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Article History

Received: 27 June 2025

Revised: 7 December 2025

Accepted: 25 January 2026

First Online: 5 February 2026

Competing interests

: The authors declare no competing interests.

: This study was conducted in accordance with French legislation on the reuse of health data for research purposes. The use of data from the French National Health Data System (SNDS) was authorised by the French data protection authority (CNIL). All data were anonymized before analysis, and no identifiable patient information was accessed. As such, individual informed consent was not required. The SNDS includes all mandatory health insurance reimbursement data of the French population, in particular data from the processing of health care reimbursements (electronic or paper treatment sheet) and data from health establishments (PMSI). EPI-PHARE has permanent regulatory access to the data from the SNDS via its constitutive bodies ANSM and CNAM, in application of the provisions of the French Decree No. 2016-1871 of 26 December 2016 relating to the processing of personal data called the ‘National Health Data System’ 15, the French law articles Art. R. 1461-1316 and R. 1461-1417 from the French Public Health Code and the CNIL decision CNIL-2016-316.18. In accordance, this work did not require any specific opinion from the French Ethical and Scientific Committee for Research, Studies and Evaluations health (CESREES) nor approval from the CNIL. All requests in the database were made by duly authorised people. The study was registered on the study register of EPIPHARE concerning studies from SNDS data under the reference T-2024-01-481.

: As this study used anonymized data from a national database, consent for publication was not required.