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<title><string language="fre"><![CDATA[Social inequalities impacts of care management and survival in patients with non-hodgkin lymphomas]]></string></title>
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<string language="fre"><![CDATA[Epidemiology
and public health
 
The principal aim of this
thesis will describe the care pathway of diffuse large B cell lymphoma (DBCL)
and follicular lymphoma (FL) in the general population and identify the factors
predicting the place of care and survival in a population based cohort of non
Hodgkin lymphoma (NHL) patients from three counties in France between 2002 and
2008. The specific aims will 1/ identify the socioeconomic
and medical factors predicting the place of care (teaching vs. non teaching
hospitals) and 5 years survival, 2/ identify the socioeconomic and
medical factors predicting longest delays of care and to study the
influence of longest delays on survival 3/ analyse all these
factors on a frailty population defined by a high age and/or other criteria of
vulnerability (such as comorbidity).
To answer these questions, the followings methods are proposed: 
 
1/ case registration of all identified NHL (DLBCL and FL) by three
haematological malignancies registries in France (Côte d’Or, Basse Normandie
and Gironde). 1977 patients are included. Individual medical data (e.g. patient
characteristics, management and treatment) from NHL incident cases diagnosed
between 2002 and 2008 was stored in a standardized database. 2/ we collected
and geocoded the patient’s place of residence at diagnosis. Each patient was
affected to an IRIS (smallest area allowing for aggregate statistics) using a
geographical information system. 3/ we applied successively Townsend
deprivation index and then the new French deprivation index available in 2012
in univariate and multivariate analyses. 4/ we used adjusted multilevel
logistic regression models to take into account the existence of aggregate
data. The overall survival probability at 1, 3 and 5 years were estimated by
the Kaplan Meier method and then Cox regression model for multivariate
analysis. Net survival (Pohar Perme) and Relative survival (Esteve’s method)
was also being performed. Finally, to palliate to a non-negligible proportion of missing values on important prognostic
factors, we used Multiple imputation by Chained Equation (MICE) method.  
We will present results of analysis of the
influence of socio-geographical, medical determinants and treatment provider on
relative survival of DBCL patients. 
Cette présentation a été donnée dans le cadre du BRIO SIRIC
scientific day 3 organisé annuellement par le SIRIC BRIO et qui a pour but de
réunir tous les acteurs du SIRIC BRIO et plus largement de la cancérologie à
Bordeaux.]]></string></description>
<keyword><string language="fre"><![CDATA[cancer]]></string></keyword><keyword><string language="fre"><![CDATA[Oncologie]]></string></keyword><keyword><string language="fre"><![CDATA[Thérapie]]></string></keyword><keyword><string language="fre"><![CDATA[Recherche]]></string></keyword>
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NOTE:Institut Bergonié, Bordeaux 
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<date><dateTime>2015-11-10</dateTime></date>
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