Room
2ème étage - E230
Theme
Data for evidence based Public Health
Chair
Viktor von Wyl
Title
Comment rendre une app pour proches aidants encore plus attractive ?
Name
Jean-Daniel Vuille
Affiliation
BFH
Abstract
LE PROJET « AIDER LES PROCHES AIDANTS »
Le projet de créer une application mobile, complétée par des prestations de support à destination des proches aidantes et des proches aidants, répond à la nécessité de mieux faire connaître l’offre disponible pour les soutenir et également de leur permettre d’évaluer leur degré d’épuisement et de prévenir celui-ci.
Ce projet s’inscrit comme une pièce complémentaire dans un dispositif général visant à mieux répondre aux enjeux du système sanitaire dont, entre autres, celui du vieillissement de la population, mieux coordonner les acteurs et favoriser une continuité d’information, en enrichissant les services existants avec des nouvelles technologies.
Il est le fruit d’une collaboration pluridisciplinaire, entre le Service cantonal de la santé publique du canton de Neuchâtel, le réseau de soins AROSS, la Haute école spécialisée bernoise BFH et MIDATA, une coopérative spécialisée dans la gestion des données personnelles.
La solution, conçue dans un environnement bilingue (Neuchâtel, Biel/Bienne, Berne), a l’ambition de pouvoir être déployée au niveau national. À cette fin, des représentants d’autres réseaux de soins romands et alémaniques ont participé à un groupe d’accompagnement.
Le développement de l’application approches s’inscrit dans le cadre de ce projet, soutenu financièrement par Promotion Santé Suisse et qui poursuit deux objectifs :
- Soutenir et préserver les proches aidants ;
- Mieux connaître les proches aidants afin de développer des offres qui répondent à leurs besoins.
FONCTIONNALITÉS DE L’APPLICATION
- Questions / réponses
La rubrique “questions / réponses” répond aux questions que l’on se pose en tant que proche aidant-e. - Services
Accès à l’ensemble des prestations et des offres proposées dans la région de la personne qui est aidée. - Ma situation
Trois questionnaires permettent de faire le point sur la situation du proche aidant ou de la proche-aidante et de son état d’épuisement.
Site Web: https://approches.ch/
Title
The Swiss Monitoring System of Addiction and Non-Communicable Diseases (MonAM.ch): The opportunities of a low-threshold, needs-based approach, and the use of synergies
Name
Fabienne
Hartmann
Affiliation
Obsan
Abstract
The Swiss Monitoring System of Addiction and Non-Communicable Diseases (MonAM.ch) has been collecting, describing and disseminating data on more than 100 indicators from the areas of addiction and non-communicable diseases (NCD) in Switzerland since 2018. It is jointly realised by the Federal Office of Public Health (FOPH) and the Swiss Health Observatory (Obsan). MonAM serves as a neutral information gateway consolidating reliable information from various sources in one format and in a simple way. Prevalence, mortality, treatment, social impact and regulation are addressed for various NCD, legal and illicit drugs, as well as for behavioral addictions, physical inactivity, overweight and diet for all age groups available. MonAM facilitates access to wellfounded figures for central stakeholders (confederation, cantons, institutions in the field of prevention) and a broad public, thereby fostering the transfer of knowledge into practice. MonAM has been developed in connection with the National Strategies on Addiction and NCD. Amongst other usage, it provides information on the achievement of the strategies' objectives. MonAM is actively used: In 2023, there were almost 100,000 page views. This corresponds nearly to a tripling in usage compared to 2022, maybe due to the fact that most of the users find what they need and that the tool is now well-known. A SWOT-analysis shows following strengths of MonAM: lowthreshold nature of the service, ongoing orientation towards theneeds of key stakeholders, and strong synergies through close cooperation with more than 30 data partners. However, there are also potential challenges, especially with regard to the continuity and topicality of the time series.MonAM will further establish and extend its position as national reference addressing these challenges and emerging developments. It will also seize the opportunities of growing needs for monitoring and transfer of knowledge
Title
Warnings on the inclusion
of cluster randomized trials in meta-analysis: results of a simulation study
Name
Joseph Alvin Ramos Santos
Affiliation
University of Applied Sciences and Arts of Southern Switzerland (SUPSI)
Abstract
Background:
The emergence of infodemic and the increase in trials and observational studies have increased the appetite for meta-analyses to summarize evidence. In public health research, consolidation of treatment effects from randomized controlled trials (RCT) is regarded as one of the highest forms of evidence. Cluster randomized controlled trials (CRCT) are increasingly used to assess the effect of interventions for logistical reasons, such as when the risk of contamination between groups within clusters is high. CRCTs that respond to the same clinical question as RCTs can be pooled in a meta-analysis; however, they need to be analyzed with adequate statistical methods. This study aimed to demonstrate the effect of inclusion of wrongly analyzed CRTs in aggregate data meta-analysis.
Methods:
Several steps were undertaken to mimic as close as possible the realistic conditions of obtaining aggregate data. Datasets were generated with a continuous treatment effect of 0.3 [variance=10] and two trial arms with equal numbers of participants [n=500 each]. For CRCTs, the number of clusters [20], participants per cluster [50], and ICC [0.05] were fixed for simplicity. Following data generation, random samples were obtained [n=250 from each arm], and the treatment effect was calculated twice using a standard linear regression and a mixed-effects regression with clusters treated as random effects to represent the wrongly and correctly analyzed CRCTs, respectively. This process was repeated to generate a set of 1000 aggregate data from each dataset. Various scenarios with wrongly analyzed CRCTs were explored. Model performance was summarized from 1000 random-effects meta-analyses for each scenario.
Results:
For all models, the coverage probabilities ranged from 84.8% to 99.9%. Overall, the inclusion of wrongly analyzed CRCTs generated a narrower confidence interval width. The percentage of statistically significant results (out of 1000 analyses) was consistently higher in the models with wrongly analyzed CRCTs than in those with correctly analyzed CRCTs, by as much as 10%. The percentage of statistically significant results was the highest when none of the CRCTs in the meta-analysis were correctly analyzed.
Conclusion:
It is important to exercise caution when incorporating CRCTs in meta-analyses. Not accounting for clustering and treating CRCTs as if participants were randomly assigned may result in false-positive conclusions about the efficacy of a treatment.
Title
Are tumour marker tests applied appropriately in clinical practice? An analysis of healthcare claims data.
Name
Sabrina Stollberg
Affiliation
Helsana Insurance Company, Research Studies
Abstract
Objectives:
Tumour markers (TM) are important in the monitoring of cancer treatment. However, inappropriate requests for screening reasons carry a high risk of false positive and negative findings, which can lead to patient anxiety, unnecessary and burdensome follow-up examinations, and high costs. We aimed to assess the prescribing patterns and appropriateness of TM testing in outpatient practice in Switzerland.
Study Design :
Retrospective cohort study based on healthcare claims data.
Methods:
Patients who had received at least one out of seven TM tests (CEA, CA19-9, CA125, CA15-3, CA72-4, Calcitonin, NSE) between 2018 and 2021 were included. Appropriate determinations were defined according to international guidelines as a request with a corresponding cancer-related diagnosis or intervention (CDI, e.g., the prescription of antineoplastic agents). Appropriateness of TM determination by patient characteristics and prescriber specialty was estimated by using multivariate analyses.
Results:
A total of 51,395 TM determinations in 36,537 patients between 2018 and 2021 were included. The mean age of patients was 64.5 years and 68.9% were female. 41.6% of all TM were determined appropriately. General practitioners most often determined TM (44.3%) and had the lowest number of appropriate requests (27.8%). A strong predictor for appropriate determinations across all individual TM were requests by medical oncologists and tertiary hospitals.
Conclusion:
A remarkable proportion of TM testing was done inappropriately, particularly in the primary care setting. Our results suggest that a considerable proportion of the population is at risk for various harms associated with misinterpretations of TM test results.
Title
Is functioning information routinely collected in Switzerland? Content comparison of Swiss surveys and cohort studies.
Name
Beatriz Moreira
Affiliation
University of Lucerne
Abstract
Determining whether people are living longer in better or worse health depends on how we measure it. Traditionally, we rely on indicators like morbidity and mortality to assess population health and guide health systems priorities. While these health indicators are essential for monitoring population biological health, they generally do not address the lived experience of health - how people live in the context of their health conditions and their environment. This lived experience is reflected in the concept of human functioning as introduced by the WHO and its International Classification of Functioning, Disability and Health (ICF).
To build a comprehensive picture of population health, we need information on functioning to complement data on mortality and morbidity. Due to the context of current socio-demographic trends, especially the ageing of the Swiss population and the rising number of people with chronic health conditions, assessing this dimension of population health becomes increasingly important. However, despite the existing collection of functioning data in Switzerland through various surveys and studies, their full potential remains untapped.
Our study aims to unlock the potential of existing functioning data by providing an overview of the currently available population-based functioning data routinely collected in Switzerland and enabling the comparison of functioning information across different population surveys and cohort studies. Using the ICF linking rules and the ICF as a reference framework, we compare questions and response options that address problems and difficulties in functioning components (body functions and structures, activities and participation domains) of four sources: the Survey of Health, Ageing and Retirement in Europe (SHARE), the Swiss Health Survey (SHS), the Lausanne cohort 65+ (Lc65+), and the Swiss Household Panel (SHP). Our analysis assesses to what extent current data collected from these sources is suitable for developing a common functioning metric and a functioning indicator for the general and the ageing population. The functioning indicator can help prioritize and tailor interventions to match population’s health needs and support evidence-based policymaking for the general and the ageing population – particularly for long-term care needs and rehabilitation.