Abstracts by keywords: prevention
Since the first publication of the "Thesis paper on the pandemic caused by SARS-CoV-2/Covid-19 - improve the database, further develop prevention in a targeted manner, protect civil rights" on April 5th, 2020, the development has taken a rapid and sometimes surprising course. On April 15, 2020, at the conference of the Federal Chancellor and Prime Minister, measures to relax containment were taken on individual points (e.g. reopening of certain shops, some schools, etc.) (Anonymous 2020). This was preceded by the Leopoldina’s third ad hoc statement (Leopoldina 2020) on April 13, 2020, the European Commission’s recommendation of April 11, 2020 to relax containment measures in the EU area (European Commission 2020) and the statement by the non-university research institutions on April 28, 2020 (Kleiner et al. 2020). The result was partially contradictory recommendations, but overall the official side is sticking to the restriction of public life, access to education, freedom of occupation and some fundamental rights such as freedom of movement and demonstration. The conference of the Federal Chancellor and Prime Minister on April 30, 2020 did not deviate from this line either, but the importance of regional problem-solving skills was emphasized (point 3).
04.04.2020
The present text sets itself the task of scientifically clarifying the epidemiological problem and deriving recommendations for effective preventive measures from the given situation. The suggestions for prevention are placed in a socio-political framework which, for the authors, is inextricably linked to the facts described. The extensive analytical part is preceded by a shorter summary, which is intended to enable quick orientation about the points of view represented. As would be expected for a thesis paper, the most important results are condensed into three theses with corresponding sub-points, which can be found verbatim in the summary and at the end of the respective chapters. The authors strive to clearly identify the facts and problems. This does not mean any criticism of the people involved who in the past few weeks had to make decisions under the conditions of - the increase is permitted - "even more incomplete information" than is the case today. In every respect, the statements in this thesis paper are intended as constructive contributions with the purpose of supporting the decisions of the coming weeks.
04.04.2020
In times of demographic change and especially with an increasing proportion of older people and chronic degenerative diseases such as cardiovascular diseases and orthopedic restrictions, the importance of caring for them increases. An important component of the supply chain is prevention services (Pfaff/Schrappe 2011: 19). Patient-relevant endpoints are central cornerstones of patient preferences: patient orientation, along with results orientation and multidisciplinarity/professionalism, is a basic assumption of health care research. We know from working with patients that the quality of results can also be seen in gains in patient care. Measures such as health and quality of life are indicators of such patient-relevant endpoints or gains. It is important to understand “what interests the patient has and how they can be actively involved in decisions” (Neugebauer 2011: 42). In the following, the current state of research on patient preferences and patient-relevant endpoints will be discussed so that the concept can then be transferred to the area of prevention services.
31.03.2015
Atrial fibrillation (AF) is one of the most common cardiac arrhythmias in adults with a high number of unreported cases and increasing prevalence. AF patients have an increased risk of death and illness, for example from strokes. Strokes, on the other hand, are life-threatening events and the most common reason for permanent disability in adulthood. They are associated with considerable medical expenses. The primary and secondary prevention of a stroke in AF is therefore of great importance. It starts with treating the cause of the AF. Oral anticoagulation (OAC) is also an effective medical method to prevent strokes in AF patients. This article is based on findings from the white paper “Stroke Prevention in Atrial Fibrillation” published by the IGES Institute in September 2015 and has been supplemented by information that has been published since then. The care recommendations presented in the white paper are based, among other things, on discussions with experts from the fields of cardiology, neurology, primary care, patient representation and health insurance.
31.03.2015
“The true profession of the dentist is the preservation of natural teeth, but not the extraction of them and the insertion of artificial ones, which may only take place when the former is no longer possible,” wrote the Leipzig dentist S. Guttmann as early as 1829 (Laurisch 2000 ). This historical definition of dentistry has lost none of its relevance today. However, a paradigm shift from curative to preventative dentistry did not occur in Germany until the mid-1990s, when systematic prophylactic concepts were developed for the entire life span with its age-typical risks (IDZ 1996). The Federal Dental Association (BZÄK), the German Society for Dentistry, Oral and Maxillofacial Medicine (DGZMK) and the National Association of Statutory Health Insurance Dentists (KZBV) jointly took up this concept as a basis for the “new description of a prevention-oriented dental, oral and maxillofacial medicine” and adopted it together with the presentation of legal framework conditions for sustainable implementation in both politics and health care (BZÄK et al. 2004). The Statutory Health Insurance Reform Act in 2000 also led to a realignment of dental treatment guidelines and a realignment of the evaluation standard for dental services (BEMA) according to the model of cause-based and prevention-oriented dentistry. Conservative surgical services were upgraded and at the same time other dental services were devalued.
24.01.2013
Chronic coronary heart disease (CHD) contributes significantly to mortality, morbidity and loss of quality of life in Germany. Improved therapies and secondary and tertiary drug prevention have contributed to a significant decrease in CHD-related mortality in recent years. The improved survival with CHD and the growing proportion of the older population lead to an increase in the prevalence of the disease and its complications. The present publication is intended to present the morbidity, mortality and prevalence of chronic CHD in Germany and to identify the population groups that are particularly frequently affected by the disease. In addition, aspects of the burden of disease (quality of life, premature mortality and medical costs) are taken into account. Furthermore, gaps in care and potential for optimizing secondary and tertiary prevention for patients with chronic CHD should be identified.
24.01.2013
The so-called multi-criteria decision analysis (MCEA) can be used to support complex technology assessments. Multi-criteria decision analysis procedures have their origins in decision theory or operations research and are used there to make decisions under uncertainty. They assist decision makers in evaluating a finite number of alternative health interventions using a finite number of performance criteria. In addition to conjoint analysis, the elimination and choice translating reality method (ELECTRE) and the multiattribute utility theory (MAUT) (Lootsma/Schujit 1997), the most widely used multi-criteria decision analysis tools include the Analytic Hierarchy Process (AHP).
24.01.2013
In Germany, medical care is largely financed by contributions from insured persons. This results in the normative and ethical obligation of statutory health insurance to provide the optimum level of health services with maximum benefit for the insured. It is important to reduce waste, use resources efficiently, and all results must be meaningful, especially for patients. The health insurance companies, together with the service providers and the patients, are responsible for achieving these goals and a primarily scientifically based approach (SGB V §§ 2, 12, 35b, 70). The question of what is useful is described, for example, in SGB V § 35b as “improving the state of health, shortening the duration of the illness, extending the lifespan, reducing side effects and improving the quality of life”. This maxim can be found in an identical form in the G-BA's Rules of Procedure, in the Drug Benefit Assessment Ordinance or in the IQWiG method paper for benefit assessment. The statement that the benefit assessment has to be based on “patient-relevant target values” is of particular importance. “In this context, “patient-relevant” should be understood as how a patient feels, can perceive their functions and activities or whether they survive.” (IQWiG 2011, p. 30f)
24.01.2013
On February 1, 2006, a pilot project began in Wolfsburg that was intended to examine the suitability of a new concept for preventing cervical cancer for everyday use. In order to evaluate the project, it is essential to understand the special features of cervical cancer, in particular the knowledge gained over the last three decades from basic research on the role of human papilloma viruses (HPV) in the development of this tumor.
23.09.2012
Diabetic foot syndrome is a secondary disease of diabetes mellitus and often leads to non-traumatic amputations. These are associated with high medical costs, loss of quality of life and high mortality (Heller et al. 2004). Diabetic foot syndrome occurs with a prevalence of 6.5% among type 2 diabetes patients (Lauterbach et al. 2010). Endogenous risk factors such as B. diabetic polyneuropathy or peripheral arterial disease (PAD) have a prevalence of 30% and 25%, respectively (Lauterbach et al. 2010). Prevention of diabetic foot syndrome is therefore very important. In addition to the endogenous risk factors mentioned, exogenous factors such as: For example, inadequate footwear or poor foot care play a crucial role (Uccioli et al. 1995; Chantelau/Haage 1994; Brent et al. 2006). According to the International Consensus on the Diabetic Foot (1999), the prevalence of diabetic foot syndrome could be reduced through, among other things, regular inspections of the feet and footwear, training of patients and family members and the wearing of suitable footwear. An important and effective intervention measure is to train and instruct patients to self-inspect their feet.