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152. Recent trends in myocardial infarction rates in northern Italy. Results of the IM MONICA and CAMUNI registers in Brianza: 1993-1994 versus 1997-1998 [Recenti andamenti temporali dei tassi di infarto miocardico in nord Italia. Risultati dei registri IM MONICA e CAMUNI in Brianza: 1993-1994 versus 1997-1998]

Author

Ferrario, M, FORNARI, CARLA, Bolognesi, L, Gussoni, M, Benedetti, M, SEGA, ROBERTO, BORCHINI, ROSSANA, CESANA, GIANCARLO, Ferrario, M, Fornari, C, Bolognesi, L, Gussoni, M, Benedetti, M, Sega, R, Borchini, R, and Cesana, G

Subjects
Myocardial infarction, Epidemiology
Abstract

Background. Previously reported time trends of myocardial infarction rates in the MONICA Brianza 35-64-year-old population showed a clear decline in coronary heart disease mortality, mostly attributable to concurrent reductions in myocardial infarction attack rates, and to a lesser extent in 28-day case fatality. The aims of this study were to estimate time trends in more recent years (up to 1997-1998) in the same population and in the same age range, and to assess the impact of myocardial infarction among 35-74-year-old residents, an age range never investigated before in Italy using standardized population-based registers. Methods. The myocardial infarction register in the Brianza population was resumed in 1997-1998, adopting the same standardized methods for data collection and classification of suspect coronary events as the WHO MONICA project, including the age group 65-74 years in addition to age groups usually covered. Age-specific and age-standardized rates of validated coronary mortality rates, of attack rates, and incidence rates and of 28-day case fatality were calculated. Time changes were estimated as the difference in rates. Results. In comparison to the rates among 35-64-year-old residents, the 35-74 age-standardized rates of coronary event mortality in the biennium are more than 3 times higher in women and more than twice in men. Similarly, the attack and incidence rates increased respectively from 243 to 381 and from 197 to 292 per 100 000 in men, from 38 to 107 and from 33 to 87 per 100 000 in women. Statistically significant reductions are observed in coronary death rates, myocardial infarction attack rates and 28-day case-fatality rates between 1993-1994 and 1997-1998 in men. Analogous but not statistically significant changes are reported for women. Conclusions. In the Brianza MONICA population in the second half of the 1990s, coronary event death rates continued to decrease. In contrast with trends observed in previous years, the prominent quote of the reduction is attributable to case-fatality rates in the acute phase

Published
2003

154. Record linkage procedures to detect cardiovascular endpoints in follow-up studies

Author

FORNARI, CARLA, BAGNARDI, VINCENZO, CORRAO, GIOVANNI, Chiodini, P, Sarman, S, Ferrario, M., Fornari, C, Bagnardi, V, Corrao, G, Chiodini, P, Sarman, S, and Ferrario, M

Subjects
Record linkage
Abstract

Since 1992, prevalence data on HTLV-I and II have been collected as part of an ongoing viral seroprevalence study in clients of six First Nations alcohol and drug treatment centres in British Columbia, Canada. Prior studies indicate that the lifetime risk of clinical disease (neurologic or hematologic) resulting from HTLV-I infection is low (less than 5%) and HTLV-II to date has not been clearly associated with clinical disease. In 1993, the first cases of HTLV-I-associated myelopathy or tropical spastic paraparesis (HAM/TSP) were reported in four Aboriginal residents of British Columbia; these were the first reports of HTLV-I linked disease among Aboriginal persons in Canada. All clients of the treatment centres involved in this study were offered confidential, voluntary testing following pre-test counseling, and the results are given to participants before the residential session is complete. 1953 men and women were tested; 11 were positive for HTLV-1 (0.56%) and 33 were positive for HTLV-2 (1.8%).

Published
2002

156. Harmonization process for the identification of medical events in eight European healthcare databases: the experience from the EU-ADR project

Author

Avillach, P, Coloma, P, Gini, R, Schuemie, M, Mougin, F, Dufour, J, Mazzaglia, G, Giaquinto, C, Fornari, C, Herings, R, Molokhia, M, Pedersen, L, Fourrier Réglat, A, Fieschi, M, Sturkenboom, M, van der Lei, J, Pariente, A, Trifirò, G, FORNARI, CARLA, Trifirò, G., Avillach, P, Coloma, P, Gini, R, Schuemie, M, Mougin, F, Dufour, J, Mazzaglia, G, Giaquinto, C, Fornari, C, Herings, R, Molokhia, M, Pedersen, L, Fourrier Réglat, A, Fieschi, M, Sturkenboom, M, van der Lei, J, Pariente, A, Trifirò, G, FORNARI, CARLA, and Trifirò, G.

Abstract

OBJECTIVE: Data from electronic healthcare records (EHR) can be used to monitor drug safety, but in order to compare and pool data from different EHR databases, the extraction of potential adverse events must be harmonized. In this paper, we describe the procedure used for harmonizing the extraction from eight European EHR databases of five events of interest deemed to be important in pharmacovigilance: acute myocardial infarction (AMI); acute renal failure (ARF); anaphylactic shock (AS); bullous eruption (BE); and rhabdomyolysis (RHABD). DESIGN: The participating databases comprise general practitioners' medical records and claims for hospitalization and other healthcare services. Clinical information is collected using four different disease terminologies and free text in two different languages. The Unified Medical Language System was used to identify concepts and corresponding codes in each terminology. A common database model was used to share and pool data and verify the semantic basis of the event extraction queries. Feedback from the database holders was obtained at various stages to refine the extraction queries. MEASUREMENTS: Standardized and age specific incidence rates (IRs) were calculated to facilitate benchmarking and harmonization of event data extraction across the databases. This was an iterative process. RESULTS: The study population comprised overall 19 647 445 individuals with a follow-up of 59 929 690 person-years (PYs). Age adjusted IRs for the five events of interest across the databases were as follows: (1) AMI: 60-148/100 000 PYs; (2) ARF: 3-49/100 000 PYs; (3) AS: 2-12/100 000 PYs; (4) BE: 2-17/100 000 PYs; and (5) RHABD: 0.1-8/100 000 PYs. CONCLUSIONS: The iterative harmonization process enabled a more homogeneous identification of events across differently structured databases using different coding based algorithms. This workflow can facilitate transparent and reproducible event extractions and understanding of differences between datab

Published
2013

157. Valutazione dell’efficienza ospedaliera in Lombardia

Author

Madotto, F, Fornari, C, Conti, S, Cesana, G, MADOTTO, FABIANA, FORNARI, CARLA, CONTI, SARA, CESANA, GIANCARLO, Madotto, F, Fornari, C, Conti, S, Cesana, G, MADOTTO, FABIANA, FORNARI, CARLA, CONTI, SARA, and CESANA, GIANCARLO

Published
2013

159. La terapia con statine nella prevenzione secondaria dell'ima. Stima di costo­efficacia nella reale pratica clinica

Author

Fornari, C, Valsecchi, M, Galimberti, S, Mantovani, L, Conti, S, Madotto, F, Cesana, G, FORNARI, CARLA, VALSECCHI, MARIA GRAZIA, GALIMBERTI, STEFANIA, MANTOVANI, LORENZO GIOVANNI, CONTI, SARA, MADOTTO, FABIANA, CESANA, GIANCARLO, Fornari, C, Valsecchi, M, Galimberti, S, Mantovani, L, Conti, S, Madotto, F, Cesana, G, FORNARI, CARLA, VALSECCHI, MARIA GRAZIA, GALIMBERTI, STEFANIA, MANTOVANI, LORENZO GIOVANNI, CONTI, SARA, MADOTTO, FABIANA, and CESANA, GIANCARLO

Published
2013

160. Worker healthy effect in cardiovascular disease prospective cohorts. Does it still matter? Comparing survival curves of northern Italian population-based and factory-based cohorts

Author

Ferrario, M, Bertù, L, Gianfagna, F, Veronesi, G, Fornari, C, Cesana, G, Corrao, G, Ferrario, MM, FORNARI, CARLA, CESANA, GIANCARLO, CORRAO, GIOVANNI, Ferrario, M, Bertù, L, Gianfagna, F, Veronesi, G, Fornari, C, Cesana, G, Corrao, G, Ferrario, MM, FORNARI, CARLA, CESANA, GIANCARLO, and CORRAO, GIOVANNI

Published
2013

161. Inflammatory bowel diseases in italy: incidence trends and patients’ characteristics

Author

Fornari, C, Madotto, F, Fiorino, G, Ardizzone, S, Bortoli, A, Caprioli, F, Cestari, R, Conti, S, Cortelezzi, C, Mantovani, L, Massari, A, Meucci, G, Ravelli, P, Vecchi, M, Danese, S, Cesana, G, FORNARI, CARLA, MADOTTO, FABIANA, CONTI, SARA, MANTOVANI, LORENZO GIOVANNI, CESANA, GIANCARLO, Fornari, C, Madotto, F, Fiorino, G, Ardizzone, S, Bortoli, A, Caprioli, F, Cestari, R, Conti, S, Cortelezzi, C, Mantovani, L, Massari, A, Meucci, G, Ravelli, P, Vecchi, M, Danese, S, Cesana, G, FORNARI, CARLA, MADOTTO, FABIANA, CONTI, SARA, MANTOVANI, LORENZO GIOVANNI, and CESANA, GIANCARLO

Published
2013

163. Application of Marginal Structural Models to estimate the cost-effectiveness of drug therapy with longitudinal observational data

Author

Fornari, C, Galimberti, S, Valsecchi, M, Conti, S, Madotto, F, Cesana, G, FORNARI, CARLA, GALIMBERTI, STEFANIA, VALSECCHI, MARIA GRAZIA, CONTI, SARA, MADOTTO, FABIANA, CESANA, GIANCARLO, Fornari, C, Galimberti, S, Valsecchi, M, Conti, S, Madotto, F, Cesana, G, FORNARI, CARLA, GALIMBERTI, STEFANIA, VALSECCHI, MARIA GRAZIA, CONTI, SARA, MADOTTO, FABIANA, and CESANA, GIANCARLO

Published
2013

164. Direct Healthcare Costs of Inflammatory Bowel Diseases in Lombardy

Author

Madotto, F, Fornari, C, Fiorino, G, Ardizzone, S, Bortoli, A, Caprioli, F, Cestari, R, Conti, S, Cortelezzi, C, Mantovani, L, Massari, A, Meucci, G, Ravelli, P, Vecchi, M, Danese, S, Cesana, G, MADOTTO, FABIANA, FORNARI, CARLA, CONTI, SARA, CESANA, GIANCARLO, Cortelezzi,C, MANTOVANI, LORENZO GIOVANNI, Madotto, F, Fornari, C, Fiorino, G, Ardizzone, S, Bortoli, A, Caprioli, F, Cestari, R, Conti, S, Cortelezzi, C, Mantovani, L, Massari, A, Meucci, G, Ravelli, P, Vecchi, M, Danese, S, Cesana, G, MADOTTO, FABIANA, FORNARI, CARLA, CONTI, SARA, CESANA, GIANCARLO, Cortelezzi,C, and MANTOVANI, LORENZO GIOVANNI

Abstract

Background Ulcerative colitis (UC) and Crohn’s disease (CD), collectively known as inflammatory bowel diseases (IBD), are chronic gastrointestinal conditions of unknown origin. Several reports suggest that these diseases are costly and represent a considerable burden to national healthcare systems (HSs), both in Europe and North America. Detailed cost studies of IBD in Italy are limited. The aim of this study was to estimate healthcare resource use and direct costs related to IBD from the perspective of HS in Lombardy, a region in Northern Italy. Methods This is an observational study based on healthcare administrative databases of Lombardy region. Data were previously organized in a data warehouse (DENALI) with probabilistic record linkage. We enrolled two study cohorts, one of patients with recently diagnosed UC and the other with CD. Subjects were identified on the basis of issuing of an exemption from co-payment healthcare costs between January 1st, 2003 and December 31st, 2009, for CD (code 009.555) or UC (code 009.556). The date of beginning of exemption was the entry date of the study. Subjects covered by Lombardy HS since less than 1 year were excluded. The two cohorts were followed until December 31st, 2009 to assess the consumption of healthcare resources (hospitalizations, pharmaceutical prescriptions and outpatient services) and the related costs incurred by the HS. Results Overall 5,637 subjects with UC and 3,398 with CD were included in the study. The mean age at CD diagnosis was 43 years (±17.2 s.d.), which was lower than that at UC diagnosis (45 ± 17.2, p<0.0001). During a mean follow-up time of 3.4 years (± 2.0), 2.2% of patients died in each cohort.

Published
2013

165. Utilization of antispasticity drugs in multiple sclerosis: analysis from an Italian administrative database

Author

Mantovani, L, Furneri, G, Scalone, L, Ciampichini, R, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Cesana, G, MANTOVANI, LORENZO GIOVANNI, SCALONE, LUCIANA, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, CESANA, GIANCARLO, Mantovani, L, Furneri, G, Scalone, L, Ciampichini, R, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Cesana, G, MANTOVANI, LORENZO GIOVANNI, SCALONE, LUCIANA, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, and CESANA, GIANCARLO

Published
2013

166. Incidence and time trends of inflammatory bowel diseases in Lombardy from 2003 to 2009

Author

Fornari, C, Madotto, F, Fiorino, G, Ardizzone, S, Bortoli, A, Caprioli, F, Cestari, R, Conti, S, Cortelezzi, C, Mantovani, L, Massari, A, Meucci, G, Ravelli, P, Vecchi, M, Danese, S, Cesana, G, FORNARI, CARLA, MADOTTO, FABIANA, CONTI, SARA, MANTOVANI, LORENZO GIOVANNI, CESANA, GIANCARLO, Fornari, C, Madotto, F, Fiorino, G, Ardizzone, S, Bortoli, A, Caprioli, F, Cestari, R, Conti, S, Cortelezzi, C, Mantovani, L, Massari, A, Meucci, G, Ravelli, P, Vecchi, M, Danese, S, Cesana, G, FORNARI, CARLA, MADOTTO, FABIANA, CONTI, SARA, MANTOVANI, LORENZO GIOVANNI, and CESANA, GIANCARLO

Published
2013

167. Economic burden of pneumoniae requiring hospitalization in italy: analysis from an administrative database

Author

Ciampichini, R, Furneri, G, Cozzolino, P, Mantovani, L, Fornari, C, Madotto, F, Chiodini, V, Cesana, G, MANTOVANI, LORENZO GIOVANNI, FORNARI, CARLA, MADOTTO, FABIANA, CESANA, GIANCARLO, Ciampichini, R, Furneri, G, Cozzolino, P, Mantovani, L, Fornari, C, Madotto, F, Chiodini, V, Cesana, G, MANTOVANI, LORENZO GIOVANNI, FORNARI, CARLA, MADOTTO, FABIANA, and CESANA, GIANCARLO

Published
2013

168. Use of health care administrative databases to estimate the burden of diabetes mellitus: a population-based study

Author

Scalone, L, Mantovani, L, Furneri, G, Ciampichini, R, Cortesi, P, Beck Peccoz, P, Orsi, E, Fornari, C, Madotto, F, Chiodini, V, Cesana, G, SCALONE, LUCIANA, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, CESANA, GIANCARLO, MANTOVANI, LORENZO GIOVANNI, Scalone, L, Mantovani, L, Furneri, G, Ciampichini, R, Cortesi, P, Beck Peccoz, P, Orsi, E, Fornari, C, Madotto, F, Chiodini, V, Cesana, G, SCALONE, LUCIANA, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, CESANA, GIANCARLO, and MANTOVANI, LORENZO GIOVANNI

Published
2013

169. Use of health care administrative databases to estimate the burden of breast cancer.

Author

Ciampichini, R, Furneri, G, Scalone, L, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Mantovani, L, Cesana, G, MANTOVANI, LORENZO GIOVANNI, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, CESANA, GIANCARLO, Ciampichini, R, Furneri, G, Scalone, L, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Mantovani, L, Cesana, G, MANTOVANI, LORENZO GIOVANNI, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, and CESANA, GIANCARLO

Published
2013

170. Use of health care administrative databases to estimate the health care burden of bone or bone marrow metastatic disease in breast cancer patients: a population-based study

Author

Mantovani, L, Scalone, L, Furneri, G, Ciampichini, R, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Cesana, G, MANTOVANI, LORENZO GIOVANNI, SCALONE, LUCIANA, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, CESANA, GIANCARLO, Mantovani, L, Scalone, L, Furneri, G, Ciampichini, R, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Cesana, G, MANTOVANI, LORENZO GIOVANNI, SCALONE, LUCIANA, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, and CESANA, GIANCARLO

Published
2013

171. Resource utilization and costs for patients with inflammatory bowel diseases in italy: a population-based assessment

Author

Madotto, F, Fornari, C, Fiorino, G, Ardizzone, S, Bortoli, A, Caprioli, F, Cestari, R, Conti, S, Cortelezzi, C, Mantovani, L, Massari, A, Meucci, G, Ravelli, P, Vecchi, M, Danese, S, Cesana, G, MADOTTO, FABIANA, FORNARI, CARLA, CONTI, SARA, MANTOVANI, LORENZO GIOVANNI, CESANA, GIANCARLO, Madotto, F, Fornari, C, Fiorino, G, Ardizzone, S, Bortoli, A, Caprioli, F, Cestari, R, Conti, S, Cortelezzi, C, Mantovani, L, Massari, A, Meucci, G, Ravelli, P, Vecchi, M, Danese, S, Cesana, G, MADOTTO, FABIANA, FORNARI, CARLA, CONTI, SARA, MANTOVANI, LORENZO GIOVANNI, and CESANA, GIANCARLO

Published
2013

173. Utilization of disease modifying agents in multiple sclerosis: from an Italian administrative database.

Author

Furneri, G, Scalone, L, Ciampichini, R, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Cesana, G, Mantovani, L, MANTOVANI, LORENZO GIOVANNI, SCALONE, LUCIANA, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, CESANA, GIANCARLO, Furneri, G, Scalone, L, Ciampichini, R, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Cesana, G, Mantovani, L, MANTOVANI, LORENZO GIOVANNI, SCALONE, LUCIANA, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, and CESANA, GIANCARLO

Published
2013

176. Administrative databases as a tool for identifying healthcare demand and costs in an over-one million population

Author

Madotto, F, Riva, M, Fornari, C, Scalone, L, Ciampichini, R, Bonazzi, M, Mantovani, L, Cesana, G, MADOTTO, FABIANA, RIVA, MICHELE AUGUSTO, FORNARI, CARLA, SCALONE, LUCIANA, BONAZZI, MARIA CHIARA, MANTOVANI, LORENZO GIOVANNI, CESANA, GIANCARLO, Madotto, F, Riva, M, Fornari, C, Scalone, L, Ciampichini, R, Bonazzi, M, Mantovani, L, Cesana, G, MADOTTO, FABIANA, RIVA, MICHELE AUGUSTO, FORNARI, CARLA, SCALONE, LUCIANA, BONAZZI, MARIA CHIARA, MANTOVANI, LORENZO GIOVANNI, and CESANA, GIANCARLO

Abstract

Background: the aim of this study was to assess healthcare demand of specific groups of population and their costs borne by Italian Health System, using healthcare administrative databases. Methods: demographic, clinical and economic data were obtained from datasets available at the Regional Health System, combined into a data warehouse (DENALI), using a probabilistic record linkage to optimize the data matching process. The study population consisted of more than 1 million people registered in 2005 at one Local Healthcare Unit of Lombardy. Eight different segments were identified. Costs occurring in 2005 for hospital admissions, drug prescriptions, outpatient medical specialist visits were quantified in each segment. Results: healthy people accounted for 53% of the population and cost € 180 per-capita. Subjects with only one chronic disease made up 16% of the population and cost € 916 per-capita, those affected by several chronic diseases accounted for 13% and cost € 3 457 per-capita. Hospitalizations were the cost driver in five segments, ranging from 42% to 89% of total expenditures. Outpatient visits were the cost driver among healthy subjects (54%) and those with a possible chronic disease (42%), while drug costs ranged between 4% ("acute event") and 32% ("one chronic disease"). Overall, healthcare cost was € 809 per-capita. ConclusionS: healthcare costs were mainly determined by people affected by chronic conditions, even if "healthy people" ranked third for total expenditure. These costs need an appropriate identification of healthcare demand, that could be efficiently monitored through the use of administrative databases.

Published
2013

179. Utilization of disease modifying agents in multiple sclerosis: analysis from an Italian administrative database.

Author

Furneri, G, Scalone, L, Ciampichini, R, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Cesana, G, Mantovani, L, Furneri G, Scalone L, Ciampichini R, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, Chiodini V, CESANA, GIANCARLO, MANTOVANI, LORENZO GIOVANNI, Furneri, G, Scalone, L, Ciampichini, R, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Cesana, G, Mantovani, L, Furneri G, Scalone L, Ciampichini R, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, Chiodini V, CESANA, GIANCARLO, and MANTOVANI, LORENZO GIOVANNI

Published
2012

180. Metodi statistici per la valutazione di costo-efficacia in HTA

Author

Fornari, C, VALSECCHI, MARIA GRAZIA, FORNARI, CARLA, Fornari, C, VALSECCHI, MARIA GRAZIA, and FORNARI, CARLA

Abstract

Health technology assessment (HTA) is a potential multidisciplinary tool for decision-making in healthcare policy. Scientific evidences for HTA processes usually come from randomized clinical trials (RCTs), which are the gold standard, but observational studies can be used to overcome study design limitations of RCTs. Nowadays, the use of healthcare administrative databases (HADs) in HTA is not widespread, despite their apparent utility. The objective of this work was to use HADs to conduct a cost-effectiveness evaluation of a pharmacological therapy under real world adherence to treatment. We analyzed the case of statin therapy in the secondary prevention of acute myocardial infarction (AMI). Data were derived from HADs of the healthcare authority of Lombardy, a region in Northern Italy. Patients hospitalized for a first event of AMI in the year 2003 were followed until the 31st December 2008, collecting data on healthcare services and vital status. We used regression methods to estimate the incremental net benefit of treatment or of adherence levels to treatment. HADs provide a rich source of information but the analysis must account for the correlation between repeated measures of the same subject, possible selection bias and endogeneity of the data. In this situation classical regression methods are not appropriate, so we applied marginal structural models (MSMs) to the health economics framework. The cost-effectiveness analysis of statin treatment in the secondary prevention of AMI confirms that statins are cost-effective while the analysis of adherence to treatment needs further assessments. The implementation of MSMs could be a future tool in economic healthcare evaluations, because MSMs make possible to account for time-varying confounding and selection bias typical of longitudinal observational studies. In this way the use of data from HADs or from observational studies could become more reliable.

Published
2012

181. The effect of revascularization procedures on myocardial infarction incidence rates and time trends: The MONICA-Brianza and CAMUNI MI registries in Northern Italy

Author

Veronesi, G, Ferrario, M, Chambless, L, Borsani, A, Fornari, C, Cesana, G, VERONESI, GIOVANNI, FORNARI, CARLA, CESANA, GIANCARLO, Veronesi, G, Ferrario, M, Chambless, L, Borsani, A, Fornari, C, Cesana, G, VERONESI, GIOVANNI, FORNARI, CARLA, and CESANA, GIANCARLO

Abstract

Purpose: Clinical guidelines recommend early reperfusion treatment in myocardial infarction (MI) patients to reduce the cardiac damage. Epidemiologic definitions of MI are often based on the evolution of the cardiac lesion. We aim to study the effect of treatment on the estimates of rates and 20-year time trends of MI. Methods: A Multinational Monitoring of trends and determinants in Cardiovascular disease (MONICA) register was active between 1985 and 2004 to survey 35- to 64-year-old residents in Brianza, Northern Italy. To the well-established MONICA definite MI, we added the MONICA possible nonfatal MI receiving either myocardial revascularization or thrombolysis within 24 hours from onset. The average annual relative changes in incidence rate and 28-day case fatality percentage were estimated from log-linear models. Results: In our population, characterized by a monotonic decrease in coronary heart disease (CHD) mortality rates, the incident rate for the standard MONICA definite MI decreased yearly by 3% in both gender groups. The addition of selected revascularizations halved the downward trends in incidence rate in men and women; conversely, the decline in 28-day case fatality became steeper. Conclusions: From an epidemiologic perspective, the increasing proportion of acute events efficaciously treated with revascularization therapy affects the estimate and the interpretation of time trends in MI incidence and CHD mortality.

Published
2012

182. Drug Safety Signals Detected Using Electronic Health Records and Spontaneous Reporting Systems Data: The Experience of EU-ADR Project

Author

Patadia, V, Schuemie, M, Coloma, P, Gini, R, Herings, R, Mazzaglia, G, Picelli, G, Fornari, C, Pedersen, L, van der Lei, J, Sturkenboom, M, Trifiro, G, FORNARI, CARLA, Trifiro, G., Patadia, V, Schuemie, M, Coloma, P, Gini, R, Herings, R, Mazzaglia, G, Picelli, G, Fornari, C, Pedersen, L, van der Lei, J, Sturkenboom, M, Trifiro, G, FORNARI, CARLA, and Trifiro, G.

Published
2012

183. Implantable cardioverter defibrillator (ICD) in Italy from 2000 to 2008: a population-based analysis using health administrative databases

Author

Madotto, F, Fornari, C, Conti, S, Chiodini, V, Mantovani, L, Cesana, G, MADOTTO, FABIANA, FORNARI, CARLA, CONTI, SARA, MANTOVANI, LORENZO GIOVANNI, CESANA, GIANCARLO, Madotto, F, Fornari, C, Conti, S, Chiodini, V, Mantovani, L, Cesana, G, MADOTTO, FABIANA, FORNARI, CARLA, CONTI, SARA, MANTOVANI, LORENZO GIOVANNI, and CESANA, GIANCARLO

Published
2012

184. Particolato atmosferico e salute pubblica: studio dell’impatto sul sistema respiratorio attraverso ricoveri e consumo farmacologico

Author

Conti, S, Madotto, F, Fornari, C, Lafranconi, A, DE VITO, G, Cesana, G, CONTI, SARA, MADOTTO, FABIANA, FORNARI, CARLA, LAFRANCONI, ALESSANDRA, DE VITO, GIOVANNI, CESANA, GIANCARLO, Conti, S, Madotto, F, Fornari, C, Lafranconi, A, DE VITO, G, Cesana, G, CONTI, SARA, MADOTTO, FABIANA, FORNARI, CARLA, LAFRANCONI, ALESSANDRA, DE VITO, GIOVANNI, and CESANA, GIANCARLO

Published
2012

185. Use of health care administrative databases to estimate incidence of foot complications in diabetes patients

Author

Scalone, L, Furneri, G, Ciampichini, R, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Mantovani, L, Cesana, G, SCALONE, LUCIANA, Furneri G, Ciampichini R, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, Chiodini V, MANTOVANI, LORENZO GIOVANNI, CESANA, GIANCARLO, Scalone, L, Furneri, G, Ciampichini, R, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Mantovani, L, Cesana, G, SCALONE, LUCIANA, Furneri G, Ciampichini R, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, Chiodini V, MANTOVANI, LORENZO GIOVANNI, and CESANA, GIANCARLO

Published
2012

187. Use of health care administrative databases to estimate the health care burden of bone or bone marrow metastatic disease in breast cancer patients: a population-based study.

Author

Mantovani, L, Scalone, L, Furneri, G, Ciampichini, R, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Cesana, G, MANTOVANI, LORENZO GIOVANNI, SCALONE, LUCIANA, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, CESANA, GIANCARLO, Mantovani, L, Scalone, L, Furneri, G, Ciampichini, R, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Cesana, G, MANTOVANI, LORENZO GIOVANNI, SCALONE, LUCIANA, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, and CESANA, GIANCARLO

Published
2012

188. Implantable Cardioverter Defibrillator in Italy from 2000 to 2008: a population-based analysis using health administrative databases.

Author

Madotto, F, Fornari, C, Conti, S, Borghetti, F, Mantovani, L, Cesana, G, MADOTTO, FABIANA, FORNARI, CARLA, CONTI, SARA, Borghetti F, MANTOVANI, LORENZO GIOVANNI, CESANA, GIANCARLO, Madotto, F, Fornari, C, Conti, S, Borghetti, F, Mantovani, L, Cesana, G, MADOTTO, FABIANA, FORNARI, CARLA, CONTI, SARA, Borghetti F, MANTOVANI, LORENZO GIOVANNI, and CESANA, GIANCARLO

Published
2012

189. Use of health care administrative databases to estimate the burden of multiple sclerosis: a population-based study

Author

Furneri, G, Ciampichini, R, Scalone, L, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Mantovani, L, Cesana, G, Furneri G, Ciampichini R, SCALONE, LUCIANA, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, Chiodini V, MANTOVANI, LORENZO GIOVANNI, CESANA, GIANCARLO, Furneri, G, Ciampichini, R, Scalone, L, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Mantovani, L, Cesana, G, Furneri G, Ciampichini R, SCALONE, LUCIANA, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, Chiodini V, MANTOVANI, LORENZO GIOVANNI, and CESANA, GIANCARLO

Published
2012

190. Use of health care administrative databases to estimate the burden of breast cancer.

Author

Ciampichini, R, Furneri, G, Scalone, L, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Mantovani, L, Cesana, G, Ciampichini R, Furneri G, SCALONE, LUCIANA, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, Chiodini V, MANTOVANI, LORENZO GIOVANNI, CESANA, GIANCARLO, Ciampichini, R, Furneri, G, Scalone, L, Cortesi, P, Fornari, C, Madotto, F, Chiodini, V, Mantovani, L, Cesana, G, Ciampichini R, Furneri G, SCALONE, LUCIANA, CORTESI, PAOLO ANGELO, FORNARI, CARLA, MADOTTO, FABIANA, Chiodini V, MANTOVANI, LORENZO GIOVANNI, and CESANA, GIANCARLO

Published
2012

191. Amplitude Spectrum Area-Based Defibrillation Decision During Prehospital Cardiopulmonary Resuscitation in Lombardia, Italy

Author

Ristagno, G, Fornari, C, Li, Y, Fumagalli, F, Finzi, A, Mauri, T, Rossi, G, Latini, R, Cesana, G, Pesenti, A, AREU Research, G, Ristagno G, Li Y, Fumagalli F, Finzi A, Rossi G, Latini R, AREU Research Group, FORNARI, CARLA, MAURI, TOMMASO, CESANA, GIANCARLO, PESENTI, ANTONIO MARIA, Ristagno, G, Fornari, C, Li, Y, Fumagalli, F, Finzi, A, Mauri, T, Rossi, G, Latini, R, Cesana, G, Pesenti, A, AREU Research, G, Ristagno G, Li Y, Fumagalli F, Finzi A, Rossi G, Latini R, AREU Research Group, FORNARI, CARLA, MAURI, TOMMASO, CESANA, GIANCARLO, and PESENTI, ANTONIO MARIA

Published
2012

192. Use of healthcare administrative databases to estimate the burden of diabaetes mellitus: a population-based study

Author

Scalone, L, Mantovani, L, Furneri, G, Ciampichini, R, Cortesi, P, Beck Peccoz, P, Orsi, E, Fornari, C, Madotto, F, Chiodini, V, Cesana, G, SCALONE, LUCIANA, MANTOVANI, LORENZO GIOVANNI, Furneri G, Ciampichini R, CORTESI, PAOLO ANGELO, Beck Peccoz P, Orsi E, FORNARI, CARLA, MADOTTO, FABIANA, Chiodini V, CESANA, GIANCARLO, Scalone, L, Mantovani, L, Furneri, G, Ciampichini, R, Cortesi, P, Beck Peccoz, P, Orsi, E, Fornari, C, Madotto, F, Chiodini, V, Cesana, G, SCALONE, LUCIANA, MANTOVANI, LORENZO GIOVANNI, Furneri G, Ciampichini R, CORTESI, PAOLO ANGELO, Beck Peccoz P, Orsi E, FORNARI, CARLA, MADOTTO, FABIANA, Chiodini V, and CESANA, GIANCARLO

Published
2012

193. Defibrillatori impiantabili in Lombardia: aspetti clinici ed economici.

Author

Madotto, F, Fornari, C, Conti, S, Borghetti, F, Cesana, G, MADOTTO, FABIANA, FORNARI, CARLA, CONTI, SARA, CESANA, GIANCARLO, Borghetti F, Madotto, F, Fornari, C, Conti, S, Borghetti, F, Cesana, G, MADOTTO, FABIANA, FORNARI, CARLA, CONTI, SARA, CESANA, GIANCARLO, and Borghetti F

Published
2012

194. Il burden delle polmoniti: analisi dai database amministrativi (DENALI) della regione Lombardia.

Author

Mantovani, L, Cesana, G, Fornari, C, Scalone, L, Furneri, G, Ciampichini, R, Cortesi, P, MANTOVANI, LORENZO GIOVANNI, Furneri G, Ciampichini R, CESANA, GIANCARLO, FORNARI, CARLA, SCALONE, LUCIANA, CORTESI, PAOLO ANGELO, Mantovani, L, Cesana, G, Fornari, C, Scalone, L, Furneri, G, Ciampichini, R, Cortesi, P, MANTOVANI, LORENZO GIOVANNI, Furneri G, Ciampichini R, CESANA, GIANCARLO, FORNARI, CARLA, SCALONE, LUCIANA, and CORTESI, PAOLO ANGELO

Published
2012

195. Marginal structural models used in estimating cost-effectiveness of time-varying drug therapy using administrative databases. the case of statin in secondary prevention.

Author

Fornari, C, Valsecchi, M, Galimberti, S, Madotto, F, Conti, S, Mantovani, L, Cesana, G, FORNARI, CARLA, VALSECCHI, MARIA GRAZIA, GALIMBERTI, STEFANIA, MADOTTO, FABIANA, CONTI, SARA, MANTOVANI, LORENZO GIOVANNI, CESANA, GIANCARLO, Fornari, C, Valsecchi, M, Galimberti, S, Madotto, F, Conti, S, Mantovani, L, Cesana, G, FORNARI, CARLA, VALSECCHI, MARIA GRAZIA, GALIMBERTI, STEFANIA, MADOTTO, FABIANA, CONTI, SARA, MANTOVANI, LORENZO GIOVANNI, and CESANA, GIANCARLO

Published
2012

196. Copertura vaccinale anti-epatite B e dose di rinforzo: risultati di uno studio su una popolazione universitaria

Author

Riva, M, Madotto, F, Conti, S, Fornari, C, Patronella, G, Sormani, M, D'Orso, M, DE VITO, G, Latocca, R, Cesana, G, RIVA, MICHELE AUGUSTO, MADOTTO, FABIANA, CONTI, SARA, FORNARI, CARLA, D'ORSO, MARCO ITALO, DE VITO, GIOVANNI, CESANA, GIANCARLO, Riva, M, Madotto, F, Conti, S, Fornari, C, Patronella, G, Sormani, M, D'Orso, M, DE VITO, G, Latocca, R, Cesana, G, RIVA, MICHELE AUGUSTO, MADOTTO, FABIANA, CONTI, SARA, FORNARI, CARLA, D'ORSO, MARCO ITALO, DE VITO, GIOVANNI, and CESANA, GIANCARLO

Abstract

This study assessed the immunisation status against hepatitis B in healthcare students and residents, before their hospital internship, as suggested by the "National Immunization Prevention Plan 2012-2014". The concentration of antibodies against hepatitis B was measured in 2,491 subjects (70.90% women), born between 1980 and 1993 and visited between January Ist 2000 and July 15th 2012. Personal and serologic data were collected for each subjects. Individuals with antibody less than 10 mlU/mL (327,13.3%) were given a booster dose and re-tested 2 months later. The multivariate logistic regression evidenced that immunization is influenced by the gender, the age at first vaccination, the time elapsed between first vaccination and antibody measurement. This study confirms the importance of measuring the concentration of antibodies against hepatitis B among healthcare students, even if they have previously been vaccinated, according to the "National Immunization Prevention Plan 2012-2014". © PI-ME, Pavia 2012.

Published
2012

197. Recent time trends in the incidence and case-fatality of coronary heart disease: the contribution of interrupted-MIs in men and women 35-74 years old

Author

Ferrario, M, Veronesi, G, Chambless, L, Borsani, A, Conti, S, Fornari, C, Cesana, G, Ferrario, MM, Chambless, LE, VERONESI, GIOVANNI, CONTI, SARA, FORNARI, CARLA, CESANA, GIANCARLO, Ferrario, M, Veronesi, G, Chambless, L, Borsani, A, Conti, S, Fornari, C, Cesana, G, Ferrario, MM, Chambless, LE, VERONESI, GIOVANNI, CONTI, SARA, FORNARI, CARLA, and CESANA, GIANCARLO

Abstract

Purpose. In the last decade, new prevention strategies and improvements in treatments have contributed to improve survival from myocardial infarction (MI). Thrombolysis first and PTCA in more recent years not only modified the prognosis but also the evolution of the ischemic damage. Clinicians report the so called non-Q-, aborted- or interrupted-MIs more and more frequently. The aim of this study is to assess the contribution of interrupted-MIs on the estimates rates and time trends of coronary heart disease (CHD). Methods. Between 1997 and 2004, the CAMUNI (CArdiovascular Monitoring Unit in Northern Italy) register was established in a northern Italian population, Brianza, for 35-74 years old residents of both genders. Suspected fatal or non-fatal coronary events were identified and validated according to the standardized WHO-MONICA procedures and criteria. In addition to the standard MONICA definition of MI (validated CHD death and definite MI), a new category is introduced including interrupted MIs, defined as a non-fatal MONICA possible MI that received either thrombolytic therapy or PTCA within 24 hours of symptoms onset. We calculated the age-standardized rates for the first MI, fatal and non-fatal, and case-fatality. The average annual change (AAC) and 95% confidence interval (CI) of rates were estimated using gender-specific log-linear models. Results. Validated CHD death rates decreased in the investigated period by -6.9% and -4.6% per year in men and women, respectively. The average incidence MI rates were 218.8 and 59.4 per 100,000 person-year in men and women, and decreased in both genders (AAC: -8.2%, 95%CI -9.2,-7.3 in men; and -5.1%, -7.2,-3.1 in women). When interrupted-MIs were included, the AAC for MI incidence fell to -3.8% in men and -1.5% in women, remaining statistically significant among men only. The AAC in case fatality was +1.5% and +0.2% in men and women, respectively, for MONICA-validated MIs, while it was -2.8% and -3.3% when interrupted

Published
2011

198. Case-only analysis of interaction between pre-hospitalization respiratory treatments and pm10 exposure. Results from administrative databases

Author

DE VITO, G, Conti, S, Lafranconi, A, Schwartz, J, Zanobetti, A, Fornari, C, Madotto, F, Cesana, G, DE VITO, GIOVANNI, CONTI, SARA, LAFRANCONI, ALESSANDRA, FORNARI, CARLA, MADOTTO, FABIANA, CESANA, GIANCARLO, DE VITO, G, Conti, S, Lafranconi, A, Schwartz, J, Zanobetti, A, Fornari, C, Madotto, F, Cesana, G, DE VITO, GIOVANNI, CONTI, SARA, LAFRANCONI, ALESSANDRA, FORNARI, CARLA, MADOTTO, FABIANA, and CESANA, GIANCARLO

Published
2011

199. Do statins mitigate the effects of pm10? a case-only analysis on hospital admissions from regional government administrative databases

Author

Conti, S, DE VITO, G, Lafranconi, A, Schwartz, J, Zanobetti, A, Fornari, C, Madotto, F, Cesana, G, CONTI, SARA, DE VITO, GIOVANNI, LAFRANCONI, ALESSANDRA, FORNARI, CARLA, MADOTTO, FABIANA, CESANA, GIANCARLO, Conti, S, DE VITO, G, Lafranconi, A, Schwartz, J, Zanobetti, A, Fornari, C, Madotto, F, Cesana, G, CONTI, SARA, DE VITO, GIOVANNI, LAFRANCONI, ALESSANDRA, FORNARI, CARLA, MADOTTO, FABIANA, and CESANA, GIANCARLO

Published
2011

200. The contribution of major risk factors and job strain to occupational class differences in coronary heart disease incidence: the MONICA Brianza and PAMELA population-based cohorts

Author

Ferrario, M, Veronesi, G, Chambless, L, Sega, R, Fornari, C, Bonzini, M, Cesana, G, VERONESI, GIOVANNI, SEGA, ROBERTO, FORNARI, CARLA, CESANA, GIANCARLO, Ferrario, M, Veronesi, G, Chambless, L, Sega, R, Fornari, C, Bonzini, M, Cesana, G, VERONESI, GIOVANNI, SEGA, ROBERTO, FORNARI, CARLA, and CESANA, GIANCARLO

Abstract

Objectives: We investigated the contribution of major coronary heart disease (CHD) risk factors and job strain to occupational class differences in CHD incidence in a pooled-cohort prospective study in northern Italy. Methods: 2964 men aged 25-74 from four northern Italian population-based cohorts were investigated at baseline and followed for first fatal or non-fatal CHD event (171 events). Standardised procedures were used for baseline risk factor measurements, follow-up and validation of CHD events. Four occupational classes were derived from the Erikson-Goldthorpe-Portocarero social class scheme: higher and lower professionals and administrators, non-manual workers, skilled and unskilled manual workers, and the self-employed. HRs were estimated with Cox models. Results: Among CHD-free subjects, with non-manual workers as the reference group, age-adjusted excess risks were found for professionals and administrators (+84%, p=0.02), the self-employed (+72%, p=0.04) and manual workers (+63%, p=0.04). The relationship was consistent across different CHD diagnostic categories. Adjusting for major risk factors only slightly reduced the reported excess risks. In a sub-sample of currently employed subjects, adjusting for major risk factors, sport physical activity and job strain reduced the excess risk for manual workers (relative change=-71.4%) but did not substantially modify the excess risks of professionals and administrators and the self-employed. Conclusions: In our study, we found higher CHD incidence rates for manual workers, professionals and administrators, and the self-employed, compared to non-manual workers. When the entire spectrum of job categories is considered, the job strain model helped explain the CHD excess risk for manual workers but not for other occupational classes.

Published
2011

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