algorithms detecting deviant health care use in French Health Insurance databases

11 Nov

French health insurance for salaried executes algorithms on its databases with a public health purpose. The following published articles aim to target potential deviant behaviours or abuses that put at risk the health of the insured.

Patterns of methylphenidate use and assessment of its abuse and diversion in two French administrative areas using a proxy of deviant behaviour determined from a reimbursement database: main trends from 2005 to 2008.

Frauger E, Pauly V, Natali F, Pradel V, Reggio P, Coudert H, Thirion X, Micallef J.

CNS Drugs. 2011 May;25(5):415-24. doi: 10.2165/11587640-000000000-00000.

Select item 206927782.

Which indicators can public health authorities use to monitor prescription drug abuse and evaluate the impact of regulatory measures? Controlling High Dosage Buprenorphine abuse.

Pauly V, Frauger E, Pradel V, Rouby F, Berbis J, Natali F, Reggio P, Coudert H, Micallef J, Thirion X.

Drug Alcohol Depend. 2011 Jan 1;113(1):29-36. doi: 10.1016/j.drugalcdep.2010.06.016. Epub 2010 Aug 8.

Select item 198204053.

Estimation of clonazepam abuse liability: a new method using a reimbursed drug database.

Frauger E, Pauly V, Thirion X, Natali F, Pradel V, Reggio P, Rouby F, Coudert H, Micallef J.

Int Clin Psychopharmacol. 2009 Nov;24(6):318-24. doi: 10.1097/YIC.0b013e328330ae4b.


Assessment of abuse potential of benzodiazepines from a prescription database using ‘doctor shopping’ as an indicator.

Pradel V, Delga C, Rouby F, Micallef J, Lapeyre-Mestre M.

CNS Drugs. 2010 Jul;24(7):611-20. doi: 10.2165/11531570-000000000-00000.


Nervous Nellie

29 Aug

Originally posted on godlessnurse:

Confession time.

Leaving the bedside as a nurse for a management job was quite possibly one of the worst things I have ever done.

Now that I have returned to the bedside, I feel nervous, anxious, worried, and doubtful. And it sucks. Big time. Things as simple as an IV push medication have become anxiety-provoking. I am afraid I’ll forget something, forget everything, forget to chart a detail, forget to draw a lab, forget my brain at home.

Yes, it’s true. I have forgotten how it feels to be a confident floor nurse.


I have bit my tongue for quite some time about my stint in management, but when I look back upon that brief experience, I don’t have much to feel good about. I felt awful going to work almost every single shift. I never once felt that I was making a difference.

I felt like I was checking boxes.

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Libel or alert ?

1 Jul


I have received in my mailbox the message below. The CEO of a French public

hospital would sue one of his Doctor for libel against his institution.

The point is that both the Doctor And the hospital CEO have the same

ultimate goal: to protect the Public Health Service.

They should, in my opinion , try to find a common ground. Filing a lawsuit

or attacking a public hospital in the media are not part of the solution but instead

are parts of the problem.


Below the message tha I have received:

De : alain braillon [mailto:xxxxxxxxx]
Envoyé : mercredi 24 juin 2015 17:13
À : Christian M
Objet : le Dr Marescaux poursuivi par son hôpital car il se bat pour la qualité des soins!

Chers tous

C’est est un brillant neurologue (voir PUBMED
Il s’inquiète du manque de moyens pour ses malades avec un AVC!
Son hôpital le poursuit en justice!
Ni le conseil de l’ordre des médecins, ni la Haute Autorité de Santé qui doivent pourtant être concernés, ne semblent agir.

Voici un lien avec son histoire dans Rue89

S’il vous plaît aidez : a) faites suivre; b) laissez une réponse en ligne pour montrer votre soutien; c) ou écrivez lui lui à … etc …
Il y a même une pétition
Merci d’avance
Dr Alain Braillon

re-identification attack

20 Jun

Working on databases we should always be aware of the possibility of a re-identification attack on the data we release in our publications. Such possibilities are in fact very rare because we aggregate  all our data in the  articles we submit to publishers. Nevertheless the odds that our data could be re-identified are to be known. Mathematicians have brilliantly addressed the issue in the article referenced below:

Title: A Game Theoretic Framework for Analyzing Re-Identification Risk
Authors: Zhiyu Wan, Yevgeniy Vorobeychik, Weiyi Xia, Ellen Wright Clayton, Murat Kantarcioglu, Ranjit Ganta, Raymond Heatherly, Bradley A. Malin

Link to the article full text

Clearly the balance has to be found between on one hand the fines paid for the consequences of privacy violation and on the other hand the gain for authors and publishers in terms of respectively grants,notoriety,transparency, and audience for releasing accurate data and practicing data sharing which is what research is heading toward.

What style of language do scientists really prefer?

28 May

Originally posted on Stroppy Editor:

“Our readers are intelligent, well-educated scientists. Why should we make our language dumbed-down, patronising and imprecise in the name of ‘readability’?”

It’s a fair question. Here’s the answer.

Never talk down to your readers. But never waste their time, either. And scientists, while intelligent and educated, are also busy. As well as their research, they may have teaching, management or clinical duties to perform, funding applications to write, presentations to plan, journals to keep up to date with… They don’t have time to wade through verbiage in search of facts.

If you’re writing about something complex, then of course you need to give all the necessary detail. If you’re writing for specialists, you can use their specialist terms. But you don’t need to add verbal complexity beyond that. Keep it clear and direct. This makes your writing more efficient and more likely to succeed in communicating your message. It’s also…

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Choosing the Singular They 

28 May

Originally posted on Explorations of Style:

In this post, I want to talk about an issue that has been troubling me for as long as I have been writing this blog. Should I be using the singular they? That is, should I be using they as a gender-neutral pronoun for a grammatically singular antecedent? In general, I have not done so, but trying to fix this sentence from a recent post forced me to revisit that policy:

An established Harvard academic writing a book is doing something very different than a new doctoral student attempting their first article.

My usual way to circumvent this issue has been to use the plural. But that solution—‘doctoral students attempting their first articles’—worked dismally here. Making the whole sentence plural sounded daft, and making only the second half plural upset the comparison. So I left it as it was and made a note to make a more systematic decision later (and…

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where you stand . . . depends on where you sit

17 May

Originally posted on Living with Open Hands:

“Where you stand . . . depends on where you sit . . .” The viewpoints you are most likely to advance (your stance politically, your opinions) are decisively determined by the place you occupy economically, in your career, in your community, in your organization, in society. We must not ever presume to speak for others; especially those outside of our scope, like the poor, the battered and bruised, the broken hearted, the “least of these.” We must ‘live’ there . . . and listen.

Three years ago, I sat in a very different place in life with very different viewpoints.
An entrepreneur, a social entrepreneur at that, making enough money to actually pay the bills.
Two income family.
Home owner.
Living in a middle class neighborhood.
Going to a middle class church in a poor neighborhood. (Made me feel better about church)
Wondering why those people in that poor…

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Ethnography: A Scientist Discovers the Value of the Social Sciences

22 Apr

Originally posted on The Scholarly Kitchen:

Picture from an early ethnographic study Bronislaw Malinowski with natives on Trobriand Islands, ca 1918.

I have always liked to think of myself as a good listener. Whether you are in therapy (or should be), conversing with colleagues, working with customers, embarking on strategic planning, or collaborating on a task, a dose of emotional intelligence – that is, embracing patience and the willingness to listen — is essential.

At the American Mathematical Society, we recently embarked on ambitious strategic planning effort across the organization. On the publishing side we have a number of electronic products, pushing us to consider how we position these products for the next generation of mathematician. We quickly realized that it is easy to be complacent. In our case we have a rich history online, and yet – have we really moved with the times? Does a young mathematician need our products?

We came to a sobering and rather exciting realization: In…

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In NEJM: Protection or Harm? Suppressing Substance-Use Data

16 Apr

This post is jointly authored by Nicholas Bagley and Austin Frakt. Yesterday evening, the New England Journal of Medicine released a Perspective piece that

via In NEJM: Protection or Harm? Suppressing Substance-Use Data.

Are We at a Tipping Point for Open Data?

18 Mar


Data sharing is on the rise, the French public health insurance shares openly its data as you can see in the link below:

Originally posted on The Scholarly Kitchen:

Street sign, park nearby Image via RP Norris

Last month, President Obama showed off his dad-joke skills while announcing the appointment of the first US Chief Data Scientist. The focus of much of the White House’s messaging around this appointment has been on making the government’s own data publicly available. In his ‘memo to the American people’, however, Dr. D.J. Patil talked about acting as a conduit between government, academia and industry. In some ways, this latest move can be seen as a continuation of a US government push toward open data that mirrors efforts in Europe and elsewhere.

For a long time, there has been an expectation that researchers share data upon request with other academics but more recently, the trend has been towards making data widely and publicly available. In February 2013, the White House Office of Science and Technology Policy released a memorandum on Expanding Public Access…

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