Diagnostic accuracy of case-identification algorithms for heart failure in the general population using routinely collected health data: a systematic review.

Background: Heart failure (HF), affecting 1-4% of adults in industrialized countries, is a major public health priority. Several algorithms based on administrative health data (HAD) have been developed to detect patients with HF in a timely and inexpensive manner, in order to perform real-world studies at the population level. However, their reported diagnostic accuracy is highly variable.

Development and user-oriented visualization of health care composite indicators at district level: territorial health profiles.

Background: after the recent reform of territorial healthcare, districts have been designated within the Lombardy Regional Health System to coordinate and deliver territorial care. This entails the need of readily available information to measure the quality of provided healthcare, identify critical areas for improvement, monitor the balance between demand and supply of healthcare services.

Objectives: to present the development of a dynamic evaluation system of processes and outcomes resulting from the integration of territorial and hospital care, based on a set of composite indicators, called 'health profiles', and their visualization and release through a dedicated web platform.

Time-series cohort study to forecast emergency department visits in the city of Milan and predict high demand: a 2-day warning system.

Objectives: The emergency department (ED) is one of the most critical areas in any hospital. Recently, many countries have seen a rise in the number of ED visits, with an increase in length of stay and a detrimental effect on quality of care. Being able to forecast future demands would be a valuable support for hospitals to prevent high demand, particularly in a system with limited resources where use of ED services for non-urgent visits is an important issue.

Administrative healthcare data to predict performance status in lung cancer patients.

The dataset includes 4488 patients diagnosed with lung cancer (ICD-O 3[3], C33-C34) between 2010-2012 and 2016-2018 in the territory of the Agency for Health Protection (ATS) of Milan, Italy, and selected from its population cancer registry on the basis of availability of the following information: performance status (PS), age, sex, and stage at diagnosis. The dataset includes also the following variables, extracted from the health databases of the ATS and linked to the variables derived from the cancer registry through deterministic record linkage on a unique key (tax code): Charlson comorbidity index, presence of chronic obstructive pulmonary disease, number of hospitalizations, outpatient visits, emergency accesses and prescribed drugs in the previous year, and dispensed durable medical equipment in the previous three years. The dataset was used to develop a logistic prediction model for PS, dichotomized as 'poor' (ECOG, 3-5) and 'good' (ECOG, 0-2), on the basis of all other variables in the dataset.

Metabolic syndrome and risk of COVID-19-related hospitalization: a large, population-based cohort study carried out during the first European outbreak of SARS-CoV-2 infection in the Metropolitan area of Milan (Lombardy Region, Northern Italy).

Background: since the beginning of the COVID-19 pandemic, specific characteristics of the infected subjects appeared to be associated with a severe disease, leading to hospitalization or death.

Objectives: to evaluate the association between three components of the metabolic syndrome (diabetes mellitus, dyslipidaemia, and hypertension), alone and in combination, and risk of hospitalization in subjects with nasopharyngeal swab-confirmed COVID-19.

Design: cohort study.

Study protocol: understanding the pathophysiologic mechanisms underlying delirium in older people undergoing hip fracture surgery.

Background: Postoperative delirium (POD) is a common complication of older people undergoing hip fracture surgery, which negatively affects clinical- and healthcare-related outcomes. Unfortunately, POD pathophysiology is still largely unknown, despite previous studies showing that neuroinflammation, neuroendocrine dysfunction, increased reactive oxidative stress (ROS), and endothelial dysfunctions may be involved. There is also evidence that many of the pathophysiological mechanisms which are involved in delirium are involved in sarcopenia too.

Excess risk of subsequent malignant neoplasms in adolescent and young adult cancer survivors: Results from the first Italian population-based cohort.

Background: Evidence about late effects in adolescent and young adult (AYA) cancer survivors is scarce. This study assessed the risk of subsequent malignant neoplasms (SMNs) to identify the most common SMNs to be considered in follow-up care.

Methods: Population-based cancer registries retrospectively identified first primary tumors (between 1976 and 2013) and SMNs in AYAs (15-39 years old at their cancer diagnosis).

Kinesio taping for rotator cuff disease.

Background: Kinesio Taping (KT) is one of the conservative treatments proposed for rotator cuff disease. KT is an elastic, adhesive, latex-free taping made from cotton, without active pharmacological agents. Clinicians have adopted it in the rehabilitation treatment of painful conditions, however, there is no firm evidence on its benefits.

Immune checkpoint inhibitors at any treatment line in advanced NSCLC: Real-world overall survival in a large Italian cohort.

Objectives: To estimate the average treatment effect of immune checkpoint inhibitors in any line of treatment in a 2016-2018 population-based cohort of patients with advanced non-small-cell lung cancer (NSCLC).

Materials And Methods: The cohort, and information on the tumor, were derived from the cancer registry of the Agency for Health Protection of Milan, Italy. Inclusion criteria were adult age, microscopically confirmed NSCLC, stage IIIB or IV at diagnosis, and having received at least one line of treatment.

Development of a multivariable model predicting mortality risk from comorbidities in an Italian cohort of 18,286 confirmed COVID-19 cases aged 40 years or older.

Objectives: to develop a risk prediction model for 30-day mortality from COVID‑19 in an Italian cohort aged 40 years or older.

Design: a population-based retrospective cohort study on prospectively collected data was conducted.

Setting And Participants: the cohort included all swab positive cases aged 40 years older (No.

Effectiveness of treatments for acute and subacute mechanical non-specific low back pain: a systematic review with network meta-analysis.

Objective: To assess the effectiveness of interventions for acute and subacute non-specific low back pain (NS-LBP) based on pain and disability outcomes.

Design: A systematic review of the literature with network meta-analysis.

Data Sources: Medline, Embase and CENTRAL databases were searched from inception until 17 October 2020.

The relationship between frailty and delirium: insights from the 2017 Delirium Day study.

Background: although frailty and delirium are among the most frequent and burdensome geriatric syndromes, little is known about their association and impact on short-term mortality.

Objective: to examine, in hospitalized older persons, whether frailty is associated with delirium, and whether these two conditions, alone or in combination, affect these patients' 30-day survival.

Design: observational study nested in the Delirium Day project, with 30-day follow-up.

Indicators of guideline-concordant care in lung cancer defined with a modified Delphi method and piloted in a cohort of over 5,800 cases.

Background: To identify indicators of guideline-concordant care in lung cancer, to implement such indicators with cancer registry data linked to health databases, and to pilot them in a cohort of patients from the cancer registry of the Milan Province.

Methods: Thirty-four indicators were selected by revision of main guidelines by cancer epidemiologists, and then evaluated by a multidisciplinary panel of clinicians involved in lung cancer care and working on the pathway of lung cancer diagnosis and treatment in the Lombardy region, Italy. With a modified Delphi method, they assessed for each indicator the content validity as a quality measure of the care pathway, the degree of modifiability from the health professional, and the relevance to the health professional.

Age-period-cohort effects in utilization of diagnostic procedures leading to incidental colorectal cancer detection.

Background And Aim: Despite the overall decrease in colorectal cancer (CRC) incidence, a small but constant rise has been recently observed in people younger than 50 years across several countries. This phenomenon can be explained by environmental or lifestyle factors, but it may also be partially justified by an increasing tendency in younger cohorts to undertake diagnostic procedures that may lead to CRC incidental diagnosis.

Methods: We performed an age-period-cohort analysis on 1 815 694 diagnostic procedures undertook by the population of the City of Milan, served by the Agency for Health Protection of Milan, between 1999 and 2018.

Assessment of the Overall Mortality during the COVID-19 Outbreak in the Provinces of Milan and Lodi (Lombardy Region, Northern Italy).

Objectives: to describe the overall mortality increase in the provinces of Milan and Lodi - area covered by the Agency for Health Protection of Milan - during the COVID-19 epidemic in the first four months of 2020, compare it with the same time period in the years 2016-2019, and evaluate to what extent the mortality can be directly attributed to the outbreak.

Design: cohort study.

Setting And Participants: using a new information system developed during the pandemic, we gathered data on the number of daily deaths in the population residing in the provinces of Milan and Lodi by Local Health Unit (ASST) and age groups.

Describing the epidemic trends of COVID-19 in the area covered by Agency for Health Protection of the Metropolitan Area of Milan.

Objectives: to describe the epidemic trends of COVID-19 over time and by area in the territory covered by Milan's Agency for Health Protection (ATS-MI) from February to May 2020.

Design: descriptive study of COVID-19 cases.

Setting And Participants: a new information system was developed to record COVID-19 cases with positive nasopharyngeal swab.

Visual and Hearing Impairment Are Associated With Delirium in Hospitalized Patients: Results of a Multisite Prevalence Study.

Objective: Sensory deficits are important risk factors for delirium but have been investigated in single-center studies and single clinical settings. This multicenter study aims to evaluate the association between hearing and visual impairment or bi-sensory impairment (visual and hearing impairment) and delirium.

Design: Cross-sectional study nested in the 2017 "Delirium Day" project.

Association between autoimmune diseases and COVID-19 as assessed in both a test-negative case-control and population case-control design.

Background: COVID-19 epidemic has paralleled with the so called infodemic, where countless pieces of information have been disseminated on putative risk factors for COVID-19. Among those, emerged the notion that people suffering from autoimmune diseases (AIDs) have a higher risk of SARS-CoV-2 infection.

Methods: The cohort included all COVID-19 cases residents in the Agency for Health Protection (AHP) of Milan that, from the beginning of the outbreak, developed a web-based platform that traced positive and negative cases as well as related contacts.

Impact of Rhabdomyosarcoma Treatment Modalities by Age in a Population-Based Setting.

Rhabdomyosarcoma (RMS) has a worse prognosis in adults than in children, but there is evidence of a better outcome in the former if treated using a pediatric-like approach. This study describes treatment for RMS in patients more than 10 years old and examines to what extent treatment contributes to explain the different age-related survival observed and to what extent treatment centers impact treatment appropriateness. A retrospective population-based study was developed considering 104 RMS cases (excluding the pleomorphic subtype) diagnosed in Italy between 2000 and 2015.

Emergency attendance for acute hyper- and hypoglycaemia in the adult diabetic population of the metropolitan area of Milan: quantifying the phenomenon and studying its predictors.

Background: We quantified, among diabetic adults, the frequency, costs, and factors associated with visits to the emergency department (EDs) and subsequent hospitalizations for acute hypoglycaemic and hyperglycaemic events.

Methods: We included adults with diabetes residing in the Milan Agency for Health Protection between 2015 and 2017. From healthcare databases, we identified demographic variables, comorbidities, type of treatment, insulin treatment duration, previous ED attendances for acute glycaemic events, and two indicators of glycaemic monitoring.

Association between uric acid and pulse wave velocity in hypertensive patients and in the general population: a systematic review and meta-analysis.

The association between serum uric acid (SUA) and pulse wave velocity (PWV), has been extensively evaluated but with some discrepancies in results. A further limitation refers to the fact that only few data were analyzed taking into account the possible effects of gender. The purpose of this study was to estimate the association between SUA and arterial stiffness in general population and hypertensive patients, as a whole population and as divided by gender, by pooling results from existing studies.

Latent composite indicators for evaluating adherence to guidelines in patients with a colorectal cancer diagnosis.

Evidence-based guidelines for the correct management of cancer patients are developed on the idea that timely care can improve health prognoses and quality of life.The aim of this paper is to evaluate the adherence of clinical pathways to clinical guidelines provided at the hospital level, for colorectal cancer care.By using a retrospective observational study, we proposed a method for associating each patient to a healthcare provider and modeling adherence as a latent construct governed by a set of 10 influential indicators.