From a Quality Assurance and Control System for Medical Processes, Through Epidemiological Trends of Medical Conditions, to a Nationwide Health Project

Machluf, Yossy; Navon, Amir; Yona, Avi; Pirogovsky, Avinoam; Palma, Elio; Tal, Orna; Ash, Nachman; Cohen, Avi J.; Chaiter, Yoram

doi:10.5772/22457

Cited by 8 publications

(9 citation statements)

References 15 publications

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“…The computerized database of the northern recruitment center was used for this study. It has been shown to have a stringent, high quality medical process with reliable data (34). The study population consisted of consecutive conscripts 16-19 years old, born during 1971-1993 who completed the medical profiling process during the years 1988-2011 with valid height and weight measures as previously described (35,36).…”

Section: Study Populationmentioning

confidence: 99%

Rheumatic Fever in Large Cohort of Adolescents in Israel

et al. 2020

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Background: Acute rheumatic fever (ARF) remains a major worldwide healthcare problem, despite its progressive decline in developed countries. The aims of our study were to estimate the prevalence of ARF among adolescents in Israel and to investigate risk factors. Methods:The study population consisted of 113,671 consecutive conscripts 16-19 years old, born during 1971-1993, who completed the medical profiling as part of the recruitment process to the IDF. ARF was diagnosed according to Jones criteria at time of illness, with confirmation relying on medical documentation and cardiologist evaluation including echocardiography.Results: The general prevalence rate of ARF was 0.12%. A downward trend was observed, from 0.19% among those born during 1971-1980 to 0.07% among those born during 1981-1993. Differences in prevalence of ARF were noted in sub-populations based on country of birth and origin-Israel, Ethiopia and the former soviet union (FUSSR). The prevalence rates of valvar disease among ARF+ and ARF-recruits were 15.7% and 0.95%, respectively. In multivariable logistic regression analyses, 4 variables were negatively associated with ARF: later birth year group, female gender, rural residence, youngest child; and 3 were positively associated with ARF: young parents, above normal BMI and valvar disease. Conclusion:Our study provides support for the documented decline in ARF prevalence and describes socio-demographic and anthropometric risk factors including the association with valvar disease and novel risk factors including above normal BMI and young parents, both warranting further investigation which might help in developing societal level prevention strategies.

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Section: Study Populationmentioning

confidence: 99%

Rheumatic Fever in Large Cohort of Adolescents in Israel

et al. 2020

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“…that involve transferring information from HMOs, hospitals, and private medical institutions. In addition, a nationwide pilot project for information sharing and cooperation between all players in the health-care arena: primary care clinics, the Ministry of Health, the National Insurance Institute, the Israeli National Cancer Registry, and the Ministry of Social Affairs and Social Services, has been running for several years ( 26 ).…”

Section: The Modelmentioning

confidence: 99%

“…Finally, a 5-digit profile and appropriate Functional Classification Codes [FCCs, which are similar to the International Classification of Disease (ICD) coding] that describe medical status (anatomical site, condition and severity, as well as an element of occupation) are assigned to each recruit and stored in a computerized database. This provides a transparent standardized record of “health status” of each individual for other physicians, whereby the rank of disability enables limiting activity by the non-medical commanding sector while the medical condition remains obscure ( 26 – 30 ).…”

Section: The Modelmentioning

confidence: 99%

“…Synchronizing all medical records—to allow continuity of medical data and information along the lifespan of individuals, and providing access to the accumulating data to the relevant parties in a multilateral manner—is pivotal to closing the evidence gap. The thorough and comprehensive medical process at the army recruitment centers, generates a massive database that provides an opportunity to assess heath status among adolescents, and may serve as a platform for planning preventive, educational, and medical intervention programs to improve current health-care services and reduce future illness ( 26 ).…”

Section: The Modelmentioning

confidence: 99%

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From Population Databases to Research and Informed Health Decisions and Policy

Machluf¹,

Tal

Navon³

et al. 2017

Front. Public Health

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BackgroundIn the era of big data, the medical community is inspired to maximize the utilization and processing of the rapidly expanding medical datasets for clinical-related and policy-driven research. This requires a medical database that can be aggregated, interpreted, and integrated at both the individual and population levels. Policymakers seek data as a lever for wise, evidence-based decision-making and information-driven policy. Yet, bridging the gap between data collection, research, and policymaking, is a major challenge.The modelTo bridge this gap, we propose a four-step model: (A) creating a conjoined task force of all relevant parties to declare a national program to promote collaborations; (B) promoting a national digital records project, or at least a network of synchronized and integrated databases, in an accessible transparent manner; (C) creating an interoperative national research environment to enable the analysis of the organized and integrated data and to generate evidence; and (D) utilizing the evidence to improve decision-making, to support a wisely chosen national policy. For the latter purpose, we also developed a novel multidimensional set of criteria to illuminate insights and estimate the risk for future morbidity based on current medical conditions.ConclusionUsed by policymakers, providers of health plans, caregivers, and health organizations, we presume this model will assist transforming evidence generation to support the design of health policy and programs, as well as improved decision-making about health and health care, at all levels: individual, communal, organizational, and national.

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“…To ensure a uniform medical baseline, we focused on conscripts who completed the medical profiling process at the age of 16-19 years, and had valid height and weight measures. Only the northern recruitment center of Israel was chosen due to its stringent assessment and reliability of its medical data collection [12], [13], [14].…”

Section: Methodsmentioning

confidence: 99%

Cardiac anomalies and associated comorbidities in a large adolescent population

Fink

Machluf

Farkash

et al. 2017

International Journal of Adolescent Medicine and Health

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Abstract:Objective: To determine the prevalence, secular trends and associations of heart disease in a large unscreened, otherwise basically healthy, adolescent population. Subjects and methods: Cross-sectional study of the cardiac status of 113,694 adolescents from the northern district of Israel, who completed the profiling process between the ages of 16 and 19, including all essential measures over a 22-year period. Results of imaging were categorized as either isolated valvar or structural abnormalities, and their clinically significant subgroups defined prospectively. The findings were correlated with the socio-demographic and anthropometric data and non-cardiac health conditions. Results: Of those sent for echocardiography, 1257 (0.93% of the total population) had isolated valvar disease and 216 (0.19%) had structural abnormalities, with 20% of both groups considered significant. Females had lower prevalence of heart disease. There was peak prevalence in the second 5-year period. Tall subjects or a past history of rheumatic fever had more valvar abnormalities. Thin subjects or those with skeletal anomalies had more structural abnormalities. Significant valvar and structural anomalies were more common in subjects with learning disorders, endocrine disorders and diabetes mellitus. Fewer valvar abnormalities were diagnosed in obese subjects. Heart disease was more common in those with non-solid tumors. Conclusion: Appreciable numbers of potentially healthy adolescents were found to have heart disease. There appeared to be an association with body size, skeletal abnormalities and relatively common medical disorders, the cause of which remains to be determined in prospective studies that could change the way common adolescent disease should be followed.

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From a Quality Assurance and Control System for Medical Processes, Through Epidemiological Trends of Medical Conditions, to a Nationwide Health Project

Cited by 8 publications

References 15 publications

Rheumatic Fever in Large Cohort of Adolescents in Israel

Rheumatic Fever in Large Cohort of Adolescents in Israel

From Population Databases to Research and Informed Health Decisions and Policy

Cardiac anomalies and associated comorbidities in a large adolescent population

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