Publications by authors named "Fabrice Denis"
Background: Delay in the diagnosis of neurodevelopmental disorders (NDDs) in toddlers and postnatal depression (PND) is a major public health issue. In both cases, early intervention is crucial but too rarely implemented in practice.
Objective: Our goal was to determine if a dedicated mobile app can improve screening of 5 NDDs (autism spectrum disorder [ASD], language delay, dyspraxia, dyslexia, and attention-deficit/hyperactivity disorder [ADHD]) and reduce PND incidence.
Introduction: Thymomas are rare intrathoracic malignancies that can relapse after surgery. Whether or not Post-Operative RadioTherapy (PORT) should be delivered after surgery remains a major issue. RADIORYTHMIC is an ongoing, multicenter, randomized phase 3 trial addressing this question in patients with completely R0 resected Masaoka-Koga stage IIb/III thymoma.
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- The study investigated the effects of COVID-19 lockdown restrictions on lung cancer patients, comparing outcomes from 2020 with those from the same period in 2019.
- Clinical characteristics were similar between the two groups, but 2020 patients were older and had more non-smokers.
- Despite concerns, the lockdown did not negatively affect lung cancer management or long-term survival; instead, some patients saw improved outcomes, especially non-smokers and those receiving systemic therapies.
Among the thousands of eHealth tools available, the vast majority do not get past pilot phases because they cannot prove value, and only a few have been systematically assessed. Although multiple eHealth assessment frameworks have been developed, these efforts face multiple challenges. This study aimed to address some of these challenges by validating and refining an initial list of 55 assessment criteria based on previous frameworks through a two-round modified Delphi process with in-between rounds of interviews.
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- - Patients with oligometastatic prostate cancer (having up to 5 metastases) generally have a better prognosis than those with more extensive disease, making this a crucial area for treatment investigation.
- - The study investigates whether combining stereotactic body radiotherapy (SBRT) with the immune checkpoint inhibitor durvalumab can improve progression-free survival in these patients compared to SBRT alone.
- - This multicenter phase II trial will evaluate various outcomes, including quality of life and immune response, by enrolling 96 participants over three years, aiming to provide insights into better treatment strategies for prostate cancer.
Background: Evidence regarding the analgesic effect of distraction through immersion in virtual reality (VR) for care-induced pain has been documented in several phase 2 trials, but comparison with standard treatments in large, randomized studies is needed.
Objective: In this open-label, multicenter, randomized, phase 3 trial, we evaluated the safety and efficacy of a novel VR therapy solution for distraction in the context of bone marrow biopsy.
Methods: Bliss is a VR software with 4 imaginary interactive environments in 3 dimensions with binaural sound (head-mounted display).
Background: The practice of regular physical activity can reduce the incidence of certain cancers (colon, breast, and prostate) and improve overall survival after treatment by reducing fatigue and the risk of relapse. This impact on survival has only been demonstrated in active patients with lymphoma before and after treatment. As poor general health status reduces the chances of survival and these patients are most likely to also have sarcopenia, it is important to be able to improve their physical function through adapted physical activity (APA) as part of supportive care management.
View Article and Find Full Text PDFBackground: Frail older people use emergency services extensively, and digital systems that monitor health remotely could be useful in reducing these visits by earlier detection of worsening health conditions.
Objective: We aimed to implement a system that produces alerts when the machine learning algorithm identifies a short-term risk for an emergency department (ED) visit and examine health interventions delivered after these alerts and users' experience. This study highlights the feasibility of the general system and its performance in reducing ED visits.
Background: In 2020, more than 250 eHealth solutions were added to app stores each day, or 90,000 in the year; however, the vast majority of these solutions have not undergone clinical validation, their quality is unknown, and the user does not know if they are effective and safe. We sought to develop a simple prescreening scoring method that would assess the quality and clinical relevance of each app. We designed this tool with 3 health care stakeholder groups in mind: eHealth solution designers seeking to evaluate a potential competitor or their own tool, investors considering a fundraising candidate, and a hospital clinician or IT department wishing to evaluate a current or potential eHealth solution.
View Article and Find Full Text PDFBackground: Delays in the diagnosis of neurodevelopmental disorders (NDDs) in toddlers and postnatal depression (PND) in mothers are major public health issues. In both cases, early intervention is crucial.
Objective: We aimed to assess if a mobile app named Malo can reduce delay in the recognition of NDD and PND.
Use of a Smartphone Self-assessment App for a Tobacco-Induced Disease (COPD, Cardiovascular Diseases, Cancer) Screening Strategy and to Encourage Smoking Cessation: Observational Study.
JMIR Public Health Surveill
February 2022
Background: Patient self-assessment via a mobile app detects actionable symptoms and has been shown to detect lung cancer relapses early, thereby lengthening survival.
Objective: The purpose of this study was to assess the incidence of chief symptoms associated with the main tobacco-induced pathologies in both current and ex-smokers through a self-assessment smartphone app and to evaluate the app's capacity to encourage users to quit smoking or reduce consumption, as well as its impact on early lung cancer stages at the time of diagnosis.
Methods: Current and ex-smokers were recruited through an advertising campaign in Sarthe county (France) proposing the free download of a smartphone app.
Article Synopsis
- Digital health is rapidly evolving, integrating innovative digital tools that enhance cooperation among healthcare professionals while benefiting users and patients.
- The rise of diverse digital solutions prompts stakeholders to assess their integration, focusing on target demographics, values, funding, and evaluation methods.
- As reimbursement frameworks for digital solutions begin to take shape, eight recommendations have been proposed to facilitate dialogue and address challenges in integrating these technologies into the healthcare system.
Electronic patient-reported outcome (ePRO) systems for symptom monitoring in patients with cancer have shown quality of life and survival benefits in controlled trials. They are beginning to be used in routine oncology practice. Many software developers provide software solutions for clinicians, but how should clinicians decide which system to use? We propose a synthesis of the main questions regarding the effectiveness, safety, and functionality of an ePRO system that a clinician should ask software providers to assist in the selection of a software product in order to obtain the best value tools for their patients and their practice.
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- The study investigates the effectiveness of combining androgen deprivation therapy (ADT) with high-dose salvage radiotherapy in men with oligorecurrent pelvic node relapses of prostate cancer, aiming to extend the period without cancer progression.
- Conducted as an open-label phase II trial with 67 participants over a median follow-up of about 49 months, the results indicate strong progression-free survival rates of 81% at 2 years and 58% at 3 years, with manageable side effects reported.
- The findings suggest that this combination treatment can lead to prolonged tumor control and remission in nearly half of the patients after 3 years, indicating a promising approach for managing this challenging cancer recurrence scenario.
Background: Persistent olfactory dysfunction is a significant complication of SARS-CoV-2 infection. Olfactory training involving aromatic oils has been recommended to improve olfactory recovery, but quantitative data are missing.
Objective: We aimed to quantify the benefit of olfactory training and visual stimulation assisted by a dedicated web application for patients who experienced olfactory dysfunction for ≥1 month.
Background: We developed a questionnaire on a web application for analyzing COVID-19 contamination circumstances in France during the second wave of the pandemic.
Objective: This study aims to analyze the impact on contamination characteristics before and after the second partial lockdown in France to adapt public health restrictions to further prevent pandemic surges.
Methods: Between December 15 and 24, 2020, after a national media campaign, users of the sourcecovid.
Background: We developed a self-assessment and participatory web-based triage app to assess the trends of the COVID-19 pandemic in France in March 2020.
Objective: We compared daily large-scale RT-PCR test results to monitor recent reports of anosmia through a web-based app to assess the dynamics of emergency department visits, hospitalizations, and intensive care unit (ICU) admissions among individuals with COVID-19 in France.
Methods: Between March 21 and November 18, 2020, users of the maladiecoronavirus.
Background: We developed a self-triage web application for COVID-19 symptoms, which was launched in France in March 2020, when French health authorities recommended all patients with suspected COVID-19 call an emergency phone number.
Objective: Our objective was to determine if a self-triage tool could reduce the burden on emergency call centers and help predict increasing burden on hospitals.
Methods: Users were asked questions about their underlying conditions, sociodemographic status, postal code, and main COVID-19 symptoms.
Background: We developed a self-assessment and participatory surveillance web application for coronavirus disease (COVID-19), which was launched in France in March 2020.
Objective: Our objective was to determine if self-reported symptoms could help monitor the dynamics of the COVID-19 outbreak in France.
Methods: Users were asked questions about underlying conditions, sociodemographic status, zip code, and COVID-19 symptoms.
Home care aides' observations and machine learning algorithms for the prediction of visits to emergency departments by older community-dwelling individuals receiving home care assistance: A proof of concept study.
PLoS One
March 2020
Background: Older individuals receiving home assistance are at high risk for emergency visits and unplanned hospitalization. Anticipating their health difficulties could prevent these events. This study investigated the effectiveness of an at-home monitoring method using social workers' observations to predict risk for 7- and 14-day emergency department (ED) visits.
View Article and Find Full Text PDFBackground: Prognostic models based on individual patient characteristics can improve treatment decisions and outcome in the future. In many (radiomic) studies, small size and heterogeneity of datasets is a challenge that often limits performance and potential clinical applicability of these models. The current study is example of a retrospective multi-centric study with challenges and caveats.
View Article and Find Full Text PDFIntroduction: A multicenter randomized clinical trial in France found an overall survival benefit of web-based patient-reported outcome (PRO)-based surveillance after initial treatment for lung cancer compared with conventional surveillance. The aim of this study was to assess the cost-effectiveness of this PRO-based surveillance in lung cancer patients.
Methods: This medico-economic analysis used data from the clinical trial, augmented by abstracted chart data and costs of consultations, imaging, transportations, information technology, and treatments.
Article Synopsis
- The study compares two approaches for monitoring patients with advanced nonprogressive lung cancer during chemotherapy: web-based patient-reported outcomes versus standard scheduled imaging.
- It focuses on the 2-year survival outcomes of these patients to evaluate the effectiveness of each method.
- The goal is to determine if symptom monitoring using technology can be as effective as traditional imaging in managing patient care and detecting recurrences.