Integrating human biomonitoring exposure data into a primary care morbidity database: a feasibility study.

Background: The detection of a local per- and polyfluoroalkyl substances (PFAS) pollution hotspot in Zwijndrecht (Belgium) necessitated immediate action to address health concerns of the local community. Several human biomonitoring (HBM) studies were initiated, gathering cross-sectional exposure data from more than 10,000 participants. The linkage of these HBM data with primary care health registries might be a useful new tool in environmental health analysis.

Model-based disease mapping using primary care registry data.

Background: Spatial modeling of disease risk using primary care registry data is promising for public health surveillance. However, it remains unclear to which extent challenges such as spatially disproportionate sampling and practice-specific reporting variation affect statistical inference.

Methods: Using lower respiratory tract infection data from the INTEGO registry, modeled with a logistic model incorporating patient characteristics, a spatially structured random effect at municipality level, and an unstructured random effect at practice level, we conducted a case and simulation study to assess the impact of these challenges on spatial trend estimation.

Association between non-registration of chronic kidney disease and mortality and cardiovascular outcome: a time-to-event analysis of retrospective primary care data.

Objective: Patients with impaired kidney function and increased albuminuria are at risk of developing cardiovascular disease (CVD). Previous research has revealed that a substantial proportion of patients with chronic kidney disease (CKD) do not get a registered diagnosis in the electronic health record of the general practitioner. The aim of this study was to investigate the association between non-registration of CKD and all-cause mortality and cardiovascular outcome.

Developing a questionnaire to evaluate an automated audit & feedback intervention: a Rand-modified Delphi method.

Background: Audit and feedback (A&F) is a widely used implementation strategy to evaluate and improve medical practice. The optimal design of an A&F system is uncertain and structured process evaluations are currently lacking. This study aimed to develop and validate a questionnaire to evaluate the use of automated A&F systems.

Assessing mental health from registry data: What is the best proxy?

Objective: Medical registries frequently underestimate the prevalence of health problems compared with surveys. This study aimed to determine the registry variables that can serve as a proxy for variables studied in a mental health survey.

Materials And Methods: Prevalences of depressive symptoms, anxiety and psychoactive medication use from the 2018 Belgian Health Interview Survey (HIS) were compared with same-year prevalences from INTEGO, a Belgian primary care registry.

Pneumococcal vaccination coverage and adherence to recommended dosing schedules in adults: a repeated cross-sectional study of the INTEGO morbidity registry.

Background: Since 2014, Belgium's Superior Health Council has recommended pneumococcal vaccination for adults aged 19-85 years at increased risk for pneumococcal diseases with a specific vaccine administration sequence and timing. Currently, Belgium has no publicly funded adult pneumococcal vaccination program. This study investigated the seasonal pneumococcal vaccination trends, evolution of vaccination coverage and adherence to the 2014 recommendations.

Trends in the registration of anxiety in Belgian primary care from 2000 to 2021: a registry-based study.

Background: Anxiety is frequently encountered in general practice, but figures regarding prevalence and incidence in this healthcare setting remain scarce.

Aim: To provide insight about the trends in prevalence and incidence of anxiety in Belgian general practice, as well as the comorbidities and treatment of anxiety in this context.

Design And Setting: Retrospective cohort study using the INTEGO morbidity registration network, with clinical data from over 600 000 patients in Flanders, Belgium.

Stakeholders' experiences and perception on transitional care initiatives within an integrated care project in Belgium: a qualitative interview study.

Background: In 2015, a plan for integrated care was launched by the Belgium government that resulted in the implementation of 12 integrated care pilot project across Belgium. The pilot project Zorgzaam Leuven consists of a multidisciplinary local consortium aiming to bring lasting change towards integrated care for the region of Leuven. This study aims to explore experiences and perceptions of stakeholders involved in four transitional care actions that are part of Zorgzaam Leuven.

The Impact of the COVID-19 Pandemic on the Registration and Care Provision of Mental Health Problems in General Practice: Registry-Based Study.

Background: The impact of the COVID-19 pandemic on mental health in general practice remains uncertain. Several studies showed an increase in terms of mental health problems during the pandemic. In Belgium, especially during the first waves of the pandemic, access to general practice was limited.

An exploration of under-registration of chronic kidney disease stages 3-5 in Belgian general practices using logistic regression.

Background: Early detection and treatment of chronic kidney disease (CKD) can prevent further deterioration and complications. Previous studies suggested that the diagnosis is often made when advanced renal failure occurs. The aims of this study were to describe the prevalence of unregistered CKD stages 3-5 in a Belgian General Practitioner population, to determine risk factors for under-registration and to investigate the diagnostic delay.

Corrigendum: IgG anti-spike antibodies and surrogate neutralizing antibody levels decline faster 3 to 10 months after BNT162b2 vaccination than after SARS-CoV-2 infection in healthcare workers.

[This corrects the article DOI: 10.3389/fimmu.2022.

Incidence rates and trends of childhood urinary tract infections and antibiotic prescribing: registry-based study in general practices (2000 to 2020).

Background: To improve the management of childhood urinary tract infections, it is essential to understand the incidence rates, testing and treatment strategy.

Methods: A retrospective study using data from 45 to 104 general practices (2000 to 2020) in Flanders (Belgium). We calculated the incidence rates (per 1000 person-years) of cystitis, pyelonephritis, and lab-based urine tests per age (< 2, 2-4, 5-9 and 10-18 years)) and gender in children and performed an autoregressive time-series analysis and seasonality analysis.

The impact of the Covid-19 pandemic on the incidence of diseases and the provision of primary care: A registry-based study.

Introduction: The Covid-19 pandemic had a tremendous impact on healthcare but uncertainty remains about the extent to which primary care provision was affected. Therefore, this paper aims to assess the impact on primary care provision and the evolution of the incidence of disease during the first year of the Covid-19 pandemic in Flanders (Belgium).

Methods: Care provision was defined as the number of new entries added to a patient's medical history.

IgG Anti-Spike Antibodies and Surrogate Neutralizing Antibody Levels Decline Faster 3 to 10 Months After BNT162b2 Vaccination Than After SARS-CoV-2 Infection in Healthcare Workers.

Background: IgG anti-spike (S) antibodies arise after SARS-CoV-2 infection as well as vaccination. Levels of IgG anti-S are linked to neutralizing antibody titers and protection against (re)infection.

Methods: We measured IgG anti-S and surrogate neutralizing antibody kinetics against Wild Type (WT) and 4 Variants of Concern (VOC) in health care workers (HCW) 3 and 10 months after natural infection ("infection", n=83) or vaccination (2 doses of BNT162b2) with ("hybrid immunity", n=17) or without prior SARS-CoV-2 infection ("vaccination", n=97).

Trends in the epidemiology of depression and comorbidities from 2000 to 2019 in Belgium.

Background: Depression is a common mental disorder in family practice with an impact on global health. The aim of this study is to provide insight in the trends of epidemiological measures as well as pharmacological treatments and comorbidities of depression.

Methods: A study using data from INTEGO, a family practice registration network in Flanders, Belgium.

A Resampling Method to Improve the Prognostic Model of End-Stage Kidney Disease: A Better Strategy for Imbalanced Data.

Background: Prognostic models can help to identify patients at risk for end-stage kidney disease (ESKD) at an earlier stage to provide preventive medical interventions. Previous studies mostly applied the Cox proportional hazards model. The aim of this study is to present a resampling method, which can deal with imbalanced data structure for the prognostic model and help to improve predictive performance.

Lower persistence of anti-nucleocapsid compared to anti-spike antibodies up to one year after SARS-CoV-2 infection.

We retrospectively compared the long-term evolution of IgG anti-spike (S) and anti-nucleocapsid (N) levels (Abbott immunoassays) in 116 non-severe and 115 severe SARS-CoV-2 infected patients from 2 university hospitals up to 365 days post positive RT-PCR. IgG anti-S and anti-N antibody levels decayed exponentially up to 365 days after a peak 0 to 59 days after positive RT-PCR. Peak antibody level/cut-off ratio 0 to 59 days after positive RT-PCR was more than 70 for anti-S compared to less than 6 for anti-N (P < 0.

IgG anti-spike antibody levels in healthcare workers with and without prior COVID-19 up to 3 months after BNT162b2 vaccination.

We report IgG anti-spike levels up to 3 months after vaccination with 2 doses of BNT162b2 mRNA vaccine in healthcare workers (HCW). The antibody response was significantly stronger in previously infected vaccinated HCW compared to uninfected HCW, and stronger after vaccination compared to (mostly) mild natural infection.

The Effects of Heatwaves on Human Morbidity in Primary Care Settings: A Case-Crossover Study.

Purpose: This study assesses the potential acute effects of heatwaves on human morbidities in primary care settings.

Methods: We performed a time-stratified case-crossover study to assess the acute effects of heatwaves on selected morbidities in primary care settings in Flanders, Belgium, between 2000 and 2015. We used conditional logistic regression models.

Impact of Heat Waves on Hospitalisation and Mortality in Nursing Homes: A Case-Crossover Study.

Climate change leads to more days with extremely hot temperatures. Previous analyses of heat waves have documented a short-term rise in mortality. The results on the relationship between high temperatures and hospitalisations, especially in vulnerable patients admitted to nursing homes, are inconsistent.

An automated data cleaning method for Electronic Health Records by incorporating clinical knowledge.

Background: The use of Electronic Health Records (EHR) data in clinical research is incredibly increasing, but the abundancy of data resources raises the challenge of data cleaning. It can save time if the data cleaning can be done automatically. In addition, the automated data cleaning tools for data in other domains often process all variables uniformly, meaning that they cannot serve well for clinical data, as there is variable-specific information that needs to be considered.

The effect of automated audit and feedback on data completeness in the electronic health record of the general physician: protocol for a cluster randomized controlled trial.

Background: The electronic health record (EHR) of the general physician (GP) is an important tool that can be used to assess and improve the quality of healthcare. However, there are some problems when (re) using the data gathered in the EHR for quality assessments. One problem is the lack of data completeness in the EHR.