Papers by Christian Jacquelinet
Studies in health technology and informatics, 2003
A Multi-Source Information System (MSIS) has been designed for the Renal Epidemiology and Informa... more A Multi-Source Information System (MSIS) has been designed for the Renal Epidemiology and Information Network (REIN) dedicated to End-Stage Renal Disease. Interoperability has been considered at 4 levels: semantics, network, formats and contents. An n-tier architecture has been chosen at the network level. It is made out of a universal client, a dynamic Web server connected to a production database and to a data warehouse. The MSIS is patient-oriented, based on a regional organization. Its implementation in the context of a regional experimentation is presented with insights on the design and underlying technologies. The n-tier architecture is a robust model and flexible enough to aggregate multiple information sources and integrate modular developments. The data warehouse is dedicated to support health care decision-making.
The Journal of Heart and Lung Transplantation, 2018
Nephrology Dialysis Transplantation, 2019
Nephrology Dialysis Transplantation, 2017
Leukemia & Lymphoma, 1998
Invasive pulmonary aspergillosis (IPA) is an increasing cause of morbidity and mortality in patie... more Invasive pulmonary aspergillosis (IPA) is an increasing cause of morbidity and mortality in patients with hematologic malignancies. A major program of construction work close to our unit prompted us to evaluate the efficacy of itraconazole prophylaxis in preventing IPA in these patients. During September 1994 to December 1995, 77 patients undergoing 96 neutropenic episodes (mean duration, 19.3 days +/- 9.1) received itraconazole as antifungal prophylaxis. All patients were treated in laminar air flow rooms. Itraconazole was administered at a loading dose of 600mg/d, (day 1 to day 3) and 400mg/d on the following days, in 87 instances. In the remaining episodes, the daily dose was 200 or 400mg. Oral doses were adjusted to reach a plasma itraconazole level (PIL) above 1000ng/l. In cases of inadequate PIL or poor oral intake, IV AmphoB was started at a 20 mg daily dose. Five cases of IPA (proven n = 2, probable n = 3) were observed. This represents an incidence of 5.2% of the total number of episodes. One out of 67 (2%) treatment episodes with adequate PIL were associated with IPA as compared to 4 of 29 (14%) episodes with inadequate PIL, (p < 0.02). AmphoB was added in 28 cases because of low PIL (n = 25), and/or antibiotic-resistant fever persistent pulmonary infiltrate (n = 8). These results need to be interpreted with caution, because of the absence of randomization or a control group. The efficacy of Itraconazole in neutropenic patients with high risk IPA has to be confirmed on larger and prospective studies.
Rev Epidemiol Sante Publ, 2004
Le nombre d’insuffisants renaux terminaux recevant, aujourd’hui en France, un traitement de suppl... more Le nombre d’insuffisants renaux terminaux recevant, aujourd’hui en France, un traitement de suppleance par dialyse ou transplantation n’est pas connu precisement. On estime qu’il s’eleve a 35 000, dont environ deux tiers de patients dialyses et un tiers de transplantes. L’incidence de l’insuffisance renale terminale traitee progresserait de 5 % par an et sa prevalence de 8 % [1]. Elle concerne une population de plus en plus âgee [2]. Le cout de la dialyse etait estime a 8 milliards de francs en 1992, soit environ 1,5 % du budget de la Securite sociale [3]. Ces quelques elements situent l’enjeu de sante publique que constitue la prise en charge de l’insuffisance renale terminale : l’ampleur de la demande, la necessaire adaptation de l’offre a la meilleure qualite et au cout le plus adapte. Nous definirons l’insuffisance renale terminale et l’insuffisance renale terminale traitee et examinerons les consequences sur la morbidite et la mortalite posterieures a la date d’institution du traitement de suppleance. Nous decrirons les systemes d’information disponibles et les besoins en information necessaires pour guider l’epidemiologie de l’insuffisance renale terminale traitee et les decisions afferentes en matiere de sante publique. Les bases d’un projet de mise en place d’un systeme d’information sur l’insuffisance renale terminale traitee, appele REIN (Reseau epidemiologie et information en nephrologie), seront abordees en conclusion.
Nephrology Dialysis Transplantation, 2012
Nephrology Dialysis Transplantation, 2005
Médecine …, 1998
Résumé : Le traitement de l'insuffisance rénale terminale représente un défi en matière de s... more Résumé : Le traitement de l'insuffisance rénale terminale représente un défi en matière de santé publique. En 1992, il mobilisait déjà 8 milliards de francs, soit 1 % du budget de l'assurance maladie [1]. D'après les données du registre de l'ERA-EDTA pour 1995 [2], l'incidence de ...
International Journal of Medical Informatics, 2003
Gastroentérologie Clinique et Biologique, 2002
This study evaluated regional differences in registration on the waiting list and access to liver... more This study evaluated regional differences in registration on the waiting list and access to liver transplantation in France. The annual incidence of registration on the waiting list was calculated with the number of transplantation candidates registered in each region between 1996 and 1998 and was used as an indicator for access to the waiting list. The median waiting time before receiving a graft was estimated for patients registered between 1992 and 1998 by the Kaplan Meier method using transplantation as the event. This was used as an indicator for access to transplantation. Shortage of liver grafts was based on the ratio between the number of registered patients and the number of transplantations. The national incidence rate on the liver transplantation waiting list was 11.5 candidates per million inhabitants (pmi). There were no significant statistical differences among regions but it was high for the Rhône-Alpes region (18.6 pmi) and low for the French West Indies (3.6 pmi). T...
Fulminate liver failure is often fatal and with the current shortage of donor transplant organs, ... more Fulminate liver failure is often fatal and with the current shortage of donor transplant organs, molecular adsorbent recirculating system (MARS) offers a bridging treatment to sustain the patient until a suitable organ becomes available or the native liver recovers. MARS, or liver dialysis, is an extracorporeal detoxification method, used in conjunction with continuous renal replacement therapy (CRRT), in which an albumin dialysis is used to clear protein bound toxins. Since its approval by the Food and Drug Administration, the University of Kansas Hospital is the first institution in the region and one of only seven in the country to implement this cutting edge therapy.
Abstract. The Etablissement français des Greffes (EfG) is a public health agency in charge of org... more Abstract. The Etablissement français des Greffes (EfG) is a public health agency in charge of organs, tissues and cells transplantation in France. Among EfG's missions is the evaluation of the organ retrieval and transplantation activities, which relies on a national information system (IS). In order to facilitate data recording, to improve information quality and homogeneity, to allow data interchange and semantic interoperability with hospital information systems and other registries, a specific work as been initiated dealing with ontological foundations of medical terminology in the domain of organ failure and transplantation. The aim of this paper is to describe how the syllepse appeared to us as a key figure that accounts for medical knowledge acquisition. 1
Nephrologie & therapeutique, 2021
BACKGROUND To be able to assess the impact of the bundled payment system on real-life management ... more BACKGROUND To be able to assess the impact of the bundled payment system on real-life management of patients with chronic kidney disease, an overview of patient-care management before its implementation is needed. PATIENTS AND METHODS We describe patterns of nephrology care over 3 years in 2835 patients with moderate to severe chronic kidney disease, who were followed-up from 2013 to 2019 in the CKD-REIN cohort study. Compliance with health authority guidelines during this period is also studied. RESULTS At baseline, patients' mean age was 67 years, 65% were men, and 43% had chronic kidney disease stage 4 or 5. The mean number of nephrology visits increased from 1.1 to 2.7 per year, from chronic kidney disease stage 3A to stage 5. The minimum number of nephrology visits as recommended by health authorities was achieved in 84%, 63%, and 33% of patients with chronic kidney disease stages 3B, 4, and 5, respectively. In chronic kidney disease stages 4 and 5, only 34% and 40% of pati...
Studies in health technology and informatics, 2004
This paper approaches lexical semantic disambiguation and polysemy in the context of medical lang... more This paper approaches lexical semantic disambiguation and polysemy in the context of medical language understanding. These issues have been addressed as linguistic and cognitive requirements to build a knowledge extraction tool that turns natural language input into conceptual graphs. Previous results obtained with semantic analysis of medical terms in the domain of transplantation and organ failure prompt us to check the capabilities of our prototype to deal with ambiguities and polysemy. Starting from linguistic observation, we attempt to demonstrate how the respect of ambiguities when the co-text is not sufficient for disambiguation implies to introduce a void type in the concept type lattice. Then we show how the "creative use of words" (i.e. new senses in novel context) imposes to dynamically allocate type, categories and roles with the co-text.
Bulletin de l'Academie nationale de medecine, 2013
Studies in health technology and informatics, 2005
The Agence de la Biomédecine is a state agency dealing with Public Health issues related, among o... more The Agence de la Biomédecine is a state agency dealing with Public Health issues related, among others, to organ, tissue and cell transplantation in France. The Agence maintains a national information system used to coordinate and administer organ procurement and transplant activities and to perform the evaluation of organ transplantation activities. This paper describes the core uses and functional requirements of Cristal, the donor, recipient and allocation software of the information system and its evolution in the new system.
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Papers by Christian Jacquelinet