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Biomedical subjects

E Jougla

Publications and source records attributed to E Jougla.

At least 73 records · Page 4Linked to original sources
PubMed1993

European study of the certification and coding of causes of death of six clinical case histories of diabetic patients. EURODIAB Subarea C Study Group.

This study was designed to investigate the large differences in diabetes mortality rates in Europe. In each of the participating countries (France, Germany, The Netherlands, Northern Ireland-UK, Republic of Ireland, Romania, Scotland-UK, Switzerland) a random sample of certifying physicians was asked to certify the causes of death of six case histories which described the deaths of diabetic patients; the responses from an average of 220 physicians per country were analysed. These registered causes were then coded nationally and the underlying cause was compared with that following a central recoding. Overall 28% of the physicians surveyed recorded diabetes on the death certificate as the underlying cause of death--France was 25% below this overall average and Germany 21% above. The national coding of diabetes as the underlying cause of death differed from the central recoding with a comparative undercoding of almost 40% in Romania, 30% in Northern Ireland and 25% in Switzerland; in contrast, there was an overcoding of diabetes by 80% in The Netherlands and 60% in the Republic of Ireland. After adjusting for central recoding, in part an adjustment for certification habits, the national coding from this simulation study was able to explain 35% of the variation in the diabetes mortality rates. With such differences in the coding of diabetes, the currently published mortality rates for diabetes are not directly comparable between European countries; some suggestions are made for the reduction of the intercountry differences in the collection and analysis of mortality data for diabetes.

Abstracting and Indexing↗
PubMed1992

Death certificate coding practices related to diabetes in European countries--the 'EURODIAB Subarea C' Study.

The objective of this study was to compare and analyse coding practices for diabetes mortality data in nine European countries (Belgium, Republic of Ireland, France, Germany, Malta, The Netherlands, Northern Ireland, Scotland and Switzerland). In each country, a sample of 200 coded death certificates, which mentioned diabetes, was randomly sampled. All death certificates were recoded at the WHO Collaborating Centre for the Classification of Diseases in the French language. The results show wide differences between national coding and central coding. Discrepancies in the underlying cause of death existed at the 3-digit coding level for 26% of all death certificates and for 44% at the 4-digit level. Coding in Northern Ireland and Malta was characterized by a marked tendency to choose diabetes less frequently. In contrast, in The Netherlands and, to a lesser extent, in the Republic of Ireland and France, diabetes was more frequently selected as the underlying cause of death. Most of the differences concerned the coding of an association involving diabetes and circulatory system diseases. In some countries, these coding differences influence the reported level of diabetes mortality. For Northern Ireland and Malta, the number of certificates with diabetes as the underlying cause of death was more than doubled after central recoding and for The Netherlands, in contrast, it was almost halved. To explain the differences a number of factors are considered: a lack of information from the International Classification of Diseases (ICD), on the application of the coding rules, between-country differences in cause of death certification practices, a divergence of opinion about the causal role of diabetes when it is associated with other conditions, a lack of homogeneity between countries in data collection procedures.(ABSTRACT TRUNCATED AT 250 WORDS)

Cause of Death↗
PubMed1992

[Trends in mortality characteristics in Aids in France 1983-1990].

From 1983 to 1990, the number of AIDS deaths in France (8119 deaths overall), increased substnatially but the annual rate of progression has fallen since 1987 (+35% in 1990). The socio-demographic characteristics of the deaths remained quite steady with the exception of the proportion of subjects living in Paris which decreased. The proportion of AIDS deaths out of all deaths is still low for the entire population (5 deaths out of 1000 in 1990) but appears important in some sub-groups. In 1990, AIDS represents for the 25-34 years old group, 12 deaths out of 100 for males and 7 deaths out of 100 for females and for the 25-44 years old group, 15 deaths out of 100 for nonmarried males and 4 deaths out of 10 for males working in an information or artistic profession. Furthermore, it accounts, in 1989, for the third of the deaths of males between 25 and 44 years living in Paris. The analyse tends to show that there is not an important under-declaration of AIDS deaths in France.

Acquired Immunodeficiency Syndrome↗
PubMed1990

"Avoidable" mortality and health services: a review of aggregate data studies.

STUDY OBJECTIVE: The aim of the study was to review published work reporting mortality from conditions amenable to medical intervention and compare the methods used and the results obtained. SOURCE MATERIAL: Two types of analysis were examined: (1) analyses of time trends, relating decline in mortality from amenable conditions to improvements in medical care (3 papers); (2) analyses of geographical variation, either between or within countries, in which mortality was related to the availability of health care resources and to other factors (8 papers). RESULTS: Time-trend studies have in general shown that mortality from amenable causes has declined faster over the past decades than most other causes of death. Studies of geographical variation have shown that mortality from amenable causes is consistently associated with socioeconomic factors, and that the association with the provision of health care resources is rather weak and inconsistent. CONCLUSIONS: (1) The low levels of mortality from amenable causes which presently prevail in industrialised countries are likely to reflect, at least in part, the increased effectiveness of health services; (2) geographical variation in mortality from amenable causes has not yet been shown to reflect differences in effectiveness of health services; and (3) if geographical variation in avoidable mortality does reflect such differences, they must arise from circumstances other than the level of supply, for example from more specific aspects of health care delivery, and are probably closely related to socioeconomic circumstances. In depth studies at the individual level are now more likely to produce information about factors limiting the effectiveness of health services than further studies of aggregate data.

Health Resources↗
PubMed1989

Sudden infant death and immunization: an extensive epidemiological approach to the problem in France--winter 1986.

In March 1986 five sudden infant deaths were reported, following the diphtheria-tetanus toxoids-pertussis and inactivated poliomyelitis virus (DTP-IPV) immunization of the infants concerned. An epidemiological study was carried out in order to investigate the possibility of a relationship between this immunization and sudden infant death syndrome (SIDS). A detailed examination of the five cases had been carried out by a doctor. An exhaustive survey of all postneonatal deaths occurring between January and March 1986 was conducted and also a matched case-control survey. No significant differences were found in the immunization rates between SIDS and other causes of death, nor between SIDS and living controls. These results are compared with the results from previously published studies on the topic.

Autopsy↗
PubMed1988

[Relationship between the development of the health status and the activity of the health care system in developed countries].

The question of the relationship between the evolution of health status and the activity of health care system in developed countries is treated frequently through epidemiological studies. However, there are numerous methodological difficulties linked to this type of investigation and it is not possible to give a certain answer to this question. Particular difficulties concern the choice of indicators (indicators of health status and indicators of health care system). This choice may influence largely the outcome of the results. If general mortality has tended to decline over the last thirty years, some causes of death have progressed and many studies show an increase of the level of morbidity and disabilities declared in the population and an increase of social disparities in health status. The analysis concerning the role of health care systems, in order to explain this evolution, does not lead to a single conclusion. Some works show the positive effect of the activity of health care systems (especially for infant mortality). According to other authors, the growth of chronic diseases must be considered as the negative aspect of the success obtained in the struggle against mortality. But above all, interpretation of results needs a continuous reference to methodologies used and it is only on this condition that such data may be useful for public health decisions.

Aged↗
PubMed1987

[Relation between the level of the development of the care system and the level of "preventable" mortality according to department in France].

"Avoidable" mortality may be defined as a selection of causes of death whose occurrence is closely related to medical intervention. We have attempted to relate the variations in mortality from these selected causes to health service input among the 95 French departments. This analysis was controlled for social factors. Firstly we performed independently two factor analysis of the departmental variations in health care variables and in social factors. These studies were carried out with the aim of creating new discriminant and independent variables. Multiple stepwise regressions were then used to analyse the independent and joint associations of these new variables with mortality. The data show principally the considerable weight of social factors in explaining mortality differences. On the contrary, we found very weak relationships between health service input and mortality. However in view of the analysis method, it would appear unjustified to interpret this result in terms of a criticism of the "avoidable" mortality concept.

Adolescent↗
PubMed1983

Health and employment of a female population in an urban area.

The authors discuss the results of a survey of women aged 25 to 50 living in a university town in southern France (Montpellier). Morbidity of these women (reported health problems, consultation with health care professionals etc) was analysed as a function of whether or not they were employed out of the home. Overall, differences were minimal; after correction for demographic factors, the only significant difference was more frequent reports of fatigue, overwork or nervousness in the employed women. Satisfaction with life situations was more closely correlated with health than was employment per se. A great similarity was seen between, on the one hand, employed women satisfied with their occupational conditions and housewives who did not report boredom, and on the other hand, between employed women dissatisfied with their occupational conditions and housewives who reported boredom.

Adult↗
PubMed1979

[Digestive diseases morbidity and need for medical care requirements. Prevalence study of declared symptoms and demand for medical care in a French "department" (author's transl)].

A survey on digestive morbidity and demand for medical care in a pilot area concerned 3504 persons, eighteen years old and over; 69.3 p. 100 of them reported that they had been affected by one or several digestive symptoms during the previous year. However, it concerns mostly just common symptoms, probably benign, observed in all age groups; only 9.4 p. 100 of those complaining (half of them being old persons) reported disorders which can be suspected as serious ones. Among the subjects presenting symptoms, there is a majority of women, of urban population, of higher educational levels and higher social classes. During this year 18.9 p. 100 of the total population sought medical advice for digestive symptoms, the average number of consultations being 0.7 for every subject. This demand is related to the age, the number and gravity of the complaints, and to the presence of a digestive history; 24.5 p. 100 of the subjects used self medication: this is related to the perception of benign disorders, to digestive history, sex and social class: factory workers, farm workers and self-operating farmers are using this least. Women complain of digestive disorders more often than men and practice self medication more frequently. They do not report serious symptoms or a history of digestive disease more often than men, nor do consult doctors more frequently.

Adult↗