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Explorer les trajectoires de patients via les bases médico-économiques : application à l'infarctus du myocarde

Abstract : With approximately 120,000 people affected each year, 12,000 deaths from the first crisis and 18,000 deaths after one year, myocardial infarction is a major public health issue. This pathology requires hospitalization and management in an intensive care cardiology unit. We study this pathology using the French national Prospective Paiement System (PPS) databases.The collection of national hospital data within the framework of the PPS generates about 25 million records per year.These data, which are initially collected for medico-economic purposes, contain information that may have other purposes: improving patient care, predicting the evolution of care, planning their costs, etc.Another emerging issue is that of providing tools for exploring patients' hospital trajectories using data from the PPS. Through several objectives, this thesis aims to suggest tools combining methods from three disciplines: medical computing, data mining and biostatistics.We make four contributions.The first contribution concerns the constitution of a quality database to analyze patient trajectories. The second contribution is a semi-automatic method for the systematic review of the literature. This part of the work delineates the contours of the trajectory concept in the biomedical field. The third contribution is the identification of care trajectories in the prediction of intra-hospital death. Our research strategy is divided into two phases: 1) Identification of typical patient trajectories using data mining tools; 2) Construction of a prediction model from these trajectories to predict death. Finally, the last contribution is the characterization of patient flows through the various hospital events, also considering of delays and costs. In this contribution, we propose a combined-data mining and a longitudinal data clustering technique.
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Submitted on : Wednesday, October 24, 2018 - 1:32:07 PM
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  • HAL Id : tel-01903477, version 1

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Jessica Pinaire. Explorer les trajectoires de patients via les bases médico-économiques : application à l'infarctus du myocarde. Médecine humaine et pathologie. Université Montpellier, 2017. Français. ⟨NNT : 2017MONTS020⟩. ⟨tel-01903477⟩

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