Catégorisation par disciplines médicales du contenu éditorial des cinq revenus de santé les plus influentes

ContexteLes grandes revues généralistes à haut facteur d'impact sont très utiles dans la formation continue des médecins. Cependant, le contenu éditorial de ces journaux a déjà été retrouvé divergent. L'objectif de ce travail était d'estimer si la représentation des disciplines médicales dans ces revues avait été différente sur la période 2005-2015.MéthodesTous les articles ayant paru dans le Lancet, le New England Journal of Medicine, le British Medical Journal et les Annals of Internai Medicine entre 2005 et 2015 et indexés par la US National Library of Medicine, furent analysés par un algorithme de catégorisation. Cet algorithme repose sur des associations entre les termes MeSH utilisés pour l'indexation de ces articles et les disciplines médicales représentées par des superconcepts.RésultatsCe sont 72 928 articles qui furent analysés. Parmi ces articles, 59 143 (81,1%) ont inféré au moins un superconcept. Les cinq disciplines les plus représentées sur l'ensemble des cinq revues étaient la santé publique (7,0%), la cardiologie (5,5%), l'infectiologie (5,3%), la neurologie (5,2%) et l'oncologie (5,2%). Néanmoins, seules trois disciplines, l'infectiologie, la neurologie et l'oncologie se trouvaient dans les 10 premières disciplines de chacun des journaux. La santé publique n'occupait que la onzième place dans le NEJM. La médecine générale occupait une place importante (3,6%) uniquement dans le BMJ.ConclusionLa représentation des disciplines médicales est différente dans les cinq journaux étudiés. Se restreindre à la lecture de seulement quelques revues majeures peut apporter une vision biaisée de la production de la littérature scientifique

Surgical Site Infection in Endometriosis Surgery Is a Rare Complication: Results of a Single Center's Prospective Surveillance of Eight Hundred Ninety-Six Procedures

International audienceBACKGROUND:There are no studies reporting the rate of surgical site infection (SSI) after surgery for endometriosis, although this information is valuable when discussing the most appropriate treatment strategy with the patient.METHODS:We conducted a prospective cohort study in a university hospital and regional reference center for endometriosis. We sought to measure the rate of SSI after endometriosis surgery using prospective SSI post-discharge surveillance data and the hospital information system via an ad hoc algorithm using both diagnosis and procedure code classifications.RESULTS:Among 896 consecutive endometriosis surgical procedures, we identified 365 procedures with involvement of the gastrointestinal tract, defined as the deep invasive procedure (DIP) group, 107 procedures with involvement of an ovary, and 424 other procedures. Twelve SSI (all organ/space infections) were observed, all in the DIP group, corresponding to an overall SSI incidence of 1.3% 95% confidence interval (CI) 0.7-2.3, and an SSI incidence in the DIP group of 2.8%, 95% CI 1.5-4.9. The median delay between the procedure and the SSI was 6.5 days (range, 3-23). At least one micro-organism was found in 10 patients (four Escherichia coli, four Enterobacter cloacae, three Enteroccus faecalis, two Bacteroides fragilis, one Pseudomonas aeruginosa, one Candida albicans).CONCLUSION:A low overall rate of SSI after surgery for endometriosis was observed. Nevertheless, procedures with involvement of the intestinal tract were at risk of SSI

Evaluation of Doc’EDS: a French semantic search tool to query health documents from a clinical data warehouse

International audienceUnstructured data from electronic health records represent a wealth of information. Doc’EDS is a pre-screening tool based on textual and semantic analysis. The Doc’EDS system provides a graphic user interface to search documents in French. The aim of this study was to present the Doc’EDS tool and to provide a formal evaluation of its semantic features. Methods Doc’EDS is a search tool built on top of the clinical data warehouse developed at Rouen University Hospital. This tool is a multilevel search engine combining structured and unstructured data. It also provides basic analytical features and semantic utilities. A formal evaluation was conducted to measure the impact of Natural Language Processing algorithms. Results Approximately 18.1 million narrative documents are stored in Doc’EDS. The formal evaluation was conducted in 5000 clinical concepts that were manually collected. The F-measures of negative concepts and hypothetical concepts were respectively 0.89 and 0.57. Conclusion In this formal evaluation, we have shown that Doc’EDS is able to deal with language subtleties to enhance an advanced full text search in French health documents. The Doc’EDS tool is currently used on a daily basis to help researchers to identify patient cohorts thanks to unstructured data

Evaluation of Doc’EDS: A French Semantic Search Tool to Query Health Documents from A Clinical Data Warehouse

Background: Unstructured data from electronic health record is a gold mine. Doc’EDS is a pre-screening tool based on textual and semantic analysis. The system provides an easy-to-use interface to search documents in French. The aim of this study is to present the tools and to provide a formal evaluation of its semantic features. Material & Methods: Doc’EDS is a search tool built on the top of the clinical data warehouse developed in the Rouen University Hospital. This tool is a multilevel search engine combining structured and unstructured data. It also provides basic analytics features and semantic utilities. A formal evaluation has been conducted to measure the implemented Natural Language Processing algorithms. Results: About 17,3 million of narrative documents are contained in this CDW. The formal evaluation has been conducted over 5,000 clinical concepts that were manually collected. Negation concepts detection F-measure was 0.89, hypothesis concept detection F-measure was 0.57. Conclusion: We hereby present Doc’EDS, a semantic search tool which deals with language subtleties to enhance an advanced full text search engine dedicated to French health documents. This tool is currently used on a daily basis to help researchers identifying patients thanks to unstructured data

Evaluation of Doc’EDS: a French semantic search tool to query health documents from a clinical data warehouse

International audienceUnstructured data from electronic health records represent a wealth of information. Doc’EDS is a pre-screening tool based on textual and semantic analysis. The Doc’EDS system provides a graphic user interface to search documents in French. The aim of this study was to present the Doc’EDS tool and to provide a formal evaluation of its semantic features. Methods Doc’EDS is a search tool built on top of the clinical data warehouse developed at Rouen University Hospital. This tool is a multilevel search engine combining structured and unstructured data. It also provides basic analytical features and semantic utilities. A formal evaluation was conducted to measure the impact of Natural Language Processing algorithms. Results Approximately 18.1 million narrative documents are stored in Doc’EDS. The formal evaluation was conducted in 5000 clinical concepts that were manually collected. The F-measures of negative concepts and hypothetical concepts were respectively 0.89 and 0.57. Conclusion In this formal evaluation, we have shown that Doc’EDS is able to deal with language subtleties to enhance an advanced full text search in French health documents. The Doc’EDS tool is currently used on a daily basis to help researchers to identify patient cohorts thanks to unstructured data

Vérité et littérature au XVIIIe siècle. Mélanges rassemblés en l'honneur de Raymond Trousson

info:eu-repo/semantics/publishe

Factors Associated With Short-term Relapse in Patients With Pemphigus Who Receive Rituximab as First-line Therapy

International audienceImportance: Rituximab and short-term corticosteroid therapy are the criterion standard treatments for patients with newly diagnosed moderate to severe pemphigus.Objective: To examine factors associated with short-term relapse in patients with pemphigus treated with rituximab.Design, setting, and participants: This post hoc analysis of a randomized clinical trial (Comparison Between Rituximab Treatment and Oral Corticosteroid Treatment in Patients With Pemphigus [RITUX 3]) conducted from January 1, 2010, to December 31, 2015, included patients from 20 dermatology departments of tertiary care centers in France from the RITUX 3 trial and 3 newly diagnosed patients treated according to the trial protocol. Data analysis was performed from February 1 to June 30, 2019.Exposure: Patients randomly assigned to the rituximab group in the RITUX 3 trial and the 3 additional patients were treated with 1000 mg of intravenous rituximab on days 0 and 14 and 500 mg at months 12 and 18 combined with a short-term prednisone regimen.Main outcomes and measures: Baseline (pretreatment) clinical and biological characteristics (Pemphigus Disease Area Index [PDAI] score, ranging from 0-250 points, with higher values indicating more severe disease) and changes in anti-desmoglein (DSG) 1 and anti-DSG3 values as measured by enzyme-linked immunosorbent assay during the 3 months after rituximab treatment were compared between patients with disease relapse and those who maintained clinical remission during the first 12 months after treatment. The positive and negative predictive values of these factors were calculated.Results: Among 47 patients (mean [SD] age, 54.3 [17.0] years; 17 [36%] male and 30 [64%] female) included in the study, the mean (SD) baseline PDAI score for patients with relapsing disease was higher than that of the patients with nonrelapsing disease (54 [33] vs 28 [24]; P = .03). At month 3, 7 of 11 patients with relapsing disease (64%) vs 7 of 36 patients with nonrelapsing disease (19%) had persistent anti-DSG1 antibody values of 20 IU/mL or higher and/or anti-DSG3 antibody values of 130 IU/mL or higher (P = .01). A PDAI score of 45 or higher defining severe pemphigus and/or persistent anti-DSG1 antibody values of 20 IU/mL or higher and/or anti-DSG3 antibody values of 130 IU/mL or higher at month 3 provided a positive predictive value of 50% (95% CI, 27%-73%) and a negative predictive value of 94% (95% CI, 73%-100%) for the occurrence of relapse after rituximab.Conclusions and relevance: The findings suggest that initial PDAI score and changes in anti-DSG antibody values after the initial cycle of rituximab might help differentiate a subgroup of patients with high risk of relapse who might benefit from maintenance rituximab infusion at month 6 from a subgroup of patients with low risk of relapse who do not need early maintenance therapy.Trial registration: NCT00784589