Publications by authors named "Aurelien Belot"

Clinicians and people with narcolepsy report varied access to higher-cost narcolepsy treatments in England associated with variations in national and local commissioning. There are no publicly available data quantifying use of these drugs to support policy decisions. We therefore aimed to describe national, regional and local prescribing trends for higher-cost narcolepsy drugs using new national databases.

View Article and Find Full Text PDF

Understanding the differences between prognostic and predictive indices is imperative for medical research advances. We have developed a new prognostic measure that will identify the strengths, limitations, and potential applications in clinical practice.

View Article and Find Full Text PDF
Article Synopsis
  • Advances in lymphoma treatment have made assessing health-related quality of life (HRQoL) crucial for newly diagnosed patients, yet there's limited information on their HRQoL profiles at diagnosis.
  • A study involving 3922 adults with various lymphoma types utilized three validated EORTC questionnaires to evaluate HRQoL at diagnosis, achieving high completion rates between 84% and 88%.
  • Findings highlighted significant impairments in global health status across lymphoma subtypes, with factors like gender, performance status, and B symptoms affecting HRQoL, providing valuable insights for future research and clinical practices.
View Article and Find Full Text PDF

Propensity score methods, such as inverse probability-of-treatment weighting (IPTW), have been increasingly used for covariate balancing in both observational studies and randomized trials, allowing the control of both systematic and chance imbalances. Approaches using IPTW are based on two steps: (i) estimation of the individual propensity scores (PS), and (ii) estimation of the treatment effect by applying PS weights. Thus, a variance estimator that accounts for both steps is crucial for correct inference.

View Article and Find Full Text PDF
Article Synopsis
  • Real-world data (RWD) are crucial for enhancing clinical trial (CT) findings, but challenges like data quality persist; the REALYSA study, launched in 2018, focuses on newly diagnosed lymphoma patients in France.
  • A proof-of-concept analysis of 645 patients with diffuse large B-cell lymphoma (DLBCL) found high data completeness (<4% missing) and revealed good survival rates, with a median follow-up of 9.9 months showing 1-year event-free survival of 77.9% and overall survival of 90.0%.
  • The study also assessed how well REALYSA's patient outcomes matched those from recent phase 3 trials (POLARIX and SENIOR), demonstrating
View Article and Find Full Text PDF

Background: Individual and tumour factors only explain part of observed inequalities in colorectal cancer survival in England. This study aims to investigate inequalities in treatment in patients with colorectal cancer.

Methods: All patients diagnosed with colorectal cancer in England between 2012 and 2016 were followed up from the date of diagnosis (state 1), to treatment (state 2), death (state 3) or censored at 1 year after the diagnosis.

View Article and Find Full Text PDF

To reduce the breast cancer burden, the French National Organised Breast Cancer Screening Programme (FNOBCSP) was implemented in 2004. The recommended participation rate has never been achieved and socio-territorial inequities in participation have been reported on several occasions. We investigated the functional forms and consistency of the relationships between neighbourhood deprivation, travel time to the nearest accredited radiology centre and screening uptake.

View Article and Find Full Text PDF
Article Synopsis
  • * It estimates a 10-year net survival rate of 65% and finds that the excess mortality hazard (EMH) associated with DLBCL decreases significantly after diagnosis, pointing to a lower long-term mortality risk for these patients.
  • * Key factors influencing EMH include performance status, number of extra-nodal sites, and serum lactate dehydrogenase levels, with the study suggesting that the presence of extra-nodal sites might indicate other significant, yet unmeasured, prognostic variables.
View Article and Find Full Text PDF

Background: In cancer net survival analyses, if life tables (LT) are not stratified based on socio-demographic characteristics, then the social gradient in mortality in the general population is ignored. Consequently, the social gradient estimated on cancer-related excess mortality might be inaccurate. We aimed to evaluate whether the social gradient in cancer net survival observed in France could be attributable to inaccurate LT.

View Article and Find Full Text PDF

Unobserved individual heterogeneity is a common challenge in population cancer survival studies. This heterogeneity is usually associated with the combination of model misspecification and the failure to record truly relevant variables. We investigate the effects of unobserved individual heterogeneity in the context of excess hazard models, one of the main tools in cancer epidemiology.

View Article and Find Full Text PDF

The LNH03-6B trial was a phase 3 randomized trial evaluating the efficacy of first-line rituximab, cyclophosphamide, doxorubicine, vincristine and prednisone (R-CHOP) delivered every 2 weeks (R-CHOP14) or 3 weeks (R-CHOP21) in patients with diffuse large B-cell lymphoma (DLBCL) aged 60 to 80 years with an aaIPI (age-adjusted International Prognostic Index) score ≥1 (registered as NCT00144755). We implemented a prospective long-term follow-up program at the end of this trial. The primary endpoints were progression-free survival (PFS) and overall survival (OS).

View Article and Find Full Text PDF

Objective: To investigate if measured inequalities in cancer survival differ when using individual-based ('person') compared with area-based ('place') measures of deprivation for three socioeconomic dimensions: income, deprivation and occupation.

Design: Cohort study.

Setting: Data from the Office for National Statistics Longitudinal Study of England and Wales, UK, linked to the National Cancer Registration Database.

View Article and Find Full Text PDF

Whether patients with coronavirus disease (COVID-19) may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. To estimate the effect of ECMO on 90-day mortality versus IMV only. Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO versus no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (Pa/Fi < 80 or Pa ⩾ 60 mm Hg).

View Article and Find Full Text PDF

Background: We aimed to investigate the impact of socio-economic inequalities in cancer survival in England on the Number of Life-Years Lost (NLYL) due to cancer.

Methods: We analysed 1.2 million patients diagnosed with one of the 23 most common cancers (92.

View Article and Find Full Text PDF

Background: Associations between socioeconomic status (SES) and breast cancer survival are most pronounced in young patients. We further investigated the relation between SES, subsequent recurrent events and mortality in breast cancer patients < 40 years. Using detailed data on all recurrences that occur between date of diagnosis of the primary tumor and last observation, we provide a unique insight in the prognosis of young breast cancer patients according to SES.

View Article and Find Full Text PDF

Background: People living in more deprived areas of high-income countries have lower cancer survival than those in less deprived areas. However, associations between individual-level socio-economic circumstances and cancer survival are relatively poorly understood. Moreover, few studies have addressed contextual effects, where associations between individual-level socio-economic status and cancer survival vary depending on area-based deprivation.

View Article and Find Full Text PDF

Objectives: We aimed to assess the association between multimorbidity and deprivation on short-term mortality among patients with diffuse large B-cell (DLBCL) and follicular lymphoma (FL) in England.

Setting: The association of multimorbidity and socioeconomic deprivation on survival among patients diagnosed with DLBCL and FL in England between 2005 and 2013. We linked the English population-based cancer registry with electronic health records databases and estimated adjusted mortality rate ratios by multimorbidity and deprivation status.

View Article and Find Full Text PDF

(1) Background: Socioeconomic inequalities of survival in patients with lymphoma persist, which may be explained by patients' comorbidities. We aimed to assess the association between comorbidities and the survival of patients diagnosed with diffuse large B-cell (DLBCL) or follicular lymphoma (FL) in England accounting for other socio-demographic characteristics. (2) Methods: Population-based cancer registry data were linked to Hospital Episode Statistics.

View Article and Find Full Text PDF

The main purpose of many medical studies is to estimate the effects of a treatment or exposure on an outcome. However, it is not always possible to randomize the study participants to a particular treatment, therefore observational study designs may be used. There are major challenges with observational studies; one of which is confounding.

View Article and Find Full Text PDF

Missing data is a common issue in epidemiological databases. Among the different ways of dealing with missing data, multiple imputation has become more available in common statistical software packages. However, the incompatibility between the imputation and substantive model, which can arise when the associations between variables in the substantive model are not taken into account in the imputation models or when the substantive model is itself nonlinear, can lead to invalid inference.

View Article and Find Full Text PDF

Introduction: Diagnostic delay is associated with lower chances of cancer survival. Underlying comorbidities are known to affect the timely diagnosis of cancer. Diffuse large B-cell (DLBCL) and follicular lymphomas (FL) are primarily diagnosed amongst older patients, who are more likely to have comorbidities.

View Article and Find Full Text PDF

People who live in more deprived areas have poorer health outcomes, and this inequality is a major driver of health and social policy. Many interventions targeting these disparities implicitly assume that poorer health is predominantly associated with area-level factors, and that these inequalities are the same for men and women. However, health differentials due to individual socio-economic status (SES) of men and women are less well documented.

View Article and Find Full Text PDF