The Ouest Data Hub: An Interregional Health Data Sharing Ecosystem for Research.

The Ouest Data Hub (ODH) a project lead by GCS HUGO which is a cooperation group of University Hospitals in the French Grand Ouest region represents a groundbreaking initiative in this territory, advancing health data sharing and reuse to support research driven by real-world health data. Central to its structure are the Clinical Data Warehouses (CDWs) and Clinical Data Centers (CDCs), essential for analytics and as the linchpin of the ODH's status as an interregional Learning Health System. Aimed at fostering innovation and research, the ODH's collaborative and multi-institutional model effectively utilizes both local and shared resources.

A software tool to support follow-up care in a French childhood cancer cohort: construction and feasibility.

Background: Treatment summaries and a personalized survivorship care plans based on internationally approved, organ-specific follow-up care recommendations are essential in preserving the health and quality of life for cancer survivors. Cohorts made up of survivors of childhood cancer have made significant contributions to the understanding of early mortality, somatic late complications, and psychosocial outcomes among former patients. New treatment protocols are needed to enhance survival and reduce the potential risk and severity of late effects, and working with treatment databases is crucial in doing so.

Ten (not so) simple rules for clinical trial data-sharing.

Clinical trial data-sharing is seen as an imperative for research integrity and is becoming increasingly encouraged or even required by funders, journals, and other stakeholders. However, early experiences with data-sharing have been disappointing because they are not always conducted properly. Health data is indeed sensitive and not always easy to share in a responsible way.

Evaluation of a risk score based on dietary and lifestyle factors to target a population at risk in colorectal cancer screening.

Background: The aim of our study was to assess three risk scores to predict lesions, advanced neoplasia (high-risk adenomas and colorectal cancer (CRC)) and CRC in individuals who participate to colorectal cancer screening.

Methods: The data of dietary and lifestyle risk factors were carried out during 2 mass screening campaigns in France (2013-2016) and the FOBT result was collected until December 2018. The colonoscopy result in positive FOBT was recovered.

Cardiopulmonary bypass and internal thoracic artery: Can roller or centrifugal pumps change vascular reactivity of the graft? The IPITA study: A randomized controlled clinical trial.

Background: Cardiopulmonary bypass (CPB) induces a systemic inflammatory response (SIRS) and affects the organ vascular bed. Experimentally, the lack of pulsatility alters myogenic tone of resistance arteries and increases the parietal inflammatory response. The purpose of this study was to compare the vascular reactivity of the internal thoracic arteries (ITAs) due to the inflammatory response between patients undergoing coronary artery bypass grafting (CABG) under CPB with a roller pump or with a centrifugal pump.

Effects of sildenafil on maximum walking time in patients with arterial claudication: The ARTERIOFIL study.

Background: Patients with lower extremity peripheral artery disease (PAD) frequently experience claudication, a clinical symptom indicative of reduced walking capacity. Recommended care consists of exercise rehabilitation combined with optimal medical treatment and surgery. The effects of a single oral dose of sildenafil, a phosphodiesterase type-5 inhibitor, on patients with claudication are discussed.

Tranexamic Acid for the Prevention of Blood Loss after Vaginal Delivery.

Background: The use of tranexamic acid reduces mortality due to postpartum hemorrhage. We investigated whether the prophylactic administration of tranexamic acid in addition to prophylactic oxytocin in women with vaginal delivery would decrease the incidence of postpartum hemorrhage.

Methods: In a multicenter, double-blind, randomized, controlled trial, we randomly assigned women in labor who had a planned vaginal delivery of a singleton live fetus at 35 or more weeks of gestation to receive 1 g of tranexamic acid or placebo, administered intravenously, in addition to prophylactic oxytocin after delivery.

Primary antiphospholipid syndrome and antiphospholipid syndrome associated to systemic lupus: Are they different entities?

Primary antiphospholipid syndrome (PAPS) and antiphospholipid syndrome associated to lupus (SAPS) have several overlapping characteristics. As systemic manifestations are also reported in patients with PAPS, and as a subgroup of PAPS patients could evaluate to a SAPS, the differentiation between the two types of APS could be performed based on the clinical experience of the medical teams and is related to a variety of clinical, biological, histological and genetic features. Several data are available in the literature with respect to the identification of distinctive features between these two entities.

Pooled analysis of higher versus lower blood pressure targets for vasopressor therapy septic and vasodilatory shock.

Purpose: Guidelines for shock recommend mean arterial pressure (MAP) targets for vasopressor therapy of at least 65 mmHg and, until recently, suggested that patients with underlying chronic hypertension and atherosclerosis may benefit from higher targets. We conducted an individual patient-data meta-analysis of recent trials to determine if patient variables modify the effect of different MAP targets.

Methods: We searched the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials for randomized controlled trials of higher versus lower blood pressure targets for vasopressor therapy in adult patients in shock (until November 2017).

Pulmonary embolism rule-out criteria (PERC) rule in European patients with low implicit clinical probability (PERCEPIC): a multicentre, prospective, observational study.

Background: The ability of the pulmonary embolism rule-out criteria (PERC) to exclude pulmonary embolism without further testing remains debated outside the USA, especially in the population with suspected pulmonary embolism who have a high prevalence of the condition. Our main objective was to prospectively assess the predictive value of negative PERC to rule out pulmonary embolism among European patients with low implicit clinical probability.

Methods: We did a multicentre, prospective, observational study in 12 emergency departments in France and Belgium.

Multifaceted Intervention to Prevent Venous Thromboembolism in Patients Hospitalized for Acute Medical Illness: A Multicenter Cluster-Randomized Trial.

Background: Misuse of thromboprophylaxis may increase preventable complications for hospitalized medical patients.

Objectives: To assess the net clinical benefit of a multifaceted intervention in emergency wards (educational lectures, posters, pocket cards, computerized clinical decision support systems and, where feasible, electronic reminders) for the prevention of venous thromboembolism.

Patients/methods: Prospective cluster-randomized trial in 27 hospitals.

Sedative premedication before surgery--A multicentre randomized study versus placebo.

Objective: Anxiolytic premedication before non-ambulatory surgery in adult patients may have become of less importance in an era of better preoperative patient information. Moreover, an oral hypnotic given the night before surgery may be as efficient as an anxiolytic for relieving patient anxiety. These two strategies were compared for superiority to a placebo and to each other for non-inferiority.

[Assessment of scientific production after initial medical education at the Faculty of Medicine of Angers from 2002 to 2008].

Introduction: The activity of scientific publication after initial medical education is unclear. The purpose of this study was to evaluate the proportion of MD theses and Board certification manuscripts resulting in a publication, their impact in terms of SIGAPS points and the main difficulties in the publication of this work.

Methods: MD theses sustained from 2002 to 2008 at the Faculty of Medicine of Angers have been identified from the "Système universitaire de documentation" (SUDOC), catalog, and specialty certification manuscripts (Board and Complementary Board) directly to diplomates.

A computerized handheld decision-support system to improve pulmonary embolism diagnosis: a randomized trial.

Background: Testing for pulmonary embolism often differs from that recommended by evidence-based guidelines.

Objective: To assess the effectiveness of a handheld clinical decision-support system to improve the diagnostic work-up of suspected pulmonary embolism among patients in the emergency department.

Design: Cluster randomized trial.

Assessment of water enema computed tomography: an effective imaging technique for the diagnosis of colon cancer: Colon cancer: computed tomography using a water enema.

Aim: The aim of this study was to assess the accuracy of water enema computed tomography (WECT) for the diagnosis of colon cancer.

Methods: A total of 191 patients referred for clinically suspected colon cancer were prospectively evaluated by WECT in a multicenter trial. Examination was contrast enhanced helical CT after colon filling through a rectal tube.