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Augustin M, Langenbruch A, Blome C, Gutknecht M, Werfel T, Ständer S, Steinke S, Kirsten N, Silva N, Sommer R. Characterizing treatment-related patient needs in atopic eczema: insights for personalized goal orientation. J Eur Acad Dermatol Venereol 2019; 34:142-152. [PMID: 31465587 DOI: 10.1111/jdv.15919] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/08/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND Atopic eczema (AE) is a common and burdensome chronic skin disease. Clinical guidelines suggest an evidence-based, personalized and stepwise treatment approach. Only few studies have so far focused on the specific patient needs in treatment. OBJECTIVES To characterize therapeutic needs of patients with AE in routine care. METHODS Nationwide cross-sectional study in 91 dermatology practices and outpatient clinics. Descriptive statistics were used for valuation. Comparisons of HRQoL and general health status were performed including subgroups (age, gender and disease duration). Group comparisons of patient needs were performed for age groups, gender and disease duration. Correlations between patients' needs (PNQ) and HRQoL, generic health status and severity were tested. In addition, a hierarchical regression analysis was performed to determine which variables contribute to explain the variance in patient needs. RESULTS Analysis of 1678 patients (60.5% female, mean age 38.35 ± 15.92 years) revealed a high disease burden with mean SCORAD of 42.26 ± 18.63, mean DLQI of 8.49 ± 6.45 and mean EQ VAS of 63.62 ± 21.98. Among the patient needs that were most frequently rated as 'quite important'/'very important' were as follows: 'to be free of itching' (96.0%), 'to get better skin quickly' (87.7%) and 'to be healed of all skin defects' (85.7%). In general, older people, women and patients who had been diagnosed with AE for 1 year or less rated the treatment needs as more important than younger patients, men and patients who had been diagnosed with AE for more than 1 year. Major determinants of higher needs were skin-related quality of life impairments, higher disease severity and higher age. CONCLUSIONS Patients with AE show a high number and variety of therapeutic needs related to disease signs and symptoms, which are associated with individual disease burden. The patient needs vary substantially according to patient characteristics. Identification of patient-specific needs may support personalized, patient-centred care and shared decision-making.
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Affiliation(s)
- M Augustin
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - A Langenbruch
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - C Blome
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Gutknecht
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hanover, Germany
| | - S Ständer
- Center for Chronic Pruritus, Department of Dermatology, University Hospital Münster, Münster, Germany
| | - S Steinke
- Center for Chronic Pruritus, Department of Dermatology, University Hospital Münster, Münster, Germany
| | - N Kirsten
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - N Silva
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - R Sommer
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Rencz F, Brodszky V, Gulácsi L, Péntek M, Poór A, Holló P, Szegedi A, Remenyik É, Sárdy M, Langenbruch A, Radtke M, Gutknecht M, Augustin M. Time to revise the Dermatology Life Quality Index scoring in psoriasis treatment guidelines. J Eur Acad Dermatol Venereol 2019; 33:e267-e269. [DOI: 10.1111/jdv.15537] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- F. Rencz
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
- Premium Postdoctoral Research Programme Hungarian Academy of Sciences Nádor u. 7 H‐1051 Budapest Hungary
| | - V. Brodszky
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - L. Gulácsi
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - M. Péntek
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - A.K. Poór
- Department of Dermatology, Venereology and Dermatooncology Semmelweis University Mária u. 41 H‐1085 Budapest Hungary
| | - P. Holló
- Department of Dermatology, Venereology and Dermatooncology Semmelweis University Mária u. 41 H‐1085 Budapest Hungary
| | - A. Szegedi
- Departments of Dermatology University of Debrecen Nagyerdei krt. 98 H‐4032 Debrecen Hungary
- Department of Dermatological Allergology University of Debrecen Nagyerdei krt. 98 H‐4032 Debrecen Hungary
| | - É. Remenyik
- Departments of Dermatology University of Debrecen Nagyerdei krt. 98 H‐4032 Debrecen Hungary
| | - M. Sárdy
- Department of Dermatology, Venereology and Dermatooncology Semmelweis University Mária u. 41 H‐1085 Budapest Hungary
| | - A. Langenbruch
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
| | - M.A. Radtke
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
| | - M. Gutknecht
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
| | - M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
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Augustin M, Langenbruch A, Gutknecht M, Reich K, Korber A, Maassen D, Mrowietz U, Thaci D, von Kiedrowski R, Radtke M. 银屑病严重程度的定义. Br J Dermatol 2018. [DOI: 10.1111/bjd.17304] [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: 11/29/2022]
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4
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Augustin M, Langenbruch A, Gutknecht M, Reich K, Körber A, Maaßen D, Mrowietz U, Thaçi D, von Kiedrowski R, Radtke M. Definition of psoriasis severity. Br J Dermatol 2018. [DOI: 10.1111/bjd.17289] [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: 11/29/2022]
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5
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Augustin M, Langenbruch A, Gutknecht M, Reich K, Körber A, Maaßen D, Mrowietz U, Thaçi D, von Kiedrowski R, Radtke M. Definition of psoriasis severity in routine clinical care: current guidelines fail to capture the complexity of long-term psoriasis management. Br J Dermatol 2018; 179:1385-1391. [DOI: 10.1111/bjd.17128] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2018] [Indexed: 12/21/2022]
Affiliation(s)
- M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - A. Langenbruch
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - M. Gutknecht
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - K. Reich
- Dematologikum Berlin; Berlin Germany
| | - A. Körber
- Clinic for Dermatology; Essen University Hospital; Essen Germany
| | - D. Maaßen
- Dermatological Practice Maxdorf; Maxdorf Germany
| | - U. Mrowietz
- Department for Dermatology, Venerology and Allergology; University Medical Center Schleswig-Holstein; Kiel Germany
| | - D. Thaçi
- Comprehensive Center for Inflammation Medicine; University Medical Center Schleswig-Holstein; Lübeck Germany
| | | | - M.A. Radtke
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
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6
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Langenbruch A, Radtke M, Gutknecht M, Augustin M. Does the Dermatology Life Quality Index (DLQI) underestimate the disease‐specific burden of psoriasis patients? J Eur Acad Dermatol Venereol 2018; 33:123-127. [DOI: 10.1111/jdv.15226] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 08/14/2018] [Indexed: 11/26/2022]
Affiliation(s)
- A. Langenbruch
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - M.A. Radtke
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - M. Gutknecht
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
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Gutknecht M, Herberger K, Klose K, Purwins S, Dietz D, Blome C, Augustin M. Cost-of-illness of patients with lymphoedema. J Eur Acad Dermatol Venereol 2017; 31:1930-1935. [DOI: 10.1111/jdv.14442] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 06/21/2017] [Indexed: 11/29/2022]
Affiliation(s)
- M. Gutknecht
- Institute for Health Services Research in Dermatology and Nursing (IVDP); German Center for Health Services Research in Dermatology (CVderm); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - K. Herberger
- Institute for Health Services Research in Dermatology and Nursing (IVDP); German Center for Health Services Research in Dermatology (CVderm); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - K. Klose
- Institute for Health Services Research in Dermatology and Nursing (IVDP); German Center for Health Services Research in Dermatology (CVderm); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - S. Purwins
- Institute for Health Services Research in Dermatology and Nursing (IVDP); German Center for Health Services Research in Dermatology (CVderm); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - D. Dietz
- Institute for Health Services Research in Dermatology and Nursing (IVDP); German Center for Health Services Research in Dermatology (CVderm); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - C. Blome
- Institute for Health Services Research in Dermatology and Nursing (IVDP); German Center for Health Services Research in Dermatology (CVderm); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP); German Center for Health Services Research in Dermatology (CVderm); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
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8
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Jungen D, Augustin M, Langenbruch A, Zander N, Reich K, Strömer K, Thaci D, Purwins S, Radtke M, Gutknecht M. Cost-of-illness of psoriasis - results of a German cross-sectional study. J Eur Acad Dermatol Venereol 2017; 32:174-180. [DOI: 10.1111/jdv.14543] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 08/03/2017] [Indexed: 02/06/2023]
Affiliation(s)
- D. Jungen
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - A. Langenbruch
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - N. Zander
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - K. Reich
- Dermatologikum Hamburg; Hamburg Germany
| | - K. Strömer
- Professional Association of German Dermatologists (BVDD); Mönchengladbach Germany
| | - D. Thaci
- Comprehensive Center for Inflammation Medicine; University Hospital Schleswig-Holstein; Campus Lübeck; Lübeck Germany
| | - S. Purwins
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - M. Radtke
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - M. Gutknecht
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
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9
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Droeschel D, Gutknecht M, Walzer S, Lindsay F, Shannon R, Augustin M. Eine probabilistische Kosteneffektivitätsanalyse einer azellulären synthetischen Matrix (ASM) als Ergänzung zur
Standardversorgung venöser und gemischter Ulzera cruris in Deutschland auf Basis eines Discrete-Event-Simulations-Modells. Gesundh ökon Qual manag 2017. [DOI: 10.1055/s-0043-109570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Zusammenfassung
Ziel Das vorliegende gesundheitsökonomische Modell wurde entwickelt, um in Deutschland standardmäßig Therapien im Bereich chronische
Wunden systematisch und vergleichend zu analysieren. In der zugrunde liegenden Analyse wurden die gesundheitsökonomischen Parameter von
Patienten mit einem Ulcus cruris venosum/mixtum, die zusätzlich zur Standardversorgung (SV) mit einer azellulären synthetischen Matrix (ASM)
behandelt wurden, berechnet und mit denen von Patienten verglichen, die nur eine Standardversorgung erhalten haben.
Methodik Zunächst wurde in den (Standard-)Literaturdatenbanken systematisch nach einem gesundheitsökonomischen Modell gesucht. Die
Ergebnisse dieser Literatursuche werden in einer anderen Publikation zur Methodik und Modellbeschreibung ausführlich diskutiert. Angesichts
des Fehlens eines publizierten, akzeptierten und für Deutschland adäquaten Modells wurde in Form eines Discrete-Event-Simulations-Modells
(DES-Modell) ein neues gesundheitsökonomisches Modell für den Bereich chronische Wunden entwickelt. Auf Basis des DES-Modells wurde eine
Kosteneffektivitätsanalyse aus Sicht der Gesetzlichen Krankenversicherung (GKV) durchgeführt. Für die Kostendaten wurden GKV-Routinedaten
genutzt. Patienten aus dem Deutschen Register chronischer Wunden (DRCW), die nur mit der SV behandelt wurden und ähnliche
Patientencharakteristika aufwiesen, wurden mit Patienten aus einer einarmigen multizentrischen Phase-II-Studie einer azellulären
synthetischen Matrix (ASM) verglichen. Die Wirksamkeit der Behandlung (1-Jahres-Vorhersage) wurde mittels Kaplan-Meier-Kurven für die
12-Wochen-Heilungszeit der SV + ASM im Vergleich zur alleinigen Behandlung mit der SV berechnet. Die Modellergebnisse wurden mittels einer
probabilistischen Sensitivitätsanalyse für ulzerationsfreie Tage validiert und die Ergebnisse jeweils in einem Scatterplot der geschätzten
gemeinsamen Dichte der inkrementellen Kosten und der inkrementellen Effekte der SV versus der SV + ASM sowie in einer
Kosteneffektivitäts-Akzeptanz-Kurve dargestellt.
Ergebnisse Die Kosteneffektivitätsanalyse zeigte, dass eine auf SV + ASM basierende Therapie gemäß dem Modell effektiver (0,008
inkrementeller Effekt ambulant; −0,045 inkrementeller Effekt stationär) und kostensparender (−321,14 €) ist und somit aus
gesundheitsökonomischer Sicht als dominant gegenüber der SV angesehen werden kann. Zusätzlich zeigten sich die Therapien in der
Versorgungssäule Facharzt gegenüber denen in der Versorgungssäule Hausarzt als zumindest gleich effektiv und kosteneinsparend und somit
dominant. Bei Berücksichtigung der ambulanten Pflege in Verbindung mit dem jeweiligen Arzt war die hausärztliche Versorgung zwar gleich
effektiv, aber kostensparender (129,40 € vs. 187,20 € = −57,80 €) als die fachärztliche Versorgung und somit dominant. Die Dominanz nach
Hausarzt und Facharzt sowie mit ambulanter Pflege war konsistent zu der, die sich aus der Kosteneffektivität ergibt.
Schlussfolgerung Die azelluläre synthetische Matrix (ASM) bestätigte in einer klinischen Studie ihre signifikanten Heilungschancen,
die in das gesundheitsökonomische Modell zur chronischen Wunde eingeflossen sind. Unter den zugrunde liegenden Modellannahmen bekräftigt das
Modell angesichts von Kosteneinsparungen in allen Behandlungspfaden eines Ulcus cruris venosum/mixtum die Wirtschaftlichkeit einer möglichen
Verordnung der ASM im deutschen Kontext.
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Affiliation(s)
- D. Droeschel
- MArS Market Access & Pricing Strategy GmbH, Weil am Rhein, Deutschland
- SRH FernHochschule Riedlingen, Riedlingen, Deutschland
| | - M. Gutknecht
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf,
Hamburg, Deutschland
| | - S. Walzer
- MArS Market Access & Pricing Strategy GmbH, Weil am Rhein, Deutschland
- Duale Hochschule Baden-Württemberg, Lörrach, Deutschland
| | | | - R. Shannon
- Health Economic Project LLT, New York, USA
- Duale Hochschule Baden-Württemberg, Lörrach, Deutschland
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf,
Hamburg, Deutschland
| | - M. Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf,
Hamburg, Deutschland
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Krenzlin H, Grauwet K, Behara1 P, Griessl M, Gutknecht M, Cook CH, Chiocca AE, Lawler S. P08.30 CMV infection influences paracrine interactions in the glioblastoma microenvironment and amplifies the angiogenic phenotype. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.219] [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: 11/13/2022] Open
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11
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Gutknecht M, Schaarschmidt ML, Herrlein O, Augustin M. A systematic review on methods used to evaluate patient preferences in psoriasis treatments. J Eur Acad Dermatol Venereol 2016; 30:1454-64. [DOI: 10.1111/jdv.13749] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 12/22/2015] [Indexed: 11/30/2022]
Affiliation(s)
- M. Gutknecht
- Institute for Health Services Research in Dermatology and Nursing (IVDP); German Center for Health Services Research in Dermatology (CVderm); University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - M.-L. Schaarschmidt
- Institute for Health Services Research in Dermatology and Nursing (IVDP); German Center for Health Services Research in Dermatology (CVderm); University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - O. Herrlein
- Institute for Health Services Research in Dermatology and Nursing (IVDP); German Center for Health Services Research in Dermatology (CVderm); University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP); German Center for Health Services Research in Dermatology (CVderm); University Medical Center Hamburg-Eppendorf; Hamburg Germany
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Lohrberg D, Gutknecht M, Blome C. Frühe Nutzenbewertungen im dermatologischen Bereich. Akt Dermatol 2015. [DOI: 10.1055/s-0034-1392785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- D. Lohrberg
- Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M. Gutknecht
- Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - C. Blome
- Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf, Hamburg
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13
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Blome C, Augustin M, Gutknecht M, Schaarschmidt M. Die Messung des patientenrelevanten Nutzens in der Dermatologie. Akt Dermatol 2015. [DOI: 10.1055/s-0034-1392784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- C. Blome
- Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M. Augustin
- Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M. Gutknecht
- Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M. Schaarschmidt
- Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf, Hamburg
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Schaarschmidt M, Gutknecht M, Augustin M. Patientenpräferenzen in der Dermatologie. Akt Dermatol 2015. [DOI: 10.1055/s-0034-1392780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- M. Schaarschmidt
- Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M. Gutknecht
- Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M. Augustin
- Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf, Hamburg
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Gutknecht M, Herrlein O, Augustin M. Methods Used To Measure Patient Preferences In Psoriasis Treatments - An Overview With Regards To The German Iqwig And G-Ba. Value Health 2014; 17:A574. [PMID: 27201924 DOI: 10.1016/j.jval.2014.08.1930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- M Gutknecht
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - O Herrlein
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Augustin
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Augustin M, Gutknecht M, Anastasiadou Z, Heyer K, Harding K, Shannon RJ, Heinrichs EL. Comparative Effectiveness of An Acellular Synthetic Matrix As An Adjunct to Standard Care In The Treatment of Venous And Mixed Leg Ulcers: Modeling of Clinical Data And Routine Data. Value Health 2014; 17:A604. [PMID: 27202091 DOI: 10.1016/j.jval.2014.08.2100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- M Augustin
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Gutknecht
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Z Anastasiadou
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Heyer
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - R J Shannon
- Global Health Economic Projects LLC, Clifton Park, NY, USA
| | - E L Heinrichs
- Daresbury Innovation Centre, Daresbury, Cheshire, UK
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17
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Blome C, Stute P, Gutknecht M, Augustin M. Entwicklung einer Methodik zur Erfassung der Lebensqualität sowie patientenseitiger Bedarfe und Nutzen in der Therapie des klinischen Bildes vulvovaginaler Atrophie. Dtsch Med Wochenschr 2012. [DOI: 10.1055/s-0032-1323195] [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: 10/27/2022]
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18
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Karger S, Krause K, Gutknecht M, Schierle K, Graf D, Steinert F, Dralle H, Führer D. ADM3, TFF3 and LGALS3 are discriminative molecular markers in fine-needle aspiration biopsies of benign and malignant thyroid tumours. Br J Cancer 2012; 106:562-8. [PMID: 22223087 PMCID: PMC3273347 DOI: 10.1038/bjc.2011.578] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Previously, we reported a six-marker gene set, which allowed a molecular discrimination of benign and malignant thyroid tumours. Now, we evaluated these markers in fine-needle aspiration biopsies (FNAB) in a prospective, independent series of thyroid tumours with proven histological outcome. Methods: Quantitative RT–PCR was performed (ADM3, HGD1, LGALS3, PLAB, TFF3, TG) in the needle wash-out of 156 FNAB of follicular adenoma (FA), adenomatous nodules, follicular and papillary thyroid cancers (TC) and normal thyroid tissues (NT). Results: Significant expression differences were found for TFF3, HGD1, ADM3 and LGALS3 in FNAB of TC compared with benign thyroid nodules and NT. Using two-marker gene sets, a specific FNAB distinction of benign and malignant tumours was achieved with negative predictive values (NPV) up to 0.78 and positive predictive values (PPV) up to 0.84. Two FNAB marker gene combinations (ADM3/TFF3; ADM3/ACTB) allowed the distinction of FA and malignant follicular neoplasia with NPV up to 0.94 and PPV up to 0.86. Conclusion: We demonstrate that molecular FNAB diagnosis of benign and malignant thyroid tumours including follicular neoplasia is possible with recently identified marker gene combinations. We propose multi-centre FNAB studies on these markers to bring this promising diagnostic tool closer to clinical practice.
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Affiliation(s)
- S Karger
- Department of Internal Medicine, Neurology and Dermatology, Clinic for Endocrinology and Nephrology, University of Leipzig, Liebigstr. 18, 04103 Leipzig, Germany
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Karger S, Krause K, Gutknecht M, Jeßnitzer B, Tannapfel A, Schmid KW, Gimm O, Dralle H, Führer D. Oxidative stress in the thyroid – DNA damage and repair: Important mechanisms in the pathogenesis of thyroid tumours? Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972282] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Karger S, Krause K, Gutknecht M, Jeßnitzer B, Tannapfel A, Schmid KW, Grimm O, Dralle H, Führer D. Oxidative stress in the thyroid: an important mechanism in the pathogenesis of cold thyroid nodules? Exp Clin Endocrinol Diabetes 2006. [DOI: 10.1055/s-2006-932903] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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21
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Karger S, Eszlinger M, Gutknecht M, Dralle H, Hoang-Vu C, Paschke R, Führer D. Quantification of PPARg expression in different thyroid pathologies. Exp Clin Endocrinol Diabetes 2004. [DOI: 10.1055/s-2004-819135] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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22
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Feige K, Gutknecht M, Drouard F, Auer JA. Fresh frozen plasma therapy for substitution of coagulation factors in 4 horses with haemoperitoneum. PFERDEHEILKUNDE 2002. [DOI: 10.21836/pem20020616] [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: 11/27/2022]
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23
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Breuninger H, Gutknecht M, Dietz K, Rassner G. [Locally infiltrative growth of squamous cell carcinoma of the skin and treatment guidelines resulting from it]. Hautarzt 1991; 42:559-63. [PMID: 1938407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The infiltrative growth behaviour of squamous cell of the skin carcinomas is characterized by subclinical outgrowths, very frequently extending horizontally and sometimes over long distances. They are presented in the form of a negative exponential function. These outgrowths have an irregular pattern. It is much more extensive in the case of tumours with a clinical diameter of more than 20 nm. All types of "blind" therapy such as cryopexy, irradiation, laser, and surgery monitored in only two dimensions involve an inevitable risk of recurrences, which can be calculated statistically from the results available. Routine histographical surgery of skin carcinomas in the form of continuous, 3-dimensional histology can dramatically reduce the risk of local relapse, especially in the case of small and medium-sized carcinomas. The test group presented here (411 carcinomas) was treated with histographic surgery using the paraffin section method; during the follow-up period (maximum: 7 years, minimum: 3 years) the danger of recurrence was 2.2% for all carcinomas but only 0.6% for those up to 20 mm in diameter (n = 340). Carcinomas with a diameter of more than 20 mm (n = 71) involved a much higher risk of recurrence with 9.8%. This is probably because of local micrometastases, which require more generous local excision with a safety margin of about 10 mm.
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