Prevalence and mortality of patients with multiple sclerosis in France in 2012: a study based on French health insurance data

Foulon, Stéphanie; Maura, Géric; Dalichampt, Marie; Alla, François; Debouverie, Marc; Moreau, Thibault; Weill, Alain

doi:10.1007/s00415-017-8513-0

Cited by 55 publications

(62 citation statements)

References 21 publications

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“…The estimated prevalence of MS in France was 151.2/100 000 individuals on December 31, 2012; i.e. a total of about 100 000 individuals nationally 7 , with a female to male ratio ranging from 2:1 to 2.5:1 8 . MS usually starts between 20 and 40 years of age, and most patients typically live with the disease for several decades.…”

Section: Introductionmentioning

confidence: 99%

Use of state sequence analysis for care pathway analysis: The example of multiple sclerosis

Roux

Grimaud

Leray

2018

Stat Methods Med Res

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The concept of care pathways is increasingly being used to enhance the quality of care and to optimize the use of resources for health care. We here propose an innovative method in epidemiology that is derived from social sciences: state sequence analysis (SSA). This method takes into account the chronology of care consumption and allows for identification of specific patterns. A process for using SSA in the health area is proposed and discussed. The main steps are: data coding, measurement of dissimilarities between sequences (focusing on optimal matching methods and the choice of related costs), and application of a clustering method to obtain a typology of sequence patterns. As an example of its use in the health area, SSA was employed to analyse care pathways of a random sample of patients with multiple sclerosis. This sample has been selected from the main French healthcare database covering the period 2007 to 2013 ( n = 1 000). A five-cluster typology was obtained which allowed distinction of care consumption groups. Overall, about half of the patients had low care consumption, about one quarter had medium to high consumption, and another quarter had high consumption. We conclude that state sequence analysis is an innovative and flexible methodology that is worth considering in health care research.

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Section: Introductionmentioning

confidence: 99%

Use of state sequence analysis for care pathway analysis: The example of multiple sclerosis

Roux

Grimaud

Leray

2018

Stat Methods Med Res

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“…Similarly, administrative and claims data are used to estimate target populations and market shares for pricing and reimbursement of new medicines as well as postmarketing surveillance studies. In addition, administrative databases are relevant sources of data to conduct epidemiological studies worldwide . In the present study, our objective was to build and validate an algorithm to assess the prevalence of CML at the nationwide level, using individual data from French national insurance databases.…”

Section: Introductionmentioning

confidence: 99%

Using healthcare claims data to analyze the prevalence of BCR‐ABL‐positive chronic myeloid leukemia in France: A nationwide population‐based study

et al. 2019

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Background Data on Chronic Myeloid Leukemia (CML) prevalence are scarce. Here we provide an estimation of the prevalence of CML in France for the year 2014 using French national health insurance data. Methods We selected patients claiming reimbursement for tyrosine kinase inhibitors (TKI) or with hospital discharge diagnoses for CML, BCR/ABL‐positive or with full reimbursement of health care expenses for myeloid leukemia. We built an algorithm which we validated on a random sample of 100 potential CML patients by comparing the results obtained using the algorithm and the opinion of two hematologists who reviewed the patient demographics and sequence of care abstracted from claims data (internal validity). For external validity, we compared the number of incident CML patients identified using the algorithm with those recorded in French population‐based cancer registries in departments covered by such a registry. Results We identified 10 789 prevalent CML patients in 2014, corresponding to a crude prevalence rate of 16.3 per 100 000 inhabitants [95% confidence interval (CI) 16.0‐16.6]: 18.5 in men [18.0‐19.0] and 14.2 in women [13.8‐14.6]. The crude CML prevalence was less than 1.6 per 100 000 [1.2‐2.0] under age 20, increasing to a maximum of 48.2 [45.4‐51.2) at ages 75‐79. It varied from 10.2 to 23.8 per 100 000 across French departments. The algorithm showed high internal and external validity. Concordance rate between the algorithm and the hematologists was 96%, and the numbers of incident CML patients identified using the algorithm and the registries were 162 and 150, respectively. Conclusion We built and validated an algorithm to identify CML patients in administrative healthcare databases. In addition to prevalence estimation, the algorithm could be used for future economic evaluations or pharmaco‐epidemiological studies in this population.

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“…The prevalence in France is about 1.5 individuals for 1000 (Foulon et al, 2017). In about 85% of cases, patients experience relapse(s) (Browne et al, 2014), that is, patients experience exacerbations of neurologic disabilities followed by partial or complete remission.…”

Section: Introductionmentioning

confidence: 99%

Ozone, NO2 and PM10 are associated with the occurrence of multiple sclerosis relapses. Evidence from seasonal multi-pollutant analyses

Jeanjean

Bind

Roux

et al. 2018

Environmental Research

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Background Triggers of multiple sclerosis (MS) relapses are essentially unknown. PM10 exposure has recently been associated with an increased risk of relapses. Objectives We further explore the short-term associations between PM10, NO2, benzene (C6H6), O3, and CO exposures, and the odds of MS relapses’ occurrence. Methods Using a case-crossover design, we studied 424 MS patients living in the Strasbourg area, France between 2000 and 2009 (1783 relapses in total). Control days were chosen to be±35 days relative to the case (relapse) day. Exposure was modeled through ADMS-Urban software at the census block scale. We consider single-pollutant and multi-pollutant conditional logistic regression models coupled with a distributed-lag linear structure, stratified by season (“hot” vs. “cold”), and adjusted for meteorological parameters, pollen count, influenza-like epidemics, and holidays. Results The single-pollutant analyses indicated: 1) significant associations between MS relapse incidence and exposures to NO2, PM10, and O3, and 2) seasonality in these associations. For instance, an interquartile range increase in NO2 (lags 0–3) and PM10 exposure were associated with MS relapse incidence (OR = 1.08; 95%CI: [1.03–1.14] and OR = 1.06; 95%CI: [1.01–1.11], respectively) during the “cold” season (i.e., October-March). We also observed an association with O3 and MS relapse incidence during “hot” season (OR = 1.16; 95%CI: [1.07–1.25]). C6H6 and CO were not significantly related to MS relapse incidence. However, using multi-pollutant models, only O3 remained significantly associated with the odds of relapse triggering during “hot” season. Conclusion We observed significant single-pollution associations between the occurrence of MS relapses and exposures to NO2, O3 and PM10, only O3 remained significantly associated with occurrence of MS relapses in the multi-pollutant model.

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Prevalence and mortality of patients with multiple sclerosis in France in 2012: a study based on French health insurance data

Cited by 55 publications

References 21 publications

Use of state sequence analysis for care pathway analysis: The example of multiple sclerosis

Use of state sequence analysis for care pathway analysis: The example of multiple sclerosis

Using healthcare claims data to analyze the prevalence of BCR‐ABL‐positive chronic myeloid leukemia in France: A nationwide population‐based study

Ozone, NO2 and PM10 are associated with the occurrence of multiple sclerosis relapses. Evidence from seasonal multi-pollutant analyses

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