1
|
Leucht S, Siafis S, Rodolico A, Peter NL, Müller K, Waibel J, Strube W, Hasan A, Bauer I, Brieger P, Davis JM, Hamann J. Shared Decision Making Assistant (SDMA) and other digital tools for choosing antipsychotics in schizophrenia treatment. Eur Arch Psychiatry Clin Neurosci 2023; 273:1629-1631. [PMID: 38017193 PMCID: PMC10713760 DOI: 10.1007/s00406-023-01712-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Affiliation(s)
- Stefan Leucht
- Department of Psychiatry and Psychotherapy, School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany.
- German Center for Mental Health (Deutsches Zentrum für Psychische Gesundheit, DZPG), Munich, Germany.
| | - Spyridon Siafis
- Department of Psychiatry and Psychotherapy, School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
- German Center for Mental Health (Deutsches Zentrum für Psychische Gesundheit, DZPG), Munich, Germany
| | - Alessandro Rodolico
- Department of Psychiatry and Psychotherapy, School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - Natalie L Peter
- Department of Psychiatry and Psychotherapy, School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - Katharina Müller
- Department of Psychiatry and Psychotherapy, School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
- Psychiatry and Psychotherapy, kbo-Isar-Amper-Klinikum München, Munich, Germany
| | - Jakob Waibel
- Department of Psychiatry and Psychotherapy, School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - Wolfgang Strube
- Psychiatry, Psychotherapy and Psychosomatics, University Augsburg, Augsburg, Germany
| | - Alkomiet Hasan
- German Center for Mental Health (Deutsches Zentrum für Psychische Gesundheit, DZPG), Munich, Germany
- Psychiatry, Psychotherapy and Psychosomatics, University Augsburg, Augsburg, Germany
| | - Ingrid Bauer
- Psychiatry, Psychotherapy and Psychosomatics, University Augsburg, Augsburg, Germany
| | - Peter Brieger
- Psychiatry and Psychotherapy, kbo-Isar-Amper-Klinikum München, Munich, Germany
| | - John M Davis
- Department of Psychiatry, University of Chicago at Illinois, Chicago, USA
| | - Johannes Hamann
- Department of Psychiatry and Psychotherapy, School of Medicine and Health, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
- Psychiatry, Bezirkskrankenhaus Mainkofen, Deggendorf, Germany
| |
Collapse
|
2
|
Siafis S, Bursch N, Müller K, Schmid L, Schuster F, Waibel J, Huynh T, Matthes F, Rodolico A, Brieger P, Bühner M, Heres S, Leucht S, Hamann J. Evidence-based Shared-Decision-Making Assistant (SDM-assistant) for choosing antipsychotics: protocol of a cluster-randomized trial in hospitalized patients with schizophrenia. BMC Psychiatry 2022; 22:406. [PMID: 35715740 PMCID: PMC9204887 DOI: 10.1186/s12888-022-04036-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/01/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Choosing an antipsychotic medication is an important medical decision in the treatment of schizophrenia. This decision requires risk-benefit assessments of antipsychotics, and thus, shared-decision making between physician and patients is strongly encouraged. Although the efficacy and side-effect profiles of antipsychotics are well-established, there is no clear framework for the communication of the evidence between physicians and patients. For this reason, we developed an evidence-based shared-decision making assistant (SDM-assistant) that presents high-quality evidence from network meta-analysis on the efficacy and side-effect profile of antipsychotics and can be used as a basis for shared-decision making between physicians and patients when selecting antipsychotic medications. METHODS The planned matched-pair cluster-randomised trial will be conducted in acute psychiatric wards (n = 14 wards planned) and will include adult inpatients with schizophrenia or schizophrenia-like disorders (N = 252 participants planned). On the intervention wards, patients and their treating physicians will use the SDM-assistant, whenever a decision on choosing an antipsychotic is warranted. On the control wards, antipsychotics will be chosen according to treatment-as-usual. The primary outcome will be patients' perceived involvement in the decision-making during the inpatient stay as measured with the SDM-Q-9. We will also assess therapeutic alliance, symptom severity, side-effects, treatment satisfaction, adherence, quality of life, functioning and rehospitalizations as secondary outcomes. Outcomes could be analysed at discharge and at follow-up after three months from discharge. The analysis will be conducted per-protocol using mixed-effects linear regression models for continuous outcomes and logistic regression models using generalised estimating equations for dichotomous outcomes. Barriers and facilitators in the implementation of the intervention will also be examined using a qualitative content analysis. DISCUSSION This is the first trial to examine a decision assistant specifically designed to facilitate shared-decision making for choosing antipsychotic medications, i.e., SDM-assistant, in acutely ill inpatients with schizophrenia. If the intervention can be successfully implemented, SDM-assistant could advance evidence-based medicine in schizophrenia by putting medical evidence on antipsychotics into the context of patient preferences and values. This could subsequently lead to a higher involvement of the patients in decision-making and better therapy decisions. TRIAL REGISTRATION German Clinical Trials Register (ID: DRKS00027316 , registration date 26.01.2022).
Collapse
Affiliation(s)
- Spyridon Siafis
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany.
| | - Nicola Bursch
- grid.6936.a0000000123222966Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | | | - Lisa Schmid
- grid.6936.a0000000123222966Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Florian Schuster
- grid.476609.a0000 0004 0477 3019Schön Klinik Roseneck, Rosenheim, Germany
| | - Jakob Waibel
- grid.6936.a0000000123222966Department of Informatics, Technical University of Munich, Munich, Germany
| | - Tri Huynh
- grid.6936.a0000000123222966Department of Informatics, Technical University of Munich, Munich, Germany
| | - Florian Matthes
- grid.6936.a0000000123222966Department of Informatics, Technical University of Munich, Munich, Germany
| | - Alessandro Rodolico
- grid.8158.40000 0004 1757 1969Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | | | - Markus Bühner
- grid.5252.00000 0004 1936 973XPsychological Methodology and Diagnostics, Ludwig Maximilian University, Munich, Germany
| | | | - Stefan Leucht
- grid.6936.a0000000123222966Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Johannes Hamann
- grid.6936.a0000000123222966Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| |
Collapse
|
3
|
Elgün S, Waibel J, Kehrer C, van Rappard D, Böhringer J, Beck-Wödl S, Just J, Schöls L, Wolf N, Krägeloh-Mann I, Groeschel S. Phenotypic variation between siblings with Metachromatic Leukodystrophy. Orphanet J Rare Dis 2019; 14:136. [PMID: 31186049 PMCID: PMC6560893 DOI: 10.1186/s13023-019-1113-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 06/04/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Metachromatic Leukodystrophy (MLD) is a rare autosomal-recessive lysosomal storage disorder caused by mutations in the ARSA gene. While interventional trials often use untreated siblings as controls, the genotype-phenotype correlation is only partly understood, and the variability of the clinical course between siblings is unclear with some evidence for a discrepant clinical course in juvenile patients. The aim of this study was to systematically investigate the phenotypic variation in MLD siblings in comparison to the variability in a larger MLD cohort and to case reports published in literature. RESULTS Detailed clinical information was available from 12 sibling-pairs (3 late-infantile, 9 juvenile) and 61 single patients (29 late-infantile, 32 juvenile). Variability of age at onset was similar between the siblings and randomly chosen pairs of the remaining cohort (no statistically different Euclidean distances). However, in children with juvenile MLD both the type of first symptoms and the dynamic of the disease were less variable between siblings compared to the general cohort. In late-infantile patients, type of first symptoms and dynamic of disease were similarly homogeneous between siblings and the whole MLD cohort. Thirteen published case reports of families with affected siblings with MLD are presented with similar findings. CONCLUSIONS In a systematic analysis of phenotypic variation in families with MLD, siblings with the late-infantile form showed a similar variability as unrelated pairs of children with late-infantile MLD, whereas siblings with juvenile MLD showed a more homogeneous phenotype regarding type of first symptoms and disease evolution in comparison to unrelated children with juvenile MLD, but not regarding their age at onset. These results are highly relevant with respect to the evaluation of treatment effects and for counseling of families with affected siblings.
Collapse
Affiliation(s)
- Saskia Elgün
- Department of Paediatric Neurology and Developmental Medicine, University Children's Hospital Tübingen, Hoppe-Seyler-Strasse 1, 72076, Tübingen, Germany
| | - Jakob Waibel
- Department of Paediatric Neurology and Developmental Medicine, University Children's Hospital Tübingen, Hoppe-Seyler-Strasse 1, 72076, Tübingen, Germany
| | - Christiane Kehrer
- Department of Paediatric Neurology and Developmental Medicine, University Children's Hospital Tübingen, Hoppe-Seyler-Strasse 1, 72076, Tübingen, Germany
| | - Diane van Rappard
- Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, and Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Judith Böhringer
- Department of Paediatric Neurology and Developmental Medicine, University Children's Hospital Tübingen, Hoppe-Seyler-Strasse 1, 72076, Tübingen, Germany
| | - Stefanie Beck-Wödl
- Department of Medical Genetics, University Hospital Tübingen, Tübingen, Germany
| | - Jennifer Just
- Clinical Neurogenetics Section, Department of Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Ludger Schöls
- Clinical Neurogenetics Section, Department of Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE) Tübingen, Tübingen, Germany
| | - Nicole Wolf
- Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, and Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Ingeborg Krägeloh-Mann
- Department of Paediatric Neurology and Developmental Medicine, University Children's Hospital Tübingen, Hoppe-Seyler-Strasse 1, 72076, Tübingen, Germany
| | - Samuel Groeschel
- Department of Paediatric Neurology and Developmental Medicine, University Children's Hospital Tübingen, Hoppe-Seyler-Strasse 1, 72076, Tübingen, Germany.
| |
Collapse
|
4
|
Karmisholt KE, Haerskjold A, Karlsmark T, Waibel J, Paasch U, Haedersdal M. Early laser intervention to reduce scar formation - a systematic review. J Eur Acad Dermatol Venereol 2018; 32:1099-1110. [PMID: 29419914 DOI: 10.1111/jdv.14856] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 01/11/2018] [Indexed: 11/28/2022]
Abstract
The ability of laser treatment to affect wound healing and subsequently minimize scar formation has been investigated in recent years. However, no systematic review links these clinical trials. The aim of this study was to systematically review and evaluate clinical evidence for early laser intervention to reduce scar formation in studies where laser treatment was introduced less than 3 months after wounding. We searched PubMed using relevant keywords in June 2017. Titles, abstracts and articles were sorted according to inclusion and exclusion criteria. Methodological quality was evaluated according to Cochrane Collaborations risk-of-bias assessment guideline by two independent authors. Twenty-five articles met the inclusion criteria. In total, 22 of 25 studies were controlled studies, and 17 of 25 studies compared laser treatment vs. untreated control scars. The following laser devices have been investigated: pulsed dye laser (PDL), potassium-titanyl-phosphate (KTP) laser, fractional erbium:glass 1540 nm/1550 nm, fractional/full ablation erbium-doped yttrium aluminium garnet (Er:YAG) laser or fractional CO2 laser. Eighteen studies applied laser treatments 2-4 times with 2- to 8-week intervals, while seven studies applied only one laser treatment. Follow-up time ranged from 1 to 12 months with 18 studies using a follow-up time ≤3 months. In general, laser-treated wounds and scars showed benefit from laser intervention, though not always reaching significance. Significant scar improvement was found in three of four studies using laser treatment in inflammation phase, in six of 16 studies with laser initiated in the proliferation phase and in two of five studies in the remodelling phase. High risk of bias was found in randomization and allocation concealment, and low risk of bias with regard to blinding of outcome assessment and lost to follow-up. In conclusion, laser intervention when introduced in inflammation, proliferation or remodelling phase has the potential to reduce cutaneous scar formation. Further, high-quality studies are needed before standard protocols can be implemented in clinical practice.
Collapse
Affiliation(s)
- K E Karmisholt
- Department of Dermatology, Venereology and Wound Healing, Bispebjerg University Hospital, Copenhagen, Denmark
| | - A Haerskjold
- Department of Dermatology, Venereology and Wound Healing, Bispebjerg University Hospital, Copenhagen, Denmark
| | - T Karlsmark
- Department of Dermatology, Venereology and Wound Healing, Bispebjerg University Hospital, Copenhagen, Denmark
| | - J Waibel
- Miami Dermatology and Laser Institute, Miami, FL, USA
| | - U Paasch
- Department of Dermatology, Venereology and Allergology, University of Leipzig, Leipzig, Germany
| | - M Haedersdal
- Department of Dermatology, Venereology and Wound Healing, Bispebjerg University Hospital, Copenhagen, Denmark
| |
Collapse
|
5
|
Hansen J, Waibel J, Clad A, Oehler M, Klar M. Validity parameters of the HPV detection tests HC2 and APTIMA with and without cytology smears after surgical treatment of high grade cervical intraepithelial neoplasia lesions. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
6
|
Frenzel M, Dettner K, Wirth D, Waibel J, Boland W. Cantharidin analogues and their attractancy for ceretopogonid flies (Diptera: Ceratopogonidae). ACTA ACUST UNITED AC 1992. [DOI: 10.1007/bf01923620] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
7
|
|
8
|
Rossi L, Waibel J, vom Bruck CG. Repeatability and reproducibility of measurements of vinyl chloride concentrations in materials and articles made of polyvinyl chloride. Food Cosmet Toxicol 1980; 18:527-35. [PMID: 7203300 DOI: 10.1016/0015-6264(80)90169-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
9
|
Affiliation(s)
- G. Billek
- Unilever Research Laboratory; Hamburg Germany
| | - G. Guhr
- Unilever Research Laboratory; Hamburg Germany
| | | |
Collapse
|
10
|
Guhr G, Waibel J. Untersuchungen an Fritierfetten; Zusammenhänge zwischen dem Gehalt an petroläther-unlöslichen oxidierten Fettsäuren und dem Gehalt an polaren Substanzen bzw. dem Gehalt an polymeren Triglyceriden. ACTA ACUST UNITED AC 1978. [DOI: 10.1002/lipi.19780800304] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
11
|
|
12
|
Arens M, Guhr G, Waibel J, Kroll S. Bestimmung des Gehaltes an petroläther-unlöslichen oxidierten Fettsäuren zur Beurteilung von Brat- und Siedefetten. ACTA ACUST UNITED AC 1977. [DOI: 10.1002/lipi.19770790802] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
13
|
Lang K, Henschel J, Waibel J, Billek G. [Nutrition-physiological properties of frying fats. 4. Influence on the life expectation of experimental animals]. Z Ernahrungswiss 1973; 12:241-7. [PMID: 4798681 DOI: 10.1007/bf02020643] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|