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Biomedical subjects

E Jougla

Publications and source records attributed to E Jougla.

At least 55 records · Page 3Linked to original sources
PubMed1998

Improvement of the quality and comparability of causes-of-death statistics inside the European Community. EUROSTAT Task Force on "causes of death statistics".

BACKGROUND: Cause-of-death statistics are widely used for comparing health characteristics of European Community (EC) countries. Before attempting to interpret between-country differences, it is essential to assess the biases affecting the comparability of the data. EUROSTAT decided to address globally this problem with the objective to improve the quality and comparability of cause-of-death data within the EC. METHODS: The material is based on a review of results of international comparative cause-of-death studies and on specific inquiries among EC. Both cause-of-death certification and codification practices are analysed. Certification is studied comparing the models of death certificates, the type of information captured, certifiers training and querying practices. The different coding systems are analysed (International classification of diseases (ICD) in use, interpretation of the ICD rules, implementation of automated coding systems). RESULTS: International studies on comparability of certification and coding practices between countries are rare. These studies are based on certification of cases histories and recoding of samples of death certificates. Recent studies on respiratory diseases, cancers and diabetes outline differences that influenced on the reported level of mortality. The specific EUROSTAT investigation (1997) outline general discrepancies: models of death certificates, nature and amount of information entered, way to establish the diagnosis, degree of consistency of the certification process, autopsy practices, certifiers practices, implementation of ICD-10 and implementation of automated coding systems. CONCLUSION: EUROSTAT studies are now focused on causes of death requiring special attention for comparability (e.g. suicide, accidental deaths, drug and alcohol related deaths, unknown and ill-defined causes), on procedures to improve the homogeneity of certifiers training and querying practices, on the effect of the transition to ICD-10. The international model of death certificate recommended by the World Health Organization should be adopted as widely as possible. Uniform complementary information (e.g. surgery, pregnancy, autopsy, place of occurrence of accidental deaths, work accident) should also be adopted. The EUROSTAT investigations must result in definitions of common recommendations and guidelines to EC.

Cause of Death↗
PubMed1997

[Medical certificate of neonatal death].

A specific neonatal death certificate has been put into use in France since April 1997. It must be completed for any infants born alive and deceased between 0 and 27 days. Its content is presented together with the results of an evaluation of its use performed during a 3 month period in 1996. This certificate is aimed to improve the mortality statistics of the neonatal period, thus helping to better define the priorities in the medical care and prevention fields.

Cause of Death↗
PubMed1997

[Statistic tests concerning population mortality indicators].

The objective of this note is to present simple statistical tests applied to common comparison problems met in descriptive studies in the general population. These tests apply to classical mortality indicators: crude and specific death rates, standardized rates (direct and indirect methods). The tests are based on the convergence of the Poisson distribution towards the normal distribution. For each type of comparison, confidence intervals are also provided.

Adult↗
PubMed1996

AIDS-related conditions: study of a representative sample of 1203 patients deceased in 1992 in France.

BACKGROUND: Little representative information exists on the frequency of human immunodeficiency virus (HIV)-related diseases among the overall AIDS population. The objective of this research is to assess the nature, frequency and characteristics of these diseases among AIDS patients during their last year of life and to analyse these frequencies according to the mode of transmission and other socio-demographic and medical characteristics. METHODS: To obtain comprehensive data, we conducted an investigation based on retrospective collection of clinical information on a representative sample (1203 deaths) of all AIDS deaths that occurred in France during 1992. RESULTS: The frequency of the diseases was markedly higher than the one described in the AIDS surveillance registers and varied between homosexuals and intravenous drug users (IVDU). After controlling for other variables (age, CD4 counts, survival times) by means of logistic regression, homosexuality remained a significant explaining factor for Kaposi's sarcoma, cytomegalovirus infections, herpes simplex and cryptosporidiosis. In contrast, HIV encephalopathy, hepatitis, mental disorders, invasive candidiasis and cachexia were more frequent in male IVDU. Few differences were observed by sex. CONCLUSIONS: Several factors may explain the differences: variation in exposure to infectious agents, general health status, use of medical care and direct influence of the mode of HIV transmission. These data are of particular value for medical services in planning the magnitude of health care needs among the AIDS population overall, for clinicians and researchers for advancing the understanding of the natural history of AIDS and in the definition of prophylactic strategies against opportunistic infections.

AIDS Dementia Complex↗
PubMed1995

Autopsies of sudden infant death syndrome--classification and epidemiology.

An enquiry into sudden infant death syndrome (SIDS) in 1987 furnished us with detailed epidemiological data for 281 cases that underwent a thorough post-mortem examination. This analysis uses these data to evaluate the role the autopsy plays in explaining sudden death. The cases were classified into three diagnostic groups: explained causes of death (group 1), unexplained deaths with anomalies (group 2), and no anomaly (group 3). These 281 cases show the three essential features that characterize SIDS: over-representation of males, increased deaths during the second and third months of life, and increased deaths during winter. The autopsy examination revealed that many of these deaths had a medical explanation. Almost half were assigned to group 1. At the time of autopsy, no precise pathology could be diagnosed for 147 deaths; of these, 140 showed histological anomalies. There were only seven sudden deaths for which no abnormal sign was evident at the autopsy. These results are compared with those of similar studies and discussed in connection with three factors: the initial selection of cases, the nature and degree of the investigations, and the possible interpretations of the symptoms uncovered.

Autopsy↗
PubMed1995

[Death due to drug addiction in Ile-de-France].

The aim of a cooperative study, carried out by the Paris Forensic Medicine Institute and the French National Institute of Health and Medical Research (INSERM SC8) was to assess the number of drug addiction-related deaths occurring in the Paris region in 1990. There were 253 deaths including 92 in Paris and 161 in Paris suburbs. A large percentage of these deaths were not recorded in the National death statistics registry (only 36% of all the deaths and only 24% of the Paris deaths had been registered). The overall drug addiction mortality in the Paris region is 29.4 per million inhabitants and is highest among the 25-29 year age group. Rates decrease rapidly after 30 years of age and are extremely low after 40. Mortality is highest in unmarried men and in the inactive population with a wide variability according to site of residence. Rates are much higher in Paris than in the suburbs. For the 20-29 year population in Paris, drug addiction has an important impact on the mortality figures for the general population, causing 12% of all deaths. It is the third cause of death after AIDS and suicide.

Adolescent↗
PubMed1994

Mortality from rheumatoid arthritis in France, 1970-1990.

BACKGROUND: The degree to which rheumatoid arthritis (RA) influences life expectancy and mortality remains controversial. There have been few attempts to analyse death certificate data for this condition. Despite limitations, the information derived from detailed death certificate analysis for a large population over a long period allows the examination of aspects of the disease process and its impact. METHODS: The mortality related to RA in France was investigated for 1970-1990 inclusive. A multiple cause of death analysis was conducted, based on information recorded in death certificates. RESULTS: Death from RA represented 0.22% of all deaths. Mortality due to RA was strongly influenced by sex (female/male ratio of number of deaths = 3.3) and age (proportional mortality ratios higher in the 65-74 and 75-84 year age groups). In women, the mean age at death for RA was slightly lower than the mean age at death from all causes, while the difference was clearly opposite in men. The impact of RA remained relatively constant during the study period, both in terms of proportional mortality and age at death. The analysis of associated causes of death did not yield significant changes in the pattern of death from RA. CONCLUSIONS: The study demonstrates the significant and relatively constant impact of RA on mortality in France over the study period. This suggests that the introduction of new treatment regimens or other environmental factors has had little influence on the impact of RA mortality in the community.

Actuarial Analysis↗