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Dive into the research topics where Jean-Michel Cauvin is active.

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Featured researches published by Jean-Michel Cauvin.


Gastroenterologie Clinique Et Biologique | 2004

Factors associated with liver steatosis and fibrosis in chronic hepatitis C patients.

Franck Cholet; Jean-Baptiste Nousbaum; Martial Richecœur; Emmanuel Oger; Jean-Michel Cauvin; Nicole Lagarde; Michel Robaszkiewicz; Hervé Gouérou

UNLABELLED Liver steatosis is a common finding in patients infected with hepatitis C virus (HCV). Host and viral factors have been associated with steatosis, but their relative contributions have not been clearly addressed. It has been suggested that steatosis plays a role in the progression of liver fibrosis. AIMS To assess: a) factors associated with steatosis in patients infected with hepatitis C virus; b) their impact on liver fibrosis. PATIENTS AND METHODS Three hundred and fourteen untreated patients were included. Lifetime alcohol consumption was estimated. Liver fibrosis, inflammation and necrosis were assessed using the METAVIR score. Body mass index (BMI) was determined. The scoring system for steatosis was as follows: 0, no steatosis; 1, less than 10%; 2, 10% to 30%; 3, 30% to 70%; 4, more than 70% of hepatocytes affected. RESULTS In univariate analysis, steatosis was associated with elevated BMI (P=0.001), excessive alcohol intake (P=0.005), genotype 3 (P<0.001) and moderate to severe histological activity (P=0.01). Multivariate analysis showed that steatosis correlated with two independent factors: genotype 3a (OR=60.7; 95% CI: 7.6-483.4) (P<0.001) and BMI (OR=4.86; 95% CI: 1.8-13.15) (P=0.002). In univariate analysis, severe fibrosis (F2-F3-F4) was associated with older age (P<10(-5)), male gender (P=0.001), disease duration (P<0.006), BMI (P<10(-4)), alcohol intake (P<10(-6)), severity of histological activity (P<10(-5)) and steatosis (P<10(-6)). In multivariate analysis, three independent factors were associated with severe fibrosis: disease duration > 10 years (OR=3.17; 95% CI: 0.65-15.4) (P=0.015), presence of steatosis (OR=3.17; 95% CI: 1-9.99) (P<0.049) and genotype 3a (OR=5.56; 95% CI: 1.4-22.1) (P=0.015). CONCLUSION In patients with chronic hepatitis C, steatosis is significantly associated with genotype 3 infection and high BMI. Steatosis is an independent risk factor associated with severe fibrosis. These results have major implications for the management of patients with chronic hepatitis C.


Gastroenterologie Clinique Et Biologique | 2005

Epidemiology and long term survival of gastric carcinoma in the French district of Finistere between 1984 and 1995.

Joseph Fayçal; Christophe Bessaguet; Jean-Baptiste Nousbaum; Jean-Michel Cauvin; Franck Cholet; Karine Bideau; Michel Robaszkiewicz; Hervé Gouérou

OBJECTIVES The aims of this study were to evaluate trends in incidence, clinical characteristics, treatment regimen and prognosis of gastric carcinoma in the area of Finistere (France) during a 12-year period. METHODS Between 1984 and 1995, the Finistere Registry of GastroIntestinal Tract Tumors listed 2 139 patients with gastric carcinoma in a population of 838 627 inhabitants. Curative resection and operative mortality were analyzed by logistic regression. Prognostic factors were determined using the Kaplan-Meier method and the Cox model. RESULTS When comparing the second period (1990-1995) to the first period (1984-1989) we observed: a) a decrease of standardized incidence (13.2 vs. 15.6/100 000 inhabitants/year in males and 5.4 vs. 7.0/100 000 inhabitants/year in females); b) a significant increase of linitis plastica (21.4% vs. 10.9%) and infiltrative tumors (53.1 vs. 31.2%) (P<0.0001); c) no variation in tumor stage at diagnosis; d) a significant increase in curative resection (65.7% vs. 45.0%; P<0.0001); e) no variation in operative mortality; f) the absence of improvement of survival rate; the latter was 29% at 2 years, 19% at 5 years and 11% at 10 years during the second period. Multivariate analysis showed that the main prognostic factors of gastric carcinoma were age, tumor stage and the type of surgical procedure. CONCLUSION This study showed a decrease in the incidence of gastric carcinoma over time and an increase of linitis plasticia and infiltrative forms. Despite improvement in management of patients, the global prognosis of gastric carcinoma did not improve significantly over a 12-year period of observation.


Acta Paediatrica | 1995

Neonatal nosocomial respiratory infection with coronavirus: a prospective study in a neonatal intensive care unit

J. Sizun; D. Soupre; M.C. Legrand; J. D. Giroux; S. Rubio; Jean-Michel Cauvin; C. Chastel; D Mix; L de Parscau

The aim of this prospective study was to evaluate the incidence of viral respiratory infection in hospitalized premature newborn infants and to assess the role of coronaviruses. All hospitalized premature infants with a gestational age less than or equal to 32 weeks were included. Tracheal or nasopharyngal specimens were studied by immunofluorescence for coronaviruses, respiratory syncytial virus, adenoviruses, influenza and parainfluenza viruses. Forty premature infants were included; 13 samples were positive in 10 newborns (coronaviruses n = 10; influenza 1 n= 2; adenovirus n= 1). None was positive at admission. All premature infants infected with coronaviruses had symptoms of bradycardia, apnea, hypoxemia, fever or abdominal distension. Chest X‐ray revealed diffuse infiltrates in two cases. However, no significant difference was observed between infected and non‐infected premature infants for gestational age, birth weight, duration of ventilation, age at discharge, incidence of apnea or bradycardia. Nosocomial respiratory tract infection with coronaviruses appears to be frequent. The clinical consequences should be evaluated in a larger population.


international conference of the ieee engineering in medicine and biology society | 2003

Computer-assisted diagnosis system in digestive endoscopy

Jean-Michel Cauvin; C. Le Guillou; B. Solaiman; Michel Robaszkiewicz; P. Le Beux; C. Roux

The purpose of this paper is to present an intelligent atlas of indexed endoscopic lesions that could be used in computer-assisted diagnosis as reference data. The development of such a system requires a mix of medical and engineering skills for analyzing and reproducing the cognitive processes that underlie the medical decision-making process. The analysis of both endoscopists experience and endoscopic terminologies developed by professional associations shows that diagnostic reasoning in digestive endoscopy uses a scene-object approach. The objects correspond to the endoscopic findings and the medical context of examination and the scene to the endoscopic diagnosis. According to expert assessment, the classes of endoscopic findings and diagnoses, their primitive characteristics (or indices), and their relationships have been listed. Each class describes an endoscopic finding or diagnosis in an intensive way. The retrieval method is based on a similarity metric that estimates the membership value of the case under investigation and the prototype of the class. A simulation test with randomized objects demonstrates a good classification of endoscopic findings. The correct class is the unique response in 68% of the tested objects, the first of multiple responses in 28%. Four descriptors are shown to be of major importance in the classification algorithm: anatomic location, shape, color, and relief. At the present time, the application database contains approximately 150 endoscopic images and is accessible via Internet. Experiments are in progress with endoscopists for the validation of the system and for the understanding of the similarity between images. The next step will integrate the system in a learning tool for junior endoscopists.


international conference of the ieee engineering in medicine and biology society | 2009

REFEROCOD: A probabilistic method to medical coding support

Laurent Lecornu; G. Thillay; C. Le Guillou; Pierre-Jean Garreau; P. Saliou; H. Jantzem; John Puentes; Jean-Michel Cauvin

Choosing diagnosis codes is a non-intuitive operation for the practitioner. Mistakes are frequent with severe consequences on healthcare evaluation and funding. French physicians have to assign a code for everything they do and they are not spared with these kinds of errors. We propose a tool named REFEROCOD to support the medical coding task in order to minimize errors without losing time, by suggesting a list of codes in accordance with the physician activities and of the patient medical context. The proposed method uses probabilistic knowledge and indicates the probability to have a proper diagnosis code considering the realized procedure, age, sex and other information available in the discharge abstract.


international conference on information fusion | 2010

Medical diagnosis by possibilistic classification reasoning

Mohammad Homam Alsun; Laurent Lecornu; Basel Solaiman; Clara Le Guillou; Jean-Michel Cauvin

In medicine, diagnostic reasoning refers to the approaches used by physicians with the aim of achieving a medical diagnosis concerning a given patient. This paper presents a new approach of medical decision support systems. The proposed approach is based on the use of possibility theory as a global framework, including knowledge representation (as a possibilistic pair of measures: Necessity, Possibility); and, building a possibilistic medical knowledge base (to be exploited in order to make a diagnostic decision (classification of new medical cases)). The efficiency validation of the proposed approach is conducted using an Endoscopic Knowledge and Case Base systems. Obtained results confirm that the proposed approach constitutes an efficient tool in terms of medical knowledge representation and possibilistic diagnostic reasoning.


international conference of the ieee engineering in medicine and biology society | 2001

Medical image indexing and compression based on vector quantization: image retrieval efficiency evaluation

J.R. Ordonez; Guy Cazuguel; John Puentes; B. Solaiman; Jean-Michel Cauvin; C. Roux

Addresses the problem of efficient image retrieval from a compressed image database, using information derived from the compression process. Images in the database are compressed applying two approaches: vector quantization (VQ) and quadtree image decomposition. Both are based on Konohens self-organizing feature maps (SOFM) for creating vector quantization codebooks. However, while VQ uses one codebook of one resolution to compress the images, Quadtree decomposition uses simultaneously 4 codebooks of four different resolutions. Image indexing is implemented by generating a feature vector (FV) for each compressed image. Accordingly, images are retrieved by means of FVs similarity evaluation between the query image and the images in the database, depending on a distance measure. Three distance measures have been analyzed to assess FV index similarity: Euclidean, intersection and correlation distances. Distance measures efficiency retrieval is evaluated for different VQ resolutions and different quadtree image descriptors. Experimental results using real data, esophageal ultrasound and eye angiography images, are presented.


Archives De Pediatrie | 1998

Pronostic neuro-intellectuel à l'âge scolaire de 62 enfants nés à un âge gestationnel inférieur à 32 semaines*

J. Sizun; C Le Pommelet; Ml Lemoine; Jean-Michel Cauvin; O Sparfel; O Louarn; G Cornec; L de Parscau

AIM: The aim of this study was to detail the incidence of cerebral palsy in children born before 32 weeks of gestation and to evaluate the scholastic and intellectual performance in non-handicapped children. POPULATION AND METHODS: The population included 63 survivors hospitalized in 1984-85 (gestational age: 30.06 +/- 1.21 weeks; birth weight: 1386 +/- 267 g; inborn 60%; male: 38.7%; small for gestational age: 4.8%; hyaline membrane disease: 32%; European: 98.4%). Neurodevelopmental assessment was performed by pediatricians and psychologists using Wisc-R, visual screening by Monoyer scale, hearing by audiometry realized by oto-rhinolaryngologists. RESULTS: There were 62 survivors (one child dead by sudden infant death syndrome). Fifty children evaluated at a mean age of 9.3 +/- 0.7 years and written data available for another eight. Twelve children presented with cerebral palsy. Risk factors were ultrasound abnormalities of parenchymal brain and male gender. In children without cerebral palsy, we observed 12 visual and two hearing impairment. Three were in special education, 32 were in an age-appropriate level, nine with one year below. Neonatal events were not associated with the Wisc-R results except for ultrasound abnormalities of parenchymal brain. Wisc-R was strongly correlated with familial economic and education level. CONCLUSION: School performances in non-handicapped children born before 32 weeks is satisfying. Intellectual performance is mainly correlated with familial economic and education level.


Computer Methods and Programs in Biomedicine | 2013

Information quality measurement of medical encoding support based on usability

John Puentes; Julien Montagner; Laurent Lecornu; Jean-Michel Cauvin

Medical encoding support systems for diagnoses and medical procedures are an emerging technology that begins to play a key role in billing, reimbursement, and health policies decisions. A significant problem to exploit these systems is how to measure the appropriateness of any automatically generated list of codes, in terms of fitness for use, i.e. their quality. Until now, only information retrieval performance measurements have been applied to estimate the accuracy of codes lists as quality indicator. Such measurements do not give the value of codes lists for practical medical encoding, and cannot be used to globally compare the quality of multiple codes lists. This paper defines and validates a new encoding information quality measure that addresses the problem of measuring medical codes lists quality. It is based on a usability study of how expert coders and physicians apply computer-assisted medical encoding. The proposed measure, named ADN, evaluates codes Accuracy, Dispersion and Noise, and is adapted to the variable length and content of generated codes lists, coping with limitations of previous measures. According to the ADN measure, the information quality of a codes list is fully represented by a single point, within a suitably constrained feature space. Using one scheme, our approach is reliable to measure and compare the information quality of hundreds of codes lists, showing their practical value for medical encoding. Its pertinence is demonstrated by simulation and application to real data corresponding to 502 inpatient stays in four clinic departments. Results are compared to the consensus of three expert coders who also coded this anonymized database of discharge summaries, and to five information retrieval measures. Information quality assessment applying the ADN measure showed the degree of encoding-support system variability from one clinic department to another, providing a global evaluation of quality measurement trends.


ieee international conference on information technology and applications in biomedicine | 2009

C2i: A tool to gather medical indexed information

L. Lecornu; C. Le Guillou; Grégoire Thillay; Pierre-Jean Garreau; H. Jantzem; Jean-Michel Cauvin

Choosing the appropriate diagnosis codes in a nomenclature is a non-intuitive task for the practitioner. Mistakes are frequent with severe consequences on healthcare evaluation and funding. As in many countries where the coding is accomplished in a decentralized way, most of the French physicians have to assign a code for everything they do and they are not spared with these kinds of errors and the coding-experts at the Medical Information Department supervise the making of the unit discharge abstracts, and their transmission to the HAS (High Authority in Health Care). The proposed system named C2i aims at supporting the medical coding task for the two involved actor types in order to ensure its completeness and to avoid errors without losing time The proposed approach consists in collecting useful and pertinent medical information in accordance with the physician activities and the patient medical context and, thus, in exploiting this data by a generic approach. The C2i platform is at the same time an inference system, a notification system and a tracking system. The C2i inference system gathers and applies the rules dedicated at each information source while the C2i notification system proposes the coding advices of each source independently or in a combined manner. The C2i tracking system conserves all the facts and applied rules as coding warrant for the retained codes by the physician and as an information source for patient further coding. A prototype of the C2i based on relational database is under development and already illustrates the potential of such a system but also the limits of the relational model to manage complex, highly interrelated information.

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Dive into the Jean-Michel Cauvin's collaboration.

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R. Debon

École Normale Supérieure

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Christian Roux

École Normale Supérieure

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Grégoire Thillay

University of Naples Federico II

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Clara Le Guillou

École Normale Supérieure

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Dalel Bouslimi

Institut Mines-Télécom

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J. Puentes

École Normale Supérieure

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