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Mise en place de stratégies d'évaluation des pratiques et des programmes de santé à travers une informatique distribuée.

Abstract : This thesis is part of a project named GINSENG. This project is part of an experimental development for a light grid infrastructure dedicated to e-health and epidemiology. This network aims to collect distributed medical data in order to perform original data analysis thanks to the innovative technologies of grid computing. This project includes the following research areas: medical informatics, epidemiology joined with a socio-economic modeling. This network aims to federate distributed and existing medical databases, particularly cytopathologic data, to make them available to regional and national epidemiologic structures. Thanks to the distributed architecture of the grid, the network should become interoperable with any medical center which would need those medical data.Thanks to GINSENG, this thesis brings quality improvement strategies and its evaluation. A first work concerns the quality of survey design to estimate the indicators of patient record keeping. It plans to exploit some functionalities of GINSENG to increase required sample size to obtain a better estimate. A second work concerns the impact of social deprivation (measured by EPICES score) on access to healthcare for pregnant women and living in rural area. We want to characterize the link between social deprivation and adverse perinatal outcomes. We discuss the possibility to integrate the EPICES score in health care institution. The last work deals with the comparison between organized screening and individual screening. Socio demographic, clinical and prognostic characteristics are analyzed from SIPATH (laboratory), ARDOC and ABIDEC (screening sites) databases. These applications illustrate benefits of using GINSENG.
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Audrey Lelong. Mise en place de stratégies d'évaluation des pratiques et des programmes de santé à travers une informatique distribuée.. Médecine humaine et pathologie. Université d'Auvergne - Clermont-Ferrand I, 2015. Français. ⟨NNT : 2015CLF1MM13⟩. ⟨tel-01657423⟩

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