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See detailVaccination against human papilloma virus in the light of quaternary prevention
Pizzanelli, Miguel; Jamoulle, Marc ULiege

in Revista Brasileira de Medicina de Família e Comunidade (2019), 14(41), 1800

In spite of the demonstrated benefits, the question of HPV massive vaccination is still subject to intense discussions and controversies. The protection against cancer is still unproven and need more time ... [more ▼]

In spite of the demonstrated benefits, the question of HPV massive vaccination is still subject to intense discussions and controversies. The protection against cancer is still unproven and need more time to be accurate about the quantification of the decrease in cervical cancer. The analysis of HPV vaccine relevance is very complex due to several overlapped levels to be considered. The authors analyze many of the ethical, sociological, economic, political and finally scientific issues involved. The population trust in vaccines has been affected owing to dubious practices of many pharmaceutical companies. Faced with this manipulation of information on a worldwide scale, general practitioners have organized themselves to fight this uncertainty. Quaternary prevention, a concept supported by the World Organization of Family doctors, advocates the application of ethically acceptable procedures in health care. This opinion article addresses some of the multiple dimensions involved to encourage reflection on this issue [less ▲]

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See detailExploring GP/FM content: Views and queries of ICPC and Q-Codes on the HeTOP database
Jamoulle, Marc ULiege; Pizzanelli, Miguel; Santiago, Luiz Miguel et al

Poster (2019, September 26)

Poster for the WICC Annual Meeting, Crete, 26-29 Sept 2019 Exploring GP/FM content: Views and queries of ICPC and Q-Codes on the HeTOP database Marc Jamoulle1 MD, PhD, Miguel Pizzanelli2, MD, MSc, Luiz ... [more ▼]

Poster for the WICC Annual Meeting, Crete, 26-29 Sept 2019 Exploring GP/FM content: Views and queries of ICPC and Q-Codes on the HeTOP database Marc Jamoulle1 MD, PhD, Miguel Pizzanelli2, MD, MSc, Luiz Miguel Santiago3, MD, PhD, Julien Grosjean4, Ir, PhD, Stefan Darmoni5, MD, PhD (contact marc.jamoulle@gmail.com ) 1. Family Physician, Scientific collaborator, university of Liege, Belgium and University of Rouen, France 2. Family Physician, Professor of family practice University de la Republica, Montevideo, Uruguay 3. Family Physician, Professor of family practice, University of Coimbra, Portugal 4. Professor of informatics, University of Rouen, France 5. Professor of medical informatics, University of Rouen, France The International Classification of Primary Care (ICPC-2) is available in many languages and ranks the most common clinical problems encountered in primary care. The non-clinical concepts treated by family physicians were described following careful analysis of family physician communications at many congresses and referred to as Q-Codes. ICPC-2 in 22 languages including process codes and Q-Codes in 12 languages were published online on the Health Terminology/Ontology Portal (HeTOP, developed at the Rouen University Hospital) under the acronym 3CGP for “Core concept Classification in General Practice / Family Medicine”. The headings in both classifications have an Unique Resource Identifier (URI) and are available in both Excel and Web Ontology Language (OWL) formats. The topics and codes are linked to the large classifications existing through the HeTOP multi-terminology server. 20% of ICPC codes and all Q-Codes are related to corresponding MeSH concepts with automatic access to a bibliography on PubMed. New translations can be introduced directly from a standardized Excel file. They can also be edited online in an advanced mode. 3CGP is used as a resource for the teaching of family medicine in Belgium (French speaking), Portugal and Uruguay. The French-speaking doctors in training (ULB-ULg-UCL) and the students of the University of Coimbra in Portugal use it to index their work of end of study (master thesis). In Uruguay, the Department of General Medicine indexes a grey literature database with this system. The HeTOP application saves action logs which makes possible the analysis of the site traffic (excluding robots and scientists with edition permission). The poster, which gives access to the website and Uniform Resource Locators (URIs), shows available data at the end of September 2019. It is noted that ICPC was the subject of 1,253 individual searches with 3,949 views (surfing on the items) in August 2019, which is to this day the highlight of monthly attendance. The non-clinical concepts exposed in the Q-codes were the subject of 1,597 searches and 9,887 views in February 2019, during which time Belgian students are encouraged to find the research theme for their final work. Unsurprisingly, the most used language is French, followed by English, then Portuguese and Spanish. More than 500 different sections of ICPC-2 were consulted, including all procedure codes. All sections of the Q-Codes (i.e. 182) were consulted between 100 and 550 times. Although the use of 3CGP for teaching general medicine and the indexation of its work has not yet been the subject of a validation study, it is shown that the system enjoys factual validation. [less ▲]

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See detailThe Q-codes: Metadata, Research data, and desiderata, oh my! Improving access to grey literature in family medicine
Resnick, Melissa P.; Ittoo, Ashwin ULiege; Jamoulle, Marc ULiege et al

in Farace, D.; Frantzen (Eds.) GL20 Proceedings Twentieth International Conference on Grey Literature “Research Data Fuels and Sustains Grey Literature”. (2019, February)

Abstract: Problem/Goal: In GL19’s “Indexing grey literature in General Practice: Family Medicine in the Eraof Semantic Web,” Jamoulle and colleagues(Jamoulle et al., 2018) propose the use of a relatively ... [more ▼]

Abstract: Problem/Goal: In GL19’s “Indexing grey literature in General Practice: Family Medicine in the Eraof Semantic Web,” Jamoulle and colleagues(Jamoulle et al., 2018) propose the use of a relatively new terminology (3CGP) to allow for the indexing and retrieval of (GP/FM) knowledge which otherwise would be lost, or difficult to locate. Though designed to meet Cimino’s (Cimino, 1998) twelve desiderata for the design of a controlled healthcare vocabulary, Jamoulle and colleagues (Jamoulle et al., 2018) acknowledge that a detailed requirement by requirement evaluation of 3CGP was not performed. The goal of this paper is to evaluate the Q-Codes component of the 3CGP terminology, in detail, with each of Cimino’s twelve desiderata. Research Method/Procedure: In our work, we will focus on qualitative analysis, whereby our taxonomy, the Q-Codes, and in particular, its vocabulary satisfies a standard set of desiderata. Qualitative analysis provides a simple and yet effective way to assess the Q-Codes taxonomy’s quality. We will briefly describe each of the desiderata and discuss how our taxonomy satisfies each one of them (or not). Anticipated Results of the Research: The qualitative evaluation is intended as an initial stage, which focuses on the Q-Codes taxonomy’s contents, namely, its vocabulary (e.g. terms and definitions). Our aim with the qualitative evaluation is to investigate whether our proposed taxonomy, and in particular its vocabulary, satisfies a set of desiderata. This will enable us to determine whether the knowledge acquisition and (part of) the conceptualization steps of our ontology development process have been performed correctly. We consider that validating our vocabulary against a set of well-defined desiderata is paramount before evaluating other aspects of the taxonomy (such as the relations). As a set of desiderata, we chose that proposed by Cimino in his seminal study entitled “Desiderata for controlled medical vocabularies in the twenty-first century” (Cimino, 1998). These desiderata ensure that our taxonomy can be successfully deployed and exploited in actual GM/FM applications / activities, such as indexing grey literature. The desiderata define a set of (desired) characteristics that (ideally all) standard medical vocabularies should satisfy. Thus, these desiderata help in alleviating inter-operability issues, with the use of common standards ensuring the efficient integration of our taxonomy with other medical vocabularies and resources (taxonomies, ontologies). From the results of this study, improvements can be made to the Q-Codes component of, and thus, the 3CGP terminology. This, in turn, improves the ability to index the grey literature with the 3CGP terminology, providing greater access to needed information. Indication of costs related to the project: This project has not been funded. 3CGP is placed under Attribution-Non-Commercial-Share-Alike4.0International(CCBY-NC-SA4.0) license. [less ▲]

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See detail“M@dNotes Project”. Giving colour to Grey Literature
Pizzanelli, Miguel; Jamoulle, Marc ULiege

in Revista Brasileira de Medicina de Família e Comunidade (2019), 14(41), 1-6

Sharing the results of research and scientific production is crucial for the survival and development of all disciplines. Health information is becoming uncertain and powerful economic interests ... [more ▼]

Sharing the results of research and scientific production is crucial for the survival and development of all disciplines. Health information is becoming uncertain and powerful economic interests disrupting medical information has triggered a loss of credibility. M@dNotes project (in Spanish NotasL@cas), is the by-product of nonprofit collaborative international knowledge network with participation of students, general practitioners, family physicians, and healthcare workers. One of the aims of this network is to discuss the validity of the information available on sensitive subjects and build a knowledge exchange network inside a community of practice. It has been created to share different materials excluded from traditional academic publishing and commercial distribution channels: monographic reports, commented articles, files with references searches. These materials product of learning process are qualified with an appropriate level because there were submitted to a peer review or judged by a scientific committee to get an approval. Includes an indexing method (Q Codes and ICPC) to manage and retrieve the materials received. The project provides a particular folder to upload and share the documents. A web blog is the dissemination friendly tool or interface to share and retrieve the documents available in the network. Through a facility in the cloud, it is possible to access an excel file with all the materials shared, codes assigned and the hyperlink to get a pdf file of each material. [less ▲]

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See detailUne base de connaissance multilingue et dynamique en ligne pour la médecine générale et les soins primaires
Jamoulle, Marc ULiege; Knupp Augusto, Daniel; Pizzanelli, Miguel et al

in Pan African Medical Journal (2019)

The International Classification of Primary Care, second version (ICPC-2) aligned with the International Classification of Diseases Tenth Revision (ICD-10) is a standard for the epidemiology of Primary ... [more ▼]

The International Classification of Primary Care, second version (ICPC-2) aligned with the International Classification of Diseases Tenth Revision (ICD-10) is a standard for the epidemiology of Primary Care. ICPC-2 is also suitable for identifying clinical topics that family physicians discuss. Contextual areas of knowledge in family medicine and Primary Health Care such as management, structure, patient categories, research methods, ethical or environmental aspects are not standardized and most often reflect expert views. A qualitative research method, applied to the analysis of multiple family medicine conferences, has identified, in addition to clinical items, a set of contextual concepts addressed by family physicians during their exchanges. Assembled in a hierarchical format, they found their place alongside the ICPC-2, under the name of Q-Codes version 2.5, on the interlingual multi-terminological server of the Department of Information and Medical Informatics (D2IM) of the University of Rouen, France. Both classifications are published under the acronym 3CGP for Core Content Classification of General Practice at www.hetop.eu/3CGP. This site provides open access to ICPC-2 in 22 languages and Q-Codes in ten languages. The result of the joint use of these two classifications, as descriptors in congresses, to identify concepts in texts, or to index gray literature in family medicine and primary care is presented here in different pilot uses. The validity and generalizability of 3CGP seems good considering the translations already done by colleagues around the world and the applicability of the method on both sides of the Atlantic. However, the reproducibility and intercoders variation are still to be tested for the Q-Codes. The question of maintenance remains. Through this method, one can highlight the conceptual extension, complexity and dynamics of the profession of general practitioner and primary care physician. [less ▲]

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See detailThe M@dnote project. Giving colour to Grey Literature in General Practice. A collaborative GPs knowledge network
Pizzanelli, Miguel; Resnick, Melissa P.; Cardillo, Elena et al

Poster (2018, December 03)

Abstract (397 words) “M@dNotes Project”. Giving colour to Grey Literature in General Practice. A collaborative GPs knowledge network. Sharing the results of research and scientific production is crucial ... [more ▼]

Abstract (397 words) “M@dNotes Project”. Giving colour to Grey Literature in General Practice. A collaborative GPs knowledge network. Sharing the results of research and scientific production is crucial for the survival of all disciplines. Health information is becoming uncertain and powerful economic interests disrupting medical information has triggered a loss of credibility. M@dNotes project (in Spanish NotasL@cas), is the by-product of non-profit collaborative international knowledge network of general practitioners, family physicians, and healthcare workers. One of the aims of this network is to discuss the validity of the information available on sensitive subjects and build a knowledge exchange network inside a community of practice. The project was born because we realized that more than 95% of the postgraduate and pregraduate research/reports/ scholar works (monographic works) to accomplish or finished one part of the training were finally lost and unpublished. Most of them come from interesting "minds" and are interesting topics to improve the applying of evidence in medical healthcare. From this perspective, M@dNotes is a unique local platform to rescue knowledge and support exchange and collaboration. Perhaps is isolated due to the circumstance of being restricted to few countries or a small group of practice. Nevertheless, we are trying to improve our qualifications in order to link M@dNotes to an open access network. It has been created to share different materials excluded from traditional academic publishing and commercial distribution channels: monographic, commented articles, files with references searches. These materials considered “grey literature” are the product of intense learning process and has been produced to achieve a qualification, be presented in a conference or were collected by users spontaneously through the web searches, with a knowledge purpose. Many of them qualified with an appropriate level because were submitted to a peer review or judged by a scientific committee to get an approval. The project includes an indexing method (Q Codes and ICPC) to manage and retrieve the materials received. Q-Codes are intended for indexing Family medicine related documentation jointly with the International Classification of Primary Care (ICPC). The project provides a particular folder to upload and share the documents. A web blog is the dissemination tool or friendly interface to share and retrieve the documents shared in the network. Through a facility in the cloud, it is possible to access an excel file with all the materials shared, codes assigned and the hyperlink to get a pdf file of each material. [less ▲]

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See detailIndexing grey multilingual literature in General Practice: Family Medicine in the Era of Semantic Web
Jamoulle, Marc ULiege; Pizzanelli, Miguel; Cardillo, Elena et al

in Grey Journal (2018), Spring 2018(1),

Problem/Goal: Sharing the results of research with General Practitioners (GPs) is crucial for the survival of the discipline of General Practice / Family Medicine (GP/FM). The production of abstracts in ... [more ▼]

Problem/Goal: Sharing the results of research with General Practitioners (GPs) is crucial for the survival of the discipline of General Practice / Family Medicine (GP/FM). The production of abstracts in GP/FM probably exceeds 15,000 per year worldwide. Each abstract often represents two years of work for its authors and is expressed in local languages. Only 45% of them are published in indexed medical journals. Usual indexing systems like MeSH are not multilingual nor adapted to the particular field of GP/FM. Consequently, these abstracts are lacking bibliographic control and more than half of the research presented by GPs at congresses is lost. Considering the absence of appropriate domain-specific terminologies or classification systems, we propose a new multilingual indexing system. The existing International Classification of Primary Care (ICPC) is currently used for clinical purposes and has now been expanded with a taxonomy related to contextual aspects (called Q-Codes) such as education, research, practice organization, ethics or policy in GP/FM, currently not captured. The set is proposed under the name Core Content Classification in General Practice (3CGP). The aim is to facilitate indexing of GP/FM specific scientific work and to improve performance in information storage and retrieval for research purposes in this field. Research Method/Procedure: Using qualitative analysis, a corpus of 1,702 abstracts from six GP/FM- related European congresses was analyzed to identify main themes discussed by GPs (e.g., continuity, accessibility or medical ethics), handled in a domain-specific taxonomy called Q-Codes and translated in 8 languages. In addition, a methodology for building a lightweight ontology (in OWL-2) was applied to Q-Codes, adding object and datatype properties to the hierarchical relations, including mapping to the MeSH thesaurus, Babelnet (www.babelnet.org) and Dbpedia. Finally, the Q-Codes in 8 languages have been integrated in a healthcare terminology service (www.hetop.eu/q) with a companion website (http://3cgp.docpatient.net). Results of the Research: The creation and the on-line publication of this multilingual terminological resource (see http://3cgp.docpatient.net), for indexing abstracts and for facilitating Medline searches, could reduce loss of knowledge in the domain. The database is available in 12 human languages and in Web Ontology Language (OWL) for computer use. In addition, through better indexing of the grey literature (online database, congress abstracts, master’s and doctoral thesis) of which we show the first results, we hope to enhance the accessibility of research in GP/FM domain and promote the emergence of networks of researchers. Indication of costs related to the project: This project has not been funded. 3CGP is placed under Attribution-Non-Commercial-Share-Alike 4.0 International (CC BY-NC-SA 4.0). ICPC is copyrighted by WONCA. Keywords General practice, Terminology, Electronic publishing, Repository, Grey Literature. [less ▲]

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See detailMultilingual resource to disseminate main concepts in Family Medicine and Primary care
Jamoulle, Marc ULiege; Bae, Jong-Myon; Pizzanelli, Miguel et al

Poster (2018, October 19)

Background: General practice/ Family Medicine (GP/FM) and Primary Health Care (PHC) Knowledge Management (KM) - High complexity by intertwined human and technical approaches - Content not harmonized. No ... [more ▼]

Background: General practice/ Family Medicine (GP/FM) and Primary Health Care (PHC) Knowledge Management (KM) - High complexity by intertwined human and technical approaches - Content not harmonized. No uniform table of content for both disciplines - Classification system available only for clinical purposes (ICPC 1987- ongoing) - No existing contextual features classification Methods - Qualitative analysis of 2300 abstracts of GP congresses - Elaboration of a taxonomy called Q-Codes about contextual information (ie not clinical), - Complementary to the International Classification of Primary care (ICPC-2) - Using online HeTOP semantic base (OWL-2) to develop terminological records - Linking concept to existing terminologies and knowledge repositories (PubMed- DBpedia-Babelnet) - Multilingual translation by dedicated GPs worldwide (10 languages – more ongoing) - Experimental use of Q-Codes in various KM situations Results • GP/FM & PHC evolutionary knowledge base on www.hetop.eu/Q (exportable in Excel and OWL-2) • 182 Q-Codes Uniform Resource Identifier (URI) in 10 languages: ex : Korean Shared Decision Making in Korean • Experiments are ongoing and presented on http://3cgp.docpatient.net/(abstracts indexing, pedagogy, master thesis indexing, discussion indexing, automatic annotators, e-learning application) Conclusion Indexing of the GP/FM literature (congress abstracts, master's and doctoral thesis, group discussions) enhance the accessibility of research results and promote the emergence of networks of researchers. The work is ongoing and will be maintained by the Q-Code working group into the WONCA International Classification Committee. More on : Jamoulle & all EJGP Dec 2017. [less ▲]

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See detailImplications éthiques, pédagogiques, socio-politiques et anthropologiques de la prévention quaternaire
Jamoulle, Marc ULiege; Roland, Michel; Bae, Jong-Myon et al

in Revue Médicale de Bruxelles (2018), 39

The concept of quaternary prevention, resulting from a reflection on the doctor-patient relationship, is presented as a renewal of the age-old ethical requirement: first, a doctor must do no harm; second ... [more ▼]

The concept of quaternary prevention, resulting from a reflection on the doctor-patient relationship, is presented as a renewal of the age-old ethical requirement: first, a doctor must do no harm; second, the doctor must control himself/herself. The origin of the concept, its endorsement by the World Organization of Family Doctors (WONCA) and the European Union of General Practitioners (UEMO), its dissemination, and the debates to which it has given rise, are presented by a panel of authors from 10 countries. This collective text deals more specifically with : the ethics of prevention, the importance of teaching Quaternary prevention and Evidence Based Medicine, the social and political implications of the concept of Quaternary prevention, and its anthropological dimensions. [less ▲]

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See detailLa desconfianza es la peor antivacunas
Jamoulle, Marc ULiege; Pizzanelli, Miguel

E-print/Working paper (2018)

La cuestión de la vacunación contra el virus del papiloma humano, es por el momento, objeto de intensas discusiones. Uno podría pensar a primera vista que se trata de una cuestión puramente médica y, por ... [more ▼]

La cuestión de la vacunación contra el virus del papiloma humano, es por el momento, objeto de intensas discusiones. Uno podría pensar a primera vista que se trata de una cuestión puramente médica y, por lo tanto, científica. Sin embargo no lo es. Veremos que se trata en primer lugar de una pregunta o problema de tipo sociológico, luego económico y político y finalmente de tipo científico. Este asunto es tan urticante que se le ha llamado “la primera guerra de vacunas” (1,2) Nuestro objetivo no es detallar la historia reciente de la vacuna, sino recordar algunos hechos interesantes. La protección de la población y los individuos ha sido siempre una de las preocupaciones de la medicina. Como los médicos lidian permanentemente con el tiempo, llegar antes de un evento es el objetivo de la prevención, a pesar de que los pacientes aún no estén enfermos o aún no se vean afectados por un daño potencial. Estamos hablando de prevención primaria. Las vacunas y el descubrimiento de la higiene del agua han sido uno de los descubrimientos históricos más importantes contra los eventos que han trastornado la esperanza de vida de los humanos. Pero es la naturaleza médica de la vacunación, sus aspectos protectores y preventivos que han afectado más a la población. [less ▲]

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See detailKnowledge management in general practice / family medicine through the Core Content Classification (3CGP), a new indexation tool.
Jamoulle, Marc ULiege; Knupp Augusto, Daniel; Pizzanelli, Miguel

Conference (2018, May 11)

Background: The lack of a General Practice / Family Medicine (GP/FM) bibliographic system hinders the Knowledge Management of the profession. We propose a multilingual indexing system for grey literature ... [more ▼]

Background: The lack of a General Practice / Family Medicine (GP/FM) bibliographic system hinders the Knowledge Management of the profession. We propose a multilingual indexing system for grey literature in GP/FM, composed by the International Classification of Primary Care (ICPC) and a new taxonomy related to contextual aspects (called Q-Codes). The set is proposed under the name Core Content Classification in General Practice (3CGP). The system, freely accessible, is ready for the Linked data universe and the future of information management in GP/FM; Keywords: General Practice, Terminology, Abstracting and Indexing as Topic, Congresses as Topic Research questions: Is there any methods to facilitate indexing and to improve performance in information storage and retrieval of unpublished GP/FM scientific work? Method: Using qualitative analysis, a corpus of 1,702 abstracts from six GP/FM European congresses, main themes discussed by GPs have been identified, handled in a domain-specific taxonomy called Q-Codes and translated in 10 languages. A methodology for building a lightweight ontology (in OWL-2), fit for semantic web, was applied to Q-Codes. The research domain of the Q-Codes is compared to the results of the 2010 EGPRN study about the themes addressed during EGPRN conferences. (Family Practice 27 (4): 459–67. doi:10.1093/fampra/cmq023.) Results: • ICPC-2 (21 languages) : http://www.hetop.org/hetop/?la=en&rr=CIP_C_ARBO&tab=1 • ICPC-2 Process (4 languages): http://www.hetop.org/hetop/?la=en&rr=CIP_C_ARBOPROC&tab=1 • Q-Codes : (10 languages): http://www.hetop.eu/hetop/Q?la=en&rr=CGP_CO_Q&tab=1 • The comparison of the EGPRN 2010 study and the Q-Codes : http://3cgp.docpatient.net/wp-content/uploads/2017/07/EGPRN_study_2010.pdf • Experiments are ongoing and presented on http://3cgp.docpatient.net/ • use of 3CGP as keywords for indexing congress (Brazil) and for indexing main issues discussed in mailing lists (Uruguay) Conclusions: Indexing of the GP/FM literature (congress abstracts, master's and doctoral thesis, group discussions) enhance the accessibility of research results and promote the emergence of networks of researchers. The work is ongoing and will be maintained by the Q-Code working group. source : Jamoulle EJGP 2017 http://dx.doi.org/10.1080/13814788.2017.1404986 Points for discussion: • Reproductibility and Interdoctorvariation have not been tested • Q-Codes need update for missed and emergent themes • Integration with other tools (like PeRI) [less ▲]

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See detailRound table. Quaternary Prevention(P4) or first do not harm.
Jamoulle, Marc ULiege; Widmer, Daniel; La Valle, Ricardo et al

Conference (2017, September 09)

Quaternary prevention (P4), born from a reflection on the doctor-patient relationship, began as an answer of family doctors facing overmedicalization. It aims to protect the patient or population against ... [more ▼]

Quaternary prevention (P4), born from a reflection on the doctor-patient relationship, began as an answer of family doctors facing overmedicalization. It aims to protect the patient or population against the danger of medicine. Harmful effects can appear with preventive activities (example: prostate cancer screening by PSA) as well as by therapeutic interventions (example: disruptive medicine). P4 promoted by the World Organization of Family Doctors (WONCA) is practiced in different ways around the world through the activity of the WONCA Special Interest Group on Quaternary Prevention and Overmedicalisation (P4&O). There are multiple initiatives and backgrounds of P4. All these multiple initiatives that lead to P4 have their origin in denouncing the inadequacies of the Hegemonic Medical Model and the excesses perpetrated in the pursuit of profit. There are many schools of thought that try to solve this situation, such as "Medicines Based on ..." These contributions are valuable but usually point to a single dimension of the problem so they do not change the situation too much. The P4, however, have understood the centrality of the political and economic dimensions and, that is why, P4 has become a movement. P4 has understood that the root causes far exceed the limits of medicine, have understood that the problem includes ethical, political, economic and epistemological aspects of medicine. It is for this reason that the definition of P4 has shifted to the function of foundational idea since the movement that has been generated around this concept has surpassed this initial definition centered in a, yet complex, but still medical vision. P4 has understood that a new model of medicine and a new pact with society is necessary. P4 is a counter-hegemonic movement with predominant development in peripheral countries. This movement includes many other perspectives developed in the central countries but is the only one that has an ideological position that discusses the current paradigm of medicine that legitimates the same causes that give rise to P4, proposing to think a new way of practice the medicine that includes Ethical values, other forms of knowledge and the return to human medicine for humans with place for uncertainty, compassion, the encounter between people and non-commodified. Justice in health care is a central aspect of this new way of conceiving the medicine that we propose. Remember what Rudolf Virchow said in the nineteenth century "Physicians are the natural advocates of the poor and social problems fall largely under their jurisdiction. Medicine is a social science, and politics is nothing more than medicine in large scale". We must reformulate our contract with society and for this we must be very clear that our loyalty must always be with the sick, the poor and those who are weak. For this new contract we must also take into account the magnitude of the power that has been given to us and to live up to such responsibility. In the Rio manifesto (2016) we propose to “Avoid and denounce the naturalization of: hunger, exclusion, manipulation, inequality, violence, racism, exploitation, which harm health more than "diseases"” . There is a better and fairer world, let's fight to get it! More about P4 on www.ph3c.org/p4 [less ▲]

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See detailQuaternary prevention library and resources (QP library)
Pizzanelli, Miguel; Lavalle, Ricardo; Jamoulle, Marc ULiege

Learning material (2017)

Collaborative Database on Quaternary Prevention Resources and References. Base de datos colaborativa de recursos y referencias bibliográficas sobre Prevención Cuaternaria. Base de Dados Colaborativa de ... [more ▼]

Collaborative Database on Quaternary Prevention Resources and References. Base de datos colaborativa de recursos y referencias bibliográficas sobre Prevención Cuaternaria. Base de Dados Colaborativa de Recursos e Referências sobre Prevenção Quaternária. Réseau collaboratif de ressources et de références en matière de Prévention du Quaternaire [less ▲]

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See detailTerminología multilingüe en medicina general y de familia - Versión en Español
Jamoulle, Marc ULiege; Mariño, María Ana; La Valle, Ricardo et al

Book published by Care Editions (2016)

Esta monografía reproduce la lista de códigos Q, versión 2.5, y sus definiciones bajo el nombre de “Terminología multilingüe en medicina general y de familia – versión española” La clasificación Códigos-Q ... [more ▼]

Esta monografía reproduce la lista de códigos Q, versión 2.5, y sus definiciones bajo el nombre de “Terminología multilingüe en medicina general y de familia – versión española” La clasificación Códigos-Q para artículos no clínicos de medicina general y de familia se ha diseñado en base al desarrollo de una ontología informática en el servidor web www.hetop.eu del Laboratorio de Bioinformática de la Universidad de Rouen, Francia. Los Códigos Q tienden a representar los conceptos organizacionales esenciales de la Medicina Familiar. Los Códigos Q forman un capítulo complementario en la Clasificación Internacional de Atención Primaria, segunda edición (CIAP-2). Ellos son parte del proyecto 3CGP (Core Content Classification in General Practice Family medicine - Clasificación del contenido esencial de la atención primaria). Por lo tanto, combina las 3CGP con la clasificación ICPC-2 y los Códigos Q con el propósito de la indexación documental en medicina general y de familia. El proyecto de un sistema específico de indexación en medicina familiar se explica con precisión así como la capacidad del servidor web HeTOP es desarrollada en detalle. Se describe a continuación una lista tabular de los Códigos-Q, sus definiciones y finalmente un índice terminológico. [less ▲]

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See detailThe Q-Codes: General Practice / Family Medicine Online Multilingual Terminology & Knowledge Base. A semantic web based resource in English, Portuguese, French, Spanish, Dutch, Vietnamese, Turkish and Korean
Jamoulle, Marc ULiege; Gusso, Gustavo; Mariño, Maria Ana et al

Conference (2016, November 02)

The session is devoted to the launch of an online knowledge database specific to GP / FM. This work is the result of a two years’ work of a cooperative project between participants from 12 countries and 8 ... [more ▼]

The session is devoted to the launch of an online knowledge database specific to GP / FM. This work is the result of a two years’ work of a cooperative project between participants from 12 countries and 8 languages. People are now used to the International classification of Primary Care (ICPC-2) which addresses the clinical issues in GP/FM , ie Symptoms, Process and Diagnosis. We have work on non-clinical issues i.e. all themes addressed by GPs during congresses which concern organizational, ethical, structure, teaching or patient related issues not encompassed by ICPC-2. The letter Q was used to name Q-Codes because this letter wasn’t yet used in ICPC-2. Q-codes are a classification of non-clinical items in General Practice / Family Medicine (GP/FM). Q-codes are a classification of non-clinical items in General Practice / Family Medicine (GP/FM). After a demonstration of the Q-Codes terminology and of the online database, we are proud to present to you a new GP/FM terminology in 6 languages freely available online. Relevant urls are : • for Q-Codes knowledge base http://www.hetop.eu/Q • for user guide and download http://3cgp.docpatient.net/ Contact marc.jamoulle@doct.ulg.ac.be [less ▲]

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See detailA semantic web based resource for GP/FM in English, Portuguese, French, Spanish, Dutch, Vietnamese & Korean
Jamoulle, Marc ULiege; Gusso, Gustavo; Mariño, Maria Ana et al

Textual, factual or bibliographical database (2016)

The session is devoted to the launch of an online knowledge database specific to GP / FM. This work is the result of a two years’ work of a cooperative project between participants from 12 countries and 8 ... [more ▼]

The session is devoted to the launch of an online knowledge database specific to GP / FM. This work is the result of a two years’ work of a cooperative project between participants from 12 countries and 8 languages. People are now used to the International classification of Primary Care (ICPC-2) which addresses the clinical issues in GP/FM , ie Symptoms, Process and Diagnosis. We have work on non-clinical issues i.e. all themes addressed by GPs during congresses which concern organizational, ethical, structure, teaching or patient related issues not encompassed by ICPC-2. The letter Q was used to name Q-Codes because this letter wasn’t yet used in ICPC-2. Q-codes are a classification of non-clinical items in General Practice / Family Medicine (GP/FM). Q-codes are a classification of non-clinical items in General Practice / Family Medicine (GP/FM). After a demonstration of the Q-Codes terminology and of the online database, we are proud to present to you a new GP/FM terminology in 6 languages freely available online. Relevant urls are : · for Q-Codes knowledge base http://www.hetop.eu/Q · for user guide and download http://3cgp.docpatient.net/tutorials Contact marc.jamoulle@doct.ulg.ac.be [less ▲]

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See detailInternational Classification of Primary Care in a cross-lingual terminology portal (Poster)
Jamoulle, Marc ULiege; Kuehlein, Thomas; Pizzanelli, Miguel et al

Poster (2015, October 23)

ICPC, reflecting the burden of family medicine, is available in the HeTOP cross-lingual terminology portal (URL: www.hetop.eu) in 19 languages, mostly European (e.g. Spanish, Portuguese) but also in ... [more ▼]

ICPC, reflecting the burden of family medicine, is available in the HeTOP cross-lingual terminology portal (URL: www.hetop.eu) in 19 languages, mostly European (e.g. Spanish, Portuguese) but also in Japanese or Mandarin. The HeTOP interface has been also translated in 10 languages by Wonca colleagues (including in Turkish, Vietnamese and Romanian). [less ▲]

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See detailThe words of prevention, part I: changing the model
Jamoulle, Marc ULiege; Gavilan, Enrique; Cardoso, Raquel Val et al

in Revista Brasileira de Medicina de Família e Comunidade (2015), 10(35), 1-9

ABSTRACT Objective: This part I article explores the different meanings of relevant keywords for General Practice/Family Medicine (GP/FM) in the prevention domain. The aim is to contribute to information ... [more ▼]

ABSTRACT Objective: This part I article explores the different meanings of relevant keywords for General Practice/Family Medicine (GP/FM) in the prevention domain. The aim is to contribute to information process in GP/FM by keeping in line with the main terms used in health care organization. Methods: Important keywords for GP/FM in the prevention domain were selected. Then, a search was carried out on the main sources in GP/FM databases, as well as in Medical Subject Heading and major terminological databases available online. Results and Discussion: There is discrepancy between the conceptual contents of major prevention models amongst the usual bibliographic sources of knowledge in GP/FM in particular and medicine in general. Conclusion: For GP/FM, distribution of preventive activities is now firmly established on a new constructivist model, privileging the doctor-patient relationships and introducing a cybernetic thinking on the health care activities with a special commitment to ethics and the positive duty of beneficence. [less ▲]

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See detailThe words of prevention, part II: ten terms in the realm of quaternary prevention
Jamoulle, Marc ULiege; Gavilan, Enrique; Cardoso, Raquel Val et al

in Revista Brasileira de Medicina de Família e Comunidade (2015), 10(35), 1-9

ABSTRACT Objective: This part II article about the ‘words of prevention’ presents in a terminological way the content of ten current concepts used in the prevention domain which are closely linked to ... [more ▼]

ABSTRACT Objective: This part II article about the ‘words of prevention’ presents in a terminological way the content of ten current concepts used in the prevention domain which are closely linked to quaternary prevention: (1) overinformation, (2) overdiagnosis, (3) medically unexplained symptoms, (4) overmedicalisation, (5) incidentaloma, (6) overscreening, (7) overtreatment, (8) shared decision making, (9) deprescribing, and (10) disease mongering. Methods: with the support of the laboratory team of the University of Rouen, France, which is dedicated to medical terminology and semantic relationships, it was possible to utilize a graphic user interface (called DBGUI) allowing the construction of links for each of chosen terms, and making automatic links to MeSH, if any. Those concepts are analyzed in their environment in current literature, as well as in their MeSH counterparts, if any, and related semantic online terminologies. Results and Discussion: The rules in terminological development aspire to cover the whole field of a concept and in the meantime, it helps to avoid the noise due to proxy and not exactly related issues. This refers to exhaustivity and specificity in information retrieval. Our finds show that referring to MeSH only in information retrieval in General Practice/Family medicine can induce much noise and poor adequacy to the subject investigated. Conclusion: Gathering concepts in specially prepared terminologies for further development of ontologies is a necessity to enter in the semantic web area and the era of distributed data. [less ▲]

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See detailInternational Classification of Primary Care in a cross-lingual terminology portal
Jamoulle, Marc ULiege; Pizzanelli, Miguel; Grosjean, Julien et al

Poster (2015, March 20)

International Classification of Primary Care in a cross-lingual terminology portal M. Jamoulle1, M. Pizzanelli2, J. Grosjean 3 , G. Kerdelhué 3, SJ. Darmoni 3&4 1 Department of General practice, Liege ... [more ▼]

International Classification of Primary Care in a cross-lingual terminology portal M. Jamoulle1, M. Pizzanelli2, J. Grosjean 3 , G. Kerdelhué 3, SJ. Darmoni 3&4 1 Department of General practice, Liege University, Belgium 2 Unidad docente asistencial rural de Florida, Uruguay 3 Deparment of Biomedical Informatics, Rouen University Hospital, Normandy & TIBS, LITIS EA 4108, France 4 LIMICS, INSERM, U1142, Paris, France. ICPC is available in the HeTOP cross-lingual terminology portal (URL: www.hetop.eu) [1] in 19 languages, mostly European (e.g. Spanish, Portuguese) but also in Japanese or Mandarin. The HeTOP interface has been also translated in 10 languages, including by Wonca colleagues (in Turkish, Vietnamese and Romanian). This is very important for non-English speakers to access a health Web site in his/her native language. Thanks to a partial manual mapping between ICPC2 and MeSH, it is now also possible to query PubMed from 20% of ICPC2 codes. This task is time consuming as in lot of cases, the mapping is 1 to N (one ICPC code generates several MeSH terms; e.g. the ICPC term "diverticular disease" is mapped to two MeSH terms " diverticulosis, colonic" and " diverticulitis". HeTOP currently contains 56 health terminologies and ontologies (only 17 are included in UMLS as most of them are French terminologies), 1,951,834 concepts, 6,636,000 terms, 8,023,181 relations and 1,340,855 relations. Overall, HeTOP contains 108 millions of SPARQL triplets. These figures underlines the possible application of the so called "health big data". Overall, the number of distinct UMLS concepts with at least one French translation in UMLS (MeSH, MedDRA, WHOART, ICPC) is 45,405 vs. 317,539 in HeTOP. 1. Grosjean, J; Merabti, T; Griffon, N; Dahamna, B & Darmoni, SJ. Teaching medicine with a terminology/ontology portal. Stud Health Technol Inform 2012:180;949-53. [less ▲]

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