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Lemcke J, Loss J, Allen J, Öztürk I, Hintze M, Damerow S, Kuttig T, Wetzstein M, Hövener C, Hapke U, Ziese T, Scheidt-Nave C, Schmich P. Erratum: Health in Germany: Establishment of a population-based health panel. J Health Monit 2024; 9:2-21. [PMID: 38628568 PMCID: PMC11017686 DOI: 10.25646/11992.2] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/22/2024] [Indexed: 04/19/2024]
Abstract
[This corrects the article on p. 2,21 in vol. 9, PMID: 38282983.].
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Affiliation(s)
- Johannes Lemcke
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
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Lemcke J, Loss J, Allen J, Öztürk I, Hintze M, Damerow S, Kuttig T, Wetzstein M, Hövener C, Hapke U, Ziese T, Scheidt-Nave C, Schmich P. Corrigendum: Health in Germany: Establishment of a population-based health panel. J Health Monit 2024; 9:21. [PMID: 38638916 PMCID: PMC11024579 DOI: 10.25646/12077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
[This corrects the article DOI: 10.25646/11992.2.].
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Baumert J, Scheidt-Nave C, Steppuhn H, Tetzlaff F, Kraywinkel K, an der Heiden M, Wengler A, Maier B. Altered Mortality From Selected Non-communicable Diseases During the COVID-19 Pandemic in Germany in 2020 and 2021. Dtsch Arztebl Int 2024; 121:135-136. [PMID: 38518297 PMCID: PMC11019757 DOI: 10.3238/arztebl.m2023.0262] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 11/24/2023] [Accepted: 11/24/2023] [Indexed: 03/24/2024]
Affiliation(s)
- Jens Baumert
- Robert Koch Institute, Department 2: Epidemiology and Health Monitoring, Berlin;
| | - Christa Scheidt-Nave
- Robert Koch Institute, Department 2: Epidemiology and Health Monitoring, Berlin;
| | - Henriette Steppuhn
- Robert Koch Institute, Department 2: Epidemiology and Health Monitoring, Berlin;
| | - Fabian Tetzlaff
- Robert Koch Institute, Department 2: Epidemiology and Health Monitoring, Berlin;
| | - Klaus Kraywinkel
- Robert Koch Institute, Department 2: Epidemiology and Health Monitoring, Berlin;
| | | | - Annelene Wengler
- Robert Koch Institute, Department 2: Epidemiology and Health Monitoring, Berlin;
| | - Birga Maier
- Robert Koch Institute, Department 2: Epidemiology and Health Monitoring, Berlin;
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Müller SA, Isaaka L, Mumm R, Scheidt-Nave C, Heldt K, Schuster A, Abdulaziz M, El-Bcheraoui C, Hanefeld J, Agweyu A. Latent viral infections as neglected risk factors for long COVID - Authors' reply. Lancet Glob Health 2024; 12:e198. [PMID: 38245110 DOI: 10.1016/s2214-109x(23)00595-8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/11/2023] [Indexed: 01/22/2024]
Affiliation(s)
- Sophie Alice Müller
- Centre for International Health Protection, Robert Koch Institute, Berlin 13353, Germany.
| | - Lynda Isaaka
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Rebekka Mumm
- Epidemiology and Health Monitoring, Robert Koch Institute, Berlin 13353, Germany
| | - Christa Scheidt-Nave
- Epidemiology and Health Monitoring, Robert Koch Institute, Berlin 13353, Germany
| | - Katharina Heldt
- Methods Development, Research Infrastructure and Information Technology, Robert Koch Institute, Berlin 13353, Germany
| | - Angela Schuster
- Centre for International Health Protection, Robert Koch Institute, Berlin 13353, Germany; Institute of General Practice and Family Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Mohammed Abdulaziz
- Division of Disease Control and Prevention, Africa CDC, Addis Ababa, Ethiopia
| | - Charbel El-Bcheraoui
- Evidence-based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Johanna Hanefeld
- Centre for International Health Protection, Robert Koch Institute, Berlin 13353, Germany
| | - Ambrose Agweyu
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya; London School of Hygiene and Tropical Medicine, London, UK
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Franco JVA, Garegnani LI, Metzendorf MI, Heldt K, Mumm R, Scheidt-Nave C. Post-covid-19 conditions in adults: systematic review and meta-analysis of health outcomes in controlled studies. BMJ Med 2024; 3:e000723. [PMID: 38293681 PMCID: PMC10826558 DOI: 10.1136/bmjmed-2023-000723] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/27/2023] [Indexed: 02/01/2024]
Abstract
Objective To assess the impact of post-covid-19 conditions among adults. Design Systematic review and meta-analysis of health outcomes in controlled studies. Data sources Two sources were searched from database inception to 20 October 2022: Cochrane covid-19 study register (comprising Cochrane Central Register of Controlled Trials, Medline, Embase, clinicalTrials.gov, World Health Organization's International Clinical Trials Registry Platform, medRxiv) and WHO's covid-19 research database. Eligibility criteria Cohort studies recruiting more than 100 participants with a control group and a follow-up of at least 12 weeks were included. Adults who were documented to have SARS-CoV-2 infection based on clinical, imaging, or laboratory criteria were included. Data extraction and synthesis Two independent reviewers extracted data. The main outcomes included quality of life, functionality in daily activities, use of resources, recovery rates (cluster of symptoms), and the incidence of new medical diagnoses. Data were pooled using a random effects model. The risk of bias was assessed with the Joanna Briggs Institute critical appraisal tool for cohort studies. Results We included 63 controlled cohort studies, encompassing more than 96 million participants. Based on five studies, we found a reduction in overall quality of life between individuals with confirmed SARS-CoV-2 infection versus controls at six to 24 months follow-up, although heterogeneity was very high (mean difference in EQ-5D scale -5.28 (95% confidence interval -7.88 to 2.68; I2=93.81%). Evidence from ten studies, which could not be pooled in a meta-analysis, indicated that an increased rate of functional impairment associated with SARS-CoV-2 infection. Use of care increased compared with controls at six to 24 months follow-up at intensive care units (risk ratio 2.00 (95% confidence interval 0.69 to 5.80), five studies, I2=91.96%) and in outpatient care (1.12 (1.01 to 1.24), seven studies, I2=99.51%). Regarding persistent symptoms, individuals with documented SARS-CoV-2 infection had an increased risk of having two or more persistent symptoms at follow-up, especially those related to neurological clusters (ie, risk ratio 1.51 (95% confidence interval 1.17 to 1.93), I2=98.91%). Evidence also showed an increased incidence of a wide variety of metabolic, cardiovascular, neurological, respiratory, haematological and other incident diagnoses. Conclusion Evidence suggests functional impairment after SARS-CoV-2 infection, in addition to a higher use of resources and a higher incidence of widely varying medical diagnoses. These results should be interpreted with caution, considering the high heterogeneity across studies and study limitations related to outcome measurement and attrition of participants. Systematic review registration Open Science Framework, osf.io/drm39.
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Affiliation(s)
- Juan Victor Ariel Franco
- Institute of General Practice, Medical Faculty, Heinrich-Heine-Universitat Dusseldorf, Dusseldorf, Nordrhein-Westfalen, Germany
| | | | - Maria-Inti Metzendorf
- Institute of General Practice, Medical Faculty, Heinrich-Heine-Universitat Dusseldorf, Dusseldorf, Nordrhein-Westfalen, Germany
| | - Katharina Heldt
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Rebekka Mumm
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Wurm J, Finkel B, Iwanowski H, Jordan S, Sandoni A, Kubisch U, Schienkiewitz A, Hintze M, Wess B, Wetzstein M, Poethko-Müller C, Scheidt-Nave C, Loss J. Day care study showed no differences in long-term symptoms in children who were and were not infected during COVID-19 outbreaks. Acta Paediatr 2024; 113:116-118. [PMID: 37877544 DOI: 10.1111/apa.17014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 09/11/2023] [Accepted: 10/12/2023] [Indexed: 10/26/2023]
Affiliation(s)
- Juliane Wurm
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Bianca Finkel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Helena Iwanowski
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Susanne Jordan
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Anna Sandoni
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Ulrike Kubisch
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Anja Schienkiewitz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Marcel Hintze
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Barbara Wess
- Department of Methodology and Research Infrastructure, Robert Koch Institute, Berlin, Germany
| | - Matthias Wetzstein
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | | | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Julika Loss
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Müller SA, Isaaka L, Mumm R, Scheidt-Nave C, Heldt K, Schuster A, Abdulaziz M, El Bcheraoui C, Hanefeld J, Agweyu A. Prevalence and risk factors for long COVID and post-COVID-19 condition in Africa: a systematic review. Lancet Glob Health 2023; 11:e1713-e1724. [PMID: 37858583 DOI: 10.1016/s2214-109x(23)00384-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 04/03/2023] [Revised: 08/01/2023] [Accepted: 08/07/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND An improved estimation of the clinical sequelae of SARS-CoV-2 infection is crucial in African countries, where the subject has received little attention despite more than 12 million reported cases and evidence that many more people were infected. We reviewed the evidence on prevalence, associated risk factors for long COVID, and systemic or sociocultural determinants of reporting long COVID. METHODS We conducted a systematic review, searching PubMed, the Living OVerview of Evidence platform, and grey literature sources for publications from Dec 1, 2019, to Nov 23, 2022. We included articles published in English, French, Spanish, or Portuguese that reported on any study type in Africa with participants of any age who had symptoms for 4 weeks or more after an acute SARS-CoV-2 infection. We excluded secondary research, comments, and correspondence. Screening and data extraction were performed by two reviewers. Summary estimates were extracted, including sociodemographic factors, medical history, prevalence of persistent symptoms, and symptoms and associated factors. Results were analysed descriptively. The study was registered on the Open Science Framework platform. FINDINGS Our search yielded 294 articles, of which 24 peer-reviewed manuscripts were included, reporting on 9712 patients from eight African countries. Only one study exclusively recruited children, and one other study included children as part of their study population. Studies indicated moderate to low risk of bias. Prevalence of long COVID varied widely, from 2% in Ghana to 86% in Egypt. Long COVID was positively associated with female sex, older age, non-Black ethnicity, low level of education, and the severity of acute infection and underlying comorbidity. HIV and tuberculosis were not identified as risk factors. Factors influencing reporting included absence of awareness, inadequate clinical data and diagnostics, and little access to health-care services. INTERPRETATION In Africa, research on long COVID is scarce, particularly among children, who represent the majority of the population. However, existing studies show a substantial prevalence across settings, emphasising the importance of vaccination and other prevention strategies to avert the effects of long COVID on individual wellbeing, the increased strain on health systems, and the potential negative effects on economically vulnerable populations. At a global level, including African countries, tools for research on long COVID need to be harmonised to maximise the usefulness of the data collected. FUNDING None.
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Affiliation(s)
- Sophie Alice Müller
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany.
| | - Lynda Isaaka
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Rebekka Mumm
- Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | | | - Katharina Heldt
- Methods Development, Research Infrastructure and Information Technology, Robert Koch Institute, Berlin, Germany
| | - Angela Schuster
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany; Institute of General Practice and Family Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Mohammed Abdulaziz
- Division of Disease Control and Prevention, Africa CDC, Addis Ababa, Ethiopia
| | - Charbel El Bcheraoui
- Evidence-based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Johanna Hanefeld
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Ambrose Agweyu
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya; London School of Hygiene and Tropical Medicine, London, UK
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Zhou B, Sheffer KE, Bennett JE, Gregg EW, Danaei G, Singleton RK, Shaw JE, Mishra A, Lhoste VPF, Carrillo-Larco RM, Kengne AP, Phelps NH, Heap RA, Rayner AW, Stevens GA, Paciorek CJ, Riley LM, Cowan MJ, Savin S, Vander Hoorn S, Lu Y, Pavkov ME, Imperatore G, Aguilar-Salinas CA, Ahmad NA, Anjana RM, Davletov K, Farzadfar F, González-Villalpando C, Khang YH, Kim HC, Laatikainen T, Laxmaiah A, Mbanya JCN, Narayan KMV, Ramachandran A, Wade AN, Zdrojewski T, Abbasi-Kangevari M, Rahim HFA, Abu-Rmeileh NM, Adambekov S, Adams RJ, Aekplakorn W, Agdeppa IA, Aghazadeh-Attari J, Agyemang C, Ahmadi A, Ahmadi N, Ahmadi N, Ahmed SH, Ajlouni K, Al-Hinai H, Al-Lahou B, Al-Lawati JA, Asfoor DA, Al Qaoud NM, Alarouj M, AlBuhairan F, AlDhukair S, Aldwairji MA, Ali MM, Alinezhad F, Alkandari A, Alomirah HF, Aly E, Amarapurkar DN, Andersen LB, Anderssen SA, Andrade DS, Ansari-Moghaddam A, Aounallah-Skhiri H, Aris T, Arlappa N, Aryal KK, Assah FK, Assembekov B, Auvinen J, Avdičová M, Azad K, Azimi-Nezhad M, Azizi F, Bacopoulou F, Balakrishna N, Bamoshmoosh M, Banach M, Bandosz P, Banegas JR, Barbagallo CM, Barceló A, Baretić M, Barrera L, Basit A, Batieha AM, Batista AP, Baur LA, Belavendra A, Ben Romdhane H, Benet M, Berkinbayev S, Bernabe-Ortiz A, Berrios Carrasola X, Bettiol H, Beybey AF, Bhargava SK, Bika Lele EC, Bikbov MM, Bista B, Bjerregaard P, Bjertness E, Bjertness MB, Björkelund C, Bloch KV, Blokstra A, Bo S, Bobak M, Boggia JG, Bonaccio M, Bonilla-Vargas A, Borghs H, Bovet P, Brajkovich I, Brenner H, Brewster LM, Brian GR, Briceño Y, Brito M, Bugge A, Buntinx F, Cabrera de León A, Caixeta RB, Can G, Cândido APC, Capanzana MV, Čapková N, Capuano E, Capuano R, Capuano V, Cardoso VC, Carlsson AC, Casanueva FF, Censi L, Cervantes‐Loaiza M, Chamnan P, Chamukuttan S, Chan Q, Charchar FJ, Chaturvedi N, Chen H, Cheraghian B, Chirlaque MD, Chudek J, Cifkova R, Cirillo M, Claessens F, Cohen E, Concin H, Cooper C, Costanzo S, Cowell C, Crujeiras AB, Cruz JJ, Cureau FV, Cuschieri S, D’Arrigo G, d’Orsi E, Dallongeville J, Damasceno A, Dastgiri S, De Curtis A, de Gaetano G, De Henauw S, Deepa M, DeGennaro V, Demarest S, Dennison E, Deschamps V, Dhimal M, Dika Z, Djalalinia S, Donfrancesco C, Dong G, Dorobantu M, Dörr M, Dragano N, Drygas W, Du Y, Duante CA, Duboz P, Dushpanova A, Dziankowska-Zaborszczyk E, Ebrahimi N, Eddie R, Eftekhar E, Efthymiou V, Egbagbe EE, Eghtesad S, El-Khateeb M, El Ati J, Eldemire-Shearer D, Elosua R, Enang O, Erasmus RT, Erbel R, Erem C, Ergor G, Eriksen L, Eriksson JG, Esmaeili A, Evans RG, Fakhradiyev I, Fall CH, Faramarzi E, Farjam M, Farzi Y, Fattahi MR, Fawwad A, Felix-Redondo FJ, Ferguson TS, Fernández-Bergés D, Ferrari M, Ferreccio C, Ferreira HS, Ferrer E, Feskens EJM, Flood D, Forsner M, Fosse S, Fottrell EF, Fouad HM, Francis DK, Frontera G, Furusawa T, Gaciong Z, Garnett SP, Gasull M, Gazzinelli A, Gehring U, Ghaderi E, Ghamari SH, Ghanbari A, Ghasemi E, Gheorghe-Fronea OF, Ghimire A, Gialluisi A, Giampaoli S, Gianfagna F, Gill TK, Gironella G, Giwercman A, Goltzman D, Gomula A, Gonçalves H, Gonçalves M, Gonzalez-Chica DA, Gonzalez-Gross M, González-Rivas JP, González-Villalpando ME, Gonzalez AR, Gottrand F, Grafnetter D, Grodzicki T, Grøntved A, Guerrero R, Gujral UP, Gupta R, Gutierrez L, Gwee X, Haghshenas R, Hakimi H, Hambleton IR, Hamzeh B, Hanekom WA, Hange D, Hantunen S, Hao J, Hari Kumar R, Harooni J, Hashemi-Shahri SM, Hata J, Heidemann C, Henrique RDS, Herrala S, Herzig KH, Heshmat R, Ho SY, Holdsworth M, Homayounfar R, Hopman WM, Horimoto ARVR, Hormiga C, Horta BL, Houti L, Howitt C, Htay TT, Htet AS, Htike MMT, Huerta JM, Huhtaniemi IT, Huisman M, Husseini A, Huybrechts I, Iacoviello L, Iakupova EM, Iannone AG, Ibrahim Wong N, Ijoma C, Irazola VE, Ishida T, Isiguzo GC, Islam SMS, Islek D, Ittermann T, Iwasaki M, Jääskeläinen T, Jacobs JM, Jaddou HY, Jadoul M, Jallow B, James K, Jamil KM, Janus E, Jarvelin MR, Jasienska G, Jelaković A, Jelaković B, Jennings G, Jha AK, Jimenez RO, Jöckel KH, Jokelainen JJ, Jonas JB, Joshi P, Josipović J, Joukar F, Jóźwiak J, Kafatos A, Kajantie EO, Kalmatayeva Z, Karki KB, Katibeh M, Kauhanen J, Kazakbaeva GM, Kaze FF, Ke C, Keinänen-Kiukaanniemi S, Kelishadi R, Keramati M, Kersting M, Khader YS, Khaledifar A, Khalili D, Kheiri B, Kheradmand M, Khosravi A, Kiechl-Kohlendorfer U, Kiechl SJ, Kiechl S, Kingston A, Klakk H, Klanova J, Knoflach M, Kolsteren P, König J, Korpelainen R, Korrovits P, Kos J, Koskinen S, Kowlessur S, Koziel S, Kriemler S, Kristensen PL, Kromhout D, Kubinova R, Kujala UM, Kulimbet M, Kurjata P, Kyobutungi C, La QN, Labadarios D, Lachat C, Laid Y, Lall L, Lankila T, Lanska V, Lappas G, Larijani B, Latt TS, Laurenzi M, Lehmann N, Lehtimäki T, Lemogoum D, Leung GM, Li Y, Lima-Costa MF, Lin HH, Lind L, Lissner L, Liu X, Lopez-Garcia E, Lopez T, Lozano JE, Luksiene D, Lundqvist A, Lunet N, Lustigová M, Machado-Coelho GLL, Machado-Rodrigues AM, Macia E, Macieira LM, Madar AA, Maestre GE, Maggi S, Magliano DJ, Magriplis E, Mahasampath G, Maire B, Makdisse M, Malekpour MR, Malekzadeh F, Malekzadeh R, Mallikharjuna Rao K, Malyutina S, Maniego LV, Manios Y, Mannix MI, Mansour-Ghanaei F, Manzato E, Margozzini P, Mariño J, Marques LP, Martorell R, Mascarenhas LP, Masinaei M, Mathiesen EB, Matsha TE, Mc Donald Posso AJ, McFarlane SR, McGarvey ST, Mediene Benchekor S, Mehlig K, Mehrparvar AH, Melgarejo JD, Méndez F, Menezes AMB, Mereke A, Meshram II, Meto DT, Minderico CS, Mini GK, Miquel JF, Miranda JJ, Mirjalili MR, Modesti PA, Moghaddam SS, Mohamed MK, Mohammad K, Mohammadi MR, Mohammadi Z, Mohammadifard N, Mohammadpourhodki R, Mohan V, Mohd Yusoff MF, Mohebbi I, Møller NC, Molnár D, Momenan A, Mondo CK, Montenegro Mendoza RA, Monterrubio-Flores E, Moosazadeh M, Moradpour F, Morejon A, Moreno LA, Morgan K, Morin SN, Moslem A, Mosquera M, Mossakowska M, Mostafa A, Mostafavi SA, Motlagh ME, Motta J, Msyamboza KP, Mu TT, Muiesan ML, Mursu J, Musa KI, Mustafa N, Muyer MTMC, Nabipour I, Nagel G, Naidu BM, Najafi F, Námešná J, Nangia VB, Naseri T, Neelapaichit N, Nejatizadeh A, Nenko I, Nervi F, Ng TP, Nguyen CT, Nguyen QN, Ni MY, Nie P, Nieto-Martínez RE, Ninomiya T, Noale M, Noboa OA, Noto D, Nsour MA, Nuhoğlu I, O’Neill TW, Odili AN, Oh K, Ohtsuka R, Omar MA, Onat A, Ong SK, Onodugo O, Ordunez P, Ornelas R, Ortiz PJ, Osmond C, Ostovar A, Otero JA, Ottendahl CB, Otu A, Owusu-Dabo E, Palmieri L, Pan WH, Panda-Jonas S, Panza F, Paoli M, Park S, Parsaeian M, Patel ND, Pechlaner R, Pećin I, Pedro JM, Peixoto SV, Peltonen M, Pereira AC, Pessôa dos Prazeres TM, Peykari N, Phall MC, Pham ST, Phan HH, Pichardo RN, Pikhart H, Pilav A, Piler P, Pitakaka F, Piwonska A, Pizarro AN, Plans-Rubió P, Plata S, Porta M, Poudyal A, Pourfarzi F, Pourshams A, Poustchi H, Pradeepa R, Providencia R, Puder JJ, Puhakka S, Punab M, Qorbani M, Quintana HK, Quoc Bao T, Rahimikazerooni S, Raitakari O, Ramirez-Zea M, Ramke J, Ramos R, Rampal L, Rampal S, Rangel Reina DA, Rashidi MM, Redon J, Renner JDP, Reuter CP, Revilla L, Rezaei N, Rezaianzadeh A, Rigo F, Roa RG, Robinson L, Rodríguez-Artalejo F, Rodriguez-Perez MDC, Rodríguez-Villamizar LA, Rodríguez AY, Roggenbuck U, Rohloff P, Romeo EL, Rosengren A, Rubinstein A, Rust P, Rutkowski M, Sabbaghi H, Sachdev HS, Sadjadi A, Safarpour AR, Safi S, Safiri S, Saghi MH, Saidi O, Saki N, Šalaj S, Salanave B, Salonen JT, Salvetti M, Sánchez-Abanto J, Santos DA, Santos LC, Santos MP, Santos TR, Saramies JL, Sardinha LB, Sarrafzadegan N, Saum KU, Sbaraini M, Scazufca M, Schaan BD, Scheidt-Nave C, Schipf S, Schmidt CO, Schöttker B, Schramm S, Sebert S, Sedaghattalab M, Sein AA, Sepanlou SG, Sewpaul R, Shamah-Levy T, Shamshirgaran SM, Sharafkhah M, Sharma SK, Sharman A, Shayanrad A, Shayesteh AA, Shimizu-Furusawa H, Shiri R, Shrestha N, Si-Ramlee K, Silva DAS, Simon M, Simons J, Simons LA, Sjöström M, Slowikowska-Hilczer J, Slusarczyk P, Smeeth L, Sobngwi E, Söderberg S, Soemantri A, Sofat R, Solfrizzi V, Somi MH, Soumaré A, Sousa-Poza A, Sparrenberger K, Staessen JA, Stavreski B, Steene-Johannessen J, Stehle P, Stein AD, Stessman J, Stokwiszewski J, Stronks K, Suarez-Ortegón MF, Suebsamran P, Sundström J, Suriyawongpaisal P, Sylva RC, Szklo M, Tamosiunas A, Tarawneh MR, Tarqui-Mamani CB, Taylor A, Taylor J, Tello T, Thankappan KR, Theobald H, Theodoridis X, Thomas N, Thrift AG, Timmermans EJ, Tjandrarini DH, Tolonen HK, Tolstrup JS, Tomaszewski M, Topbas M, Torres-Collado L, Traissac P, Triantafyllou A, Tuitele J, Tuliakova AM, Tulloch-Reid MK, Tuomainen TP, Tzala E, Tzourio C, Ueda P, Ugel E, Ukoli FAM, Ulmer H, Uusitalo HMT, Valdivia G, van den Born BJ, Van der Heyden J, Van Minh H, van Rossem L, Van Schoor NM, van Valkengoed IGM, van Zutphen EM, Vanderschueren D, Vanuzzo D, Vasan SK, Vega T, Velasquez-Melendez G, Verstraeten R, Viet L, Villalpando S, Vioque J, Virtanen JK, Viswanathan B, Voutilainen A, Wan Bebakar WM, Wan Mohamud WN, Wang C, Wang N, Wang Q, Wang YX, Wang YW, Wannamethee SG, Webster-Kerr K, Wedderkopp N, Wei W, Westbury LD, Whincup PH, Widhalm K, Widyahening IS, Więcek A, Wilks RJ, Willeit J, Willeit P, Wilsgaard T, Wojtyniak B, Wong A, Wong EB, Woodward M, Wu FC, Xu H, Xu L, Yaacob NA, Yan L, Yan W, Yoosefi M, Yoshihara A, Younger-Coleman NO, Yu YL, Yu Y, Yusoff AF, Zainuddin AA, Zamani F, Zambon S, Zampelas A, Zaw KK, Zeljkovic Vrkic T, Zeng Y, Zhang ZY, Zholdin B, Zimmet P, Zitt E, Zoghlami N, Zuñiga Cisneros J, Ezzati M. Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c. Nat Med 2023; 29:2885-2901. [PMID: 37946056 PMCID: PMC10667106 DOI: 10.1038/s41591-023-02610-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 09/25/2023] [Indexed: 11/12/2023]
Abstract
Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance.
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Tesch F, Ehm F, Vivirito A, Wende D, Batram M, Loser F, Menzer S, Jacob J, Roessler M, Seifert M, Kind B, König C, Schulte C, Buschmann T, Hertle D, Ballesteros P, Baßler S, Bertele B, Bitterer T, Riederer C, Sobik F, Reitzle L, Scheidt-Nave C, Schmitt J. Incident autoimmune diseases in association with SARS-CoV-2 infection: a matched cohort study. Clin Rheumatol 2023; 42:2905-2914. [PMID: 37335408 PMCID: PMC10497688 DOI: 10.1007/s10067-023-06670-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/11/2023] [Accepted: 06/08/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES To investigate whether the risk of developing an incident autoimmune disease is increased in patients with prior COVID-19 disease compared to those without COVID-19, a large cohort study was conducted. METHOD A cohort was selected from German routine health care data. Based on documented diagnoses, we identified individuals with polymerase chain reaction (PCR)-confirmed COVID-19 through December 31, 2020. Patients were matched 1:3 to control patients without COVID-19. Both groups were followed up until June 30, 2021. We used the four quarters preceding the index date until the end of follow-up to analyze the onset of autoimmune diseases during the post-acute period. Incidence rates (IR) per 1000 person-years were calculated for each outcome and patient group. Poisson models were deployed to estimate the incidence rate ratios (IRRs) of developing an autoimmune disease conditional on a preceding diagnosis of COVID-19. RESULTS In total, 641,704 patients with COVID-19 were included. Comparing the incidence rates in the COVID-19 (IR=15.05, 95% CI: 14.69-15.42) and matched control groups (IR=10.55, 95% CI: 10.25-10.86), we found a 42.63% higher likelihood of acquiring autoimmunity for patients who had suffered from COVID-19. This estimate was similar for common autoimmune diseases, such as Hashimoto thyroiditis, rheumatoid arthritis, or Sjögren syndrome. The highest IRR was observed for autoimmune diseases of the vasculitis group. Patients with a more severe course of COVID-19 were at a greater risk for incident autoimmune disease. CONCLUSIONS SARS-CoV-2 infection is associated with an increased risk of developing new-onset autoimmune diseases after the acute phase of infection. Key Points • In the 3 to 15 months after acute infection, patients who had suffered from COVID-19 had a 43% (95% CI: 37-48%) higher likelihood of developing a first-onset autoimmune disease, meaning an absolute increase in incidence of 4.50 per 1000 person-years over the control group. • COVID-19 showed the strongest association with vascular autoimmune diseases.
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Affiliation(s)
- Falko Tesch
- Center for Evidence-Based Healthcare (ZEGV), University Hospital and Faculty of Medicine Carl Gustav Carus at TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
| | - Franz Ehm
- Center for Evidence-Based Healthcare (ZEGV), University Hospital and Faculty of Medicine Carl Gustav Carus at TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Annika Vivirito
- InGef - Institute for Applied Health Research Berlin GmbH, Berlin, Germany
| | - Danny Wende
- BARMER Institut für Gesundheitssystemforschung (bifg), Berlin, Germany
| | | | | | | | - Josephine Jacob
- InGef - Institute for Applied Health Research Berlin GmbH, Berlin, Germany
| | - Martin Roessler
- BARMER Institut für Gesundheitssystemforschung (bifg), Berlin, Germany
| | - Martin Seifert
- Center for Evidence-Based Healthcare (ZEGV), University Hospital and Faculty of Medicine Carl Gustav Carus at TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Barbara Kind
- Center for Evidence-Based Healthcare (ZEGV), University Hospital and Faculty of Medicine Carl Gustav Carus at TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | | | - Claudia Schulte
- BARMER Institut für Gesundheitssystemforschung (bifg), Berlin, Germany
| | | | - Dagmar Hertle
- BARMER Institut für Gesundheitssystemforschung (bifg), Berlin, Germany
| | - Pedro Ballesteros
- BARMER Institut für Gesundheitssystemforschung (bifg), Berlin, Germany
| | | | | | | | | | | | | | | | - Jochen Schmitt
- Center for Evidence-Based Healthcare (ZEGV), University Hospital and Faculty of Medicine Carl Gustav Carus at TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
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Tesch F, Ehm F, Vivirito A, Wende D, Batram M, Loser F, Menzer S, Jacob J, Roessler M, Seifert M, Kind B, König C, Schulte C, Buschmann T, Hertle D, Ballesteros P, Baßler S, Bertele B, Bitterer T, Riederer C, Sobik F, Reitzle L, Scheidt-Nave C, Schmitt J. Correction to: Incident autoimmune diseases in association with SARS-CoV-2 infection: A matched cohort study. Clin Rheumatol 2023; 42:2919-2920. [PMID: 37405528 PMCID: PMC10497701 DOI: 10.1007/s10067-023-06692-8] [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: 07/06/2023]
Affiliation(s)
- Falko Tesch
- Center for Evidence-Based Healthcare (ZEGV), University Hospital and Faculty of Medicine Carl Gustav Carus at TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
| | - Franz Ehm
- Center for Evidence-Based Healthcare (ZEGV), University Hospital and Faculty of Medicine Carl Gustav Carus at TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Annika Vivirito
- InGef - Institute for Applied Health Research Berlin GmbH, Berlin, Germany
| | - Danny Wende
- BARMER Institut für Gesundheitssystemforschung (bifg), Berlin, Germany
| | | | | | | | - Josephine Jacob
- InGef - Institute for Applied Health Research Berlin GmbH, Berlin, Germany
| | - Martin Roessler
- BARMER Institut für Gesundheitssystemforschung (bifg), Berlin, Germany
| | - Martin Seifert
- Center for Evidence-Based Healthcare (ZEGV), University Hospital and Faculty of Medicine Carl Gustav Carus at TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Barbara Kind
- Center for Evidence-Based Healthcare (ZEGV), University Hospital and Faculty of Medicine Carl Gustav Carus at TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | | | - Claudia Schulte
- BARMER Institut für Gesundheitssystemforschung (bifg), Berlin, Germany
| | | | - Dagmar Hertle
- BARMER Institut für Gesundheitssystemforschung (bifg), Berlin, Germany
| | - Pedro Ballesteros
- BARMER Institut für Gesundheitssystemforschung (bifg), Berlin, Germany
| | | | | | | | | | | | | | | | - Jochen Schmitt
- Center for Evidence-Based Healthcare (ZEGV), University Hospital and Faculty of Medicine Carl Gustav Carus at TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
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Fuchs J, Gaertner B, Perlitz H, Kuttig T, Klingner A, Baumert J, Hüther A, Kuhnert R, Wolff J, Scheidt-Nave C. Study on Health of Older People in Germany (Gesundheit 65+): objectives, design and implementation. J Health Monit 2023; 8:61-83. [PMID: 37829118 PMCID: PMC10565879 DOI: 10.25646/11666] [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] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 08/07/2023] [Indexed: 10/14/2023]
Abstract
Background The longitudinal population-based study Gesundheit 65+ aimed to close data gaps on health and well-being of older adults in Germany in times of the COVID-19 pandemic. Methods The target population comprised persons 65 years and older permanently residing in Germany and with sufficient German language skills. Proxy interviews were possible and consent from legal representatives was obtained as necessary in order to enable participation of physically or cognitively impaired persons. A two-stage sampling process, was used to draw 128 primary sample points (PSUs) and within these PSUs sex- and age-stratified random samples were drawn from population registries. A mixed-mode design was applied to contact the study population and for data collection. Data were collected between June 2021 and April 2023. Participants were surveyed a total of four times at intervals of four months. At month 12 participants were offered a home visit including a non-invasive examination. Data on all-cause mortality and information on neighborhood social and built environment as well as health insurance data will be linked to primarily collected data at the individual level. Discussion Results will inform health politicians and other stakeholders in the care system on health and health care needs of older people in Germany.
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Affiliation(s)
- Judith Fuchs
- Corresponding author Dr Judith Fuchs, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62–66, 12101 Berlin, Germany, E-mail:
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Gaertner B, Scheidt-Nave C, Koschollek C, Fuchs J. Health status of the old and very old people in Germany: results of the Gesundheit 65+ study. J Health Monit 2023; 8:7-29. [PMID: 37829119 PMCID: PMC10565703 DOI: 10.25646/11663] [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] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/12/2023] [Indexed: 10/14/2023]
Abstract
Background The demographic change makes comprehensive health reporting on health at older age an important topic. Methods Gesundheit 65+ is a longitudinal epidemiological study on the health status of persons aged 65 and older in Germany. Based on a two-stage stratified random sample from 128 local population registers, 3,694 persons participated in the baseline survey between June 2021 and April 2022 (47.9 % women, mean age 78.8 years). Weighted prevalences for 19 indicators of the baseline survey are presented overall and by age, sex, education and region of residence. Results Overall, 52.0 % of all participants of the baseline survey reported to be in good or very good health, and 78.5 % reported high or very high satisfaction with their life. This was in contrast to the large number of health/functional limitations whose prevalences ranged from 5.3 % for severe visual limitations to 69.2 % for multimorbidity. The health status of women was clearly worse than that of men, and the health status of persons aged 80 and older was worse than between 65 and 79 years of age. There was a clear educational gradient evident in the health status, but there were no differences between West and East Germany. Conclusions Gesundheit 65+ provides a comprehensive database for description of the health status of old and very old people in Germany, on the basis of which recommendations for action for policy and practice can be derived.
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Affiliation(s)
- Beate Gaertner
- Robert Koch Institute, Berlin, Germany Department of Epidemiology and Health Monitoring
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Heidemann C, Sarganas G, Du Y, Gaertner B, Poethko-Müller C, Cohrdes C, Schmidt S, Schlaud M, Scheidt-Nave C. Long-term health consequences among individuals with SARS-CoV-2 infection compared to individuals without infection: results of the population-based cohort study CoMoLo Follow-up. BMC Public Health 2023; 23:1587. [PMID: 37605232 PMCID: PMC10440884 DOI: 10.1186/s12889-023-16524-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/14/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Most of the previous studies on health sequelae of COVID-19 are uncontrolled cohorts and include a relatively short follow-up. This population-based multi-center cohort study examined health consequences among individuals about 1 to 1.5 years after SARS-CoV-2 infection compared with non-infected. METHODS The study population consisted of adults (≥ 18 years) from four municipalities particularly affected by the COVID-19 pandemic in the year 2020 who completed a detailed follow-up questionnaire on health-related topics. Exposure was the SARS-CoV-2 infection status (based on IgG antibodies, PCR test, or physician-diagnosis of COVID-19) at baseline (May to December 2020). Outcomes assessed at follow-up (October 2021 to January 2022; mean: 452 days) included recurrent or persistent health complaints, incident diseases, health-related quality of life (PROMIS-29), subjective health, and subjective memory impairment. Logistic and linear regression models were adjusted for baseline sociodemographic and lifestyle characteristics (age, sex, municipality, education, smoking, body mass index), pre-existing health conditions (chronic disease/health problem, health-related activity limitation, depressive/anxiety disorder), and follow-up time. RESULTS Among 4817 participants, 350 had a SARS-CoV-2 infection at baseline and 4467 had no infection at baseline or during follow-up. Those with an infection statistically significantly more often reported 7 out of 18 recurrent or persistent health complaints at follow-up: smell/taste disorders (12.8% vs. 3.4%, OR 4.11), shortness of breath (23.0% vs. 9.5%, 3.46), pain when breathing (4.7% vs. 1.9%, 2.36), fatigue (36.9% vs. 26.1%, 1.76), weakness in legs (12.8% vs. 7.8%, 1.93), myalgia/joint pain (21.9% vs. 15.1%, 1.53) and cough (30.8% vs. 24.8%, 1.34) and 3 out of 6 groups of incident diseases: liver/kidney (2.7% vs. 0.9%, 3.70), lung (3.2% vs. 1.1%, 3.50) and cardiovascular/metabolic (6.5% vs. 4.0%, 1.68) diseases. Those with an infection were significantly more likely to report poor subjective health (19.3% vs. 13.0%, 1.91), memory impairment (25.7% vs. 14.3%, 2.27), and worse mean scores on fatigue and physical function domains of PROMIS-29 than non-infected. CONCLUSION Even after more than one year, individuals with SARS-CoV-2 infection showed an increased risk of various health complaints, functional limitations, and worse subjective well-being, pointing toward profound health consequences of SARS-CoV-2 infection relevant for public health.
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Affiliation(s)
- Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Giselle Sarganas
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Yong Du
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Beate Gaertner
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | | | - Caroline Cohrdes
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Sein Schmidt
- Clinical Study Center, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Martin Schlaud
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Pennells L, Kaptoge S, Østergaard HB, Read SH, Carinci F, Franch-Nadal J, Petitjean C, Taylor O, Hageman SHJ, Xu Z, Shi F, Spackman S, Gualdi S, Holman N, Da Providencia E Costa RB, Bonnet F, Brenner H, Gillum RF, Kiechl S, Lawlor DA, Potier L, Schöttker B, Sofat R, Völzke H, Willeit J, Baltane Z, Fava S, Janos S, Lavens A, Pildava S, Poljicanin T, Pristas I, Rossing P, Sascha R, Scheidt-Nave C, Stotl I, Tibor G, Urbančič-Rovan V, Vanherwegen AS, Vistisen D, Du Y, Walker MR, Willeit P, Ference B, De Bacquer D, Halle M, Huculeci R, McEvoy JW, Timmis A, Vardas P, Dorresteijn JAN, Graham I, Wood A, Eliasson B, Herrington W, Danesh J, Mauricio D, Benedetti MM, Sattar N, Visseren FLJ, Wild S, Di Angelantonio E, Balkau B, Bonnet F, Fumeron F, Stocker H, Holleczek B, Schipf S, Schmidt CO, Dörr M, Tilg H, Leitner C, Notdurfter M, Taylor J, Dale C, Prieto-Merino D, Gillum RF, Lavens A, Vanherwegen AS, Poljicanin T, Pristas I, Buble T, Ivanko P, Rossing P, Carstensen B, Heidemann C, Du Y, Scheidt-Nave C, Gall T, Sandor J, Baltane Z, Pildava S, Lepiksone J, Magri CJ, Azzopardi J, Stotl I, Real J, Vlacho B, Mata-Cases M. SCORE2-Diabetes: 10-year cardiovascular risk estimation in type 2 diabetes in Europe. Eur Heart J 2023; 44:2544-2556. [PMID: 37247330 PMCID: PMC10361012 DOI: 10.1093/eurheartj/ehad260] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 04/06/2023] [Accepted: 04/17/2023] [Indexed: 05/31/2023] Open
Abstract
AIMS To develop and validate a recalibrated prediction model (SCORE2-Diabetes) to estimate the 10-year risk of cardiovascular disease (CVD) in individuals with type 2 diabetes in Europe. METHODS AND RESULTS SCORE2-Diabetes was developed by extending SCORE2 algorithms using individual-participant data from four large-scale datasets comprising 229 460 participants (43 706 CVD events) with type 2 diabetes and without previous CVD. Sex-specific competing risk-adjusted models were used including conventional risk factors (i.e. age, smoking, systolic blood pressure, total, and HDL-cholesterol), as well as diabetes-related variables (i.e. age at diabetes diagnosis, glycated haemoglobin [HbA1c] and creatinine-based estimated glomerular filtration rate [eGFR]). Models were recalibrated to CVD incidence in four European risk regions. External validation included 217 036 further individuals (38 602 CVD events), and showed good discrimination, and improvement over SCORE2 (C-index change from 0.009 to 0.031). Regional calibration was satisfactory. SCORE2-Diabetes risk predictions varied several-fold, depending on individuals' levels of diabetes-related factors. For example, in the moderate-risk region, the estimated 10-year CVD risk was 11% for a 60-year-old man, non-smoker, with type 2 diabetes, average conventional risk factors, HbA1c of 50 mmol/mol, eGFR of 90 mL/min/1.73 m2, and age at diabetes diagnosis of 60 years. By contrast, the estimated risk was 17% in a similar man, with HbA1c of 70 mmol/mol, eGFR of 60 mL/min/1.73 m2, and age at diabetes diagnosis of 50 years. For a woman with the same characteristics, the risk was 8% and 13%, respectively. CONCLUSION SCORE2-Diabetes, a new algorithm developed, calibrated, and validated to predict 10-year risk of CVD in individuals with type 2 diabetes, enhances identification of individuals at higher risk of developing CVD across Europe.
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Nübel J, Du Y, Baumert J, Hapke U, Färber F, Heidemann C, Scheidt-Nave C. Perceived Chronic Stress Is Associated With the German Diabetes Risk Score Among Adults Without Known Diabetes in Germany. Psychosom Med 2023; 85:332-340. [PMID: 36917488 DOI: 10.1097/psy.0000000000001183] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
OBJECTIVE There is evidence that psychological distress increases the risk of type 2 diabetes (T2D), but implications for prevention remain elusive. We examined the association between chronic stress and the German Diabetes Risk Score (GDRS) among adults without diabetes in Germany. METHODS The study population consisted of 4654 persons aged 18 to 64 years without known diabetes drawn from the German Health Interview and Examination Survey for Adults (2008-2011). The predicted 5-year T2D risk (in percent) was estimated using the GDRS. Perceived chronic stress was assessed by the Screening Scale of the Trier Inventory for the Assessment of Chronic Stress and categorized into "up to average," "above average," and "high." The cross-sectional association of chronic stress with log-transformed GDRS (expressed as geometric mean ratio [GMR]) was analyzed in multivariable linear regression models. Covariables included age, sex, community size, region, educational level, living alone, social support, depression, and alcohol use. RESULTS The mean predicted 5-year T2D risk rates were 2.7%, 2.9%, and 3.0% for chronic stress up to average, above average, and high chronic stress, respectively. Adjusted mean predicted 5-year risk was significantly higher among persons with chronic stress above average (GMR = 1.10, 95% confidence interval = 1.02-1.19) and high stress (GMR = 1.21, 95% CI = 1.06-1.39) compared with persons with chronic stress up to average. No interactions with sex or other covariables were found. CONCLUSIONS Perceived chronic stress is independently associated with an increased predicted T2D risk in cross-sectional analysis and should be considered as T2D risk factor in longitudinal studies.
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Affiliation(s)
- Julia Nübel
- From the Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Reitzle L, Heidemann C, Baumert J, Kaltheuner M, Adamczewski H, Icks A, Scheidt-Nave C. Pregnancy complications in women with pregestational and gestational diabetes mellitus. Deutsches Ärzteblatt international 2023; 120:81-86. [PMID: 36518030 PMCID: PMC10114134 DOI: 10.3238/arztebl.m2022.0387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 07/26/2022] [Accepted: 11/23/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Diabetes mellitus (DM) is a major risk factor for complications of pregnancy. Based on information for all inpatient births in Germany, we assessed the risks for selected pregnancy complications in women with pregestational diabetes mellitus (preDM) or gestational diabetes mellitus (GDM). METHODS The underlying data comprised all singleton births contained in the inpatient perinatal medicine quality assurance statistics for the years 2013-2019. The frequencies of premature birth, elevated birth weight (large for gestational age, LGA), cesarean section, transfer of the newborn to the perinatal unit, and stillbirth were stratified by maternal age and diabetes status (preDM, GDM, no DM). Poisson regression was used to calculate the relative risks (RR) with 95% confidence intervals (95% CI) for the whole period and for each individual year in women with preDM or GDM relative to women without DM. RESULTS Among the 4 991 275 singleton births included, GDM was documented in 283 210 (5.7%) and preDM in 46 605 (0.93%) cases. GDM was associated with higher RR for premature birth (1.13 [1.12; 1.15]), LGA (1.57 [1.55; 1.58]), cesarean section (1.26 [1.25; 1.27]), and transfer of the newborn (1.54 [1.52; 1.55]). These associations were even stronger in women with preDM: premature birth (2.13 [2.08; 2.18]), LGA (2.72 [2.67; 2.77]), cesarean section (1.62 [1.60; 1.64]), transfer of the newborn (2.61 [2.56; 2.66]). PreDM increased the risk of stillbirth (RR: 2.34 [2.11; 2.59]); GDM was associated with a lower risk (RR: 0.67 [0.62; 0.72]). For women with preDM, the risk of pregnancy complications increased over the study period. CONCLUSION GDM and preDM are still associated with elevated risks of pregnancy complications. In the case of preDM, the risks may be attributable to the fact that the hyperglycemia is more severe and is already present before conception. Continuous monitoring should include risk factors in pregnant women and care-relevant aspects.
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Du Y, Baumert J, Paprott R, Färber F, Nübel J, Hermanns N, Heidemann C, Scheidt-Nave C. Diabetes-related distress and associated factors among adults with diabetes in Germany: Results of the nationwide study "Disease knowledge and information needs - Diabetes mellitus 2017". J Psychosom Res 2023; 164:111073. [PMID: 36370499 DOI: 10.1016/j.jpsychores.2022.111073] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 09/30/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Diabetes-related distress (DRD) can affect diabetes management adversely. In lack of population-based data, the frequency and determinants of DRD among adults with diabetes in Germany remain controversial. METHODS This study included 1367 adults with diabetes who participated in a nationwide health telephone survey conducted among German adults aged 18 years and older in 2017. The short form of the Problem Areas in Diabetes (PAID-5) scale was used to assess DRD. The associations of high DRD (PAID-5 sum score ≥ 8) with socio-demographics, diabetes-related risk factors, diabetes clinical characteristics as well as quality of self-care and chronic illness care assessed by patients were tested in multivariable logistic regression models. RESULTS The overall DRD prevalence was 15.1% (95% confidence intervals, 95% CIs, 12.5-18.0%) with no significant difference between men (14.7%, 95% CIs 11.2-19.1%) and women (15.4%, 11.9-19.8%). In multivariable analyses, DRD was significantly associated with younger age (odds ratio 0.96, 95% CIs 0.94-0.98, per year), immigration background (2.26, 1.16-4.42), current smoking (2.06, 1.14-3.70), insulin use (2.57, 1.45-4.56), and the presence of diabetes-specific complications (1.80, 1.10-2.94) or depressive symptoms (5.34, 3.24-8.81). Among those with depressive symptoms (18,4% of the study population), 38.3% also had DRD, which accounted for 7.0% (95% CIs 5.3-9.3%) of the study population. CONCLUSION DRD is a common health problem among adults with diabetes in Germany, and highly correlates with depressive symptoms, current smoking, immigration background, and insulin use. Addressing DRD needs to become an integrative part of ambulatory diabetes care.
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Affiliation(s)
- Yong Du
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Jens Baumert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Rebecca Paprott
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Francesca Färber
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Julia Nübel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Norbert Hermanns
- Research Institute of the Diabetes-Academy Bad Mergentheim (FIDAM), Bad Mergentheim, Baden-Württemberg, Germany
| | - Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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18
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Porst M, von der Lippe E, Leddin J, Anton A, Wengler A, Breitkreuz J, Schüssel K, Brückner G, Schröder H, Gruhl H, Plaß D, Barnes B, A. Busch M, Haller S, Hapke U, Neuhauser H, Reitzle L, Scheidt-Nave C, Schlotmann A, Steppuhn H, Thom J, Ziese T, Rommel A. The Burden of Disease in Germany at the National and Regional Level. Dtsch Arztebl Int 2022; 119:785-792. [PMID: 36350160 PMCID: PMC9902892 DOI: 10.3238/arztebl.m2022.0314] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/01/2022] [Accepted: 08/29/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND .Summary measures such as disability-adjusted life years (DALY) are becoming increasingly important for the standardized assessment of the burden of disease due to death and disability. The BURDEN 2020 pilot project was designed as an independent burden-of-disease study for Germany, which was based on nationwide data, but which also yielded regional estimates. METHODS DALY is defined as the sum of years of life lost due to death (YLL) and years lived with disability (YLD). YLL is the difference between the age at death due to disease and the remaining life expectancy at this age, while YLD quantifies the number of years individuals have spent with health impairments. Data are derived mainly from causes of death statistics, population health surveys, and claims data from health insurers. RESULTS In 2017, there were approximately 12 million DALY in Germany, or 14 584 DALY per 100 000 inhabitants. Conditions which caused the greatest number of DALY were coronary heart disease (2321 DALY), low back pain (1735 DALY), and lung cancer (1197 DALY). Headache and dementia accounted for a greater disease burden in women than in men, while lung cancer and alcohol use disorders accounted for a greater disease burden in men than in women. Pain disorders and alcohol use disorders were the leading causes of DALY among young adults of both sexes. The disease burden rose with age for some diseases, including cardiovascular diseases, dementia, and diabetes mellitus. For some diseases and conditions, the disease burden varied by geographical region. CONCLUSION The results indicate a need for age- and sex-specific prevention and for differing interventions according to geographic region. Burden of disease studies yield comprehensive population health surveillance data and are a useful aid to decision-making in health policy.
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Affiliation(s)
- Michael Porst
- Robert Koch Institute, Department 2, Epidemiology and Health Monitoring, Berlin
| | - Elena von der Lippe
- Robert Koch Institute, Department 2, Epidemiology and Health Monitoring, Berlin
| | - Janko Leddin
- Robert Koch Institute, Department 2, Epidemiology and Health Monitoring, Berlin
| | - Aline Anton
- Robert Koch Institute, Department 2, Epidemiology and Health Monitoring, Berlin
| | - Annelene Wengler
- Robert Koch Institute, Department 2, Epidemiology and Health Monitoring, Berlin
| | | | | | | | | | - Heike Gruhl
- German Federal Environment Agency, Department II 1 Environmental Hygiene, Berlin
| | - Dietrich Plaß
- German Federal Environment Agency, Department II 1 Environmental Hygiene, Berlin
| | - Benjamin Barnes
- Robert Koch Institute, Department 2, Epidemiology and Health Monitoring, Berlin
| | - Markus A. Busch
- Robert Koch Institute, Department 2, Epidemiology and Health Monitoring, Berlin
| | - Sebastian Haller
- Robert Koch Institute, Department 3, Infectious Disease Epidemiology, Berlin
| | - Ulfert Hapke
- Robert Koch Institute, Department 2, Epidemiology and Health Monitoring, Berlin
| | - Hannelore Neuhauser
- Robert Koch Institute, Department 2, Epidemiology and Health Monitoring, Berlin
| | - Lukas Reitzle
- Robert Koch Institute, Department 2, Epidemiology and Health Monitoring, Berlin
| | | | | | - Henriette Steppuhn
- Robert Koch Institute, Department 2, Epidemiology and Health Monitoring, Berlin
| | - Julia Thom
- Robert Koch Institute, Department 2, Epidemiology and Health Monitoring, Berlin
| | - Thomas Ziese
- Robert Koch Institute, Department 2, Epidemiology and Health Monitoring, Berlin
| | - Alexander Rommel
- Robert Koch Institute, Department 2, Epidemiology and Health Monitoring, Berlin
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19
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Franco JVA, Garegnani LI, Oltra GV, Metzendorf MI, Trivisonno LF, Sgarbossa N, Ducks D, Heldt K, Mumm R, Barnes B, Scheidt-Nave C. Short and Long-Term Wellbeing of Children following SARS-CoV-2 Infection: A Systematic Review. Int J Environ Res Public Health 2022; 19:ijerph192114392. [PMID: 36361269 PMCID: PMC9657555 DOI: 10.3390/ijerph192114392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/30/2022] [Accepted: 11/01/2022] [Indexed: 05/13/2023]
Abstract
Post-COVID conditions in children and adolescents were mostly investigated as the incidence of individual or clusters of symptoms. We aimed to describe the findings of studies assessing key outcomes related to global wellbeing and recovery in children and adolescents from a public health perspective. We searched the Cochrane COVID-19 Study Register and WHO COVID-19 Global literature on coronavirus disease database on 5 November 2021 and tracked ongoing studies published after this date. We included observational studies on children and adolescents with a follow-up greater than 12 weeks and focused on the outcomes of quality of life, recovery/duration of symptoms, school attendance and resource use/rehabilitation. We assessed their methodological quality, and we prepared a narrative synthesis of the results. We included 21 longitudinal and 4 cross-sectional studies (6 with a control group) with over 68 thousand unvaccinated children and adolescents with mostly asymptomatic or mild disease. Study limitations included convenience sampling, a poor description of their study population and heterogeneous definitions of outcomes. Quality of life was not largely affected in adolescents following COVID-19, but there might be greater impairment in young children and in those with more severe forms of the disease (4 studies). There might also be an impairment in daily activities and increased school absenteeism following COVID-19, but the findings were heterogeneous (5 studies). A total of 22 studies provided highly variable estimates based on heterogeneous definitions of overall persistence of symptoms (recovery), ranging from 0 to 67% at 8-12 weeks and 8 to 51% at 6-12 months. We found limited data on resource use and the need for rehabilitation. One controlled study indicated that the quality of life of infected children and adolescents might not substantially differ from controls. All controlled studies found a higher burden of persistent symptoms in COVID-19 cases compared with test-negative controls or cases of influenza. There is limited evidence on the short and long-term well-being of children following SARS-CoV-2 infection. High-quality longitudinal studies with control groups are needed to describe the outcomes in this population, especially in vaccinated children and those affected by new variants of the virus.
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Affiliation(s)
- Juan Victor Ariel Franco
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany
- Correspondence:
| | - Luis Ignacio Garegnani
- Research Department, Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires 4234, Argentina
| | - Gisela Viviana Oltra
- Research Department, Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires 4234, Argentina
| | - Maria-Inti Metzendorf
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany
| | | | - Nadia Sgarbossa
- Department of Health Science, Universidad Nacional de La Matanza, Buenos Aires 1754, Argentina
| | - Denise Ducks
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, 13353 Berlin, Germany
| | - Katharina Heldt
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, 13353 Berlin, Germany
| | - Rebekka Mumm
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, 13353 Berlin, Germany
| | - Benjamin Barnes
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, 13353 Berlin, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, 13353 Berlin, Germany
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20
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Roessler M, Tesch F, Batram M, Jacob J, Loser F, Weidinger O, Wende D, Vivirito A, Toepfner N, Ehm F, Seifert M, Nagel O, König C, Jucknewitz R, Armann JP, Berner R, Treskova-Schwarzbach M, Hertle D, Scholz S, Stern S, Ballesteros P, Baßler S, Bertele B, Repschläger U, Richter N, Riederer C, Sobik F, Schramm A, Schulte C, Wieler L, Walker J, Scheidt-Nave C, Schmitt J. Post-COVID-19-associated morbidity in children, adolescents, and adults: A matched cohort study including more than 157,000 individuals with COVID-19 in Germany. PLoS Med 2022; 19:e1004122. [PMID: 36355754 DOI: 10.1101/2021.10.21.21265133] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 10/12/2022] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Long-term health sequelae of the Coronavirus Disease 2019 (COVID-19) are a major public health concern. However, evidence on post-acute COVID-19 syndrome (post-COVID-19) is still limited, particularly for children and adolescents. Utilizing comprehensive healthcare data on approximately 46% of the German population, we investigated post-COVID-19-associated morbidity in children/adolescents and adults. METHODS AND FINDINGS We used routine data from German statutory health insurance organizations covering the period between January 1, 2019 and December 31, 2020. The base population included all individuals insured for at least 1 day in 2020. Based on documented diagnoses, we identified individuals with polymerase chain reaction (PCR)-confirmed COVID-19 through June 30, 2020. A control cohort was assigned using 1:5 exact matching on age and sex, and propensity score matching on preexisting medical conditions. The date of COVID-19 diagnosis was used as index date for both cohorts, which were followed for incident morbidity outcomes documented in the second quarter after index date or later.Overall, 96 prespecified outcomes were aggregated into 13 diagnosis/symptom complexes and 3 domains (physical health, mental health, and physical/mental overlap domain). We used Poisson regression to estimate incidence rate ratios (IRRs) with 95% confidence intervals (95% CIs). The study population included 11,950 children/adolescents (48.1% female, 67.2% aged between 0 and 11 years) and 145,184 adults (60.2% female, 51.1% aged between 18 and 49 years). The mean follow-up time was 236 days (standard deviation (SD) = 44 days, range = 121 to 339 days) in children/adolescents and 254 days (SD = 36 days, range = 93 to 340 days) in adults. COVID-19 and control cohort were well balanced regarding covariates. The specific outcomes with the highest IRR and an incidence rate (IR) of at least 1/100 person-years in the COVID-19 cohort in children and adolescents were malaise/fatigue/exhaustion (IRR: 2.28, 95% CI: 1.71 to 3.06, p < 0.01, IR COVID-19: 12.58, IR Control: 5.51), cough (IRR: 1.74, 95% CI: 1.48 to 2.04, p < 0.01, IR COVID-19: 36.56, IR Control: 21.06), and throat/chest pain (IRR: 1.72, 95% CI: 1.39 to 2.12, p < 0.01, IR COVID-19: 20.01, IR Control: 11.66). In adults, these included disturbances of smell and taste (IRR: 6.69, 95% CI: 5.88 to 7.60, p < 0.01, IR COVID-19: 12.42, IR Control: 1.86), fever (IRR: 3.33, 95% CI: 3.01 to 3.68, p < 0.01, IR COVID-19: 11.53, IR Control: 3.46), and dyspnea (IRR: 2.88, 95% CI: 2.74 to 3.02, p < 0.01, IR COVID-19: 43.91, IR Control: 15.27). For all health outcomes combined, IRs per 1,000 person-years in the COVID-19 cohort were significantly higher than those in the control cohort in both children/adolescents (IRR: 1.30, 95% CI: 1.25 to 1.35, p < 0.01, IR COVID-19: 436.91, IR Control: 335.98) and adults (IRR: 1.33, 95% CI: 1.31 to 1.34, p < 0.01, IR COVID-19: 615.82, IR Control: 464.15). The relative magnitude of increased documented morbidity was similar for the physical, mental, and physical/mental overlap domain. In the COVID-19 cohort, IRs were significantly higher in all 13 diagnosis/symptom complexes in adults and in 10 diagnosis/symptom complexes in children/adolescents. IRR estimates were similar for age groups 0 to 11 and 12 to 17. IRs in children/adolescents were consistently lower than those in adults. Limitations of our study include potentially unmeasured confounding and detection bias. CONCLUSIONS In this retrospective matched cohort study, we observed significant new onset morbidity in children, adolescents, and adults across 13 prespecified diagnosis/symptom complexes, following COVID-19 infection. These findings expand the existing available evidence on post-COVID-19 conditions in younger age groups and confirm previous findings in adults. TRIAL REGISTRATION ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT05074953.
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Affiliation(s)
- Martin Roessler
- Center for Evidence-Based Healthcare (ZEGV), University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Falko Tesch
- Center for Evidence-Based Healthcare (ZEGV), University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Manuel Batram
- Vandage GmbH, Bielefeld, Germany and Faculty for Business Administration and Economics, Bielefeld University, Bielefeld, Germany
| | - Josephine Jacob
- InGef-Institute for Applied Health Research Berlin, Berlin, Germany
| | | | | | - Danny Wende
- BARMER Institut für Gesundheitssystemforschung (bifg), Berlin, Germany
| | - Annika Vivirito
- InGef-Institute for Applied Health Research Berlin, Berlin, Germany
| | - Nicole Toepfner
- Department of Pediatrics, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Franz Ehm
- Center for Evidence-Based Healthcare (ZEGV), University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Martin Seifert
- Center for Evidence-Based Healthcare (ZEGV), University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Oliver Nagel
- InGef-Institute for Applied Health Research Berlin, Berlin, Germany
| | | | | | - Jakob Peter Armann
- Department of Pediatrics, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Reinhard Berner
- Department of Pediatrics, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
| | | | - Dagmar Hertle
- BARMER Institut für Gesundheitssystemforschung (bifg), Berlin, Germany
| | | | - Stefan Stern
- AOK Bayern-Die Gesundheitskasse, Regensburg, Germany
| | - Pedro Ballesteros
- BARMER Institut für Gesundheitssystemforschung (bifg), Berlin, Germany
| | | | | | - Uwe Repschläger
- BARMER Institut für Gesundheitssystemforschung (bifg), Berlin, Germany
| | | | | | | | - Anja Schramm
- AOK Bayern-Die Gesundheitskasse, Regensburg, Germany
| | - Claudia Schulte
- BARMER Institut für Gesundheitssystemforschung (bifg), Berlin, Germany
| | | | - Jochen Walker
- InGef-Institute for Applied Health Research Berlin, Berlin, Germany
| | | | - Jochen Schmitt
- Center for Evidence-Based Healthcare (ZEGV), University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
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21
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Fuchs J, Gaertner B, Perlitz H, Kuttig T, Scheidt-Nave C. The study on health of older people in Germany (Health 65+): Design and first results. Eur J Public Health 2022. [PMCID: PMC9594600 DOI: 10.1093/eurpub/ckac131.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Integrating older persons into continuous national public health monitoring is crucial but challenging. Health 65+ is the first national health interview and examination survey in Germany specifically tailored to the needs of the population 65+ years. Methods Health 65+ is based on two-stage stratified random sampling from 128 local population registries. It is based on a previously tested three-step procedure to contact the study population (letter, telephone, home visits). 12,448 individuals 65+ years were invited for survey participation between June 2021 and April 2022. Participation comprised answering a baseline-questionnaire/interview covering a consented set of key health indicators including SARS-COV2 infections, and 3 follow-ups. After one year participants are invited to an examination (e.g. blood pressure, grip strength, cognitive function) during a home visit. All-cause mortality, health insurance data and information on social and built environment will be linked to survey data. The preliminary data set comprises 3,107 baseline participants. Preliminary results Only few individuals were excluded for survey participation as they had deceased before invitation, moved to an unknown residence or had insufficient German language skills. Of the adjusted gross sample, 32% took part in the survey (47.9% women, mean age 78.8 years). Only 3.3% of the participants did not receive any vaccination against COVID-19, with no differences between gender or age-groups. 3.5% had already experienced a laboratory-confirmed SARS-CoV-2 infection. Conclusions Health 65+ collects information that cannot be obtained from any other data sources. In combination with information from routine health data and official health statistics, the results will aid health policy planning and implementation research to improve health and wellbeing of older people in Germany. For example, preliminary results show, that vaccination acceptance was high in persons 65+ years in Germany. Key messages • Health 65+ will provide health data of people 65+ years in Germany. • The results will aid health policy planning.
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Affiliation(s)
- J Fuchs
- Department of Epidemiology and Health Monitor, Robert Koch Institute , Berlin, Germany
| | - B Gaertner
- Department of Epidemiology and Health Monitor, Robert Koch Institute , Berlin, Germany
| | - H Perlitz
- Department of Epidemiology and Health Monitor, Robert Koch Institute , Berlin, Germany
| | - T Kuttig
- Department of Epidemiology and Health Monitor, Robert Koch Institute , Berlin, Germany
| | - C Scheidt-Nave
- Department of Epidemiology and Health Monitor, Robert Koch Institute , Berlin, Germany
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22
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Franco JVA, Garegnani LI, Oltra GV, Metzendorf MI, Trivisonno LF, Sgarbossa N, Ducks D, Heldt K, Mumm R, Barnes B, Scheidt-Nave C. Long-Term Health Symptoms and Sequelae Following SARS-CoV-2 Infection: An Evidence Map. Int J Environ Res Public Health 2022; 19:ijerph19169915. [PMID: 36011562 PMCID: PMC9408764 DOI: 10.3390/ijerph19169915] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/07/2022] [Accepted: 08/09/2022] [Indexed: 05/27/2023]
Abstract
Post-COVID-19 conditions, also known as 'Long-COVID-19', describe a longer and more complex course of illness than acute COVID-19 with no widely accepted uniform case definition. We aimed to map the available evidence on persistent symptoms and sequelae following SARS-CoV-2 in children and adults. We searched the Cochrane COVID-19 Study Register and the WHO COVID-19 Global literature on coronavirus disease database on 5 November 2021. We included longitudinal and cross-sectional studies and we extracted their characteristics, including the type of core outcomes for post-COVID-19 conditions. We included 565 studies (657 records). Most studies were uncontrolled cohort studies. The median follow-up time was 13 weeks (IQR 9 to 24). Only 72% of studies were conducted in high-income countries, 93% included unvaccinated adults with mild-to-critical disease, only 10% included children and adolescents, and less than 5% included children under the age of five. While most studies focused on health symptoms, including respiratory symptoms (71%), neurological symptoms (57%), fatigue (54%), pain (50%), mental functioning (43%), cardiovascular functioning (40%), and post-exertion symptoms (28%), cognitive function (26%), fewer studies assessed other symptoms such as overall recovery (24%), the need for rehabilitation (18%), health-related quality of life (16%), changes in work/occupation and study (10%), or survival related to long-COVID-19 (4%). There is a need for controlled cohort studies with long-term follow-up and a focus on overall recovery, health-related quality of life, and the ability to perform daily tasks. Studies need to be extended to later phases of the pandemic and countries with low resources.
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Affiliation(s)
- Juan Victor Ariel Franco
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany
| | - Luis Ignacio Garegnani
- Research Department, Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires C1199, Argentina
| | - Gisela Viviana Oltra
- Research Department, Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires C1199, Argentina
| | - Maria-Inti Metzendorf
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany
| | | | - Nadia Sgarbossa
- Department of Health Science, Universidad Nacional de La Matanza, Buenos Aires B1754JEC, Argentina
| | - Denise Ducks
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, 13353 Berlin, Germany
| | - Katharina Heldt
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, 13353 Berlin, Germany
| | - Rebekka Mumm
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, 13353 Berlin, Germany
| | - Benjamin Barnes
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, 13353 Berlin, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, 13353 Berlin, Germany
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23
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Tschorn M, Loss J, Allen J, Blume M, Scheidt-Nave C, Thamm R, Poethko-Müller C, Neuperdt L, Hölling H, Mauz E, Waldhauer J, Mueters S, Hövener C, Flerlage N, Krug S. Wie steht es um die Gesundheit von Kindern und Jugendlichen in der
SARS-CoV-2-Pandemie im Jahr 2022? – Ergebnisse der KIDA-Studie des
Robert Koch-Instituts. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753975] [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: 12/12/2022]
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24
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Tschorn M, Poethko-Müller C, Thamm R, Scheidt-Nave C. Subjektive Gesundheit, körperliche Symptombelastung und
spezieller Versorgungsbedarf von Kindern und Jugendlichen nach zwei Jahren
SARS-CoV-2-Pandemie: erste Ergebnisse der KIDA-Studie 2022. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753979] [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: 12/12/2022]
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Heidemann C, Reitzle L, Schmidt C, Fuchs J, Prütz F, Scheidt-Nave C. Non-utilisation of health care services during the COVID-19 pandemic: Results of the CoMoLo study. J Health Monit 2022; 7:2-17. [PMID: 35356069 PMCID: PMC8939005 DOI: 10.25646/9564] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/20/2022] [Indexed: 11/18/2022]
Abstract
Based on data from the CORONA-MONITORING lokal (CoMoLo) study conducted in four municipalities particularly affected by the COVID-19 pandemic, this article investigates the non-utilisation of health care services in the population aged 18 years and older (n=9,002) in relation to the period after the introduction of the containment measures in March 2020. The results show that about one third of the respondents (35.5%) gave up at least one of the surveyed health care services. The most frequent cancellations were dental (15.2%) and specialist check-ups (11.8%), followed by postponement of physiotherapy, ergotherapy or speech therapy (6.1%), cancellation of general practitioner (GP) check-ups (5.8%), postponement of psychotherapy (2.0%), postponement of planned hospital treatment (1.8%) and not going to an emergency room (0.7%). Almost 10% of the respondents reported not visiting a physician despite health complaints. Compared to respondents without such a waiver, these respondents were more often female and younger than 35 years, less often rated their health as very good or good, more often had a diagnosis of depression and more often used telemedical contacts as an alternative to visiting the practice during the pandemic. Further analyses of trends in utilisation behaviour and changes in health status over the course of the COVID-19 pandemic are important.
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Affiliation(s)
- Christin Heidemann
- Corresponding author Dr Christin Heidemann, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62–66, 12101 Berlin, Germany, E-mail:
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Nübel J, Truthmann J, Heidemann C, Du Y, Paprott R, Hapke U, Kruse J, Scheidt-Nave C, Baumert J. Sex-specific impact of major depressive disorder on 12-year change in glycaemic status: Results from a nationwide cohort study of adults without diabetes in Germany. Diabet Med 2022; 39:e14767. [PMID: 34890066 DOI: 10.1111/dme.14767] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/11/2021] [Accepted: 12/08/2021] [Indexed: 12/01/2022]
Abstract
AIMS There is evidence for an increased type 2 diabetes (T2D) risk associated with depression, but its role for diabetes prevention remains unclear. This study aimed to add insight by investigating the impact of major depressive disorder (MDD) on prospective glycaemic changes. METHODS The study was based on a cohort of n = 1,766 adults without diabetes (776 men, 990 women; 18-65 years of age) who participated in the mental health supplement of the German National Health Interview and Examination Survey (GNHIES98-MHS, 1997-1999) and in a follow-up survey (DEGS1, 2008-2011). Glycaemic status was defined as normoglycaemia [HbA1c < 39 mmol/mol (<5.7%)], prediabetes [39 ≤ HbA1c < 48 mmol/mol (5.7-6.4%)] and diabetes [HbA1c ≥ 48 mmol/mol (≥ 6.5%), diagnosed diabetes, or antidiabetic medication], and glycaemic changes categorized as 'remission', 'stability' and 'progression'. Baseline MDD was assessed via a modified German version of the WHO Composite International Diagnostic Interview. Multivariable logistic regressions were applied to analyse the association of MDD with glycaemic changes and incident T2D, adjusting for socio-demographics, lifestyle conditions, chronic diseases, antidepressant use and mental health care. RESULTS MDD prevalence was 21.4% for women and 8.9% for men. Among women, MDD was associated with a lower chance for remission (RRR 0.43; 95% CI 0.23, 0.82). Among men, MDD was not significantly related to glycaemic changes. MDD had no significant effect on incident T2D (men: OR 1.58; 0.55, 4.52; women: OR 0.76; 0.37, 1.58). CONCLUSIONS Findings of the current study highlight the role of depression in T2D prevention, particularly among women.
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Affiliation(s)
- Julia Nübel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Julia Truthmann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- Department of Family Medicine, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Yong Du
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Rebecca Paprott
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Ulfert Hapke
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Johannes Kruse
- Department of Psychosomatic Medicine and Psychotherapy, University of Giessen, Giessen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University of Marburg, Marburg, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jens Baumert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Carinci F, Štotl I, Cunningham SG, Poljicanin T, Pristas I, Traynor V, Olympios G, Scoutellas V, Azzopardi J, Doggen K, Sandor J, Adany R, Løvaas KF, Jarosz-Chobot P, Polanska J, Pruna S, de Lusignan S, Monesi M, Di Bartolo P, Scheidt-Nave C, Heidemann C, Zucker I, Maurina A, Lepiksone J, Rossing P, Arffman M, Keskimäki I, Gudbjornsdottir S, Di Iorio CT, Dupont E, de Sabata S, Klazinga N, Benedetti MM. Making Use of Comparable Health Data to Improve Quality of Care and Outcomes in Diabetes: The EUBIROD Review of Diabetes Registries and Data Sources in Europe. Front Clin Diabetes Healthc 2021; 2:744516. [PMID: 36994337 PMCID: PMC10012140 DOI: 10.3389/fcdhc.2021.744516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/08/2021] [Indexed: 12/16/2022]
Abstract
BackgroundRegistries and data sources contain information that can be used on an ongoing basis to improve quality of care and outcomes of people with diabetes. As a specific task of the EU Bridge Health project, we carried out a survey of diabetes-related data sources in Europe.ObjectivesWe aimed to report on the organization of different sources of diabetes information, including their governance, information infrastructure and dissemination strategies for quality control, service planning, public health, policy and research.MethodsSurvey using a structured questionnaire to collect targeted data from a network of collaborating institutions managing registries and data sources in 17 countries in the year 2017.ResultsThe 18 data sources participating in the study were most frequently academic centres (44.4%), national (72.2%), targeting all types of diabetes (61.1%) covering no more than 10% of the target population (44.4%). Although population-based in over a quarter of cases (27.8%), sources relied predominantly on provider-based datasets (38.5%), fewer using administrative data (16.6%). Data collection was continuous in the majority of cases (61.1%), but 50% could not perform data linkage. Public reports were more frequent (72.2%) as well as quality reports (77.8%), but one third did not provide feedback to policy and only half published ten or more peer reviewed papers during the last 5 years.ConclusionsThe heterogeneous implementation of diabetes registries and data sources hampers the comparability of quality and outcomes across Europe. Best practices exist but need to be shared more effectively to accelerate progress and deliver equitable results for people with diabetes.
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Affiliation(s)
- Fabrizio Carinci
- Department of Statistical Sciences, University of Bologna, Bologna, Italy
- *Correspondence: Fabrizio Carinci,
| | - Iztok Štotl
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Scott G. Cunningham
- Department of Population Health and Genomics, University of Dundee, Dundee, United Kingdom
| | - Tamara Poljicanin
- Division for Health Informatics and Biostatistics, Croatian Institute of Public Health, Zagreb, Croatia
| | - Ivan Pristas
- Division for Health Informatics and Biostatistics, Croatian Institute of Public Health, Zagreb, Croatia
| | - Vivie Traynor
- Diabetes Department, Larnaca Hospital Cyprus, Larnaca, Cyprus
| | - George Olympios
- Diabetes Department, Larnaca Hospital Cyprus, Larnaca, Cyprus
| | - Vasos Scoutellas
- Diabetes Department, Larnaca Hospital Cyprus, Larnaca, Cyprus
- Health Monitoring Unit, Ministry of Health, Nicosia, Cyprus
| | | | - Kris Doggen
- Health Services Research, Sciensano, Brussels, Belgium
| | - János Sandor
- Department of Public Health and Epidemiology, School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Roza Adany
- Department of Public Health and Epidemiology, School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Karianne F. Løvaas
- Norwegian Diabetes Register for Adults, Norwegian Organisation for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Przemka Jarosz-Chobot
- Department of Children’s Diabetology, Medical University of Silesia, Katowice, Poland
| | - Joanna Polanska
- Department of Data Science and Engineering, The Silesian University of Technology, Gliwice, Poland
| | | | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Marcello Monesi
- Diabetes Unit “Sant’Anna” Hospital Ferrara, Ferrara, Italy
- Associazione Medici Diabetologi (AMD), Rome, Italy
| | - Paolo Di Bartolo
- Associazione Medici Diabetologi (AMD), Rome, Italy
- Azienda Unità Sanitaria Locale (AUSL) Diabetes Unit Romagna, Ravenna, Italy
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Inbar Zucker
- Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anita Maurina
- Research and Health Statistics Department, Centre for Disease Prevention and Control of Latvia, Riga, Latvia
| | - Jana Lepiksone
- Research and Health Statistics Department, Centre for Disease Prevention and Control of Latvia, Riga, Latvia
| | | | - Martti Arffman
- Welfare State Research and Reform Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Ilmo Keskimäki
- Welfare State Research and Reform Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Soffia Gudbjornsdottir
- Department of Molecular and Clinical Medicine, University of Gothenburg and Sahlgrenska Hospital, Gothenburg, Sweden
| | | | - Elisabeth Dupont
- International Diabetes Federation European Region, Brussels, Belgium
| | - Stella de Sabata
- International Diabetes Federation European Region, Brussels, Belgium
| | - Niek Klazinga
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Massimo Massi Benedetti
- International Diabetes Federation European Region, Brussels, Belgium
- Hub for International Health Research, Perugia, Italy
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Nübel J, Du Y, Baumert J, Paprott R, Hapke U, Färber F, Heidemann C, Scheidt-Nave C. Erhöht chronischer Stress das Diabetesrisiko? Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732014] [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: 10/20/2022]
Affiliation(s)
- J Nübel
- Robert Koch-Institut, Abteilung für Epidemiologie und Gesundheitsmonitoring
| | - Y Du
- Robert Koch-Institut, Abteilung für Epidemiologie und Gesundheitsmonitoring
| | - J Baumert
- Robert Koch-Institut, Abteilung für Epidemiologie und Gesundheitsmonitoring
| | - R Paprott
- Robert Koch-Institut, Abteilung für Epidemiologie und Gesundheitsmonitoring
| | - U Hapke
- Robert Koch-Institut, Abteilung für Epidemiologie und Gesundheitsmonitoring
| | - F Färber
- Robert Koch-Institut, Abteilung für Epidemiologie und Gesundheitsmonitoring
| | - C Heidemann
- Robert Koch-Institut, Abteilung für Epidemiologie und Gesundheitsmonitoring
| | - C Scheidt-Nave
- Robert Koch-Institut, Abteilung für Epidemiologie und Gesundheitsmonitoring
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Heidemann C, Scheidt-Nave C, Beyer AK, Baumert J, Thamm R, Maier B, Neuhauser H, Fuchs J, Kuhnert R, Hapke U. Health situation of adults in Germany - Results for selected indicators from GEDA 2019/2020-EHIS. J Health Monit 2021; 6:3-25. [PMID: 35146314 PMCID: PMC8734117 DOI: 10.25646/8459] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/09/2021] [Indexed: 01/20/2023]
Abstract
In this article, we examine selected health indicators for the adult population aged 18 years and older in Germany (n=22,708) from the German Health Update (GEDA 2019/2020-EHIS) conducted between April 2019 and September 2020. These indicators include those of self-assessed health and depressive symptoms as well as chronic physical diseases and conditions. In young adulthood (18 to 44 years), over 80% of participants report good or very good subjective health. During this phase of life, most chronic diseases and conditions are rare, although allergies are frequent, and bronchial asthma and depressive symptoms are not uncommon. From mid adulthood (45 years and older), there is a gradual increase in the prevalence of chronic diseases such as cardiovascular disease, diabetes, chronic obstructive pulmonary disease and osteoarthritis. Over 60% of older adults (65 years and older) report a chronic disease or long-term health problem, while only half continue to report good or very good subjective health. During this stage of life, allergies and depressive symptoms become less prevalent. For some diseases, there are also differences according to gender and level of education. This article demonstrates the high public health relevance of age-associated chronic physical diseases and health related limitations in everyday life in an ageing society as well as the need to provide care for certain health conditions already in young adulthood.
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Affiliation(s)
- Christin Heidemann
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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Heidemann C, Scheidt-Nave C, Beyer AK, Baumert J, Thamm R, Maier B, Neuhauser H, Fuchs J, Kuhnert R, Hapke U. Health situation of adults in Germany - Results for selected indicators from GEDA 2019/2020-EHIS. J Health Monit 2021. [PMID: 35146314 DOI: 10.25646/8456:3-27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
In this article, we examine selected health indicators for the adult population aged 18 years and older in Germany (n=22,708) from the German Health Update (GEDA 2019/2020-EHIS) conducted between April 2019 and September 2020. These indicators include those of self-assessed health and depressive symptoms as well as chronic physical diseases and conditions. In young adulthood (18 to 44 years), over 80% of participants report good or very good subjective health. During this phase of life, most chronic diseases and conditions are rare, although allergies are frequent, and bronchial asthma and depressive symptoms are not uncommon. From mid adulthood (45 years and older), there is a gradual increase in the prevalence of chronic diseases such as cardiovascular disease, diabetes, chronic obstructive pulmonary disease and osteoarthritis. Over 60% of older adults (65 years and older) report a chronic disease or long-term health problem, while only half continue to report good or very good subjective health. During this stage of life, allergies and depressive symptoms become less prevalent. For some diseases, there are also differences according to gender and level of education. This article demonstrates the high public health relevance of age-associated chronic physical diseases and health related limitations in everyday life in an ageing society as well as the need to provide care for certain health conditions already in young adulthood.
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Affiliation(s)
- Christin Heidemann
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | | | - Ann-Kristin Beyer
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jens Baumert
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Roma Thamm
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Birga Maier
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Hannelore Neuhauser
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Judith Fuchs
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ronny Kuhnert
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ulfert Hapke
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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Baumert J, Du Y, Nübel J, Heidemann C, Scheidt-Nave C. Soziale Unterstützung als Effektmodifikator für das relative Sterberisiko bei Diabetes – Ergebnisse des Mortalitäts-Follow-ups des Bundesgesundheitssurveys. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732259] [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: 10/20/2022]
Affiliation(s)
| | - Y Du
- Berlin, Robert Koch-Institut
| | - J Nübel
- Berlin, Robert Koch-Institut
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Du Y, Baumert J, Damerow S, Rommel A, Scheidt-Nave C, Heidemann C. Utilisation of outpatient medical services by people with diagnosed diabetes during the COVID-19 pandemic in Germany. J Health Monit 2021; 6:51-58. [PMID: 35146310 PMCID: PMC8734185 DOI: 10.25646/8333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/29/2021] [Indexed: 06/14/2023]
Abstract
People with diabetes regularly need outpatient medical care due to their disease and possible concomitant and secondary illnesses. Using data from the nationwide GEDA 2019/2020-EHIS survey conducted from April 2019 to September 2020, the present study examines developments in outpatient utilisation behaviour during the measures put in place to contain the SARS-CoV-2 pandemic. During the observation period, people with diabetes had a significantly higher rate of utilisation of medical services provided by general practitioners (GPs) and specialists than the population as a whole. In the spring of 2020, when the restrictions were put in place, utilisation of specialist medical services by people with diabetes decreased temporarily by 46% compared to the 2019 reference period. In contrast, no relevant decline in the utilisation of medical services provided by GPs was observed, but this could be related to adaptations of care provision through telephone consultations for people with regularly requiring GP office visits. The issue examined here requires further observations in view of the renewed containment measures.
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Affiliation(s)
- Yong Du
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
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Reitzle L, Schmidt C, Heidemann C, Icks A, Kaltheuner M, Ziese T, Scheidt-Nave C. Gestational diabetes in Germany: Development of screening participation and prevalence. J Health Monit 2021; 6:3-18. [PMID: 35146306 PMCID: PMC8734204 DOI: 10.25646/8325] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/01/2021] [Indexed: 12/03/2022]
Abstract
Gestational diabetes mellitus (GDM) is an important risk factor for pregnancy complications. Since 2012, the Federal Joint Committee's maternity directive recommends a two-step screening for GDM with a pre-test and subsequent diagnostic test if the pre-test is positive. This study analyses the implementation and development over time of GDM screening participation and prevalence in Germany. The data basis is the external inpatient obstetrics quality assurance documentation, which covers all births in hospital. Women with diabetes before pregnancy were excluded. The study defined women as GDM cases if the condition was documented in maternity records or if the ICD-10 diagnosis O24.4 was coded for inpatients at discharge and figures were determined for the years 2013 to 2018. As the documentation of screening tests has only been included in the data set since 2016, screening participation for the years 2016 to 2018 were estimated and evaluated based on the pre-test and/or diagnostic tests documented in maternity records. In 2018, the majority of all women who gave birth in hospitals had had a pre-test conducted (65.0%) or a pre-test and diagnostic test (18.2%) in line with the two-step procedure. A further 6.7% received a diagnostic test alone. GDM screening participation increased over time from 83.4% in 2016 to 89.9% in 2018. The prevalence of a documented GDM increased from 4.6% to 6.8% between 2013 and 2018. In 2018, this equates to 51,318 women with GDM. Reliably assessing the extent and causes of this development will require continuous analyses of screening implementation, documentation and changes in maternal risk factors.
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Affiliation(s)
- Lukas Reitzle
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Christian Schmidt
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Christin Heidemann
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at the Heinrich Heine University Düsseldorf, Düsseldorf
- Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg
| | | | - Thomas Ziese
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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Baumert J, Paprott R, Du Y, Heidemann C, Scheidt-Nave C. Self-assessed quality of care among adults with diagnosed diabetes in Germany. J Health Monit 2021; 6:36-42. [PMID: 35146308 PMCID: PMC8734079 DOI: 10.25646/8329] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/30/2021] [Indexed: 11/30/2022]
Abstract
People who have diabetes require regular medical care. The views of patients about the quality of their care are becoming increasingly relevant when it comes to chronic diseases such as diabetes. As part of the nationwide study Disease Knowledge and Information Needs - Diabetes mellitus (2017), data on self-assessed quality of care by people with diagnosed diabetes was collected using the Patient Assessment of Chronic Illness Care - DAWN short form (PACIC-DSF, scale 1 to 5) and analysed for respondents aged 45 years or above. The average score for quality of care was 2.47 and was lower for women than for men (2.33 vs 2.58). The respondents assessed the quality of their care as being worse with rising age and size of the population in their residential area. No significant differences were observed by education group. Overall, people with diabetes in Germany consider the quality of their care to be moderate, which indicates a need for improvement in care.
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Affiliation(s)
- Jens Baumert
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
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Gaertner B, Fuchs J, Möhler R, Meyer G, Scheidt-Nave C. Older people at the beginning of the COVID-19 pandemic: A scoping review. J Health Monit 2021; 6:2-37. [PMID: 35586562 PMCID: PMC8832372 DOI: 10.25646/7857] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/12/2021] [Indexed: 12/23/2022]
Abstract
This scoping review focuses on evidence gaps regarding the effects on health, social participation and life contexts of older people at the beginning of the COVID-19 pandemic. It is based on a systematic search strategy of the international literature covering a period between December 2019 and June 2020. The review is supplemented by a search of the websites of selected organisations in Germany (cut-off date: 29 June 2020). Search hits were differentiated by types of publication (empirical study, review, discussion paper). The contents were summarised in tabular form according to topic. The publications mainly discussed the high risks of suffering severe courses of COVID-19 faced by older people, specifically those belonging to certain subgroups. In addition, further main topics were the pandemic’s indirect impacts on physical and mental health, physical and cognitive functions and participation in society. Social isolation, loneliness, reduced levels of physical activity and difficulties in maintaining care were discussed as major health risks. Ageism was an issue that was addressed across all of the identified topics. The publications highlighted the need, but also the opportunity, for raising public awareness of the needs of older people in various life contexts. Publications pointed to the urgent need for research into the biological and social causes of older peoples’ high infection risk and how measures could be adapted in a differentiated manner (infection prevention and control measures, social support, medical and nursing care).
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Affiliation(s)
- Beate Gaertner
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Judith Fuchs
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ralph Möhler
- Heinrich Heine University Düsseldorf, Institute for Health Services Research and Health Economics.,Bielefeld University, School of Public Health, Department of Health Services Research and Nursing Science
| | - Gabriele Meyer
- Martin Luther University Halle-Wittenberg, Institute for Health and Nursing Science
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Jung A, Du Y, Nübel J, Busch MA, Heidemann C, Scheidt-Nave C, Baumert J. Are depressive symptoms associated with quality of care in diabetes? Findings from a nationwide population-based study. BMJ Open Diabetes Res Care 2021; 9:e001804. [PMID: 33753346 PMCID: PMC7986897 DOI: 10.1136/bmjdrc-2020-001804] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/08/2021] [Accepted: 01/18/2021] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION We investigated whether the presence of depressive symptoms among adults with diagnosed diabetes is associated with adverse quality of diabetes care. RESEARCH DESIGN AND METHODS The study population was drawn from the German national health survey 'German Health Update' 2014/2015-European Health Interview Survey and included 1712 participants aged ≥18 years with self-reported diabetes during the past 12 months. Depressive symptoms in the past 2 weeks were assessed by the eight-item depression module of the Patient Health Questionnaire (PHQ-8), with PHQ-8 sum score values ≥10 indicating current depressive symptoms. We selected 12 care indicators in diabetes based on self-reported information on care processes and outcomes. Associations of depressive symptoms with those indicators were examined in multivariable logistic regression models with stepwise adjustments. RESULTS Overall, 15.6% of adults with diagnosed diabetes reported depressive symptoms, which were higher in women than in men (18.7% vs 12.9%). Adjusted for age, sex, education, social support, health-related behaviors, and diabetes duration, adults with depressive symptoms were more likely to report acute hypoglycemia (OR 1.81, 95% CI 1.13 to 2.88) or hyperglycemia (OR 2.10, 95% CI 1.30 to 3.37) in the past 12 months, long-term diabetes complications (OR 2.30, 95% CI 1.55 to 3.39) as well as currently having a diet plan (OR 2.14, 95% CI 1.39 to 3.29) than adults without depressive symptoms. Significant associations between depressive symptoms and other care indicators were not observed. CONCLUSIONS The present population-based study of adults with diagnosed diabetes indicates an association between depressive symptoms and adverse diabetes-specific care with respect to outcome but largely not to process indicators. Our findings underline the need for intensified care for persons with diabetes and depressive symptoms. Future research needs to identify underlying mechanisms with a focus on the inter-relationship between diabetes, depression and diabetes-related distress.
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Affiliation(s)
- Andreas Jung
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- Berlin School of Public Health, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Yong Du
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Julia Nübel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Markus A Busch
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jens Baumert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Scheidt-Nave C, Barnes B, Beyer AK, Busch MA, Hapke U, Heidemann C, Imhoff M, Mumm R, Paprott R, Steppuhn H, von Berenberg-Gossler P, Kraywinkel K. Care for the chronically ill in Germany - The challenges during the COVID-19 pandemic. J Health Monit 2021; 5:2-27. [PMID: 35146280 PMCID: PMC8734154 DOI: 10.25646/7168] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/02/2020] [Indexed: 12/16/2022]
Abstract
The COVID-19 pandemic is posing major challenges to the health care sector. This scoping review compiles evidence concerning changes to health care service availability and utilisation as well as possible impacts on health for selected groups of chronically ill people in Germany. The focus is on cancer, cardiovascular diseases, diabetes mellitus and mental disorders. Most empirical data available concerned inpatient care and showed a clear decline in the utilisation of inpatient treatments in March and April 2020 in the areas of oncology and cardiology as well as in mental health. For cardiovascular emergencies such as heart attack and stroke, a decline was observed especially regarding less serious cases. Although there were indications of treatment delays, there was no evidence thus far that emergency care had been generally compromised due to adjustments to inpatient care capacities. In the outpatient setting, extensive adjustments to health care services availability were observed for all disease groups considered. Overall, very limited empirical data were available. In particular, hardly any data were available on how changes in care impacted population health. There is an urgent need for continuous surveillance and evaluation based on health care and epidemiological data.
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Schmidt C, Reitzle L, Heidemann C, Paprott R, Ziese T, Scheidt-Nave C, Baumert J. Excess mortality in adults with documented diabetes in Germany: routine data analysis of all insurance claims in Germany 2013-2014. BMJ Open 2021; 11:e041508. [PMID: 33408205 PMCID: PMC7789443 DOI: 10.1136/bmjopen-2020-041508] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Little is known about the age-specific excess mortality pattern of people with diagnosed diabetes in Germany. Thus, our goal was to determine the excess mortality in diagnosed diabetes overall and stratified by age and sex based on claims data. DESIGN Routine data analysis using a claims dataset from all statutory health-insured persons in Germany in 2013, which accounts for about 90% of the population. PARTICIPANTS We included persons who lived in Germany, were insured at least 360 days, were not self-paying any health services and were aged 30 years or older leading to a total number of 47.3 million insured persons for analyses. EXPOSURE Diabetes was determined by the International Classification of Diseases-10 codes E10-E14, which were documented in 2013 in at least two-quarters on an outpatient setting or at least once on an inpatient setting. OUTCOME MEASURES The vital status in the study population was drawn from the claims dataset for the year 2014. We derived the excess mortality estimated as an age-adjusted mortality rate ratio (MRR) by sex and for age groups using a Poisson model. MAIN RESULTS We found age-adjusted MRRs (95% CI) for diabetes of 1.52 (1.51 to 1.52) for women and 1.56 (1.56 to 1.56) for men. These figures declined with increasing age and were highest for ages 30-34 years with 6.76 (4.99 to 9.15) for women and 6.87 (5.46 to 8.64) for men, and lowest for age 95 years and older with 1.13 (1.10 to 1.15) for women and 1.11 (1.05 to 1.17) for men. CONCLUSIONS We derived deeply age-stratified figures on excess mortality in diabetes for Germany. Establishing a sustainable analysis of excess mortality is aimed at within the framework of diabetes surveillance.
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Affiliation(s)
- Christian Schmidt
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Lukas Reitzle
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Rebecca Paprott
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Thomas Ziese
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jens Baumert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Tönnies T, Heidemann C, Paprott R, Seidel-Jacobs E, Scheidt-Nave C, Brinks R, Hoyer A. Estimating the impact of tax policy interventions on the projected number and prevalence of adults with type 2 diabetes in Germany between 2020 and 2040. BMJ Open Diabetes Res Care 2021; 9:9/1/e001813. [PMID: 33455907 PMCID: PMC7813323 DOI: 10.1136/bmjdrc-2020-001813] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/04/2020] [Accepted: 12/30/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION As a population-wide intervention, it has been proposed to raise taxes on unhealthy products to prevent diseases such as type 2 diabetes. In this study, we aimed to estimate the effect of tax policy interventions in 2020 on the projected prevalence and number of people with type 2 diabetes in the German adult population in 2040. RESEARCH DESIGN AND METHODS We applied an illness-death model and the German Diabetes Risk Score (GDRS) to project the prevalence and number of adults with type 2 diabetes in Germany under a base case scenario and under a tax policy intervention scenario. For the base case scenario, we assumed constant age-specific incidence rates between 2020 and 2040. For the intervention scenario, we assumed a 50% price increase for sugar-sweetened beverages, tobacco and red meat products in the year 2020. Based on price elasticities, we estimated the impact on these risk factors alone and in combination, and calculated subsequent reductions in the age-specific and sex-specific GDRS. These reductions were used to determine reductions in the incidence rate and prevalence using a partial differential equation. RESULTS Compared with the base case scenario, combined tax interventions in 2020 resulted in a 0.95 percentage point decrease in the prevalence of type 2 diabetes (16.2% vs 17.1%), which corresponds to 640 000 fewer prevalent cases of type 2 diabetes and a relative reduction by 6%. CONCLUSIONS Taxation of sugar-sweetened beverages, tobacco products and red meat by 50% modestly lowered the projected number and prevalence of adults with type 2 diabetes in Germany in 2040. Raising taxes on unhealthy products as a stand-alone measure may not be enough to attenuate the future rise of type 2 diabetes.
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Affiliation(s)
- Thaddäus Tönnies
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Rebecca Paprott
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Esther Seidel-Jacobs
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Ralph Brinks
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Chair for Medical Biometry and Epidemiology, Witten/Herdecke University, Faculty of Health/School of Medicine, Witten, Germany
- Department of Statistics, Ludwig Maximilians University Munich, Munich, Germany
| | - Annika Hoyer
- Department of Statistics, Ludwig Maximilians University Munich, Munich, Germany
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Du Y, Baumert J, Paprott R, Teti A, Heidemann C, Scheidt-Nave C. Factors associated with undiagnosed type 2 diabetes in Germany: results from German Health Interview and Examination Survey for Adults 2008-2011. BMJ Open Diabetes Res Care 2020; 8:e001707. [PMID: 33067247 PMCID: PMC7569997 DOI: 10.1136/bmjdrc-2020-001707] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/01/2020] [Accepted: 09/05/2020] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION To identify characteristics of people with undiagnosed type 2 diabetes (T2D) among adults in Germany. RESEARCH DESIGN AND METHODS The study population comprised participants aged 40-79 years of the German Health Interview and Examination Survey for Adults 2008-2011. Glycemic status was categorized as undiagnosed T2D (glycated hemoglobin A1c (HbA1c) ≥48 mmol/mol (6.5%), n=135), diagnosed T2D (n=518) and normoglycemia (HbA1c<48 mmol/mol (6.5%), n=4451). Multinomial logistic regression models including glycemic status as the outcome variable and sociodemographic characteristics, living alone, diabetes risk factors and healthcare services utilization as independent variables were used to identify factors associated with undiagnosed T2D compared with normoglycemia and diagnosed T2D. Odds ratios (ORs) and 95% confidence intervals (CIs) are reported as measure of association between the outcome and independent variables. RESULTS The prevalence of undiagnosed T2D was 2.9% (95% CI 2.2% to 3.9%) at an overall prevalence of 12.3% (11.0% to 13.6%) of persons with undiagnosed or diagnosed T2D. In multivariable analyses, factors associated with undiagnosed as well as diagnosed T2D in comparison to normoglycemia were older age (OR 1.04, 95% CI 1.01 to 1.06, per year, for undiagnosed T2D; OR 1.08, 1.07 to 1.10 for diagnosed T2D), male sex (3.33, 2.18 to 5.07; 1.91, 1.43 to 2.56), obesity (3.47, 2.17 to 5.56; 2.68, 2.04 to 3.52), hypertension (1.66, 1.09 to 2.53; 2.04, 1.42 to 2.95) and parental history of diabetes (2.04, 1.24 to 3.35; 3.16, 2.30 to 4.34). Variables independently associated with undiagnosed T2D but not diagnosed T2D included living alone (2.20; 1.36 to 3.56) and not seeing a doctor within the past year (2.57; 1.34 to 4.93). People with undiagnosed T2D were further younger and more likely to be male sex and reside in the western part of Germany than people with diagnosed T2D. CONCLUSION Apart from major known risk factors of diabetes, characteristics specific to undiagnosed diabetes among adults in Germany will serve to inform the national education and communication strategy on diabetes mellitus in Germany.
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Affiliation(s)
- Yong Du
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jens Baumert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Rebecca Paprott
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Andrea Teti
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- Institute for Gerontology, University of Vechta, Vechta, Lower Saxony, Germany
| | - Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Baumert J, Schmid GL, Du Y, Paprott R, Carmienke S, Stühmann LM, Frese T, Heidemann C, Scheidt-Nave C. Patient-assessed quality of care in type 2 diabetes in a German nationwide health survey 2017. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Patient-assessed quality of chronic illness care is important to guide medical care for patients with diabetes and other complex chronic diseases, but information from epidemiological studies is scarce. Thus, we examined self-assessed quality of care among adults with type 2 diabetes (T2D) based on a population-based design.
Methods
The study population was drawn from a nationwide survey on diabetes-related knowledge and information needs conducted in Germany in 2017 and included participants aged ≥18 years with known type 2 diabetes (T2D) in the last 12 months (n = 1,328). A German short version of the “Patient assessment of chronic illness care (PACIC-DSF)” consisting of 9 items based on 5-point Likert scale was applied to assess self-reported quality of care in diabetes which was operationalized by a standardized PACIC sum score ranging from 1 to 5. Linear regression with different stages of adjustment was applied to assess the association of basic characteristics and diabetes-related factors with the PACIC score.
Results
Quality of care was assessed less favorably by women than by men (PACIC score: 2.38 vs. 2.47) overall and decreased along with age. The PACIC score significantly increased in participants with insulin use (β = 0.16, p = 0.024), ever participating in a diabetes education program (β = 0.33, p < 0.001), following a diet plan at least once a week (β = 0.33, p < =0.001) as well as performing daily self-examination of feet (β = 0.14, p = 0.023), self-control of blood glucose (β = 0.34, p < 0.001), and being physically active for at least 30 min (β = 0.21, p < 0.001) compared to participants without the respective trait.
Conclusions
Self-assessed quality of care by adults with known T2D from this population-based study is moderate and seems lower compared to findings from clinical studies.
Key messages
An active involvement of people with type 2 diabetes into the implementation of care is essential and may contribute to improved self-perceived quality of care. To identify and overcome obstacles in diabetes care based on the patient’s perspective remains a public health challenge.
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Affiliation(s)
- J Baumert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - G L Schmid
- Department of General Practice, Medical Faculty of University of Leipzig, Leipzig, Germany
| | - Y Du
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - R Paprott
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - S Carmienke
- Institute for General Practice and Family Medicine, Medical Faculty of Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - L M Stühmann
- Institute of Medical Sociology and Rehabilitation Science, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - T Frese
- Institute for General Practice and Family Medicine, Medical Faculty of Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - C Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - C Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Baumert J, von der Lippe E, Paprott R, Du Y, Reitzle L, Heidemann C, Schmidt C, Scheidt-Nave C. Life expectancy and healthy life years associated with diabetes in Germany. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
While life expectancy (LE) is rising, years lived with severe health impairments especially due to chronic diseases also increase. Diabetes is one of the major chronic diseases with high potential for co-morbidity and premature deaths needing life-long care. Therefore, information about loss in LE and healthy life years (HLY) in people with diabetes compared to people without diabetes is essential for assessing the burden of diabetes.
Methods
Data on all-cause mortality rates for the general population of Germany in 2014 was drawn from the Federal Statistical Office; mortality rate ratios for people with diabetes compared to people without diabetes were based on claims data from about 70 million people covered by statutory health insurances in 2014. Data of three nationwide health telephone surveys conducted among adults in Germany 2009-2012 (n ∼ 60,000) were used to assess severe health impairments defined as self-reported limitations in daily activities due to diseases for at least six months in people with and without diabetes. Based on these figures, estimates on LE and HLY could be calculated by sex and 5-year age-groups for people with and without diabetes aged ≥ 30 years.
Results
In both sexes and in all 5-year age-groups, LE and HLY were substantially lower for people with than for people without diabetes. For example, among women in the age group 30-34 years, LE and HLY estimates were 48.0 and 36.4 years for those with diabetes compared to 54.9 and 47.6 years for those without diabetes; in men, these figures were estimated as 42.6 and 32.4 years for those with diabetes compared to 50.3 and 44.1 years for those without diabetes. Differences in LE and HLY between people with and without diabetes attenuated with increasing age.
Conclusions
The present study revealed substantial reductions in LE and HLY related to diabetes and underlines the importance of integrating both figures in a national diabetes surveillance.
Key messages
There are substantial differences in life expectancy and healthy life years between people with and without diabetes. Specific intervention and prevention activities should be implemented to tackle disability in persons with diabetes.
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Affiliation(s)
- J Baumert
- Robert Koch Institute, Berlin, Germany
| | | | - R Paprott
- Robert Koch Institute, Berlin, Germany
| | - Y Du
- Robert Koch Institute, Berlin, Germany
| | - L Reitzle
- Robert Koch Institute, Berlin, Germany
| | | | - C Schmidt
- Robert Koch Institute, Berlin, Germany
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Reitzle L, Paprott R, Färber F, Heidemann C, Schmidt C, Thamm R, Scheidt-Nave C, Ziese T. [Health reporting as part of public health surveillance: the example of diabetes]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:1099-1107. [PMID: 32813075 PMCID: PMC7437109 DOI: 10.1007/s00103-020-03201-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The continuous collection and analysis of health data on relevant diseases (surveillance) is at the core of public health. The surveillance enables the implementation of measures to protect the populations' health. Therefore, relevant information needs to be provided in a timely and target-group-specific manner to the respective stakeholders.A dissemination strategy supports the effective communication of results and considers three key questions: (1) "What content is relevant to the surveillance?", (2) "Who requires which information?" and (3) "How are the results disseminated to the target audience?" In this context, digitalisation allows for novel possibilities in the design of publication formats.Since 2015, diabetes surveillance has been established at the Robert Koch Institute. Within a structured process of consensus, we defined four fields of action relevant for health policy including 40 indicators. Thereafter, we developed the first publication formats in collaboration with the scientific advisory board of the project that reflected novel possibilities offered by digitalisation. In addition to articles in scientific journals, the essential formats of the first project phase comprise the report "Diabetes in Germany" and a website including interactive visualisations of results. Additional posts on Twitter and YouTube are used to increase coverage.In addition to the further development of the indicator set, the focus of the next project phase is the advancement of the dissemination towards user- and action-oriented reporting. In close exchange with the scientific advisory board, we aim to explore the requirements of the target audience and reflect them in the design of further publication formats.
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Affiliation(s)
- Lukas Reitzle
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland.
| | - Rebecca Paprott
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Francesca Färber
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Christin Heidemann
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Christian Schmidt
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Roma Thamm
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Christa Scheidt-Nave
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Thomas Ziese
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut (RKI), General-Pape-Str. 62-66, 12101, Berlin, Deutschland
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Reitzle L, Paprott R, Heidemann C, Schmidt C, Baumert J, Färber F, Du Y, Scheidt-Nave C, Ziese T. Towards NCD surveillance in Germany – diabetes as a paradigm. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Non-communicable diseases (NCD) are a major public health challenge in Germany and throughout the world. The epidemiology of diabetes, in particular type 2 diabetes, exemplifies the need for effective prevention and control. To support policy making with actionable evidence, the Robert Koch Institute (RKI) is developing a diabetes surveillance system for Germany serving as model for NCD surveillance.
Methods
First, we consented a conceptual framework and key indicators among experts and stakeholders based on an extensive literature review including national and international NCD surveillance systems. After prioritization of indicators applying a two-step Delphi method, we identified data sources for sustainable surveillance including data from nationwide RKI health surveys as well as external data such as claims or registry data. Lastly, in cooperation with stakeholders we developed first dissemination products.
Results
During concept phase, we identified 40 indicators ranging from risk factors, disease incidence and prevalence to quality of care, mortality and burden of disease. During implementation, suitable data sources and results on temporal trends have been obtained for a large part of the indicators. For dissemination we developed a website with interactive visualization of results supported by an explainer video on YouTube. Additionally, we prepared a printed diabetes report summarizing and interpreting key findings for a broader audience, including health politicians and public health researchers.
Conclusions
We demonstrated the feasibility of the systematic collection and analysis of health data to describe the disease and care situation of diabetes in Germany. The methodology and data sources of indicators can be transferred to further NCDs and shared risk factors are already depicted. Next steps are to close remaining data gaps and to advance dissemination products in collaboration with our stakeholder network tailored to their information needs.
Key messages
Considering available health data, we showed the feasibility of implementing a diabetes surveillance system for Germany providing reliable information on disease dynamics for various stakeholders. The knowledge on methodology and data sources gained establishing a diabetes surveillance system can be extended to other noncommunicable diseases.
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Affiliation(s)
- L Reitzle
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - R Paprott
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - C Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - C Schmidt
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - J Baumert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - F Färber
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Y Du
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - C Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - T Ziese
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Scheidt-Nave C, Fehr A, Haller S, Sarganas G, Steppuhn H, Truthmann J, Harder T. Providing actionable evidence in Public Health - The 2018 international workshop on evidence-based public health at the Robert Koch Institute, Berlin. J Health Monit 2020; 5:3-6. [PMID: 35146283 PMCID: PMC8734086 DOI: 10.25646/6499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 01/20/2020] [Indexed: 06/14/2023]
Affiliation(s)
| | - Angela Fehr
- Robert Koch Institute, Berlin, Centre for International Health Protection
| | - Sebastian Haller
- Robert Koch Institute, Berlin, Department of Infectious Disease Epidemiology
| | - Giselle Sarganas
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
| | - Henriette Steppuhn
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
| | - Julia Truthmann
- Formerly Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
| | - Thomas Harder
- Robert Koch Institute, Berlin, Department of Infectious Disease Epidemiology
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Taddei C, Zhou B, Bixby H, Carrillo-Larco RM, Danaei G, Jackson RT, Farzadfar F, Sophiea MK, Di Cesare M, Iurilli MLC, Martinez AR, Asghari G, Dhana K, Gulayin P, Kakarmath S, Santero M, Voortman T, Riley LM, Cowan MJ, Savin S, Bennett JE, Stevens GA, Paciorek CJ, Aekplakorn W, Cifkova R, Giampaoli S, Kengne AP, Khang YH, Kuulasmaa K, Laxmaiah A, Margozzini P, Mathur P, Nordestgaard BG, Zhao D, Aadahl M, Abarca-Gómez L, Rahim HA, Abu-Rmeileh NM, Acosta-Cazares B, Adams RJ, Agdeppa IA, Aghazadeh-Attari J, Aguilar-Salinas CA, Agyemang C, Ahluwalia TS, Ahmad NA, Ahmadi A, Ahmadi N, Ahmed SH, Ahrens W, Ajlouni K, Alarouj M, AlBuhairan F, AlDhukair S, Ali MM, Alkandari A, Alkerwi A, Aly E, Amarapurkar DN, Amouyel P, Andersen LB, Anderssen SA, Anjana RM, Ansari-Moghaddam A, Aounallah-Skhiri H, Araújo J, Ariansen I, Aris T, Arku RE, Arlappa N, Aryal KK, Aspelund T, Assunção MCF, Auvinen J, Avdicová M, Azevedo A, Azizi F, Azmin M, Balakrishna N, Bamoshmoosh M, Banach M, Bandosz P, Banegas JR, Barbagallo CM, Barceló A, Barkat A, Bata I, Batieha AM, Batyrbek A, Baur LA, Beaglehole R, Belavendra A, Ben Romdhane H, Benet M, Benn M, Berkinbayev S, Bernabe-Ortiz A, Bernotiene G, Bettiol H, Bhargava SK, Bi Y, Bienek A, Bikbov M, Bista B, Bjerregaard P, Bjertness E, Bjertness MB, Björkelund C, Bloch KV, Blokstra A, Bo S, Boehm BO, Boggia JG, Boissonnet CP, Bonaccio M, Bongard V, Borchini R, Borghs H, Bovet P, Brajkovich I, Breckenkamp J, Brenner H, Brewster LM, Bruno G, Bugge A, Busch MA, de León AC, Cacciottolo J, Can G, Cândido APC, Capanzana MV, Capuano E, Capuano V, Cardoso VC, Carvalho J, Casanueva FF, Censi L, Chadjigeorgiou CA, Chamukuttan S, Chaturvedi N, Chen CJ, Chen F, Chen S, Cheng CY, Cheraghian B, Chetrit A, Chiou ST, Chirlaque MD, Cho B, Cho Y, Chudek J, Claessens F, Clarke J, Clays E, Concin H, Confortin SC, Cooper C, Costanzo S, Cottel D, Cowell C, Crujeiras AB, Csilla S, Cui L, Cureau FV, D’Arrigo G, d’Orsi E, Dallongeville J, Damasceno A, Dankner R, Dantoft TM, Dauchet L, Davletov K, De Backer G, De Bacquer D, de Gaetano G, De Henauw S, de Oliveira PD, De Ridder D, De Smedt D, Deepa M, Deev AD, Dehghan A, Delisle H, Dennison E, Deschamps V, Dhimal M, Di Castelnuovo AF, Dika Z, Djalalinia S, Dobson AJ, Donfrancesco C, Donoso SP, Döring A, Dorobantu M, Dragano N, Drygas W, Du Y, Duante CA, Duda RB, Dzerve V, Dziankowska-Zaborszczyk E, Eddie R, Eftekhar E, Eggertsen R, Eghtesad S, Eiben G, Ekelund U, El Ati J, Eldemire-Shearer D, Eliasen M, Elosua R, Erasmus RT, Erbel R, Erem C, Eriksen L, Eriksson JG, Escobedo-de la Peña J, Eslami S, Esmaeili A, Evans A, Faeh D, Fall CH, Faramarzi E, Farjam M, Fattahi MR, Felix-Redondo FJ, Ferguson TS, Fernández-Bergés D, Ferrante D, Ferrari M, Ferreccio C, Ferrieres J, Föger B, Foo LH, Forslund AS, Forsner M, Fouad HM, Francis DK, do Carmo Franco M, Franco OH, Frontera G, Fujita Y, Fumihiko M, Furusawa T, Gaciong Z, Galvano F, Gao J, Garcia-de-la-Hera M, Garnett SP, Gaspoz JM, Gasull M, Gazzinelli A, Geleijnse JM, Ghanbari A, Ghasemi E, Gheorghe-Fronea OF, Ghimire A, Gianfagna F, Gill TK, Giovannelli J, Gironella G, Giwercman A, Goltzman D, Gonçalves H, Gonzalez-Chica DA, Gonzalez-Gross M, González-Rivas JP, González-Villalpando C, González-Villalpando ME, Gonzalez AR, Gottrand F, Graff-Iversen S, Grafnetter D, Gregor RD, Grodzicki T, Grøntved A, Grosso G, Gruden G, Gu D, Guallar-Castillón P, Guan OP, Gudmundsson EF, Gudnason V, Guerrero R, Guessous I, Gunnlaugsdottir J, Gupta R, Gutierrez L, Gutzwiller F, Ha S, Hadaegh F, Haghshenas R, Hakimi H, Hambleton IR, Hamzeh B, Hantunen S, Kumar RH, Hashemi-Shahri SM, Hata J, Haugsgjerd T, Hayes AJ, He J, He Y, Hendriks ME, Henriques A, Herrala S, Heshmat R, Hill AG, Ho SY, Ho SC, Hobbs M, Hofman A, Homayounfar R, Hopman WM, Horimoto ARVR, Hormiga CM, Horta BL, Houti L, Howitt C, Htay TT, Htet AS, Htike MMT, Huerta JM, Huhtaniemi IT, Huisman M, Hunsberger ML, Husseini AS, Huybrechts I, Hwalla N, Iacoviello L, Iannone AG, Ibrahim MM, Wong NI, Iglesia I, Ikeda N, Ikram MA, Iotova V, Irazola VE, Ishida T, Islam M, al-Safi Ismail A, Iwasaki M, Jacobs JM, Jaddou HY, Jafar T, James K, Jamrozik K, Janszky I, Janus E, Jarvelin MR, Jasienska G, Jelakovic A, Jelakovic B, Jennings G, Jensen GB, Jeong SL, Jha AK, Jiang CQ, Jimenez RO, Jöckel KH, Joffres M, Jokelainen JJ, Jonas JB, Jørgensen T, Joshi P, Joukar F, Józwiak J, Juolevi A, Kafatos A, Kajantie EO, Kalter-Leibovici O, Kamaruddin NA, Kamstrup PR, Karki KB, Katz J, Kauhanen J, Kaur P, Kavousi M, Kazakbaeva G, Keil U, Keinänen-Kiukaanniemi S, Kelishadi R, Keramati M, Kerimkulova A, Kersting M, Khader YS, Khalili D, Khateeb M, Kheradmand M, Khosravi A, Kiechl-Kohlendorfer U, Kiechl S, Killewo J, Kim HC, Kim J, Kim YY, Klumbiene J, Knoflach M, Ko S, Kohler HP, Kohler IV, Kolle E, Kolsteren P, König J, Korpelainen R, Korrovits P, Kos J, Koskinen S, Kouda K, Kowlessur S, Kratzer W, Kriemler S, Kristensen PL, Krokstad S, Kromhout D, Kujala UM, Kurjata P, Kyobutungi C, Laamiri FZ, Laatikainen T, Lachat C, Laid Y, Lam TH, Lambrinou CP, Lanska V, Lappas G, Larijani B, Latt TS, Laugsand LE, Lazo-Porras M, Lee J, Lee J, Lehmann N, Lehtimäki T, Levitt NS, Li Y, Lilly CL, Lim WY, Lima-Costa MF, Lin HH, Lin X, Lin YT, Lind L, Linneberg A, Lissner L, Liu J, Loit HM, Lopez-Garcia E, Lopez T, Lotufo PA, Lozano JE, Luksiene D, Lundqvist A, Lundqvist R, Lunet N, Ma G, Machado-Coelho GLL, Machado-Rodrigues AM, Machi S, Madar AA, Maggi S, Magliano DJ, Magriplis E, Mahasampath G, Maire B, Makdisse M, Malekzadeh F, Malekzadeh R, Rao KM, Manios Y, Mann JI, Mansour-Ghanaei F, Manzato E, Marques-Vidal P, Martorell R, Mascarenhas LP, Mathiesen EB, Matsha TE, Mavrogianni C, McFarlane SR, McGarvey ST, McLachlan S, McLean RM, McLean SB, McNulty BA, Mediene-Benchekor S, Mehdipour P, Mehlig K, Mehrparvar AH, Meirhaeghe A, Meisinger C, Menezes AMB, Menon GR, Merat S, Mereke A, Meshram II, Metcalf P, Meyer HE, Mi J, Michels N, Miller JC, Minderico CS, Mini GK, Miquel JF, Miranda JJ, Mirjalili MR, Mirrakhimov E, Modesti PA, Moghaddam SS, Mohajer B, Mohamed MK, Mohammad K, Mohammadi Z, Mohammadifard N, Mohammadpourhodki R, Mohan V, Mohanna S, Yusoff MFM, Mohebbi I, Mohebi F, Moitry M, Møllehave LT, Møller NC, Molnár D, Momenan A, Mondo CK, Monterrubio-Flores E, Moosazadeh M, Morejon A, Moreno LA, Morgan K, Morin SN, Moschonis G, Mossakowska M, Mostafa A, Mota J, Motlagh ME, Motta J, Msyamboza KP, Muiesan ML, Müller-Nurasyid M, Mursu J, Mustafa N, Nabipour I, Naderimagham S, Nagel G, Naidu BM, Najafi F, Nakamura H, Námešná J, Nang EEK, Nangia VB, Nauck M, Neal WA, Nejatizadeh A, Nenko I, Nervi F, Nguyen ND, Nguyen QN, Nieto-Martínez RE, Nihal T, Niiranen TJ, Ning G, Ninomiya T, Noale M, Noboa OA, Noto D, Nsour MA, Nuhoğlu I, O’Neill TW, O’Reilly D, Ochoa-Avilés AM, Oh K, Ohtsuka R, Olafsson Ö, Olié V, Oliveira IO, Omar MA, Onat A, Ong SK, Ordunez P, Ornelas R, Ortiz PJ, Osmond C, Ostojic SM, Ostovar A, Otero JA, Owusu-Dabo E, Paccaud FM, Pahomova E, Pajak A, Palmieri L, Pan WH, Panda-Jonas S, Panza F, Parnell WR, Patel ND, Peer N, Peixoto SV, Peltonen M, Pereira AC, Peters A, Petersmann A, Petkeviciene J, Peykari N, Pham ST, Pichardo RN, Pigeot I, Pilav A, Pilotto L, Piwonska A, Pizarro AN, Plans-Rubió P, Plata S, Pohlabeln H, Porta M, Portegies MLP, Poudyal A, Pourfarzi F, Poustchi H, Pradeepa R, Price JF, Providencia R, Puder JJ, Puhakka SE, Punab M, Qorbani M, Bao TQ, Radisauskas R, Rahimikazerooni S, Raitakari O, Rao SR, Ramachandran A, Ramos E, Ramos R, Rampal L, Rampal S, Redon J, Reganit PFM, Revilla L, Rezaianzadeh A, Ribeiro R, Richter A, Rigo F, Rinke de Wit TF, Rodríguez-Artalejo F, del Cristo Rodriguez-Perez M, Rodríguez-Villamizar LA, Roggenbuck U, Rojas-Martinez R, Romaguera D, Romeo EL, Rosengren A, Roy JGR, Rubinstein A, Ruidavets JB, Ruiz-Betancourt BS, Russo P, Rust P, Rutkowski M, Sabanayagam C, Sachdev HS, Sadjadi A, Safarpour AR, Safiri S, Saidi O, Saki N, Salanave B, Salmerón D, Salomaa V, Salonen JT, Salvetti M, Sánchez-Abanto J, Sans S, Santaliestra-Pasías AM, Santos DA, Santos MP, Santos R, Saramies JL, Sardinha LB, Sarrafzadegan N, Saum KU, Savva SC, Sawada N, Sbaraini M, Scazufca M, Schaan BD, Schargrodsky H, Scheidt-Nave C, Schienkiewitz A, Schipf S, Schmidt CO, Schöttker B, Schramm S, Sebert S, Sein AA, Sen A, Sepanlou SG, Servais J, Shakeri R, Shalnova SA, Shamah-Levy T, Sharafkhah M, Sharma SK, Shaw JE, Shayanrad A, Shi Z, Shibuya K, Shimizu-Furusawa H, Shin DW, Shin Y, Shirani M, Shiri R, Shrestha N, Si-Ramlee K, Siani A, Siantar R, Sibai AM, Silva DAS, Simon M, Simons J, Simons LA, Sjöström M, Skaaby T, Slowikowska-Hilczer J, Slusarczyk P, Smeeth L, Snijder MB, Söderberg S, Soemantri A, Sofat R, Solfrizzi V, Somi MH, Sonestedt E, Sørensen TIA, Jérome CS, Soumaré A, Sozmen K, Sparrenberger K, Staessen JA, Stathopoulou MG, Stavreski B, Steene-Johannessen J, Stehle P, Stein AD, Stessman J, Stevanović R, Stieber J, Stöckl D, Stokwiszewski J, Stronks K, Strufaldi MW, Suárez-Medina R, Sun CA, Sundström J, Suriyawongpaisal P, Sy RG, Sylva RC, Szklo M, Tai ES, Tamosiunas A, Tan EJ, Tarawneh MR, Tarqui-Mamani CB, Taylor A, Taylor J, Tell GS, Tello T, Thankappan KR, Thijs L, Thuesen BH, Toft U, Tolonen HK, Tolstrup JS, Topbas M, Topór-Madry R, Tormo MJ, Tornaritis MJ, Torrent M, Torres-Collado L, Traissac P, Trinh OTH, Truthmann J, Tsugane S, Tulloch-Reid MK, Tuomainen TP, Tuomilehto J, Tybjaerg-Hansen A, Tzourio C, Ueda P, Ugel E, Ulmer H, Unal B, Uusitalo HMT, Valdivia G, Valvi D, van Dam RM, van der Schouw YT, Van Herck K, Van Minh H, van Rossem L, Van Schoor NM, van Valkengoed IGM, Vanderschueren D, Vanuzzo D, Varbo A, Varona-Pérez P, Vasan SK, Vatten L, Vega T, Veidebaum T, Velasquez-Melendez G, Venero-Fernández SJ, Veronesi G, Verschuren WMM, Victora CG, Vidiawati D, Viet L, Villalpando S, Vioque J, Virtanen JK, Visvikis-Siest S, Viswanathan B, Vlasoff T, Vollenweider P, Voutilainen A, Wade AN, Wagner A, Walton J, Bebakar WMW, Mohamud WNW, Wang MD, Wang N, Wang Q, Wang YX, Wang YW, Wannamethee SG, Wedderkopp N, Wei W, Whincup PH, Widhalm K, Widyahening IS, Wiecek A, Wijga AH, Wilks RJ, Willeit J, Willeit P, Wilsgaard T, Wojtyniak B, Wong-McClure RA, Wong A, Wong TY, Woo J, Woodward M, Wu FC, Wu S, Xu H, Xu L, Yan W, Yang X, Yasuharu T, Ye X, Yeow TP, Yiallouros PK, Yoosefi M, Yoshihara A, You SL, Younger-Coleman NO, Yusoff AF, Zainuddin AA, Zakavi SR, Zali MR, Zamani F, Zambon S, Zampelas A, Zaw KK, Zdrojewski T, Vrkic TZ, Zhang ZY, Zhao W, Zhen S, Zheng Y, Zholdin B, Zhussupov B, Zoghlami N, Cisneros JZ, Gregg EW, Ezzati M. Repositioning of the global epicentre of non-optimal cholesterol. Nature 2020; 582:73-77. [PMID: 32494083 PMCID: PMC7332422 DOI: 10.1038/s41586-020-2338-1] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 04/02/2020] [Indexed: 11/25/2022]
Abstract
High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular risk-changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.
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Stühmann LM, Paprott R, Heidemann C, Baumert J, Hansen S, Zahn D, Scheidt-Nave C, Gellert P. Health App Use and Its Correlates Among Individuals With and Without Type 2 Diabetes: Nationwide Population-Based Survey. JMIR Diabetes 2020; 5:e14396. [PMID: 32432555 PMCID: PMC7270854 DOI: 10.2196/14396] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 04/15/2019] [Revised: 11/17/2019] [Accepted: 02/05/2020] [Indexed: 12/22/2022] Open
Abstract
Background Evidence suggests that mobile health app use is beneficial for the prevention and management of type 2 diabetes (T2D) and its associated complications; however, population-based research on specific determinants of health app use in people with and without T2D is scarce. Objective This cross-sectional study aimed to provide population-based evidence on rates and determinants of health app use among adults with and without T2D, thereby covering a prevention perspective and a diabetes management perspective, respectively. Methods The study population included 2327 adults without a known diabetes diagnosis and 1149 adults with known T2D from a nationwide telephone survey in Germany conducted in 2017. Rates of smartphone ownership and health app use were estimated based on weighted sample proportions. Among smartphone owners, determinants of health app use were identified for both groups separately in multivariable logistic regression models. Sociodemographic factors, diabetes-related factors or indicators, psychological and health-related factors, and physician-provided information were selected as potential determinants. Results Among participants without known diabetes, 74.72% (1690/2327) were smartphone owners. Of those, 49.27% (717/1690) used health apps, most often to improve regular physical activity. Among participants with T2D, 42.26% (481/1149) were smartphone owners. Of those, 41.1% (171/481) used health apps, most commonly to target a healthy diet. Among people without known diabetes, determinants significantly (all P values <.05) associated with an increased likelihood of health app use compared with their reference group were as follows: younger and middle age of 18 to 44 or 45 to 64 years (odds ratios [ORs] 3.89; P<.001 and 1.76; P=.004, respectively), overweight or obesity (ORs 1.58; P<.001 and 2.07; P<.001, respectively), hypertension diagnosis (OR 1.31; P=.045), former or current smoking (ORs 1.51; P=.002 and 1.58; P<.001, respectively), perceiving health as very good (OR 2.21; P<.001), other chronic diseases (OR 1.48; P=.002), and having received health advice from a physician (OR 1.48; P<.001). A slight or high perceived diabetes risk (ORs 0.78; P=.04 and 0.23; P<.001, respectively) was significantly associated with a decreased likelihood of health app use. Among people with T2D, younger and middle age (18-64 years; OR 1.84; P=.007), female gender (OR 1.61; P=.02), and using a glucose sensor in addition or instead of a glucose meter (OR 2.74; P=.04) were significantly positively associated with health app use. Conclusions In terms of T2D prevention, age, diabetes-related risk factors, psychological and health-related factors, and medical health advice may inform app development for specific target groups. In addition, health professionals may encourage health app use when giving advice on health behaviors. Concerning T2D management, only a few determinants seem relevant for explaining health app use among people with T2D, indicating a need for more future research on which people with T2D use health apps and why.
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Affiliation(s)
- Lena M Stühmann
- Institute for Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Rebecca Paprott
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jens Baumert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Sylvia Hansen
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, Cologne, Germany
| | - Daniela Zahn
- Preventive Cardiology and Medical Prevention, Department of Cardiology, University Medical Centre, Johannes Gutenberg University, Mainz, Germany.,Federal Center for Health Education (BZgA), Office for National Education and Communication on Diabetes Mellitus, Cologne, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Paul Gellert
- Institute for Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Stühmann LM, Paprott R, Heidemann C, Ziese T, Hansen S, Zahn D, Scheidt-Nave C, Gellert P. Psychometric properties of a nationwide survey for adults with and without diabetes: the "disease knowledge and information needs - diabetes mellitus (2017)" survey. BMC Public Health 2020; 20:192. [PMID: 32028928 PMCID: PMC7006078 DOI: 10.1186/s12889-020-8296-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 01/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In order to close existing information gaps on diabetes-related health perceptions, diabetes knowledge, and information-seeking behaviors among adults in Germany, a representative population-based survey targeting the German-speaking population 18 years and older with and without diabetes was conducted. The aim of the present work was to analyze the psychometric properties of the multi-item scales, applied in the survey in order to provide guidance for decisions on the use of these measurements for future research. METHODS Based on data from participants who completed the final survey (N = 1479 with known diabetes; N = 2327 without known diabetes) reliability and unidimensionality of multi-item scales were tested using Cronbach's Alpha and confirmatory factor analysis (CFA). RESULTS Psychometric properties and model fit varied across scales. Cronbach's alpha values ranged from very good to unacceptable. Model fit indices suggested evidence of a single underlying factor in some but not all scales. Adequate reliability and at least mediocre model fit were found for diabetes distress and patient-provider-relationship in people with diabetes and for perceived level of information in individuals without diabetes. Scales revealing inacceptable reliability values or not suggesting unidimensionality were e.g. diabetes-related stigmatization in both individuals with and without diabetes, self-efficacy in individuals with diabetes, and perceived personal control in those without diabetes. CONCLUSION Based on results of the current study, some of the scales applied in the survey can be recommended for present and future analyses of the survey data and for future surveys (e.g. diabetes distress, patient-provider-relationship in people with diabetes). Other scales should be interpreted and used with caution (e.g. depressive symptoms in people with diabetes) while others should be reformulated, interpreted only as single items, or need further investigation (e.g. diabetes-related stigmatization in people with and without diabetes). Findings provide researchers the opportunity to evaluate diabetes-specific scales in population-based studies of adults with and without diabetes.
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Affiliation(s)
- Lena M Stühmann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Institute for Medical Sociology and Rehabilitation Science, Berlin, Germany
| | - Rebecca Paprott
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Thomas Ziese
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Sylvia Hansen
- Ceres - Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, Cologne, Germany
| | - Daniela Zahn
- Federal Centre for Health Education (BZgA), Office for National Education and Communication on Diabetes Mellitus, Cologne, Germany
- Preventive Cardiology and Medical Prevention, Department of Cardiology, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Paul Gellert
- Charité - Universitätsmedizin Berlin, Institute for Medical Sociology and Rehabilitation Science, Berlin, Germany.
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Gaertner B, Busch MA, Scheidt-Nave C, Fuchs J. Corrigendum: Limitations in activities of daily living in old age in Germany and the EU - Results from the European Health Interview Survey (EHIS) 2. J Health Monit 2020; 4:56. [PMID: 35146258 PMCID: PMC8790792 DOI: 10.25646/6806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
[This corrects the article on p. 48-56 in vol. 4.].
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National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio: a pooled analysis of 458 population-based studies in Asian and Western countries. Int J Epidemiol 2020; 49:173-192. [PMID: 31321439 PMCID: PMC7245049 DOI: 10.1093/ije/dyz099] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Although high-density lipoprotein (HDL) and non-HDL cholesterol have opposite associations with coronary heart disease, multi-country reports of lipid trends only use total cholesterol (TC). Our aim was to compare trends in total, HDL and non-HDL cholesterol and the total-to-HDL cholesterol ratio in Asian and Western countries. METHODS We pooled 458 population-based studies with 82.1 million participants in 23 Asian and Western countries. We estimated changes in mean total, HDL and non-HDL cholesterol and mean total-to-HDL cholesterol ratio by country, sex and age group. RESULTS Since ∼1980, mean TC increased in Asian countries. In Japan and South Korea, the TC rise was due to rising HDL cholesterol, which increased by up to 0.17 mmol/L per decade in Japanese women; in China, it was due to rising non-HDL cholesterol. TC declined in Western countries, except in Polish men. The decline was largest in Finland and Norway, at ∼0.4 mmol/L per decade. The decline in TC in most Western countries was the net effect of an increase in HDL cholesterol and a decline in non-HDL cholesterol, with the HDL cholesterol increase largest in New Zealand and Switzerland. Mean total-to-HDL cholesterol ratio declined in Japan, South Korea and most Western countries, by as much as ∼0.7 per decade in Swiss men (equivalent to ∼26% decline in coronary heart disease risk per decade). The ratio increased in China. CONCLUSIONS HDL cholesterol has risen and the total-to-HDL cholesterol ratio has declined in many Western countries, Japan and South Korea, with only a weak correlation with changes in TC or non-HDL cholesterol.
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