ABSTRACT
Background Innovative solutions are used to monitor the spread of COVID-19, to research and develop vaccines, and to ensure online privacy and security. The aim of the study is to investigate which innovative methods, including algorithms and digital tools (e.g., social media, artificial intelligence, contact tracing applications) are used to monitor health issues related to COVID-19 in Europe, and who is using them. Methods A questionnaire was developed and administered online to European countries’ representatives and stakeholders of the project Population Health Information Research Infrastructure (PHIRI). The survey investigated the use of innovative solutions and digital tools in Europe to monitor COVID-19 and vaccination programs, to research and develop diagnostics and teleconsultations, and to fight online disinformation. Legislative and ethical aspects were also considered. A descriptive data analysis was performed. Results 19 responses were collected from 14 countries. Digital tools are used to monitor COVID-19 (13/14 countries), vaccination programs (12/14), for telemedicine (7/14), and to fight disinformation (10/14). Specific algorithms to detect the patterns of the pandemic spread are available in five countries. The main target groups of the tools are the general population, healthcare providers, patients and epidemiologists. The uptake rate of the tools ranged 5-100% across countries. Measures to evaluate the impact of digital tools (e.g., user surveys, reviews, evaluation teams) have been adopted in seven countries. Information on legislative and ethical aspects related to the use of digital solutions are available in 10 countries. Conclusions The development and use of innovative methods for population health monitoring and research purposes have been the key to mitigate the COVID-19 pandemic. Improving the uptake rate, impact assessment of digital tools and fight against disinformation could enhance countries’ preparedness for future pandemics. Key messages • Given that digital solutions are deployed in population health monitoring, research, and for online privacy and security, they have a key role in mitigating the COVID-19 pandemic. • Enhancement of the uptake rate and assessment of digital tools, and fight against disinformation could strengthen countries’ preparedness for future pandemics.
ABSTRACT
Background International comparisons of population indicators of maternal and newborn health are valuable for guiding health policy and practice. The Covid-19 pandemic revealed the difficulties of compiling comparable, timely data in Europe. As part of the PHIRI (Population Health Information Research Infrastructure) project, we developed a protocol to facilitate the exchange and analysis of population birth data in Europe. Methods The Euro-Peristat network, which includes experts from 31 European countries, developed a common data model and R scripts to facilitate rapid exchange of anonymised aggregate tables (https://zenodo.org/record/5148032#.YmlUttpBxPY). These tables were used to compile comparable perinatal health indicators from routine population-based sources for the years 2015 to 2020. We assessed the feasibility of this approach and the availability, quality and comparability of the data. Results Building on previous Euro-Peristat recommendations and a structured consensus process, the network defined a common data model including 22 variables for the testing phase. 17 additional variables were considered important and feasible for a second phase. 25 countries created patient-level data files. Most countries had 20 or more of the data items, whereas 1 had 18, 3 had 16 and 2 had 15 variables. Limiting factors included not having all data in a single database, most often the case for neonatal and infant mortality or vital statistics versus healthcare data, and the diversity or absence of data on socioeconomic status. Setting up the model was time consuming, but once established, running the R scripts was easy and quick (<15 min). The protocol requires the active participation of each country to ensure it is correctly applied. Conclusions We illustrated the feasibility of using a common data model with open source scripts to facilitate rapid production of data and analysis on key perinatal health indicators in European countries
ABSTRACT
Background The COVID-19 pandemic has had an unprecedented impact on Europe. Health systems came under strain, with non-urgent treatments postponed and resources reserved for treatment of COVID-19 patients. Delayed care seeking has been reported, for fear of infection with SARS-CoV2. Yet, the scale of this impact remains under researched. This study aims to compare indirect effects of the pandemic in a European cross-country study aiming to highlight the potential of Population Health Information Research Infrastructures (www.phiri.eu). Methods Focusing on (i) major vascular events (MVE) and (ii) elective surgery for joint replacements (ESJR) as well as (iii) serious trauma this study analyses individual level hospital data in a standardised harmonised data model. We compared pre-pandemic incidence rates (2018-2019) with rates for 2020 and 2021. Analyses are systematically contrasted with SARS CoV2 incidence rates, and policy measures taken based on the OxCGRT index. Results A drop in hospital discharge rates was observed during the pandemic in all countries but differing by condition and month. Socio-economic differences also varied by condition. Our evidence suggests that periods of more severe policy measures also correlated with more dramatic drops in regular hospital activities. Conclusions Our findings provide new insights on the dramatic level of de-prioritisation of essential services faced by non-COVID-19 patients in Europe. From a public health perspective, hospital escalation plans should be developed early on to avoid negative mid and long-term health and financial consequences of indirect effects. The study demonstrates the tremendous potential in exploiting health information systems in a systematic way across countries and the value of the PHIRI system. Further research should investigate policy trade-offs involved in severe lockdown measures during a pandemic and variations in health service resilience for future pandemic preparedness.
ABSTRACT
Background Mobilizing real world data from multiple data hubs in multiple countries to carry out policy-oriented research, requires orchestrating the governance of workflows, being compliant with legal and ethical requirements, and semantic harmonization and technological interoperability. In the context of PHIRI, policy-oriented research has to provide insight to policy-makers to cope with pandemics. Methods PHIRI builds this concept on the deployment of four use cases throughout a federated research infrastructure. A central hub orchestrates all the elements encompassing the development of such an infrastructure;so, a common governance model, common methodology pursuing semantic interoperability, and the development and deployment of technological solution containing ETL processes, data quality assessment solutions and data analyses, all packaged to be rolled out in the different data hubs composing the federation. Results A prototype orchestrating those workflows is being followed in four use cases: indirect effects of the pandemic on vulnerable populations, delayed breast cancer treatments due to the pandemic, perinatal health affections along the COVID19 crisis, effects of the pandemic on mental health care. A prototype of the technological platform supporting interoperable federated analyses has been prepared. Conclusions It is pertinent, feasible and reliable using a federated research infrastructure leveraging real world data from many data hubs in many countries to answer research queries on the COVID19 pandemic.
ABSTRACT
Background Wide variations in COVID-19 infection and outcomes exist across Europe and within countries. PHIRI will look at COVID-19 impacts in specific subgroups by conducting research through use cases of immediate relevance for public health policies focusing on indirect effects of the pandemic related to healthcare and other policies to contain the pandemic. Furthermore, the use cases represent pilot activities for the benefits and added value of a research infrastructure by bringing together data from different European countries. Methods Four research use cases will focus on selected aspects of vulnerable population groups and risk factors, delayed medical care in cancer, perinatal health outcomes, as well as mental health outcomes and are selected based on public health importance, geographic coverage, feasibility of producing actionable insights and relevance for the PHIRI infrastructure. The use cases will demonstrate how a broad variety of secondary data (e.g. administrative and survey data) can be pooled and/or reused in a distributed way across Europe. Results The outputs of the use cases will be processed by formalizing data models, data management processes and analytical pipelines in an interoperable way to feed in the federated research infrastructure. The use cases facilitate research by making scalable, reproducible methods available within PHIRI and by publishing the FAIRified use cases analysis results on the Health Information Portal. They will provide outcomes to guide policy makers in preparedness and response scenarios and will ensure the development of a format for the timely dissemination of use case results to the targeted groups. Conclusions PHIRI will provide insights in real life use cases to generate immediate results on key health impacts of COVID-19 on population health to underpin decision making and will drive the development of the federated research infrastructure that allows rapid cycle analysis.
ABSTRACT
This paper argues that for regional policies to be effective for resilience and economic diversification, a larger understanding of both the complexity of inter-regional networks and the absorptive capacities of firms in regions is needed. Using Brexit and the corona pandemic as examples of shocks, the heterogeneity of regional and sectoral impacts on firms is shown. Although exposures to and potentials of shocks can be identified for regions (speculatively, as both shocks have not materialized fully yet), translation of these into policy measures that address firms’ selective competitive needs is challenging. Many impacts are generated and distributed along market and competition relations, which are not always sensitive to (the same) place-based policies. A discussion on policies that link to a broader interpretation of resilience (of both repair and renewal) is presented, and a research agenda is adhered that more extensively explores how local policies can be implemented in the multilevel network-region-firm structure of impacts. © Società editrice il Mulino.