Abstract
Background
Chronic liver diseases (CLDs) are frequent in Europe, including in France, and are mainly driven by alcohol, metabolic dysfunction (diabetes and obesity), and viral hepatitis. Although risk factors are well established and easy to identify, CLDs are frequently diagnosed at an advanced stage, translating into poor prognosis. Descriptive data on CLD burden in France remain scarce, and health trajectories of these patients are uncharted. However, such data are crucial to guide clinical practice, to determine the target population for personalized public health policies, and to develop innovative strategies to reduce inequities in access to health care 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
The RESONANCE cohort was derived from the French National Health Data System (Système National des Données de Santé [SNDS]). Patients with at least one CLD-specific ICD-10 (International Statistical Classification of Diseases, Tenth Revision) code (including primary liver cancer [PLC] and rare diseases), or related procedure, biology, or drug and/or a cause of death related to one of these ICD-10 codes, were targeted from the 2% representative SNDS sample (ESND [Échantillon du Système National des Données], Simplified Sample of the French National Health Data System). Demographic characteristics, risk factors, comorbidities, etiologies, social environment and health care accessibility, as well as severity of the liver disease at first identification and medical management, were assessed. This paper describes the procedures used to build the cohort, outlines main variables, and defines the research objectives.
Results
Overall, 26,663 incident and prevalent CLD cases identified between 2015 and 2021 were included in the RESONANCE cohort. Men accounted for 58.1% (15,490) of the cohort, and the mean age was 59.9 (SD 17.4) years. The cohort covers a broad spectrum of etiologies, including alcohol-related liver disease (7580/26,663, 28.4%), metabolic-associated liver disease (6030/26,663, 24.8%), viral hepatitis (3450/26,663, 12.9%), and rare liver diseases (839/26,663, 3.1%). A total of 43% (11,461/26,663) of the patients lived in a socially deprived environment (according to the 4th and 5th quintiles of the French Deprivation Index).
Conclusions
This paper will enable a detailed, real-world analysis of epidemiology, care trajectories, and outcomes of CLDs across France. With a particular focus on gender and socioeconomic disparities, it offers a unique opportunity to identify vulnerable populations and inform proportionate universalism strategies in prevention and care.
International Registered Report Identifier (IRRID)
DERR1-10.2196/89577