; Boulanger, E.; Beuscart, J. B.; Martin, T.; Podvin, J.; and Puisieux, F.\n\n\n \n\n\n\n European Geriatric Medicine, 6(2): 124–127. 2015.\n \n\n\n\n
\n\n\n\n \n \nPaper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n\n\n\n
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Paper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n\n\n\n\n
\n\n\n@article{huvent-grelle_women_2015-1,\n\ttitle = {“{Women} in the middle”: {An} observational study of a generation story in {Alzheimer} disease in {France}},\n\tvolume = {6},\n\tissn = {1878-7649},\n\tshorttitle = {“{Women} in the middle”},\n\turl = {http://www.sciencedirect.com/science/article/pii/S1878764914002307},\n\tdoi = {10.1016/j.eurger.2014.10.001},\n\tabstract = {Background\nIt is well known that informal care giving for Alzheimer patients can be a burden and may result in caregivers’ distress and stress. Caring for a person with Alzheimer's disease (AD) is a difficult task, which can become overwhelming. Their caregivers need attention as well.\nObjectives\nThe present study examines the socio-demographic characteristics and the quality of health and life of the sandwich grandparent generation (SGP) caregivers defined as providing care to both old demented parents and young grandchildren.\nStudy design\nMulticentric, prospective and observational study over a one-year period.\nSetting\nEleven voluntary Memory Clinics across the North of France.\nParticipants\nVoluntary SGP caregivers recruited in Memory Clinics who completed an oral questionnaire, during an interview one to one with a physician.\nResults\nA vast majority of our SGP caregivers were women, mean age 59 years, married, retired, described in the literature as “women in the middle”, felling stressed and not sleeping well in more than half of the cases. They had three grandchildren, mean age 7 years. The AD patient, mean age 86-years-old, was most frequently the caregiver's mother. Many SGPs had been providing their help for 5 years or even longer. Nevertheless, the SGPs considered themselves satisfied about their health, and said they had a good quality of life.\nConclusion\nAlthough SGP women caregivers reported high levels of perceived burden, they considered that their health and quality of life were good.},\n\tnumber = {2},\n\turldate = {2016-03-01},\n\tjournal = {European Geriatric Medicine},\n\tauthor = {Huvent-Grelle, D. and Boulanger, E. and Beuscart, J. B. and Martin, T. and Podvin, J. and Puisieux, F.},\n\tyear = {2015},\n\tkeywords = {Alzheimer Disease, Caregiver burden, Caregiving},\n\tpages = {124--127},\n}\n\n\n\n Background It is well known that informal care giving for Alzheimer patients can be a burden and may result in caregivers’ distress and stress. Caring for a person with Alzheimer's disease (AD) is a difficult task, which can become overwhelming. Their caregivers need attention as well. Objectives The present study examines the socio-demographic characteristics and the quality of health and life of the sandwich grandparent generation (SGP) caregivers defined as providing care to both old demented parents and young grandchildren. Study design Multicentric, prospective and observational study over a one-year period. Setting Eleven voluntary Memory Clinics across the North of France. Participants Voluntary SGP caregivers recruited in Memory Clinics who completed an oral questionnaire, during an interview one to one with a physician. Results A vast majority of our SGP caregivers were women, mean age 59 years, married, retired, described in the literature as “women in the middle”, felling stressed and not sleeping well in more than half of the cases. They had three grandchildren, mean age 7 years. The AD patient, mean age 86-years-old, was most frequently the caregiver's mother. Many SGPs had been providing their help for 5 years or even longer. Nevertheless, the SGPs considered themselves satisfied about their health, and said they had a good quality of life. Conclusion Although SGP women caregivers reported high levels of perceived burden, they considered that their health and quality of life were good.\n
\n\n\n\n \n\n \n \n \n \n \n \n Prise en charge des chutes répétées chez l’hypertendu âgé.\n \n \n \n \n\n\n \n Puisieux, F.; Boulanger, E.; and Beuscart, J. -.\n\n\n \n\n\n\n Archives des Maladies du Coeur et des Vaisseaux - Pratique, 2015(242): 8–13. November 2015.\n \n\n\n\n
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\n\n\n@article{puisieux_prise_2015,\n\ttitle = {Prise en charge des chutes répétées chez l’hypertendu âgé},\n\tvolume = {2015},\n\tissn = {1261-694X},\n\turl = {http://www.sciencedirect.com/science/article/pii/S1261694X15000498},\n\tdoi = {10.1016/j.amcp.2015.09.011},\n\tabstract = {Résumé\nParmi les personnes de 65 ans et plus, deux tiers sont hypertendus et un tiers tombe chaque année. Hypertension artérielle (HTA) et chutes coexistent fréquemment chez un même patient, portant chacun un risque de déclin fonctionnel et de mortalité. La majorité des chutes résultent de l’interaction de multiples facteurs prédisposants et précipitants. L’hypotension orthostatique est reconnue comme un facteur de risque de chute. Bien que les traitements antihypertenseurs puissent contribuer à l’hypotension orthostatique, les études suggèrent que les liens unissant HTA, médicaments antihypertenseurs, hypotension orthostatique et chutes sont plus complexes qu’attendu. Le traitement de l’HTA est bénéfique pour la prévention des accidents vasculaires cérébraux et l’insuffisance cardiaque même chez les sujets âgés fragiles à haut risque de chutes, mais représente dans ce groupe de patients un challenge en termes de sécurité et de qualité de vie. La confirmation du diagnostic par une mesure ambulatoire de la pression artérielle est indispensable. La prescription doit être prudente, avec des objectifs tensionnels raisonnables, en évitant des traitements trop intensifs. Les cardiologues doivent prêter plus d’attention au risque de chute de leurs patients âgés hypertendus dans le but de prévenir le risque de chute et de chute grave.\nSummary\nAmong people aged 65 years or over, two thirds have hypertension (HTA) and one third fall each year. These conditions frequently coexist in the same patient, and each carries a risk for functional decline or mortality. The majority of falls result from interactions between multiple predisposing and precipitating factors. Orthostatic hypotension is recognized as a risk factor of falling. Although antihypertensive treatment may contribute to orthostatic hypotension, data from studies suggest that the link between HTA, antihypertensive medication, orthostatic hypotension and falls is more complex than expected. The treatment of HTA is crucial for the prevention of stroke and heart failure even in the frail old person at high risk for falling, but represents in this group of patients a challenge in terms of safety and quality of life. Confirmation of the diagnosis with 24-hour ambulatory blood pressure monitoring or BP monitoring at home is important. Cautious drug prescription, with adapted blood pressure targets, avoiding too intensive treatments, is important for treatment adequacy and safety. Cardiologists must pay greater attention to fall risk in older adults with HTA in an effort to prevent falls and injurious falls.},\n\tnumber = {242},\n\turldate = {2016-03-01},\n\tjournal = {Archives des Maladies du Coeur et des Vaisseaux - Pratique},\n\tauthor = {Puisieux, F. and Boulanger, E. and Beuscart, J. -B.},\n\tmonth = nov,\n\tyear = {2015},\n\tpages = {8--13},\n}\n\n\n\n Résumé Parmi les personnes de 65 ans et plus, deux tiers sont hypertendus et un tiers tombe chaque année. Hypertension artérielle (HTA) et chutes coexistent fréquemment chez un même patient, portant chacun un risque de déclin fonctionnel et de mortalité. La majorité des chutes résultent de l’interaction de multiples facteurs prédisposants et précipitants. L’hypotension orthostatique est reconnue comme un facteur de risque de chute. Bien que les traitements antihypertenseurs puissent contribuer à l’hypotension orthostatique, les études suggèrent que les liens unissant HTA, médicaments antihypertenseurs, hypotension orthostatique et chutes sont plus complexes qu’attendu. Le traitement de l’HTA est bénéfique pour la prévention des accidents vasculaires cérébraux et l’insuffisance cardiaque même chez les sujets âgés fragiles à haut risque de chutes, mais représente dans ce groupe de patients un challenge en termes de sécurité et de qualité de vie. La confirmation du diagnostic par une mesure ambulatoire de la pression artérielle est indispensable. La prescription doit être prudente, avec des objectifs tensionnels raisonnables, en évitant des traitements trop intensifs. Les cardiologues doivent prêter plus d’attention au risque de chute de leurs patients âgés hypertendus dans le but de prévenir le risque de chute et de chute grave. Summary Among people aged 65 years or over, two thirds have hypertension (HTA) and one third fall each year. These conditions frequently coexist in the same patient, and each carries a risk for functional decline or mortality. The majority of falls result from interactions between multiple predisposing and precipitating factors. Orthostatic hypotension is recognized as a risk factor of falling. Although antihypertensive treatment may contribute to orthostatic hypotension, data from studies suggest that the link between HTA, antihypertensive medication, orthostatic hypotension and falls is more complex than expected. The treatment of HTA is crucial for the prevention of stroke and heart failure even in the frail old person at high risk for falling, but represents in this group of patients a challenge in terms of safety and quality of life. Confirmation of the diagnosis with 24-hour ambulatory blood pressure monitoring or BP monitoring at home is important. Cautious drug prescription, with adapted blood pressure targets, avoiding too intensive treatments, is important for treatment adequacy and safety. Cardiologists must pay greater attention to fall risk in older adults with HTA in an effort to prevent falls and injurious falls.\n
\n\n\n\n \n\n \n \n \n \n \n Medication Review: Human Factors Study Aiming at Helping an Acute Geriatric Unit to Sustain and Systematize the Process.\n \n \n \n\n\n \n Wawrzyniak, C.; Beuscart-Zephir, M.; Marcilly, R.; Douze, L.; Beuscart, J.; Lecoutre, D.; Puisieux, F.; and Pelayo, S.\n\n\n \n\n\n\n Studies in Health Technology and Informatics, 218: 80–85. 2015.\n \n\n\n\n
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\n\n\n@article{wawrzyniak_medication_2015,\n\ttitle = {Medication {Review}: {Human} {Factors} {Study} {Aiming} at {Helping} an {Acute} {Geriatric} {Unit} to {Sustain} and {Systematize} the {Process}},\n\tvolume = {218},\n\tissn = {0926-9630},\n\tshorttitle = {Medication {Review}},\n\tabstract = {BACKGROUND: Medication Review (MRev) has been implemented in many hospitals to improve patient safety and well-being. However, it seems sometimes difficult to implement, maintain and systematize this process, especially when key-elements are absent. This study focuses on the analysis of a MRev process implemented in an Acute Geriatric Unit (AGU) which, at the time of the study, had no Computerized Physician Order Entry (CPOE) and no sufficient staff to - normally - support the process.\nOBJECTIVE: This study describes the MRev process as existing in the AGU with a particular focus on the preparatory MRev meeting phase and presents our recommendations to maintain and optimize it.\nMETHODS: Human Factor experts have collected and analyzed data during MRev process by interviews, shadowing observations and video recording from April to October 2014 at Lille University Hospital.\nRESULTS: MRev process consists of three phases (meeting preparation, MRev meeting and patient discharge) and includes seven main tasks for which actors, documented supports, outcomes and difficulties are identified. Although allocating a fulltime pharmacist for the AGU would solve several problems, the main realistic recommendations concern training for junior and senior actors according to their roles and the improvement of some tasks processes.\nCONCLUSION: Despite less than optimal conditions as compared to those recommended by the literature, the observed AGU performs an efficient review based on well designed tools and processes.},\n\tlanguage = {eng},\n\tjournal = {Studies in Health Technology and Informatics},\n\tauthor = {Wawrzyniak, Clément and Beuscart-Zephir, Marie-Catherine and Marcilly, Romaric and Douze, Laura and Beuscart, Jean-Baptiste and Lecoutre, Dominique and Puisieux, François and Pelayo, Sylvia},\n\tyear = {2015},\n\tpmid = {26262531},\n\tpages = {80--85},\n}\n\n\n\n BACKGROUND: Medication Review (MRev) has been implemented in many hospitals to improve patient safety and well-being. However, it seems sometimes difficult to implement, maintain and systematize this process, especially when key-elements are absent. This study focuses on the analysis of a MRev process implemented in an Acute Geriatric Unit (AGU) which, at the time of the study, had no Computerized Physician Order Entry (CPOE) and no sufficient staff to - normally - support the process. OBJECTIVE: This study describes the MRev process as existing in the AGU with a particular focus on the preparatory MRev meeting phase and presents our recommendations to maintain and optimize it. METHODS: Human Factor experts have collected and analyzed data during MRev process by interviews, shadowing observations and video recording from April to October 2014 at Lille University Hospital. RESULTS: MRev process consists of three phases (meeting preparation, MRev meeting and patient discharge) and includes seven main tasks for which actors, documented supports, outcomes and difficulties are identified. Although allocating a fulltime pharmacist for the AGU would solve several problems, the main realistic recommendations concern training for junior and senior actors according to their roles and the improvement of some tasks processes. CONCLUSION: Despite less than optimal conditions as compared to those recommended by the literature, the observed AGU performs an efficient review based on well designed tools and processes.\n
\n\n\n\n \n\n \n \n \n \n \n Registration on the renal transplantation waiting list and mortality on dialysis: an analysis of the French REIN registry using a multi-state model.\n \n \n \n\n\n \n Beuscart, J.; Pagniez, D.; Boulanger, E.; and Duhamel, A.\n\n\n \n\n\n\n Journal of Epidemiology / Japan Epidemiological Association, 25(2): 133–141. 2015.\n \n\n\n\n
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\n\n\n@article{beuscart_registration_2015,\n\ttitle = {Registration on the renal transplantation waiting list and mortality on dialysis: an analysis of the {French} {REIN} registry using a multi-state model},\n\tvolume = {25},\n\tissn = {1349-9092},\n\tshorttitle = {Registration on the renal transplantation waiting list and mortality on dialysis},\n\tdoi = {10.2188/jea.JE20130193},\n\tabstract = {BACKGROUND: Access to the renal transplantation (RT) waiting list depends on factors related to lower mortality rates and often occurs after dialysis initiation. The aim of the study was to use a flexible regression model to determine if registration on the RT waiting list is associated with mortality on dialysis, independent of the comorbidities associated with such registration.\nMETHODS: Data from the French REIN registry on 7138 incident hemodialysis (HD) patients were analyzed. A multi-state model including four states ('HD, not wait-listed', 'HD, wait-listed', 'death', and 'RT') was used to estimate the effect of being wait-listed on the probability of death.\nRESULTS: During the study, 1392 (19.5\\%) patients were wait-listed. Of the 2954 deaths observed in the entire cohort during follow-up, 2921 (98.9\\%) were observed in the not wait-listed group compared with only 33 (1.1\\%) in the wait-listed group. In the multivariable analysis, the adjusted hazard ratio for death associated with non-registration on the waiting list was 3.52 (95\\% CI, 1.70-7.30). The risk factors for death identified for not wait-listed patients were not found to be significant risk factors for wait-listed patients, with the exception of age.\nCONCLUSIONS: The use of a multi-state model allowed a flexible analysis of mortality on dialysis. Patients who were not wait-listed had a much higher risk of death, regardless of co-morbidities associated with being wait-listed, and did not share the same risk factors of death as wait-listed patients. Registration on the waiting list should therefore be taken into account in survival analysis of patients on dialysis.},\n\tlanguage = {eng},\n\tnumber = {2},\n\tjournal = {Journal of Epidemiology / Japan Epidemiological Association},\n\tauthor = {Beuscart, Jean-Baptiste and Pagniez, Dominique and Boulanger, Eric and Duhamel, Alain},\n\tyear = {2015},\n\tpmid = {25721069},\n\tpmcid = {PMC4310874},\n\tpages = {133--141},\n}\n\n\n\n BACKGROUND: Access to the renal transplantation (RT) waiting list depends on factors related to lower mortality rates and often occurs after dialysis initiation. The aim of the study was to use a flexible regression model to determine if registration on the RT waiting list is associated with mortality on dialysis, independent of the comorbidities associated with such registration. METHODS: Data from the French REIN registry on 7138 incident hemodialysis (HD) patients were analyzed. A multi-state model including four states ('HD, not wait-listed', 'HD, wait-listed', 'death', and 'RT') was used to estimate the effect of being wait-listed on the probability of death. RESULTS: During the study, 1392 (19.5%) patients were wait-listed. Of the 2954 deaths observed in the entire cohort during follow-up, 2921 (98.9%) were observed in the not wait-listed group compared with only 33 (1.1%) in the wait-listed group. In the multivariable analysis, the adjusted hazard ratio for death associated with non-registration on the waiting list was 3.52 (95% CI, 1.70-7.30). The risk factors for death identified for not wait-listed patients were not found to be significant risk factors for wait-listed patients, with the exception of age. CONCLUSIONS: The use of a multi-state model allowed a flexible analysis of mortality on dialysis. Patients who were not wait-listed had a much higher risk of death, regardless of co-morbidities associated with being wait-listed, and did not share the same risk factors of death as wait-listed patients. Registration on the waiting list should therefore be taken into account in survival analysis of patients on dialysis.\n
\n\n\n\n \n\n \n \n \n \n \n Dietary CML-enriched protein induces functional arterial aging in a RAGE-dependent manner in mice.\n \n \n \n\n\n \n Grossin, N.; Auger, F.; Niquet-Leridon, C.; Durieux, N.; Montaigne, D.; Schmidt, A. M.; Susen, S.; Jacolot, P.; Beuscart, J.; Tessier, F. J.; and Boulanger, E.\n\n\n \n\n\n\n Molecular Nutrition & Food Research. February 2015.\n \n\n\n\n
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\n\n\n@article{grossin_dietary_2015,\n\ttitle = {Dietary {CML}-enriched protein induces functional arterial aging in a {RAGE}-dependent manner in mice},\n\tissn = {1613-4133},\n\tdoi = {10.1002/mnfr.201400643},\n\tabstract = {SCOPE:: Advanced glycation end-products (AGEs) are endogenously produced and are present in food. N(ε) -carboxymethyllysine (CML) is an endothelial activator via the receptor for AGEs (RAGE) and is a major dietary AGE. This work investigated the effects of a CML-enriched diet and RAGE involvement in aortic aging in mice.\nMETHODS AND RESULTS:: After 9 months of a control diet or CML-enriched diets (50, 100 or 200μgCML /g of food), endothelium-dependent relaxation (EDR), RAGE, vascular cell adhesion molecule-1 (VCAM-1) and sirtuin-1 (SIRT1) expression, pulse wave velocity (PWV) and elastin disruption were measured in aortas of wild-type or RAGE(-/-) male C57BL/6 mice. Compared to the control diet, EDR was reduced in the wild-type mice fed the CML-enriched diet (200μgCML /g) (66.8±12.26 vs 94.3±2.6\\%, p{\\textless}0.01). RAGE and VCAM-1 (p{\\textless}0.05) expression were increased in the aortic wall. RAGE(-/-) mice were protected against CML-enriched diet-induced endothelial dysfunction. Compared to control diet, the CML-enriched diet (200μgCML /g) increased the aortic PWV (86.6±41.1 vs 251.4±41.1cm/s, p{\\textless}0.05) in wild-type animals. Elastin disruption was found to a greater extent in the CML-fed mice (p{\\textless}0.05). RAGE(-/-) mice fed the CML-enriched diet were protected from aortic stiffening.\nCONCLUSION:: Chronic CML ingestion induced endothelial dysfunction and arterial stiffness and aging in a RAGE dependent manner. This article is protected by copyright. All rights reserved.},\n\tlanguage = {ENG},\n\tjournal = {Molecular Nutrition \\& Food Research},\n\tauthor = {Grossin, Nicolas and Auger, Florent and Niquet-Leridon, Céline and Durieux, Nicolas and Montaigne, David and Schmidt, Ann Marie and Susen, Sophie and Jacolot, Philippe and Beuscart, Jean-Baptiste and Tessier, Frédéric J. and Boulanger, Eric},\n\tmonth = feb,\n\tyear = {2015},\n\tpmid = {25655894},\n}\n\n\n\n SCOPE:: Advanced glycation end-products (AGEs) are endogenously produced and are present in food. N(ε) -carboxymethyllysine (CML) is an endothelial activator via the receptor for AGEs (RAGE) and is a major dietary AGE. This work investigated the effects of a CML-enriched diet and RAGE involvement in aortic aging in mice. METHODS AND RESULTS:: After 9 months of a control diet or CML-enriched diets (50, 100 or 200μgCML /g of food), endothelium-dependent relaxation (EDR), RAGE, vascular cell adhesion molecule-1 (VCAM-1) and sirtuin-1 (SIRT1) expression, pulse wave velocity (PWV) and elastin disruption were measured in aortas of wild-type or RAGE(-/-) male C57BL/6 mice. Compared to the control diet, EDR was reduced in the wild-type mice fed the CML-enriched diet (200μgCML /g) (66.8±12.26 vs 94.3±2.6%, p\\textless0.01). RAGE and VCAM-1 (p\\textless0.05) expression were increased in the aortic wall. RAGE(-/-) mice were protected against CML-enriched diet-induced endothelial dysfunction. Compared to control diet, the CML-enriched diet (200μgCML /g) increased the aortic PWV (86.6±41.1 vs 251.4±41.1cm/s, p\\textless0.05) in wild-type animals. Elastin disruption was found to a greater extent in the CML-fed mice (p\\textless0.05). RAGE(-/-) mice fed the CML-enriched diet were protected from aortic stiffening. CONCLUSION:: Chronic CML ingestion induced endothelial dysfunction and arterial stiffness and aging in a RAGE dependent manner. This article is protected by copyright. All rights reserved.\n
\n\n\n\n \n\n \n \n \n \n \n Systematic skin examination in an acute geriatric unit: skin cancer prevalence.\n \n \n \n\n\n \n Templier, C.; Boulanger, E.; Boumbar, Y.; Puisieux, F.; Dziwniel, V.; Mortier, L.; and Beuscart, J. B.\n\n\n \n\n\n\n Clinical and Experimental Dermatology. January 2015.\n \n\n\n\n
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\n\n\n@article{templier_systematic_2015,\n\ttitle = {Systematic skin examination in an acute geriatric unit: skin cancer prevalence},\n\tissn = {1365-2230},\n\tshorttitle = {Systematic skin examination in an acute geriatric unit},\n\tdoi = {10.1111/ced.12562},\n\tabstract = {BACKGROUND: Ageing is a determining factor in skin cancer, but the incidence and prevalence of skin cancer in elderly patients are not known.\nAIM: To determine the prevalence of skin cancers in elderly patients and to assess their associated geriatric syndromes.\nMETHODS: Between January and April 2013, all consecutive incident patients hospitalized in the Acute Geriatric Unit of Lille University Hospital underwent a geriatric assessment and a systematic dermatological examination. A biopsy was taken whenever there was any lesion with suspicion of malignancy.\nRESULTS: In total, 204 patients (mean age 85.4 years) were included, and 16 cutaneous biopsies were taken from 15 patients. Histological examination confirmed skin cancer in 11 biopsies from 10 patients: 9 basal cell carcinomas, 1 squamous cell carcinoma (SCC) and 1 malignant lentigo. The prevalence of skin cancer was 4.9\\%. The geriatric assessment revealed severe geriatric syndromes in the 10 patients with skin cancer: severe dependence (8/10), possible cognitive impairment (10/10), and moderate or severe malnutrition (5/10).\nCONCLUSIONS: The prevalence of skin cancer is high in frail elderly patients. The association of severe geriatric syndromes suggests that close collaboration between geriatricians and dermatologists is essential to optimize the treatment of skin carcinoma in elderly patients.},\n\tlanguage = {ENG},\n\tjournal = {Clinical and Experimental Dermatology},\n\tauthor = {Templier, C. and Boulanger, E. and Boumbar, Y. and Puisieux, F. and Dziwniel, V. and Mortier, L. and Beuscart, J. B.},\n\tmonth = jan,\n\tyear = {2015},\n\tpmid = {25623526},\n}\n\n\n\n BACKGROUND: Ageing is a determining factor in skin cancer, but the incidence and prevalence of skin cancer in elderly patients are not known. AIM: To determine the prevalence of skin cancers in elderly patients and to assess their associated geriatric syndromes. METHODS: Between January and April 2013, all consecutive incident patients hospitalized in the Acute Geriatric Unit of Lille University Hospital underwent a geriatric assessment and a systematic dermatological examination. A biopsy was taken whenever there was any lesion with suspicion of malignancy. RESULTS: In total, 204 patients (mean age 85.4 years) were included, and 16 cutaneous biopsies were taken from 15 patients. Histological examination confirmed skin cancer in 11 biopsies from 10 patients: 9 basal cell carcinomas, 1 squamous cell carcinoma (SCC) and 1 malignant lentigo. The prevalence of skin cancer was 4.9%. The geriatric assessment revealed severe geriatric syndromes in the 10 patients with skin cancer: severe dependence (8/10), possible cognitive impairment (10/10), and moderate or severe malnutrition (5/10). CONCLUSIONS: The prevalence of skin cancer is high in frail elderly patients. The association of severe geriatric syndromes suggests that close collaboration between geriatricians and dermatologists is essential to optimize the treatment of skin carcinoma in elderly patients.\n
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\n \n \n\n \n \n \n \n \n \n Potentially inappropriate medications (PIMs) and anticholinergic levels in the elderly: a population based study in a French region.\n \n \n \n \n\n\n \n Beuscart, J.; Dupont, C.; Defebvre, M.; and Puisieux, F.\n\n\n \n\n\n\n Archives of Gerontology and Geriatrics, 59(3): 630–635. December 2014.\n \n\n\n\n
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Paper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n\n
\n\n\n@article{beuscart_potentially_2014,\n\ttitle = {Potentially inappropriate medications ({PIMs}) and anticholinergic levels in the elderly: a population based study in a {French} region},\n\tvolume = {59},\n\tissn = {1872-6976},\n\tshorttitle = {Potentially inappropriate medications ({PIMs}) and anticholinergic levels in the elderly},\n\turl = {https://nextcloud.univ-lille.fr/index.php/s/Tj78wkkJN5c3R5K},\n\tdoi = {10.1016/j.archger.2014.08.006},\n\tabstract = {Prescriptions of PIMs and anticholinergic drugs lead to adverse events and hospitalizations in the elderly. The objective of this study was to determine the prevalence of PIMs and prescriptions with a high anticholinergic effect in a French region. All prescriptions dispensed at community pharmacies in patients aged 75 and older between January 1 and March 31, 2012 were extracted from French Health Insurance information System - Nord-Pas-de-Calais Region for patients affiliated to the Social Security. Prescription of PIMs was defined according to the Laroche list. The anticholinergic score for each prescription was calculated using the Anticholinergic Drug Scale (ADS). 65.6\\% (n=207,979) of people aged over 75 years, living in the Nord-Pas-de-Calais Region were included, of which 4.5\\% (n=9284) living in nursing homes. Patients received an average of 8.3 drugs over the 3-month study period. In 32.6\\% (n=67,863) of patients, at least one PMI was prescribed. According to the ADS, 10.0\\% (n=20,978) of patients in the general population and 24.0\\% (n=2231) of patients living in nursing homes was exposed to a prescription with a high or very high anticholinergic score (ADS≥3). Hydroxyzine prescribed in 51.4\\% (n=10,792) of them ranked first among drugs most often reported. In conclusion, PMIs and anticholinergic drugs were commonly prescribed in elderly living in the Nord-Pas-de-Calais Region. Improving the quality of prescriptions in the elderly appears necessary.},\n\tlanguage = {eng},\n\tnumber = {3},\n\tjournal = {Archives of Gerontology and Geriatrics},\n\tauthor = {Beuscart, Jean-Baptiste and Dupont, Corinne and Defebvre, Marie-Margueritte and Puisieux, Francois},\n\tmonth = dec,\n\tyear = {2014},\n\tpmid = {25192614},\n\tkeywords = {Aged, Aged, 80 and over, Cholinergic Antagonists, Community Pharmacy Services, Drug Utilization, Female, France, Health Services for the Aged, Hospitalization, Humans, Inappropriate Prescribing, Male, Nursing Homes, Pharmacies, Pharmacoepidemiology, Physician's Practice Patterns, Prevalence},\n\tpages = {630--635},\n}\n\n\n\n Prescriptions of PIMs and anticholinergic drugs lead to adverse events and hospitalizations in the elderly. The objective of this study was to determine the prevalence of PIMs and prescriptions with a high anticholinergic effect in a French region. All prescriptions dispensed at community pharmacies in patients aged 75 and older between January 1 and March 31, 2012 were extracted from French Health Insurance information System - Nord-Pas-de-Calais Region for patients affiliated to the Social Security. Prescription of PIMs was defined according to the Laroche list. The anticholinergic score for each prescription was calculated using the Anticholinergic Drug Scale (ADS). 65.6% (n=207,979) of people aged over 75 years, living in the Nord-Pas-de-Calais Region were included, of which 4.5% (n=9284) living in nursing homes. Patients received an average of 8.3 drugs over the 3-month study period. In 32.6% (n=67,863) of patients, at least one PMI was prescribed. According to the ADS, 10.0% (n=20,978) of patients in the general population and 24.0% (n=2231) of patients living in nursing homes was exposed to a prescription with a high or very high anticholinergic score (ADS≥3). Hydroxyzine prescribed in 51.4% (n=10,792) of them ranked first among drugs most often reported. In conclusion, PMIs and anticholinergic drugs were commonly prescribed in elderly living in the Nord-Pas-de-Calais Region. Improving the quality of prescriptions in the elderly appears necessary.\n
\n\n\n\n \n\n \n \n \n \n \n Place of neurocryostimulation in the treatment of post-traumatic pain in Emergency Department.\n \n \n \n\n\n \n Morelle, M.; Cardon, F.; Beuscart, J.; Campagne, J.; Wiel, E.; Boulanger, E.; and Assez, N.\n\n\n \n\n\n\n Annales Francaises de Medecine d'Urgence, 4(2): 89–95. 2014.\n \n\n\n\n
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\n\n\n@article{morelle_place_2014,\n\ttitle = {Place of neurocryostimulation in the treatment of post-traumatic pain in {Emergency} {Department}},\n\tvolume = {4},\n\tshorttitle = {Intérêt de la neurocryostimulation dans la prise en charge de la douleur post-traumatique en médecine d'urgence},\n\tdoi = {10.1007/s13341-013-0400-4},\n\tabstract = {Objective: This work was designed to assess the antalgic effect of neurocryostimulation on traumatic pain in the emergency room. Methods: This prospective cohort study was conducted in an emergency room during 12 days. Patients who were more than 12-year-old and admitted to the emergency room for up to 24 h for trauma pain were included. After pain assessment by a pain intensity numeric rating scale (PRS; score 0 to 100) during the first medical contact (t0), the patients received a single neurocryostimulation session. Pain intensity was re-evaluated just after the cryotherapy session (t1), and when the patients went out of the emergency room (t2). Results: Forty-nine patients were included in this study. During the first medical contact (t0), the average pain intensity was about 63 ± 16. The pain score rapidly decreased to 46 ± 23 (27\\% of reduction, P {\\textless} 0.05) after the neurocryostimulation session (t1). Pain decrease was constant: the value of pain intensity at the release of the patients from the emergency room was 34 ± 20 (46\\% of reduction, P {\\textless} 0.05). The decrease of pain intensity tends to be more important for patients with a PRS ≥ 70 (49\\% of reduction, P {\\textless} 0.05). Conclusion: Neurocryostimulation is an effective antalgic technique for emergency trauma for mild and major pains, as a supplement to usual antalgic treatments. © 2013 Société française de médecine d'urgence and Springer-Verlag France.},\n\tnumber = {2},\n\tjournal = {Annales Francaises de Medecine d'Urgence},\n\tauthor = {Morelle, M. and Cardon, F. and Beuscart, J.-B. and Campagne, J.-B. and Wiel, E. and Boulanger, E. and Assez, N.},\n\tyear = {2014},\n\tkeywords = {Antalgy, Cryotherapy, Emergency, Pain, Traumatology},\n\tpages = {89--95},\n}\n\n\n\n Objective: This work was designed to assess the antalgic effect of neurocryostimulation on traumatic pain in the emergency room. Methods: This prospective cohort study was conducted in an emergency room during 12 days. Patients who were more than 12-year-old and admitted to the emergency room for up to 24 h for trauma pain were included. After pain assessment by a pain intensity numeric rating scale (PRS; score 0 to 100) during the first medical contact (t0), the patients received a single neurocryostimulation session. Pain intensity was re-evaluated just after the cryotherapy session (t1), and when the patients went out of the emergency room (t2). Results: Forty-nine patients were included in this study. During the first medical contact (t0), the average pain intensity was about 63 ± 16. The pain score rapidly decreased to 46 ± 23 (27% of reduction, P \\textless 0.05) after the neurocryostimulation session (t1). Pain decrease was constant: the value of pain intensity at the release of the patients from the emergency room was 34 ± 20 (46% of reduction, P \\textless 0.05). The decrease of pain intensity tends to be more important for patients with a PRS ≥ 70 (49% of reduction, P \\textless 0.05). Conclusion: Neurocryostimulation is an effective antalgic technique for emergency trauma for mild and major pains, as a supplement to usual antalgic treatments. © 2013 Société française de médecine d'urgence and Springer-Verlag France.\n
\n\n\n\n \n\n \n \n \n \n \n A new tool to fight against drug related problems in the elderly.\n \n \n \n\n\n \n Podvin-Deleplanque, J.; Charani, C.; Verheyde, I.; Huvent, D.; Beuscart, J.; and Puisieux, F.\n\n\n \n\n\n\n Revue de Geriatrie, 39(10): 649–657. 2014.\n \n\n\n\n
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\n\n\n@article{podvin-deleplanque_new_2014,\n\ttitle = {A new tool to fight against drug related problems in the elderly},\n\tvolume = {39},\n\tshorttitle = {Un nouvel outil pour lutter contre la iatrogénic chez les personnes agees},\n\tabstract = {Background: Improuing drug prescription and medication compliance among the elderly is a public health priority. The monitoring table "My Treatment" has been developed to help the prescribing physician reassess a prescription and to improve patient adherence. The table is filled in after a hospital stay and is shown to the patient. It is then sent over to his or her general physician who will have to ensure the patient's good comprehension and adhesion. Objectives: The study aimed at evaluating the feasibility and quality of the process. It also helped understanding potential issues faced when filling in the questionnaires. Methods: The monitoring table has been tested in partnership with OMEDIT Nord-Pas-de-Calais, Reseau Sante-Qualite and URPS Medecins Liberaux Nord-Pas-de-Calais, in 8 hospitals between February and June 2012. Physicians' opinions along with the quality of the forms were evaluated. Results: Thanks to the 8 hospitals who took part in the study, 384 tables were analyzed. Hospital and general physicians found the tool useful and considered it contributed to a better communication between hospitals and town. They also considered it provided patient with better information the other, that is to say, its irreducible otherness. Positive treatment is no longer an assertiveness in the name of good, but the respectful reception of the other's speech, and silent response to his call.},\n\tnumber = {10},\n\tjournal = {Revue de Geriatrie},\n\tauthor = {Podvin-Deleplanque, J. and Charani, C. and Verheyde, I. and Huvent, D. and Beuscart, J.-B. and Puisieux, F.},\n\tyear = {2014},\n\tkeywords = {Others, Philosophy, Practice, Welfare, Well},\n\tpages = {649--657},\n}\n\n\n\n Background: Improuing drug prescription and medication compliance among the elderly is a public health priority. The monitoring table \"My Treatment\" has been developed to help the prescribing physician reassess a prescription and to improve patient adherence. The table is filled in after a hospital stay and is shown to the patient. It is then sent over to his or her general physician who will have to ensure the patient's good comprehension and adhesion. Objectives: The study aimed at evaluating the feasibility and quality of the process. It also helped understanding potential issues faced when filling in the questionnaires. Methods: The monitoring table has been tested in partnership with OMEDIT Nord-Pas-de-Calais, Reseau Sante-Qualite and URPS Medecins Liberaux Nord-Pas-de-Calais, in 8 hospitals between February and June 2012. Physicians' opinions along with the quality of the forms were evaluated. Results: Thanks to the 8 hospitals who took part in the study, 384 tables were analyzed. Hospital and general physicians found the tool useful and considered it contributed to a better communication between hospitals and town. They also considered it provided patient with better information the other, that is to say, its irreducible otherness. Positive treatment is no longer an assertiveness in the name of good, but the respectful reception of the other's speech, and silent response to his call.\n
\n\n\n\n \n\n \n \n \n \n \n Quality assurance: Automatic detection of inappropriate prescriptions in the elderly.\n \n \n \n\n\n \n Ferret, L.; Beuscart, J.; Ficheur, G.; Perichon, R.; and Beuscart, R.\n\n\n \n\n\n\n Studies in Health Technology and Informatics, 205: 1230. 2014.\n \n\n\n\n
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\n\n\n\n@article{ferret_quality_2014,\n\ttitle = {Quality assurance: {Automatic} detection of inappropriate prescriptions in the elderly},\n\tvolume = {205},\n\tshorttitle = {Quality assurance},\n\tdoi = {10.3233/978-1-61499-432-9-1230},\n\tjournal = {Studies in Health Technology and Informatics},\n\tauthor = {Ferret, L. and Beuscart, J.-B. and Ficheur, G. and Perichon, R. and Beuscart, R.},\n\tyear = {2014},\n\tkeywords = {Inappropriate prescribing, cholinergic antagonists, data mining, health information technology, quality assurance},\n\tpages = {1230},\n}\n\n\n\n \n\n \n \n \n \n \n A new tool to fight against drug related problems in the elderly.\n \n \n \n\n\n \n Podvin-Deleplanque, J.; Charani, C.; Verheyde, I.; Huvent, D.; Beuscart, J.; and Puisieux, F.\n\n\n \n\n\n\n Revue de Geriatrie, 39(10): 649–657. 2014.\n \n\n\n\n
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\n\n\n@article{podvin-deleplanque_new_2014-1,\n\ttitle = {A new tool to fight against drug related problems in the elderly},\n\tvolume = {39},\n\tissn = {0397-7927},\n\tshorttitle = {Un nouvel outil pour lutter contre la iatrogénic chez les personnes agees},\n\tabstract = {Background: Improuing drug prescription and medication compliance among the elderly is a public health priority. The monitoring table "My Treatment" has been developed to help the prescribing physician reassess a prescription and to improve patient adherence. The table is filled in after a hospital stay and is shown to the patient. It is then sent over to his or her general physician who will have to ensure the patient's good comprehension and adhesion. Objectives: The study aimed at evaluating the feasibility and quality of the process. It also helped understanding potential issues faced when filling in the questionnaires. Methods: The monitoring table has been tested in partnership with OMEDIT Nord-Pas-de-Calais, Reseau Sante-Qualite and URPS Medecins Liberaux Nord-Pas-de-Calais, in 8 hospitals between February and June 2012. Physicians' opinions along with the quality of the forms were evaluated. Results: Thanks to the 8 hospitals who took part in the study, 384 tables were analyzed. Hospital and general physicians found the tool useful and considered it contributed to a better communication between hospitals and town. They also considered it provided patient with better information the other, that is to say, its irreducible otherness. Positive treatment is no longer an assertiveness in the name of good, but the respectful reception of the other's speech, and silent response to his call.},\n\tlanguage = {French},\n\tnumber = {10},\n\tjournal = {Revue de Geriatrie},\n\tauthor = {Podvin-Deleplanque, J. and Charani, C. and Verheyde, I. and Huvent, D. and Beuscart, J.-B. and Puisieux, F.},\n\tyear = {2014},\n\tkeywords = {Others, Philosophy, Practice, Welfare, Well},\n\tpages = {649--657},\n}\n\n\n\n Background: Improuing drug prescription and medication compliance among the elderly is a public health priority. The monitoring table \"My Treatment\" has been developed to help the prescribing physician reassess a prescription and to improve patient adherence. The table is filled in after a hospital stay and is shown to the patient. It is then sent over to his or her general physician who will have to ensure the patient's good comprehension and adhesion. Objectives: The study aimed at evaluating the feasibility and quality of the process. It also helped understanding potential issues faced when filling in the questionnaires. Methods: The monitoring table has been tested in partnership with OMEDIT Nord-Pas-de-Calais, Reseau Sante-Qualite and URPS Medecins Liberaux Nord-Pas-de-Calais, in 8 hospitals between February and June 2012. Physicians' opinions along with the quality of the forms were evaluated. Results: Thanks to the 8 hospitals who took part in the study, 384 tables were analyzed. Hospital and general physicians found the tool useful and considered it contributed to a better communication between hospitals and town. They also considered it provided patient with better information the other, that is to say, its irreducible otherness. Positive treatment is no longer an assertiveness in the name of good, but the respectful reception of the other's speech, and silent response to his call.\n
\n\n\n\n \n\n \n \n \n \n \n Adverse drug events with hyperkalaemia during inpatient stays: evaluation of an automated method for retrospective detection in hospital databases.\n \n \n \n\n\n \n Ficheur, G.; Chazard, E.; Beuscart, J.; Merlin, B.; Luyckx, M.; and Beuscart, R.\n\n\n \n\n\n\n BMC medical informatics and decision making, 14(1): 83. 2014.\n \n\n\n\n
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\n\n\n@article{ficheur_adverse_2014,\n\ttitle = {Adverse drug events with hyperkalaemia during inpatient stays: evaluation of an automated method for retrospective detection in hospital databases},\n\tvolume = {14},\n\tissn = {1472-6947},\n\tshorttitle = {Adverse drug events with hyperkalaemia during inpatient stays},\n\tdoi = {10.1186/1472-6947-14-83},\n\tabstract = {BACKGROUND: Adverse drug reactions and adverse drug events (ADEs) are major public health issues. Many different prospective tools for the automated detection of ADEs in hospital databases have been developed and evaluated. The objective of the present study was to evaluate an automated method for the retrospective detection of ADEs with hyperkalaemia during inpatient stays.\nMETHODS: We used a set of complex detection rules to take account of the patient's clinical and biological context and the chronological relationship between the causes and the expected outcome. The dataset consisted of 3,444 inpatient stays in a French general hospital. An automated review was performed for all data and the results were compared with those of an expert chart review. The complex detection rules' analytical quality was evaluated for ADEs.\nRESULTS: In terms of recall, 89.5\\% of ADEs with hyperkalaemia "with or without an abnormal symptom" were automatically identified (including all three serious ADEs). In terms of precision, 63.7\\% of the automatically identified ADEs with hyperkalaemia were true ADEs.\nCONCLUSIONS: The use of context-sensitive rules appears to improve the automated detection of ADEs with hyperkalaemia. This type of tool may have an important role in pharmacoepidemiology via the routine analysis of large inter-hospital databases.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {BMC medical informatics and decision making},\n\tauthor = {Ficheur, Grégoire and Chazard, Emmanuel and Beuscart, Jean-Baptiste and Merlin, Béatrice and Luyckx, Michel and Beuscart, Régis},\n\tyear = {2014},\n\tpmid = {25212108},\n\tpages = {83},\n}\n\n\n\n BACKGROUND: Adverse drug reactions and adverse drug events (ADEs) are major public health issues. Many different prospective tools for the automated detection of ADEs in hospital databases have been developed and evaluated. The objective of the present study was to evaluate an automated method for the retrospective detection of ADEs with hyperkalaemia during inpatient stays. METHODS: We used a set of complex detection rules to take account of the patient's clinical and biological context and the chronological relationship between the causes and the expected outcome. The dataset consisted of 3,444 inpatient stays in a French general hospital. An automated review was performed for all data and the results were compared with those of an expert chart review. The complex detection rules' analytical quality was evaluated for ADEs. RESULTS: In terms of recall, 89.5% of ADEs with hyperkalaemia \"with or without an abnormal symptom\" were automatically identified (including all three serious ADEs). In terms of precision, 63.7% of the automatically identified ADEs with hyperkalaemia were true ADEs. CONCLUSIONS: The use of context-sensitive rules appears to improve the automated detection of ADEs with hyperkalaemia. This type of tool may have an important role in pharmacoepidemiology via the routine analysis of large inter-hospital databases.\n
\n\n\n\n \n\n \n \n \n \n \n Proposal and evaluation of FASDIM, a Fast And Simple De-Identification Method for unstructured free-text clinical records.\n \n \n \n\n\n \n Chazard, E.; Mouret, C.; Ficheur, G.; Schaffar, A.; Beuscart, J.; and Beuscart, R.\n\n\n \n\n\n\n International Journal of Medical Informatics, 83(4): 303–312. April 2014.\n \n\n\n\n
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\n\n\n@article{chazard_proposal_2014,\n\ttitle = {Proposal and evaluation of {FASDIM}, a {Fast} {And} {Simple} {De}-{Identification} {Method} for unstructured free-text clinical records},\n\tvolume = {83},\n\tissn = {1872-8243},\n\tdoi = {10.1016/j.ijmedinf.2013.11.005},\n\tabstract = {PURPOSE: Medical free-text records enable to get rich information about the patients, but often need to be de-identified by removing the Protected Health Information (PHI), each time the identification of the patient is not mandatory. Pattern matching techniques require pre-defined dictionaries, and machine learning techniques require an extensive training set. Methods exist in French, but either bring weak results or are not freely available. The objective is to define and evaluate FASDIM, a Fast And Simple De-Identification Method for French medical free-text records.\nMETHODS: FASDIM consists in removing all the words that are not present in the authorized word list, and in removing all the numbers except those that match a list of protection patterns. The corresponding lists are incremented in the course of the iterations of the method. For the evaluation, the workload is estimated in the course of records de-identification. The efficiency of the de-identification is assessed by independent medical experts on 508 discharge letters that are randomly selected and de-identified by FASDIM. Finally, the letters are encoded after and before de-identification according to 3 terminologies (ATC, ICD10, CCAM) and the codes are compared.\nRESULTS: The construction of the list of authorized words is progressive: 12h for the first 7000 letters, 16 additional hours for 20,000 additional letters. The Recall (proportion of removed Protected Health Information, PHI) is 98.1\\%, the Precision (proportion of PHI within the removed token) is 79.6\\% and the F-measure (harmonic mean) is 87.9\\%. In average 30.6 terminology codes are encoded per letter, and 99.02\\% of those codes are preserved despite the de-identification.\nCONCLUSION: FASDIM gets good results in French and is freely available. It is easy to implement and does not require any predefined dictionary.},\n\tlanguage = {eng},\n\tnumber = {4},\n\tjournal = {International Journal of Medical Informatics},\n\tauthor = {Chazard, Emmanuel and Mouret, Capucine and Ficheur, Grégoire and Schaffar, Aurélien and Beuscart, Jean-Baptiste and Beuscart, Régis},\n\tmonth = apr,\n\tyear = {2014},\n\tpmid = {24370391},\n\tpages = {303--312},\n}\n\n\n\n PURPOSE: Medical free-text records enable to get rich information about the patients, but often need to be de-identified by removing the Protected Health Information (PHI), each time the identification of the patient is not mandatory. Pattern matching techniques require pre-defined dictionaries, and machine learning techniques require an extensive training set. Methods exist in French, but either bring weak results or are not freely available. The objective is to define and evaluate FASDIM, a Fast And Simple De-Identification Method for French medical free-text records. METHODS: FASDIM consists in removing all the words that are not present in the authorized word list, and in removing all the numbers except those that match a list of protection patterns. The corresponding lists are incremented in the course of the iterations of the method. For the evaluation, the workload is estimated in the course of records de-identification. The efficiency of the de-identification is assessed by independent medical experts on 508 discharge letters that are randomly selected and de-identified by FASDIM. Finally, the letters are encoded after and before de-identification according to 3 terminologies (ATC, ICD10, CCAM) and the codes are compared. RESULTS: The construction of the list of authorized words is progressive: 12h for the first 7000 letters, 16 additional hours for 20,000 additional letters. The Recall (proportion of removed Protected Health Information, PHI) is 98.1%, the Precision (proportion of PHI within the removed token) is 79.6% and the F-measure (harmonic mean) is 87.9%. In average 30.6 terminology codes are encoded per letter, and 99.02% of those codes are preserved despite the de-identification. CONCLUSION: FASDIM gets good results in French and is freely available. It is easy to implement and does not require any predefined dictionary.\n
\n\n\n\n \n\n \n \n \n \n \n Anti-sRAGE autoimmunity in obesity: Downturn after bariatric surgery is independent of previous diabetic status.\n \n \n \n\n\n \n Lorenzi, R.; Pattou, F.; Beuscart, J.; Grossin, N.; Lambert, M.; Fontaine, P.; Caiazzo, R.; Pigeyre, M.; Patrice, A.; Daroux, M.; Boulanger, E.; and Dubucquoi, S.\n\n\n \n\n\n\n Diabetes & Metabolism. June 2014.\n \n\n\n\n
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\n\n\n \n\n\n\n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n
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\n\n\n@article{lorenzi_anti-srage_2014,\n\ttitle = {Anti-{sRAGE} autoimmunity in obesity: {Downturn} after bariatric surgery is independent of previous diabetic status},\n\tissn = {1878-1780},\n\tshorttitle = {Anti-{sRAGE} autoimmunity in obesity},\n\tdoi = {10.1016/j.diabet.2014.04.008},\n\tabstract = {AIM: Morbid obesity increases the risk of cardiovascular disease (CVD). The receptor for advanced glycation end-products (RAGE) is implicated in proinflammatory processes that underlie CVD. Its soluble form (sRAGE) has been proposed as a vascular biomarker. Recently, anti-sRAGE autoantibodies were described and found to be increased in diseases where RAGE is overexpressed. This study aimed to investigate serum levels of anti-sRAGE autoantibodies in morbidly obese patients.\nMETHODS: After exclusion based on specific criteria, 150 subjects (50 normoglycemics, 50 glucose-intolerants and 50 diabetics) were randomly recruited from a cohort of 750 obese patients (ABOS). Serum sRAGE and anti-sRAGE autoantibodies were measured before bariatric surgery. Sixty-nine patients were followed for up to 1year after gastric bypass, and their levels of sRAGE and anti-sRAGE autoantibodies measured. The control group consisted of healthy blood donors.\nRESULTS: Compared with controls, baseline levels of sRAGE and anti-sRAGE autoantibodies were significantly higher in all obese patients independently of glucose regulation (P{\\textless}0.001). At 1year after gastric bypass, sRAGE and anti-sRAGE were decreased (P{\\textless}0.001). The decrease in anti-sRAGE autoantibodies was correlated with an increase in high-density lipoprotein (HDL; P=0.02).\nCONCLUSION: Independently of previous diabetic status, morbid obesity increases sRAGE and anti-sRAGE levels. Weight loss after gastric bypass is followed by a decrease in both titres. The decrease in anti-sRAGE correlates with an increase in HDL.},\n\tlanguage = {ENG},\n\tjournal = {Diabetes \\& Metabolism},\n\tauthor = {Lorenzi, R. and Pattou, F. and Beuscart, J.-B. and Grossin, N. and Lambert, M. and Fontaine, P. and Caiazzo, R. and Pigeyre, M. and Patrice, A. and Daroux, M. and Boulanger, E. and Dubucquoi, S.},\n\tmonth = jun,\n\tyear = {2014},\n\tpmid = {24933232},\n}\n\n\n\n AIM: Morbid obesity increases the risk of cardiovascular disease (CVD). The receptor for advanced glycation end-products (RAGE) is implicated in proinflammatory processes that underlie CVD. Its soluble form (sRAGE) has been proposed as a vascular biomarker. Recently, anti-sRAGE autoantibodies were described and found to be increased in diseases where RAGE is overexpressed. This study aimed to investigate serum levels of anti-sRAGE autoantibodies in morbidly obese patients. METHODS: After exclusion based on specific criteria, 150 subjects (50 normoglycemics, 50 glucose-intolerants and 50 diabetics) were randomly recruited from a cohort of 750 obese patients (ABOS). Serum sRAGE and anti-sRAGE autoantibodies were measured before bariatric surgery. Sixty-nine patients were followed for up to 1year after gastric bypass, and their levels of sRAGE and anti-sRAGE autoantibodies measured. The control group consisted of healthy blood donors. RESULTS: Compared with controls, baseline levels of sRAGE and anti-sRAGE autoantibodies were significantly higher in all obese patients independently of glucose regulation (P\\textless0.001). At 1year after gastric bypass, sRAGE and anti-sRAGE were decreased (P\\textless0.001). The decrease in anti-sRAGE autoantibodies was correlated with an increase in high-density lipoprotein (HDL; P=0.02). CONCLUSION: Independently of previous diabetic status, morbid obesity increases sRAGE and anti-sRAGE levels. Weight loss after gastric bypass is followed by a decrease in both titres. The decrease in anti-sRAGE correlates with an increase in HDL.\n
\n\n\n\n \n\n \n \n \n \n \n Quality assurance: automatic detection of inappropriate prescriptions in the elderly.\n \n \n \n\n\n \n Ferret, L.; Beuscart, J.; Ficheur, G.; Perichon, R.; and Beuscart, R.\n\n\n \n\n\n\n Studies in Health Technology and Informatics, 205: 1230. 2014.\n \n\n\n\n
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\n\n\n\n@article{ferret_quality_2014-1,\n\ttitle = {Quality assurance: automatic detection of inappropriate prescriptions in the elderly},\n\tvolume = {205},\n\tissn = {0926-9630},\n\tshorttitle = {Quality assurance},\n\tlanguage = {eng},\n\tjournal = {Studies in Health Technology and Informatics},\n\tauthor = {Ferret, Laurie and Beuscart, Jean-Baptiste and Ficheur, Grégoire and Perichon, Renaud and Beuscart, Régis},\n\tyear = {2014},\n\tpmid = {25160421},\n\tpages = {1230},\n}\n\n\n\n
\n\n \n \n 2013\n \n \n (2)\n \n \n
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\n \n \n\n \n \n \n \n \n \n Intérêt de la neurocryostimulation dans la prise en charge de la douleur post-traumatique en médecine d’urgence.\n \n \n \n \n\n\n \n Morelle, M.; Cardon, F.; Beuscart, J.; Campagne, J.; Wiel, E.; Boulanger, E.; and Assez, N.\n\n\n \n\n\n\n Annales françaises de médecine d'urgence, 4(2): 89–95. December 2013.\n \n\n\n\n
\n\n\n\n \n \nPaper\n \n \n\n \n \n doi\n \n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n\n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n\n\n
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\n\n\n@article{morelle_interet_2013,\n\ttitle = {Intérêt de la neurocryostimulation dans la prise en charge de la douleur post-traumatique en médecine d’urgence},\n\tvolume = {4},\n\tissn = {2108-6524, 2108-6591},\n\turl = {http://link.springer.com/article/10.1007/s13341-013-0400-4},\n\tdoi = {10.1007/s13341-013-0400-4},\n\tabstract = {Objective This work was designed to assess the antalgic effect of neurocryostimulation on traumatic pain in the emergency room. Methods This prospective cohort study was conducted in an emergency room during 12 days. Patients who were more than 12-year-old and admitted to the emergency room for up to 24 h for trauma pain were included. After pain assessment by a pain intensity numeric rating scale (PRS; score 0 to 100) during the first medical contact (t0), the patients received a single neurocryostimulation session. Pain intensity was re-evaluated just after the cryotherapy session (t1), and when the patients went out of the emergency room (t2). Results: Forty-nine patients were included in this study. During the first medical contact (t0), the average pain intensity was about 63 ± 16. The pain score rapidly decreased to 46 ± 23 (27\\% of reduction, P {\\textless} 0.05) after the neurocryostimulation session (t1). Pain decrease was constant: the value of pain intensity at the release of the patients from the emergency room was 34 ± 20 (46\\% of reduction, P {\\textless} 0.05). The decrease of pain intensity tends to be more important for patients with a PRS ≥ 70 (49\\% of reduction, P {\\textless} 0.05). Conclusion Neurocryostimulation is an effective antalgic technique for emergency trauma for mild and major pains, as a supplement to usual antalgic treatments.},\n\tlanguage = {fr},\n\tnumber = {2},\n\turldate = {2016-03-01},\n\tjournal = {Annales françaises de médecine d'urgence},\n\tauthor = {Morelle, M. and Cardon, F. and Beuscart, J.-B. and Campagne, J.-B. and Wiel, E. and Boulanger, E. and Assez, N.},\n\tmonth = dec,\n\tyear = {2013},\n\tkeywords = {Anesthesiology, Antalgie, Antalgy, Cryotherapy, Cryothérapie, Douleur, Emergency, Intensive / Critical Care Medicine, Pain, Traumatologie, Traumatology, Urgence, emergency medicine},\n\tpages = {89--95},\n}\n\n\n\n Objective This work was designed to assess the antalgic effect of neurocryostimulation on traumatic pain in the emergency room. Methods This prospective cohort study was conducted in an emergency room during 12 days. Patients who were more than 12-year-old and admitted to the emergency room for up to 24 h for trauma pain were included. After pain assessment by a pain intensity numeric rating scale (PRS; score 0 to 100) during the first medical contact (t0), the patients received a single neurocryostimulation session. Pain intensity was re-evaluated just after the cryotherapy session (t1), and when the patients went out of the emergency room (t2). Results: Forty-nine patients were included in this study. During the first medical contact (t0), the average pain intensity was about 63 ± 16. The pain score rapidly decreased to 46 ± 23 (27% of reduction, P \\textless 0.05) after the neurocryostimulation session (t1). Pain decrease was constant: the value of pain intensity at the release of the patients from the emergency room was 34 ± 20 (46% of reduction, P \\textless 0.05). The decrease of pain intensity tends to be more important for patients with a PRS ≥ 70 (49% of reduction, P \\textless 0.05). Conclusion Neurocryostimulation is an effective antalgic technique for emergency trauma for mild and major pains, as a supplement to usual antalgic treatments.\n
\n\n\n\n \n\n \n \n \n \n \n Routine Use of the \"ADE Scorecards\", an Application for Automated ADE Detection in a General Hospital.\n \n \n \n\n\n \n Chazard, E.; Luyckx, M.; Beuscart, J.; Ferret, L.; and Beuscart, R.\n\n\n \n\n\n\n Studies in health technology and informatics, 192: 308–312. 2013.\n \n\n\n\n
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\n\n\n@article{chazard_routine_2013,\n\ttitle = {Routine {Use} of the "{ADE} {Scorecards}", an {Application} for {Automated} {ADE} {Detection} in a {General} {Hospital}},\n\tvolume = {192},\n\tissn = {0926-9630},\n\tabstract = {Retrospective detection of Adverse Drug Events (ADEs) is challenging, notably because ADEs result from complex interactions between many factors. Data mining techniques have recently emerged in the field of automated retrospective ADE detection. The "ADE Scorecards" are a research application based on data-mining that has been built in the framework of the PSIP European Project, and potentially enables automated ADE retrospective detection. The objective of this paper is to evaluate the use of the ADE Scorecards in a real-life healthcare situation. For that purpose, the ADE Scorecards have been implemented in a French general hospital and have been used by the physicians and pharmacists for three years (corresponding to 73,000 inpatient stays). According to the results, 2\\% of the analyzed inpatient stays have a potential ADE with hyperkalemia, and 1\\% of them have a potential ADE with vitamin K antagonist overdose. In practice, the application, which was first designed to be a standalone web-based application for the physicians, has been used as a part of a more global quality improvement approach led by the pharmacists.},\n\tlanguage = {eng},\n\tjournal = {Studies in health technology and informatics},\n\tauthor = {Chazard, Emmanuel and Luyckx, Michel and Beuscart, Jean-Baptiste and Ferret, Laurie and Beuscart, Régis},\n\tyear = {2013},\n\tpmid = {23920566},\n\tpages = {308--312},\n}\n\n\n Retrospective detection of Adverse Drug Events (ADEs) is challenging, notably because ADEs result from complex interactions between many factors. Data mining techniques have recently emerged in the field of automated retrospective ADE detection. The \"ADE Scorecards\" are a research application based on data-mining that has been built in the framework of the PSIP European Project, and potentially enables automated ADE retrospective detection. The objective of this paper is to evaluate the use of the ADE Scorecards in a real-life healthcare situation. For that purpose, the ADE Scorecards have been implemented in a French general hospital and have been used by the physicians and pharmacists for three years (corresponding to 73,000 inpatient stays). According to the results, 2% of the analyzed inpatient stays have a potential ADE with hyperkalemia, and 1% of them have a potential ADE with vitamin K antagonist overdose. In practice, the application, which was first designed to be a standalone web-based application for the physicians, has been used as a part of a more global quality improvement approach led by the pharmacists.\n
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\n\n \n \n 2012\n \n \n (1)\n \n \n
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\n \n \n\n \n \n \n \n \n \n Overestimation of the probability of death on peritoneal dialysis by the Kaplan-Meier method: advantages of a competing risks approach.\n \n \n \n \n\n\n \n Beuscart, J.; Pagniez, D.; Boulanger, E.; Foy, C. L. d. S.; Salleron, J.; Frimat, L.; and Duhamel, A.\n\n\n \n\n\n\n BMC Nephrology, 13(1): 31. May 2012.\n \n\n\n\n
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\n\n\n@article{beuscart_overestimation_2012,\n\ttitle = {Overestimation of the probability of death on peritoneal dialysis by the {Kaplan}-{Meier} method: advantages of a competing risks approach},\n\tvolume = {13},\n\tcopyright = {http://creativecommons.org/licenses/by/2.0/},\n\tissn = {1471-2369},\n\tshorttitle = {Overestimation of the probability of death on peritoneal dialysis by the {Kaplan}-{Meier} method},\n\turl = {http://www.biomedcentral.com/1471-2369/13/31/abstract},\n\tdoi = {10.1186/1471-2369-13-31},\n\tabstract = {In survival analysis, patients on peritoneal dialysis are confronted with three different outcomes: transfer to hemodialysis, renal transplantation, or death. The Kaplan-Meier method takes into account one event only, so whether it adequately considers these different risks is questionable. The more recent competing risks method has been shown to be more appropriate in analyzing such situations},\n\tlanguage = {en},\n\tnumber = {1},\n\turldate = {2012-07-04},\n\tjournal = {BMC Nephrology},\n\tauthor = {Beuscart, Jean-Baptiste and Pagniez, Dominique and Boulanger, Eric and Foy, Celia Lessore de Sainte and Salleron, Julia and Frimat, Luc and Duhamel, Alain},\n\tmonth = may,\n\tyear = {2012},\n\tpages = {31},\n}\n\n\n\n In survival analysis, patients on peritoneal dialysis are confronted with three different outcomes: transfer to hemodialysis, renal transplantation, or death. The Kaplan-Meier method takes into account one event only, so whether it adequately considers these different risks is questionable. The more recent competing risks method has been shown to be more appropriate in analyzing such situations\n
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\n\n\n\n\n \n \n 2011\n \n \n (1)\n \n \n
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\n \n \n\n \n \n \n \n \n \n Aggregated serum free light chains may prevent adequate removal by high cut-off haemodialysis.\n \n \n \n \n\n\n \n Harding, S.; Provot, F.; Beuscart, J.; Cook, M.; Bradwell, A. R; Stringer, S.; White, D.; Cockwell, P.; and Hutchison, C. A\n\n\n \n\n\n\n Nephrology, Dialysis, Transplantation: Official Publication of the European Dialysis and Transplant Association - European Renal Association, 26(4): 1438. April 2011.\n \n\n\n\n
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\n\n\n@article{harding_aggregated_2011,\n\ttitle = {Aggregated serum free light chains may prevent adequate removal by high cut-off haemodialysis},\n\tvolume = {26},\n\tissn = {1460-2385},\n\turl = {http://www.ncbi.nlm.nih.gov/pubmed/21406545},\n\tdoi = {10.1093/ndt/gfr019},\n\tabstract = {Free light chain (FLC) removal by high cut-off haemodialysis has been described as an adjuvant therapy for the management of patients with severe renal failure complicating multiple myeloma. The two cases reported here are the first patients in whom this treatment did not remove FLCs. In both patient's sera, size-exclusion chromatography identified large FLC aggregates, with molecular weights above the cut-off of the dialyser. It is important for clinicians to be aware of FLC aggregates as a reason for failure to remove FLCs by this new modality.},\n\tnumber = {4},\n\turldate = {2011-10-06},\n\tjournal = {Nephrology, Dialysis, Transplantation: Official Publication of the European Dialysis and Transplant Association - European Renal Association},\n\tauthor = {Harding, Stephen and Provot, Francois and Beuscart, Jean-Baptise and Cook, Mark and Bradwell, Arthur R and Stringer, Stephanie and White, Darren and Cockwell, Paul and Hutchison, Colin A},\n\tmonth = apr,\n\tyear = {2011},\n\tpmid = {21406545},\n\tkeywords = {Chromatography, Gel, Female, Humans, Immunoglobulin Light Chains, Kidney Failure, Chronic, Male, Middle Aged, Multiple Myeloma, Renal Dialysis},\n\tpages = {1438},\n}\n\n\n\n Free light chain (FLC) removal by high cut-off haemodialysis has been described as an adjuvant therapy for the management of patients with severe renal failure complicating multiple myeloma. The two cases reported here are the first patients in whom this treatment did not remove FLCs. In both patient's sera, size-exclusion chromatography identified large FLC aggregates, with molecular weights above the cut-off of the dialyser. It is important for clinicians to be aware of FLC aggregates as a reason for failure to remove FLCs by this new modality.\n
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