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Étude de l'accès à la transplantation rénale en Lorraine par méthodes biostatistiques conventionnelles et par fouille de données

Abstract : Among renal replacement therapy techniques, transplantation is associated with longer survival and lower long-term cost. We studied access to renal transplantation in NEPHROLOR network of care in the French administrative region Lorraine. All incident patients beginning renal replacement therapy in NEPHROLOR between July 1, 1997 and June 30, 2003 (1725 patients) were included in the study. In Lorraine, access to renal transplant waiting list and to transplantation after registration on the list was primarily associated with medical determinants. Nevertheless, patients followed up in the nephrology department performing transplantation were more likely to be placed on the waiting list. After taking into account comorbidities, transplantation was associated with longer survival even among elderly patients (> 60 years). Moreover, patients' survival was associated with medical determinants of access to renal transplant waiting list. These facts validate the current care process of registration on the waiting list in Lorraine. However, access to the waiting list in the NEPHROLOR network can be improved by encouraging nephrology facilities without transplantation to extend the selection criteria of transplant candidates. Data mining algorithms can represent the probability of being registered on the list based on the patient's characteristics. Using such an algorithm at the first registration of patient in NEPHROLOR information system could optimize the renal transplant registration process and improve access to renal transplantation in NEPHROLOR.
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https://hal.univ-lorraine.fr/tel-01777278
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S. Bayat-Makoei. Étude de l'accès à la transplantation rénale en Lorraine par méthodes biostatistiques conventionnelles et par fouille de données. Médecine humaine et pathologie. Université Henri Poincaré - Nancy 1, 2008. Français. ⟨NNT : 2008NAN10049⟩. ⟨tel-01777278⟩

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