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Biomedical subjects

Y Matillon

Publications and source records attributed to Y Matillon.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Management of myocardial infarction in the Rhone-Alps area. Are there many variations in practice?].

The aim of this study was to determine the diagnostic and therapeutic strategies after myocardial infarction and to examine variations in medical and surgical practice with respect to the severity of disease, status of the hospital and patients' characteristics. The method used was a prospective study with follow-up at 30 days and 18 months. The subjects came from an exhaustive cohort of all patients admitted to hospital for myocardial infarction during the month of April 1991 in 57 public and private hospitals in the Rhone-Alps region (n = 311). The patients were identified after admission by consulting physicians of the Department of Social Security. The study included all patients with acute myocardial infarction with at least two of the three usual diagnostic criteria (prolonged, constrictive chest pain, enzyme increases and electrocardiographic changes). The study excluded patients who were dead before arrival at hospital. The parameters analysed included the clinical management, use of echocardiography, exercise stress testing, myocardial scintigraphy, coronary angiography, thrombolysis, angioplasty and coronary bypass surgery in the first 30 days after admission. The severity of infarction was assessed by seven clinical, enzymatic and electrocardiographic criteria by physicians from the Department of Social Security (pain, syncope, shock, left ventricular dysfunction, elevation of CPK > 1000 IU, anterior or extensive necrosis, arrhythmias). The mortality rate of this cohort was calculated from hospital statistics and then by enquiring in the town halls of the region. The demographic features of the cohort were marked by a predominance of men (69.5%) and a relatively high mean age (69 years; 23% over 80 years). Complementary investigations were used with the following frequencies: echocardiography, 61.1%; coronary angiography, 26.4%; exercise stress testing 22.8%; myocardial scintigraphy, 5.5%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Data quality in a DRG-based information system.

The aim of this study initiated in May 1990 was to evaluate the quality of the medical data collected from the main hospital of the "Hospices Civils de Lyon", Edouard Herriot Hospital. We studied a random sample of 593 discharge abstracts from 12 wards of the hospital. Quality control was performed by checking multi-hospitalized patients' personal data, checking that each discharge abstract was exhaustive, examining the quality of abstracting, studying diagnoses and medical procedures coding, and checking data entry. Assessment of personal data showed a 4.4% error rate. It was mainly accounted for by spelling mistakes in surnames and first names, and mistakes in dates of birth. The quality of a discharge abstract was estimated according to the two purposes of the medical information system: description of hospital morbidity per patient and Diagnosis Related Group's case mix. Error rates in discharge abstracts were expressed in two ways: an overall rate for errors of concordance between Discharge Abstracts and Medical Records, and a specific rate for errors modifying classification in Diagnosis Related Groups (DRG). For abstracting medical information, these error rates were 11.5% (SE +/- 2.2) and 7.5% (SE +/- 1.9) respectively. For coding diagnoses and procedures, they were 11.4% (SE +/- 1.5) and 1.3% (SE +/- 0.5) respectively. For data entry on the computerized data base, the error rate was 2% (SE +/- 0.5) and 0.2% (SE +/- 0.05). Quality control must be performed regularly because it demonstrates the degree of participation from health care teams and the coherence of the database.(ABSTRACT TRUNCATED AT 250 WORDS)

Data Collection↗
PubMed1993

[Analysis of the medical decision].

Analysis of clinical decision making is a quantitative method using probabilities to evaluate the process in uncertain situations. It provides a model of clinical decision making by integrating experimental and epidemiological data, the opinions of specialists and an assessment of the patient's state of health. There is also a place for the integration of the patients' opinions and of their quality of life. Using this information and eventually associating the cost of management, analysis of decision making tries to demonstrate a preference for a given strategy in a given clinical or public health problem. This article presents the methodological basis of analysis of decision making using a simple example of clinical cardiological practice and discusses the value of this method for debating a clinical choice with criteria integrating the patients' quality of life and the cost to society.

Cost of Illness↗
PubMed1991

Descriptive analysis of a series of operations for prostatic adenomas in inhabitants of Lyon, France, in 1988. Urological College of Lyon.

A retrospective, population-based study was conducted in Lyon, France, to elucidate the benefits and risks of a treatment for prostatic adenoma (benign prostatic hyperplasia). Case records were reviewed for all prostatectomies performed on patients in Lyon in 1988 for benign prostatic hyperplasia. Data were obtained from all records of public and private hospitals. Of 408 procedures, 312 involved endourethral resection (transurethral resection) and 96 open surgery. The mean weight of resected tissue was 20.3 +/- 0.9 g after endourethral resection and 71.7 +/- 6.4 g after open surgery. About 20% of the resections took place in a university hospital center, 43% in a not-for-profit private hospital, and 37% in a private clinic; there were eight deaths in the first 3 postoperative months, and 11 patients required hospitalization for urologic complications. Length of hospital stay uniquely correlated with age and type of surgery.

Aged↗
PubMed1986

[The Lyons Hypertension Control Program (1972-1978). Community analysis].

A Community Control Program of Hypertension was undertaken in Lyon, as part of a WHO program. It dealed with two occupational, Study (S) and Reference (R), communities, each amounting to about 12,500 subjects. Its goal was to improve the level of treatment of hypertension in S, by stimulating the usual health care system without modifying it. It began in 1972 by a baseline total survey of both communities. Its aim was to check that the percentage of treated hypertensive subjects (HT) was the same in S and R (respectively 10.9% and 11.7%, n.s.), and to detect all HT's (subject being given an antihypertensive drug treatment, and/or BP greater than or equal to 160 and/or 94, or greater than or equal to 150 and/or 90 before age 30). The S intervention involved: detection of "new HT's" during the whole program; information of HT's, and referral to the treating physician of their choice, who was informed about the aim of the program and received later periodic information about hypertension management; periodic follow-up reconvocations. A leaflet including advices for C-V prevention was distributed to the whole S community in 1976. Evaluation was performed by a terminal total survey of both communities, from 1977 to 6/1978 (examination rates: 94.4 and 91.6% in S and R). The evaluation involved two analysis of 1977 data. -Cohort analysis (reported before): the percentage of treated HT's in the cohorts of 1972 HT's, still present in the community and hypertensive, was higher in S (63.0) than in R (46.1) (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗