Public Health, Epidemiology and Health Economics (URSAPES)

The general research theme of the "Public Health, Epidemiology and Health Economics (URSAPES)" Research Unit is in line with the recommendations expressed by the World Health Organization (WHO), within the framework of its program privileging the approaches allowing to maintain the aging population in a state as close as possible to the concept of ideal health (Healthy Ageing). This Research Unit works closely with the WHO Collaborating Centre for Epidemiological Aspects of Musculoskeletal Health and Ageing.

Through observational, analytical, interventional and evaluative studies, the work of URSAPES and the Collaborating Center is focused on the development of reflections, procedures and tools that allow for a better understanding of the determinants of the evolution of health states in order to promote aging free of physical and mental disabilities. Currently, the research of this unit focuses mainly, but not exclusively, on pathologies or health states related to aging of the locomotor system such as osteoporosis, osteoarthritis, sarcopenia, frailty, undernutrition, or falls. Cognitive aspects of aging are the subject of a longer-term research project.  Meta-research has also been a theme of particular interest for several years.

In order to identify and enable the validation and implementation of strategies leading to the ultimate goal of "healthy" aging, URSAPES and the Collaborating Centre are focusing more particularly on areas considered as priorities by the WHO:

• The evaluation of new pharmacological and non-pharmacological interventions from a clinical, ethical, social and economic perspective;
• The evaluation of the determinants of therapeutic adherence in various diseases, at different stages of the disease and at different ages of life;
• The impact of patient participation, taking into account their preferences and their investment in their life project, on the development of therapeutic strategies for the management of chronic locomotor pathologies in the elderly;
• The establishment of procedures for the production and dissemination of Good Clinical Practice recommendations, on a diagnostic and therapeutic level, for health professionals and patients;
• The development and validation, in French and in the languages considered most important by the WHO, of quality of life measurement tools, usable by patients or health care professionals and allowing an immediate evaluation of their condition by primary health care;
• Assessment of dietary habits and preferences and the implication of possible deficiencies in essential nutrients in the development or aggravation of locomotor problems, in high income countries as well as in those considered as middle and low income by the WHO;
• The promotion of physical and psychological health and the prevention of locomotor disabilities through the development of physical activity programs adapted to the elderly;
• The establishment, follow-up and exploitation of large cohorts of healthy subjects and those suffering from locomotor pathologies, in order to understand the factors responsible for the onset and progression of disability;
• The development and validation of techniques allowing the quantification of biological markers, coming from different biological fluids, whose assays help in the diagnosis of musculoskeletal diseases, in the identification of subjects at high risk of rapid progression and in the implementation of strategies of stratified or personalized medicine, joining the "theranostic" concept;
• The development of advanced pharmaco-economic models, such as Monte Carlo micro-simulations or Markov models, recognized by international scientific societies as reference tools for the evaluation of diagnostic, screening, prevention or treatment strategies for bone, cartilage and muscle diseases;
• The use of new technologies, such as connected devices or access to information via the internet or social networks, as evaluative, predictive or preventive tools for the deterioration of health conditions, with an emphasis on interaction with the patient and his involvement in the evaluation of his pathology, for example by means of surveys and "on-line" investigations;
• The validation of portable measurement tools allowing their use in conditions where the movement of subjects to health care facilities is limited;
• The realization of systematic reviews of the literature (systematic reviews, scoping reviews, ...) and meta-analyses (classic or "network" type);
• Dissemination of reference documents produced by the WHO as part of their "Healthy Ageing" project;
• The provision of epidemiological data to the WHO as part of their analysis of the clinical, social and economic impact of musculoskeletal aging;
• Logistical support to WHO for the organization of thematic meetings related to musculoskeletal aging;
• The provision of scientific and regulatory advice in the development of new chemical entities for the diagnosis, prevention and treatment of pathological conditions related to musculoskeletal aging.