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一种在法国全国范围内监测性早熟的新方法。

A new efficient method to monitor precocious puberty nationwide in France.

机构信息

Environmental Health Division, Santé publique France, 12 rue duVal d'Osne, 94415, Saint-Maurice, France.

Department of Pediatric Endocrinology and Diabetology, and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Robert-Debré, F-75019, Paris, France.

出版信息

Eur J Pediatr. 2018 Feb;177(2):251-255. doi: 10.1007/s00431-017-3012-y. Epub 2017 Oct 3.

Abstract

UNLABELLED

Clinical precocious puberty (PP) is a disease, reputed to be on the increase and suspected to be linked to endocrine disrupting chemicals (EDC) exposure. Population-based epidemiological data are lacking in France and scarce elsewhere. We accessed the feasibility of monitoring PP nationwide in France in this context, using a nationwide existing database, the French National Health Insurance Information System. Here, we present the method we used with a step-by-step approach to build and select the most suitable indicator. We built three indicators reflecting the incidence of idiopathic central precocious puberty (ICPP), the most frequent form of PP, and we compared these indicators according to their strengths and weaknesses with respect to surveillance purposes.

CONCLUSION

Monitoring ICPP in France proved feasible using a Drug reimbursement indicator. Our method is cost efficient and highly relevant in public health surveillance. Our step-by-step approach proved helpful to achieve this project and could be proposed for assessing the feasibility of monitoring health outcomes of interest using existing data bases. What is known: • Precocious puberty (PP) is suspected to be related to EDC exposure and it is believed to be on the increase in France and in others countries. • Very few epidemiologic data on PP are currently available in the world at the national scale. What is new: • This is the first study describing a method to monitor the most frequent form of PP, idiopathic central PP (ICPP) nationwide in a cost-efficient way, using health insurance databases. • This cost-effective method will allow to estimate and monitor the incidence of ICPP in France and to analyze spatial variations at a very precise scale, which will be very useful to examine the role of environmental exposures, especially to EDCs.

摘要

未加标签

临床性早熟(PP)是一种疾病,据信其发病率正在上升,并疑似与内分泌干扰化学物质(EDC)暴露有关。法国缺乏基于人群的流行病学数据,其他地方也很少。在这种情况下,我们利用法国现有的全国性数据库——国家健康保险信息系统,评估了在全国范围内监测 PP 的可行性。在此,我们介绍了我们使用的方法,包括分步骤构建和选择最合适指标的方法。我们构建了三个反映特发性中枢性性早熟(ICPP)发病率的指标,这是 PP 最常见的形式,我们根据这些指标在监测目的方面的优缺点进行了比较。

结论

使用药物报销指标在法国监测 ICPP 是可行的。我们的方法具有成本效益,在公共卫生监测方面非常相关。我们的分步骤方法对实现这一项目很有帮助,并且可以用于评估使用现有数据库监测感兴趣的健康结果的可行性。已知情况:•性早熟(PP)疑似与 EDC 暴露有关,并且在法国和其他国家,它被认为正在增加。•目前全球范围内,关于 PP 的流行病学数据非常有限。新发现:•这是第一项描述使用医疗保险数据库以具有成本效益的方式在全国范围内监测最常见形式的性早熟(特发性中枢性性早熟(ICPP))的方法的研究。•这种具有成本效益的方法将能够估计和监测法国 ICPP 的发病率,并在非常精确的范围内分析空间变化,这对于研究环境暴露,特别是内分泌干扰物的作用非常有用。

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