La recherche au service de la performance en Santé
U.INSERM 1290 - La recherche au service de la performance en Santé
Université Claude Bernard Lyon 1
U.INSERM 1290 - La recherche au service de la performance en Santé

Actualités du laboratoire Hesper

Correction to: Beyond the map: evidencing the spatial dimension of health inequalities

Yohan Fayet, Delphine Praud, Béatrice Fervers, Isabelle Ray-Coquard, Jean-Yves Blay, Françoise Ducimetiere, Guy Fagherazzi & Elodie Faure


Spatial inequalities in health result from different exposures to health risk factors according to the features of geographical contexts, in terms of physical environment, social deprivation, and health care accessibility. Using a common geographical referential, which combines indices measuring these contextual features, could improve the comparability of studies and the understanding of the spatial dimension of health inequalities.


We developed the Geographical Classification for Health studies (GeoClasH) to distinguish French municipalities according to their ability to influence health outcomes. Ten contextual scores measuring physical and social environment as well as spatial accessibility of health care have been computed and combined to classify French municipalities through a K-means clustering. Age-standardized mortality rates according to the clusters of this classification have been calculated to assess its effectiveness.


Significant lower mortality rates compared to the mainland France population were found in the Wealthy Metropolitan Areas (SMR = 0.868, 95% CI 0.863–0.873) and in the Residential Outskirts (SMR = 0.971, 95% CI 0.964–0.978), while significant excess mortality were found for Precarious Population Districts (SMR = 1.037, 95% CI 1.035–1.039), Agricultural and Industrial Plains (SMR = 1.066, 95% CI 1.063–1.070) and Rural Margins (SMR = 1.042, 95% CI 1.037–1.047). 

Using the Brief Health Literacy Screen in Chronic Care in French Hospital Settings: Content Validity of Patient and Healthcare Professional Reports

Adèle Perrin, Luiza Siqueira do Prado, Amélie Duché, Anne-Marie Schott, Alexandra L. Dima and Julie Haesebaert.


Objectives: Assess the content validity of the French translation of both the patient-reported and healthcare professionals (HCP)-reported Brief Health Literacy Screen (BHLS) in chronic care within hospital settings.

Design: Qualitative analysis on interview data using the survey response Tourangeau model through cognitive interviews with patients and HCPs.

Participants: Patients with an appointment in the outpatient clinic of the participating hospital for the respiratory follow-up of a chronic disease. Physicians, nurses, and assistant nurses working in a hospital facility in chronic care.

Setting: A respiratory diseases department at the university hospital Hospices Civils de Lyon (HCL), the departments of cardiology and psychiatry of the HCL and diabetology of the Centre Hospitalier Universitaire Grenoble-Alpes (CHUGA).


Prevalence of low health literacy levels in decompensated heart failure compared with acute myocardial infarction patients.

Adèle Perrin, Gergis Abdalla, Marie Viprey, François Delahaye, Nathan Mewton, Michel Ovize, Laurent Sebbag, Thomas Bochaton, Alexandra L. Dima, Estelle Bravant, Anne-Marie Schott, Julie Haesebaert.


Objectives: Estimate the prevalence of low HL level patients hospitalized for acute myocardial infarction (AMI) or acute decompensated heart failure (ADHF) and explore low HL determinants.

Design: A prospective cross-sectional study was performed and 208 participants were included.

Participants: Patients with ADHF and AMI. Proportion of low HL was 36% overall; 51% in ADHF patients and 21% in AMI patients.

Setting: Three units in a French cardiology teaching hospital: a cardiology intensive care unit and two conventional cardiology units.


High-dimensional propensity scores improved the control of indication bias in surgical comparative effectiveness studies

Payet C, Polazzi S, Obadia JF, Armoiry X, Labarère J, Rabilloud M, Duclos A. High-dimensional propensity scores improved the control of indication bias in surgical comparative effectiveness studies. J Clin Epidemiol. 2020 Oct 14;130:78-86. doi: 10.1016/j.jclinepi.2020.10.003. PMID: 33065165.
Key findings: High-dimensional propensity score (hdPS) estimations were more consistent with results seen in randomized controlled trials than propensity score (PS) estimations.
What this study adds: This study evaluate the performance of hdPSs for controlling indication bias in surgical comparative effectiveness studies.
What is the implication: The hdPS approach could be used in future comparative effectiveness studies in surgery using nationwide hospital databases