General practice and surveillance: the example of influenza in France
General practice and surveillance: the example of influenza in France
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DOI：
10.1016/j.medmal.2005.02.012
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发表时间：
2005-05-01
影响因子：
5
通讯作者：
Van Der Werf, S
中科院分区：
文献类型：
--
作者：
Cohen, JM;Mosnier, A;Van Der Werf, S
自1984年以来，流感监测区域小组国家网络的数据登记有助于查明方法问题。哨兵的选择和指标的选择取决于对实际流感后果的分析。可能涉及各种哨兵：健康保险公司，私营公司，学校，医生，药剂师。卫生保健组织修正了指标的有效性。例如，在法国，1995年以前，家访是一个很好的预警指标，但这一指标已不再像以前那样有效。流感病毒学检测取决于运输组织（样本、结果）。病例定义的预测价值取决于感染的发生率。在特异性和敏感性之间的选择程度改变了对爆发的看法。哨点参与率影响样本的代表性。该比率离100%越远，结果有效性降低越多（与患者失访损害临床试验结果的有效性相同）。结果的公布可以改变卫生费用和行为。- GROG网络强调全科医生在健康监测中的重要作用;它还提出了数学、统计、专业组织、培训、教育和政治领域的问题。(c)2005年由Elsevier SAS出版。
Data registration by the GROG national network (Regional Group for the Surveillance of Influenza) since 1984 has helped to identify methodological problems. The choice of sentinels and the selection of indicators depend on the analysis of actual influenza consequences. Various sentinels may be concerned: Health Insurance Companies, Private Companies, Schools, Physicians, Pharmacists. Health care organization modifies the validity of indicators. In France, for instance, home visits were an excellent indicator for early warning before 1995 but this indicator is no longer as efficient as before. The virological detection of Influenza depends on the organization of transportation (samples, results). The predictive value of cases definitions depends on the incidence of infection. The level of choice between specificity and sensibility modifies the perception of outbreaks. Sentinel participation rate influences the sample representativity. The farther this rate is from 100%, the more result validity decreases (in the same way that patients lost to follow-up compromise the validity of results in clinical trials). The publication of results can modify health expenses and behaviors.Conclusion. - The GROG network stresses the important role that general practitioners play in health surveillance; it also raises questions in the field of mathematics, statistics, professional organization, training, education, and politics. (c) 2005 Publie par Elsevier SAS.