JMIR Publications

ABSTRACT

Background:

Chronic liver diseases (CLD) are frequent in Europe, including in France and mainly driven by alcohol, metabolic dysfunction (diabetes and obesity) and viral hepatitis. Despite risk factors are well established and easy to identify, CLD are frequently diagnosed at an advanced stage, translating into poor prognosis. Descriptive data on the burden of CLD in France remain scarce and health trajectories of these patients are uncharted. However, such data are crucial to guide clinical practice, to determine target population for personalized public health policies and to develop innovative strategies to reduce inequities in access to healthcare and ultimately improve survival.

Objective:

The aim of the French RESONANCE cohort is to provide a detailed description of CLD burden in France and study health trajectories.

Methods:

RESONANCE cohort was obtained leveraging data from the French National Health Database (Système National des Données de Santé (SNDS)). Patients with at least one CLD specific International Classification of Diseases, 10th Revision (ICD-10) code (including primary liver cancer (PLC) and rare diseases), procedure, biology, or drug and/or a cause of death related to one of these ICD-10 codes identified between 2013–2021, were targeted from the 2% representative SNDS sample (ESND). Demographic characteristics, etiologies, risk factors, comorbidities, data on social environment and healthcare accessibility, as well as severity of the liver disease at diagnosis and medical management were assessed. This protocol article describes the procedures used to build the cohort and main variables and defines the research objectives.

Results:

Data extraction and cohort construction have been completed and 26,663 incident and prevalent cases of CLD had been identified between 2015 and 2021. Incident cases account for almost 75% of the patients included. The collection of follow-up data, including vital status and mortality information, is complete.

Conclusions:

This protocol will enable a detailed, real-world analysis of epidemiology, care trajectories and outcomes of chronic liver diseases across France. With a particular focus on gender and socio-economic disparities, it offers an unique opportunity to identify vulnerable populations and informing proportionate universalism strategies in prevention and care. Clinical Trial: All necessary accreditations for secure data access have been obtained and a RESONANCE is registered in the health data hub under No F20230224144925, projet number 26266080. According to French regulation (Articles L1461-1 and R1461-13 of the French Public Health Code), studies conducted using anonymized SNDS data do not require approval from an Institutional Review Board (IRB) or ethics committee, or patient individual consent, since no directly identifiable data are used and no contact with patients occurs.