Portrait - Sophie Houzard, public health physician
Through her choice to become a public health physician, Sophie Houzard has always been interested in the organizational aspect of care. For a long time she has coordinated the breast cancer follow-up network, Gynécomed. This network includes 300 general practitioners, and aims to provide high-quality local follow-up and care in doctors' surgeries for more than 5,000 patients after breast cancer. She works hand-in-hand with Institut Curie.
Two years ago, in January 2017, she joined the data team at Institut Curie. "They were looking for someone to work on the SNDS (national health data system) and I seized the opportunity to work on this huge database, a real jewel!" she enthuses. And for good reason, since the SNDS, created by the law on modernization of our health system (2016), gives access to the main public health databases (health insurance, health institutions, causes of death, etc.), or over 90% of the French population. "The database is almost exhaustive, and the envy of many countries", she continues. "Its main advantage is that it lets us track a course of treatment until the patient's death, from 2006 to the present." In concrete terms, anything that has been reimbursed by health insurance (e.g.: medications, biological or X-ray procedure, hospital stay, surgical procedure) is reported in this base and may be used via access specific to the project.
Real-time data By providing access to health data, the idea is to exploit its full potential, in the interests of the community. This idea is changing and evolving: "in addition to clinical trials for which we collect data for research, in a prospective manner, we are now developing research that uses the data we have in real life - through care and research - to answer a great many questions concerning practices and courses of treatment." This opens up many options for research, to improve therapeutic decisions, practices and the organization of care.
Sophie Houzard's work involves crossing the SNDS base with the Institut Curie bases, for example the Breast base. These bases give very precise information on patients and their cancer, but they are limited to their treatment at Curie. By merging them with the SNDS bases, Dr. Houzard can collect a huge amount of information on courses of treatment, outside of their treatment at Institut Curie, about events arising during other pathologies, treated in other centers, or life events such as pregnancy. In short, information that is not necessarily included in patients' medical records.
Today 4,500 medical records of patients treated for breast cancer at Curie have been merged with their SNDS data. Their long-term goal is to obtain data for 40,000 patients treated for breast cancer since 2006.
"Through this chaining with the SNDS, I will for example be able to identify pregnancies of patients treated for breast cancer at Curie, those that received another treatment during their chemotherapy, etc. And there we have another field of research!"
But what do we actually do with this data? Since she has been working on the project, Sophie Houzard has worked on the cervical cancer vaccination as well as follow-up after breast cancer.
The access to real-life data is very instructive in terms of the patient's course of treatment," she explains. We noticed that after breast cancer, patients are not as well monitored as best practice recommendations require, and that we have some way to go in terms of organization. The aim behind all this is to streamline and improve these courses of treatment and better understand their impact on survival.