Incidence, clinical characteristics and management of inflammatory bowel disease in Spain: large-scale epidemiological study

(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD—Crohn’s disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)—during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100, 000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31–56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

Las bases Bayesianas de la teoría de la credibilidad

Uno de los objetivos de la Matemática Actuarial es la elaboración de Sistemas de Tarificación que garanticen la solvencia de la entidad aseguradora (principio de suficiencia) pero que simultáneamente resulten lo más justos posible (principio de equidad). Los sistemas de tarificación a posteriori se caracterizan porque la prima de riesgo individual depende de la evolución de la siniestralidad de ese mismo riesgo individual. Una solución a este problema viene dada por los Modelos de Credibilidad, los cuales buscan la estimación de la prima del seguro en colectivos, más o menos heterogéneos, combinando la información global disponible con la individual, frecuentemente ésta última de carácter más limitado. A principios de siglo, y como consecuencia de que las técnicas estadísticas en uso no permitían resolver los problemas actuariales, los actuarios desarrollaron sus propios métodos de forma aislada a la corriente estadística de la época, caracterizada porque todo conocimiento a priori carecía de valor estadístico. Hasta entonces, apenas existían situaciones en las que se demandara la utilización de información de naturaleza diferente a la procedente de observaciones puramente empíricas, para ser incorporada a los análisis