The general aim of the Laboratory of Clinical Epidemiology is to contribute to the improvement of health care in different medical fields.
The are two main guiding principles: to help physicians in using the available knowledge and resources at their best, and to contribute to the growth of applied knowledge for clinical practice.
The laboratory operates in the field of intensive care medicine. As the main area of activity the laboratory coordinates one of the first and largest groups of collaborative research in the world, the GiViTI (Italian Group for theEvaluation of Interventions in ICU).
Laboratory of Clinical Epidemiology collaborates with AREU (Regional Agency for Emergency Urgency) of Lombardy Region. They work together in SOPAPP project. During the 2020 health emergency, AREU set up a telephone triage service (SOPAPP) that ensure the taking charge and follow-up of patients with suspected or confirmed CoViD-19, without respiratory failure. Now AREU wants extend the SOPAPP activity. The main challenge of this activity is to refer acute non-urgent patients to where they are most clinically and organizationally appropriate. To initiate this activity AREU was collaborating with ATS (local health companies). The main objective of this research project is to evaluate the effectiveness and safety of the SOPAPP program.
The collaboration with the world of emergency medicine began around a project on semi-intensive care units and continued with the Emergency Departments. This led to the establishment of a new collaborative research group called Fenice (fenice.marionegri.it). Regarding the semi-intensive care units, the aim is to carry out a project for the continuous evaluation and improvement of the care quality based on outcome indicators. In this sense, various indicators will be developed according to the characteristics of the patients. Each department will receive not only an annual report accompanied by various personalized performance indicators, but also it will have the opportunity to conduct data analyses independently through appropriate systems developed ad hoc. The project will also make it possible to promote the research activity in these departments. With regard to the Emergency Department, a study was launched on the appropriateness of hospitalizations of patients who access the ED with non-specific manifestations affecting the pulmonary, cardiovascular and abdominal districts. The aim is the construction and validation of an appropriateness classification algorithm based on databases. The laboratory, as coordinator, won the funding of an international project called eCREAM (enabling Clinical Research in Emergency and Acute care Medicine through automated data extraction) by the call HORIZON-HLTH-2021. The project involves 8 country (France, Greece, England, Italy, Poland, Slovakia, Slovenia, Switzerland) and 11 partner. The aim is to develop new technical solutions to extract reliable clinical information from structured and unstructured data contained in different electronic patient files to use in scientific research. The project wants also pilot the exploitation of the established databases intwo relevant use cases: i) assessment of ED propensity to hospitalise a patient, and ii) development of a dashboard to be used by citizens and policymakers to improve the quality of care in ED. Databases of the project will be made in a FAIRify way (i.e. making data Findable, Accessible, Interoperable, and Re-usable) for linicians, researchers, health policymakers and citizens while respecting the European and national legislations.
Intensive rehabilitation in severe brain injuries
With the departments of intensive rehabilitation for severe brain injuries a collaboration has been started with the CREACTIVE project on severe head injury. The collaboration led to the creation of a collaborative group (Tiresia) with the aim of continuously evaluating the care quality and making comparative evaluations of the effectiveness of different rehabilitation treatments. It was designed a first study in which the participating centres will be compared on the ability to achieve three treatment goals 4 months after the acute event on patients with acquired severe brain injuries: the achievement of total nutrition by mouth, satisfactory trunk control and tracheostomy tube removal.
International Consensus on Cardiopulmonary Resuscitation.