1. Annual Report 2025
  2. Research
  3. GRIMTra

GRIMTra

Research Group on the Impact of Chronic Diseases and Their Trajectories 

The research group primarily focuses on investigating the associations between chronic diseases, a concept known as multimorbidity (MM).

Disease development relies on numerous genetic factors as well as external factors that influence gene expression, such as environmental conditions, social status, and lifestyle.

The study of MM across individuals' lifespans and the duration within each MM category is commonly referred to as MM trajectories or disease trajectories.

Utilizing artificial intelligence and bioinformatics, the group aims to integrate diverse data types through algorithms to personalize health recommendations more effectively.

Consequently, the group's objectives include the identification of MM clusters, determination of their trajectories, and analysis of the influencing factors.

These objectives will be pursued by leveraging electronic medical records, genetic and environmental data, lifestyle and social information, using advanced informatics techniques within population-based cohorts connected to electronic health records.

Grup projects​​​​​​

  • Salut mental i factors associats en els adults joves de La Mina i La Pau després de la pandèmia COVID-19. 2022-2025. IP: Francesc Orfila Pernas.

  • Prevalença del registre de la malaltia per fetge gras no alcohòlic a les històries clíniques a l'atenció primària. LiverRecord project (estudi pilot). Fundació d'Atenció Primària (FAP) - CAMFIC. 2024-2027. IP: Alba Martínez Escudé.

  • Niveles de TSH como factor de riesgo independiente del HGNA y fibrosis hepática en la población general. Col.legi Oficial de Metges de Barcelona. 2022-2025. IP: Carmen Expósito Martínez.

  • Multimorbilidad en el Sistema Nacional de Salud: Caracterización poblacional e impacto de sus patrones y trayectorias en personas mayores (Proyecto MM-SNS). (PI22/01398). Instituto de Salud Carlos III. 2022-2025. IP: Concepció Violán Fors.

  • L'impacte de la barrera idiomàtica en l'atenció a la consulta d'atenció primària de la població dels barris de Raval Nord i Gòtic de Barcelona. 2022-2025. IP: Francesc Orfila Pernas.

  • Infecció post-vacunal per SARS-CoV2: Estudi de cohort per la caracterització de la resposta immune i desenvolupament d'un model de predicció per establir criteris de revacunació a Catalunya (BreakCOVID). (SLT021/21/000038). Generalitat Catalunya. 2022-2025. IP: Concepció Violán Fors.

  • Expresión de PD-L1 y Marcadores Inflamatorios en la Evolución de Infecciones Virales Respiratorias Agudas en Adultos Mayores de 60 años: Estudio Observacional Prospectivo en Ateción Primaria. (CPP2024-011444). Affirma Biotech S.L; Ministerio de Ciencia e Innovación. 2025-2028. IP: Concepció Violán Fors.

  • Estudi de l'impacte de la pandèmia per Sars-CoV-2 en les cobertures vacunals a Catalunya. ICS - Institut Català de la Salut. 2022-2025. IP: Edurne Zabaleta del Olmo.

  • Epidemiología clínica de la enfermedad del hígado graso no alcohólico en niños y adolescentes. Estudio LiverKids. (SLT021/21/000047). Generalitat Catalunya. 2022-2025. IP: Carmen Expósito Martínez.

  • Construcción y validación de un Score predictivo de riesgo de institucionalización, ingresos hospitalarios y mortalidad, en mayores de 65 años con multimorbilidad y fragilidad - Validación SNAC-K (OMOP). 2023-2026. IP: Concepció Violán Fors.

  • Caracterització dels equips d'atenció primària de Catalunya i predicció dels ingressos hospitalaris evitables durant el període 2018-2022. Institut d'Investigació en Atenció Primària Jordi Gol i Gurina (IDIAPJGol). 2024-2027. IP: Concepció Violán Fors.

  • Avaluació de la Fragilitat Física, Cognitiva i Social. Interrelacions, factors associats i factors pronòstic d'institucionalització i mort. ICS - Institut Català de la Salut. 2022-2025. IP: Francesc Orfila Pernas.

  • Adaptació i validació de la "Practice Environment Scale of the Nursing Work Index" al context organitzatiu dels equips d'Atenció Primària de salut i penitenciària de l'Institut Català de la Salut. 2022-2025. IP: Edurne Zabaleta del Olmo.

  • Multimorbidity and Frailty Trajectories and Explainable Prediction Models for Health-related Outcomes Using Longitudinal Electronic Health Records of the Ageing Catalan Population. Institut d'Investigació en Atenció Primària Jordi Gol i Gurina (IDIAPJGol). IP: Lucía Amalia Carrasco Ribelles.

  • La microcirculació retiniana com a factor de risc cardiovascular. ICS - Institut Català de la Salut. 2023IP: Antoni Heras Tébar.

  • Estudi del fetge gras no alcohòlic i les seves comorbiditats associades a Catalunya. Fundació Academia Ciencies Mediques de Catalunya I de Balears (L'Acadèmia). 2023IP: Alba Martínez Escudé.

  • Construcción y validación de un Score predictivo de riesgo de institucionalización, ingresos hospitalarios y mortalidad, en mayores de 65 años con multimorbilidad y fragilidad. (FI20/00040). Instituto de Salud Carlos III. 2020-2025. IP: Lucía Amalia Carrasco Ribelles.

  • Clinical epidemiology of non-alcoholic fatty liver disease in children and adolescents. The LiverKids Study. (PREDOC_ECO-23/18). ICS - Institut Català de la Salut. 2024-2029. IP: Carla Chacón Valera.

Group publications

  • Orfila F, Leiva Bañuelos N, Vázquez Ibar O, Molloy DW, O'Caoimh R. Validity of the Spanish version of the quick mild cognitive impairment screen (Qmci-S). J. Alzheimers Dis. 2026;109(2):853-863. PMID:41348517.

  • Carrasco Ribelles LA, Cabrera Bean M, Llanes Jurado J, Violán C. Use of Attention Maps to Enrich Discriminability in Deep Learning Prediction Models Using Longitudinal Data from Electronic Health Records. Appl. Sci.- Basel. 2025;15(1).

  • Blay N, Carrasco Ribelles LA, Farré X, Iraola Guzmán S, Danés Castells M, Violán C et al. Weighting health-related estimates in the GCAT cohort and the general population of Catalonia. Sci Rep. 2025;15(1):16984-16984. PMID:40374680.

  • Alvarez Sierra D, Martínez Gallo M, Sánchez Montalvá A, Fernández Sanmartín M, Colobran R, Espinosa Pereiro J et al. The immune response to SARS-CoV-2 in COVID-19 as a recall response susceptible to immune imprinting: A prospective cohort study. Clin. Immunol. 2025;272110429-110429. PMID:39842683.

  • Zabaleta Olmo E, Rey Renones C, Marchal Torralbo A, Sauch Valmana G, Calvet Tort G, Planas Campmany C et al. Structural Validity and Reliability of an Adapted Practice Environment Scale-Nursing Work Index for Primary Health Care Nurses. Res. Nurs. Health. 2025;48(5):533-544. PMID:40464625.

  • Lamonja Vicente N, Dacosta Aguayo R, Lopez Oloriz J, Prades Senovilla L, Soriano Raya JJ, Clemente IC et al. Sex and APOE e2 Interactive Effects on the Longitudinal Change in Cognition in a Population-Based Cohort of Older Adults with Vascular Risk Factors. Int. J. Mol. Sci. 2025;26(21): PMID:41226628.

  • Sánchez Recio R, Oliván Blázquez B, Méndez López F, Gascón Santos S, Marti Lluch R, Zabaleta Olmo E et al. Self-reported health and depression among EIRA cohort: a moderated mediation model of sex and perceived social support. Front. Psychol. 2025;161540530-1540530. PMID:40584072.

  • Lopez Dicastillo O, Iriarte Roteta A, Antoñanzas Baztán E, Sola Cia S, Mujika A, Hernantes N et al. PromoACTIVA-SC: A Tool Aiming at Identifying Health Promotion Practice of Civil Society Organizations. Healthcare. 2025;13(17):PMID:40941450.

  • Bermudo Gallaguet A, Ariza M, Agudelo D, Camins Vila N, Boldó M, Ferrer Uris B et al. Effects of mindfulness and exercise on cognition and emotion in adults with mild deficits in the chronic post-stroke phase: A randomized controlled trial. Ann. Phys. Rehabil. Med. 2025;68(7):102008-102008. PMID:40845631.

  • Lamonja Vicente N, Tintorer DL, Palau Antoja M, León Gómez BB, Torán Monserrat P. Dietary and Behavioral Interventions for Diabetes: Current Evidence, Challenges, and Opportunities. Nutrients. 2025;17(16):PMID:40871632.

  • López Luque M, Chuecos Molina M, Ortega Cuelva G, Vázquez López MJ, Orfila Pernas F, Granel Giménez N et al. Effectiveness of a Structured Self-Management Intervention to Improve Quality of Life in Individuals With Chronic Obstructive Pulmonary Disease (AMPOC Study). Open Respir Arch. 2025;7(2):100426-100426. PMID:40547384.

  • Moreno Gabriel E, Bielsa Pascual J, Verdaguer M, Carmona Cervelló M, Lamonja Vicente N, León Gómez BB et al. Experiencias de las personas con sintomatología neuropsicológica de covid persistente en Cataluña: un estudio fenomenológico. Aten. Prim. 2025;57(6):103214-103214. PMID:39854988.

  • Arteaga I, Chacón C, Martínez Escudé A, Rojano IR, Diez Fadrique G, Carmona Cervelló M et al. Evaluating Pediatric NAFLD with Controlled Attenuation Parameter: A Comprehensive Narrative Review. Diagnostics. 2025;15(3):PMID:39941229.

  • Romaguera M, Heras A, Gonfaus MS, Màrquez BD, Guarner M, Alòs F. From global strategy to local consultation: A future vision of physical activity in primary care. Aten. Prim. 2025;57(8):103321-103321. PMID:40592238.

  • Esteban Fabró R, Coma E, Marin Gomez FX, Hermosilla E, Mendez Boo L, Guiriguet C et al. Financial incentives and information provision for post-pandemic primary care quality recovery: a longitudinal study in Catalonia. Br. J. Gen. Pract. 2026;PMID:41344817.

  • Violán C, Quirant Sánchez B, Palau Antoja M, Palacin D, Pradenas E, Trigueros M et al. Immune Durability and Breakthrough Infections 15 Months After SARS-CoV-2 Boosters in People over 65: The Innersion Study. Vaccines. 2025;13(7):PMID:40733715.

  • Domínguez Armengol G, Ribas Aulinas F, Balló E, Alzamora Sas M, Serrat Costa M, Ruiz Comellas A et al. Health program for prEvention of cardiovascuLar disEases based on a risk screeNing strategy with Ankle-brachial index: HELENA study protocol. Front. Public Health. 2025;131484163-1484163. PMID:40520295.

  • López C, Reverté L, Príncep RB, Sauras E, Gallardo Borràs N, Fischer Carles A et al. Influence of the Molecular Subtype-Dependent Immune Microenvironment of Metastatic Axillary Lymph Nodes on Breast Cancer Patient Outcomes. Pathobiology. 2025;1-13. PMID:41474659.

  • Marzo Castillejo M, Mascort Roca J, Brau Tarrida A, Carrasco Ribelles L, Monteagudo Zaragoza M, Guiriguet Capdevila C et al. Participant selection for lung cancer screening using primary care electronic medical records: The Catalan scenario. Aten. Prim. 2026;58(1):103363-103363. PMID:41260054.

  • Alòs F, Romaguera M, Claramunt FXC, Orfila F, Mínguez DA, Puig Ribera A. Physical activity in the digital age: Challenges and opportunities for primary care. Aten. Prim. 2025;57(12):103301-103301. PMID:40494157.

  • Graupera I, Thiele M, Castera L, Pera G, Piano S, Soria A et al. High prevalence of undiagnosed liver fibrosis in the adult european population driven by metabolic risk factors and alcohol consumption. results from the prospective liverscreen cohort in 30,541 subjects. J. Hepatol. 2025;82.

  • Politi J, Black A, Barboza C, Mosseveld M, Crespo LP, Palomar Cros A et al. DARWIN EU®-Prevalence of Frailty and Polypharmacy in Selected Cancers: results from Six European Countries in a Real-World Context. Pharmacoepidemiol. Drug Saf. 2025;34201-202.

  • Gratac s Gin s J, Soria A, Nadal R, Pera G, Perez Guasch M, Cervera M et al. ALD is diagnosed at more advanced stages of fibrosis as compared to MetALD and MASLD in the general population. J. Hepatol. 2025;82.

  • Murrin O, Mounier N, Voller B, Tata L, Gallego Moll C, Roso Llorach A et al. A systematic analysis of the contribution of genetics to multimorbidity and comparisons with primary care data. EBioMedicine. 2025;113105584-105584. PMID:39919332.

  • Seyedi S, Sottile S, Abedini M, Boffetta P, Violante FS, Lodi V et al. Antibody Kinetics of Immunological Memory in SARS-CoV-2-Vaccinated Healthcare Workers-The Orchestra Project. Vaccines. 2025;13(6):PMID:40573941.

  • Giner Soriano M, Carrasco Ribelles LA, Fernández García S, Castel Llobet J, Cereza García G, Morros R. Association Between Anticoagulants and Interacting Drugs and Risk of Major Bleeding in Nonvalvular Atrial Fibrillation: Case-Control Study in SIDIAP, Catalonia, Spain. Clin. Ther. 2025;47(7):484-491. PMID:40348694.

  • Gonzalez Rio M, Merchan Ruiz M, Reñé A, Bertran Noguer C, Ramió Torrentà L, Zabaleta Olmo E. Cognitive interviewing study to assess the content validity of a Spanish version of the Multiple Sclerosis Health Literacy Questionnaire. Public Health. 2025;245105761-105761. PMID:40393337

  • Gallego Moll C, Carrasco Ribelles LA, Casajuana M, Maynou L, Arocena P, Violán C et al. Predicting Healthcare Utilization Outcomes With Artificial Intelligence: A Large Scoping Review. Value Health. 2026;29(1):159-171. PMID:40848744.

  • Zabaleta Olmo E, Reñé A, Sauch Valmaña G, Rios Jiménez A, Marchal Torralbo A, Rey Reñones C et al. Practice Environment Scale-Nursing Work Index for use in primary health care: a qualitative content validity study. RqR Enferm. Comunitaria. 2025;13(3).

  • Torres SC, Parra Vargas E, Carrasco Ribelles L, Marín Morales J, Alcaniz M. Detecting inhibition and activation tendencies in organizational behavior: a virtual reality and machine learning-based methodological framework. Curr. Psychol. 2025;44(17):14282-14293.

  • Antón Solanas I, Callén Galindo M, Urcola Pardo F, López Dicastillo O, Mujika A, Hernantes N et al. Development and content validation of a questionnaire of activities in health promotion for primary and secondary education: PromoACTIVA-CE. BMC Public Health. 2025;26(1):324-324. PMID:41437015.

  • Carrasco Ribelles LA, Cabrera Bean M, Khalid S, Roso Llorach A, Violan C. Development of Attention-based Prediction Models for All-cause Mortality, Home Care Need, and Nursing Home Admission in Ageing Adults in Spain Using Longitudinal Electronic Health Record Data. J. Med. Syst. 2025;49(1):17-17. PMID:39862306.

  • La Carrasco Ribelles, M Cabrera Bean, A Prats Uribe, S Khalid, C Viol n. Is fine-tuning useful in EHR-based prediction models? A use case on mortality prediction with longitudinal data from Spanish (SIDIAP) and UK (CPRD) populations aged over 65 years. 2025 Ieee 38th International Symposium On Computer-Based Medical Systems, Cbms. 2025;107-. 110.

  • Velickovic VM, Bou J, Cegri F, Llatas FP. Management of Moderate-to-Highly Exuding Leg Ulcers With Polyacrylate Dressings VS. Foam Dressings in Spanish Settings: an Early Stage Cost-Effectiveness and Budget-Impact Analysis. Value Health. 2025;28(12).

  • Raventos A, Clavé P, Bascompte C, Bartolomé M, Engel G, Toran P et al. Prevalence and clinical characteristics of fecal incontinence in women from Mataró: A population-based study. Neurogastroenterol. Motil. 2025;37.

  • Soria A, Nadal R, Cervera M, Carol M, Hoyo J, Martinez S et al. Validation of small transient elastography device for liver fibrosis and steatosis detection in a population-based study. J. Hepatol. 2025;82.

  • Lopez LifanteVM, HerreroC, LamonjaN, BoguñaL, CharroC, ToránP. Adecuación entre la derivación a oftalmologia desde atención primária por sospecha de retinografia diabética y el diagnóstico final en base a la retinografia de cribado en práctica clínica habitualy utilidad e un sistema automatizado de detección. RETINA. En: XLV Congreso de la semFYC. 2025.

  • León Gómez BB, Carmona Cervelló M, Dacosta Aguayo R, Lamonja Vicente N, Bielsa Pascual J, López Lifante VM et al. Prevalence and severity of anxiety, stress, and depression in long COVID among adults in Barcelona. BJGP Open. 2025;9(3):PMID:39848702.

  • Herrero C. Lopez LifanteVM, PriorA, ToránP, ViolanC. Programas de ejercicio supervisado versus no supervisado y calidad de visa usando VascuQoL 6 y Short Forum 12 en pacientes de edad avanzada con claudicación intermitente: un ensayo aleatorizado. En: 47 Congreso Nacional SEMERGEN. 2025

  • Martínez CE, Jorde SF, Garrido A, Garmilla NF, García JC. Survey on knowledge of metabolic liver disease (EHMet) among Primary Care Physicians in Spain. Med. Fam.-SEMERGEN. 2025;51(5): PMID:39908841.

Proceeding Papers

  • Soria A, Nadal R, Cervera M, Carol M, Hoyo J, Martinez S et al. Validation of small transient elastography device for liver fibrosis and steatosis detection in a population-based study. J. Hepatol. 2025;82

  • Raventos A, Clavé P, Bascompte C, Bartolomé M, Engel G, Toran P et al. Prevalence and clinical characteristics of fecal incontinence in women from Mataró: A population-based study. Neurogastroenterol. Motil. 2025;37

  • Velickovic VM, Bou J, Cegri F, Llatas FP. Management of Moderate-to-Highly Exuding Leg Ulcers With Polyacrylate Dressings VS. Foam Dressings in Spanish Settings: an Early Stage Cost-Effectiveness and Budget-Impact Analysis. Value Health. 2025;28(12):

  • La Carrasco Ribelles, M Cabrera Bean, A Prats Uribe, S Khalid, C Viol n. Is fine-tuning useful in EHR-based prediction models? A use case on mortality prediction with longitudinal data from Spanish (SIDIAP) and UK (CPRD) populations aged over 65 years. 2025 Ieee 38th International Symposium On Computer-Based Medical Systems, Cbms. 2025;107-. 110.

  • Graupera I, Thiele M, Castera L, Pera G, Piano S, Soria A et al. High prevalence of undiagnosed liver fibrosis in the adult european population driven by metabolic risk factors and alcohol consumption. results from the prospective liverscreen cohort in 30,541 subjects. J. Hepatol. 2025;82

  • Politi J, Black A, Barboza C, Mosseveld M, Crespo LP, Palomar Cros A et al. DARWIN EU®-Prevalence of Frailty and Polypharmacy in Selected Cancers: results from Six European Countries in a Real-World Context. Pharmacoepidemiol. Drug Saf. 2025;34201-202.

  • Gratac s Gin s J, Soria A, Nadal R, Pera G, Perez Guasch M, Cervera M et al. ALD is diagnosed at more advanced stages of fibrosis as compared to MetALD and MASLD in the general population. J. Hepatol. 2025;82

  • HerreroC, Lopez LifanteVM, PriorA, ToránP, ViolanC. Programas de ejercicio supervisado versus no supervisado y calidad de visa usando VascuQoL 6 y Short Forum 12 en pacientes de edad avanzada con claudicación intermitente: un ensayo aleatorizado. En: 47 Congreso Nacional SEMERGEN. 2025.

  • Lopez LifanteVM, HerreroC, LamonjaN, BoguñaL, CharroC, ToránP. Adecuación entre la derivación a oftalmologia desde atención primária por sospecha de retinografia diabética y el diagnóstico final en base a la retinografia de cribado en práctica clínica habitualy utilidad e un sistema automatizado de detección. RETINA. En: XLV Congreso de la semFYC. 2025.

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