[Linkage of statutory health insurance data with those of a hospital information system: feasible, but also "useful"?].

Aim: Administrative data are increasingly being linked with other data sources for research purposes in the field of epidemiology and health services research abroad. In Germany, the direct linkage of routine data of statutory health insurance (SHI) providers with other data sources is complicated due to strict data protection requirements. The aim of this analysis was to evaluate an indirect linkage of SHI routine data with data of a hospital information system (HIS).

Evaluation of invalid vaccine doses in 31 countries of the WHO African Region.

We examined (a) the fraction of and extent to which vaccinations were administered earlier than recommended (age-invalid) or with too short intervals between vaccine doses (interval-invalid) in countries of the World Health Organisation (WHO) African Region and (b) individual- and community-level factors associated with invalid vaccinations using multilevel techniques. Data from the Demographic and Health Surveys conducted in the last 10 years in 31 countries were used. Information about childhood vaccinations was based on vaccination records (n=134,442).

Proposing an empirically justified reference threshold for blood culture sampling rates in intensive care units.

Early and appropriate blood culture sampling is recommended as a standard of care for patients with suspected bloodstream infections (BSI) but is rarely taken into account when quality indicators for BSI are evaluated. To date, sampling of about 100 to 200 blood culture sets per 1,000 patient-days is recommended as the target range for blood culture rates. However, the empirical basis of this recommendation is not clear.

Interinstitutional variations in mode of birth after a previous caesarean section: a cross-sectional study in six German hospitals.

Aims: Regional and interinstitutional variations have been recognized in the increasing incidence of caesarean section. Modes of birth after previous caesarean section vary widely, ranging from elective repeat caesarean section (ERCS) and unplanned repeat caesarean section (URCS) after trial of labour to vaginal birth after caesarean section (VBAC). This study describes interinstitutional variations in mode of birth after previous caesarean section in relation to regional indicators in Germany.

Trajectories of injecting behavior in the Amsterdam Cohort Study among drug users.

Background: Injecting frequency among people who inject drugs (IDU) can change along distinct trajectories, which can reflect on incidence of HIV and HCV infections. We aimed at assessing these patterns of longitudinal changes, their predictors and their association with the incidence of HIV and HCV.

Methods: We analyzed data from the Amsterdam Cohort Study among Drug Users, selecting participants recruited from 1985 to 2005, injecting drugs before cohort entry and with records in at least three different six months intervals (N=740).

[Therapy Goals for Children and Adolescents with ADHD and their Primary Caregivers. A Content Analysis and Examination of Agreement of ADHD Patients and their Primary Caregivers].

Objective: The aim of this study was to identify individual therapy goals (ITGs) of children and adolescents with ADHD and their primary caregivers.

Methods: Within the evaluation of the selective contract for children and adolescents with ADHD in Bremerhaven, Germany, ITGs of 42 study participants (aged 8-17) and their primary caregivers were collected with the psychotherapy basis documentation for children and adolescents (Psy-BaDo-KJ). ITGs were analysed following the classification of categories for individual therapy goals (KITZ) and their modification for children and adolescents.

Illicit substance use among university students from seven European countries: a comparison of personal and perceived peer use and attitudes towards illicit substance use.

Objective: To compare European students' personal use and approval of illicit substance use with their perceptions of peer behaviours and attitudes, and investigate whether perceptions of peer norms are associated with personal use of illicit substances and attitudes.

Method: This study used baseline data from the Social Norms Intervention for the prevention of Polydrug usE (SNIPE) project involving 4482 students from seven European countries in 2012. Students completed an online survey which included questions on personal and perceived peer illicit substance use and personal and perceived peer attitude towards illicit substances.

Evaluating methods for intersectoral comparison of quality of care. A routine data analysis of elective percutaneous coronary interventions.

Objectives: To compare the quality of care regarding the use of elective percutaneous coronary interventions (PCIs) in the inpatient and outpatient setting and to evaluate different methods of confounder control in this context.

Methods: Based on data of three statutory health insurances including more than nine million insurance members, a retrospective cohort study between 2005 and 2009 was conducted. The occurrence of myocardial infarction, stroke, further coronary intervention and death was ascertained following the first PCI in the study period, which was preceded by a one-year period without a PCI.

Quality of life in Parkinson's disease patients with motor fluctuations and dyskinesias in five European countries.

Background: Little is known about the relationship between specific subtypes of treatment-associated motor complications and different domains of health-related Quality of Life (QoL) in patients with Parkinson's disease (PD). Larger studies that investigate these aspects within a cross-cultural setting are scarce.

Objective: To assess QoL and its association with on-off fluctuations, peak-dose dyskinesias, biphasic dyskinesias, and off-dystonias in PD patients from five European countries.

[Use of routine data from statutory health insurances for federal health monitoring purposes].

Federal health monitoring deals with the state of health and the health-related behavior of populations and is used to inform politics. To date, the routine data from statutory health insurances (SHI) have rarely been used for federal health monitoring purposes. SHI routine data enable analyses of disease frequency, risk factors, the course of the disease, the utilization of medical services, and mortality rates.

HPV vaccine uptake after introduction of the vaccine in Germany: an analysis of administrative data.

In Germany, vaccination against human papilloma virus (HPV) has been recommended by the German Standing Vaccination Committee (STIKO) for girls aged 12-17 years since March 2007. The vaccine is free of charge for this age group. Additionally, some statutory health insurance providers (SHI) offer reimbursement for women aged 18-26 years.

Women's attitudes towards mechanisms of action of birth control methods: a cross-sectional study in five European countries.

Aims And Objectives: To assess women's attitudes towards the mechanisms of action of birth control methods.

Background: When addressing women's knowledge of and attitudes towards birth control methods, researchers frequently focus on side effects, effectiveness or correct use. Women's opinions about mechanisms of action have been much less investigated, and research is usually concentrated on the EC pill.

Spousal violence against women and its association with women's mental health in Pakistan.

In Pakistan, the issue of spousal violence is under-researched and still not considered a public health problem. To assess the association of spousal violence with women's mental health, a hospital-based cross-sectional survey was conducted through a structured interview schedule with 373 randomly selected ever-married women of reproductive age in eight randomly selected hospitals in the cities of Lahore and Sialkot, Pakistan. After controlling for sociodemographic variables, women's experiences of past and current psychological, physical, and sexual violence remained significantly associated with women's poor mental health.

Evaluation of pregnancy outcome records in the German Pharmacoepidemiological Research Database (GePaRD).

Purpose: Routine health care data are a valuable source for the assessment of risks of drugs during pregnancy. Therefore, the aim of the current analysis was the evaluation of pregnancy outcome records in German health insurance data.

Methods: We used the German Pharmacoepidemiologic Research Database including data of more than 15 million insurants (about 18% of the German population).

Twin and sibling studies using health insurance data: the example of attention deficit/hyperactivity disorder (ADHD).

Background And Aims: Twin studies are used to assess the contribution of genetic factors to the aetiology of diseases. To show the feasibility of such research on the basis of health insurance data, we analysed twin and sibling data on the attention deficit/hyperactivity disorder (ADHD) in the German Pharmacoepidemiological Research Database (GePaRD).

Methods: The GePaRD consists of data from four statutory health insurances, including around 17% of the total population of Germany.

Regional variation in caesarean deliveries in Germany and its causes.

Background: Determinants of regional variation in caesarean sections can contribute explanations for the observed overall increasing trend of caesarean sections. We assessed which mechanism explains the higher rate of caesarean sections in the former West than East Germany: a more liberal use of caesarean sections in the case of relative indications or more common caesarean sections without indications.

Methods: We used a health insurance database from all regions of Germany with approximately 14 million insured individuals (about 17% of the total population in Germany).

Estimating the long-term effects of HPV vaccination in Germany.

In Germany, vaccination against the most oncogenic HPV types 16/18 is recommended by the Standing Committee on Vaccination (STIKO) for 12-17 year old girls since March 2007. We developed a dynamic mathematical model for the natural history and transmission of HPV infections to estimate the impact of vaccination on incidence and mortality of cervical cancer and its pre-stages, and on anogenital warts. We focused on an extensive model calibration to epidemiologic data for all stages of the natural history model as well as on a detailed implementation of cervical cancer screening modalities in Germany.

Incidence, prevalence, and antithrombotic management of atrial fibrillation in elderly Germans.

Aims: Data on the epidemiology of atrial fibrillation (AF) and its antithrombotic management in elderly populations are scarce. The aims of this study were to estimate the incidence and prevalence of AF in the elderly in Germany and to describe antithrombotic management of AF cases.

Methods And Results: Estimation of prevalence and incidence was based on data of three German statutory health insurances, which insured more than 800 000 people aged 65 years and older in the study period.

Comorbidities in ADHD children treated with methylphenidate: a database study.

Background: Methylphenidate (MPH) is the most common drug treatment of attention deficit / hyperactivity disorder (ADHD) in children. Treatment with MPH is contraindicated in the presence of certain psychiatric, cerebro- and cardiovascular conditions. We assessed MPH treatment prevalence and incidence and the frequency of comorbid conditions related to these contraindications in new MPH users compared to a control group without ADHD and ADHD medication.

Health-related locus of control and health behaviour among university students in North Rhine Westphalia, Germany.

Background: Health control beliefs were postulated to be associated with health behaviour. However, the results of studies assessing these associations suggest that they might not be universal. Among young adults associations have been reported, but the evidence is limited.

Changes in incidence of anogenital warts diagnoses after the introduction of human papillomavirus vaccination in Germany-an ecologic study.

In a large health insurance database in Germany, incidence of anogenital warts among 15- to 19-year-old females decreased from 316/100,000 person-years in 2007 to 242 in 2008 (23% reduction, P = 0.0001). The decrease started between the first and second quarter of 2007 (human papillomavirus vaccination was introduced in March 2007).

Drug treatment patterns of attention-deficit/hyperactivity disorder in children and adolescents in Germany: results from a large population-based cohort study.

Objective: Despite a substantial increase in total methylphenidate (MPH) prescriptions in Germany over the last 20 years, and the introduction of modified release MPH (MR MPH) and atomoxetine (ATX), remarkably little is known about treatment patterns of attention- deficit/hyperactivity disorder (ADHD) in individual patients.

Methods: Usage patterns of ADHD drugs in children and adolescents in Germany were analyzed using data from one large German health insurance including >7,200,000 members. Of those, 6210 ADHD patients newly diagnosed in 2005 were followed for a maximum of 4 years.

Individual development of preschool children-prevalences and determinants of delays in Germany: a cross-sectional study in Southern Bavaria.

Background: Even minor abnormalities of early child development may have dramatic long term consequences. Accurate prevalence rates for a range of developmental impairments have been difficult to establish. Since related studies have used different methodological approaches, direct comparisons of the prevalence of developmental delays are difficult.