Publications by authors named "Rene Schmidt"

The analysis of multiple time-to-event outcomes in a randomized controlled clinical trial can be accomplished with existing methods. However, depending on the characteristics of the disease under investigation and the circumstances in which the study is planned, it may be of interest to conduct interim analyses and adapt the study design if necessary. Due to the expected dependency of the endpoints, the full available information on the involved endpoints may not be used for this purpose.

View Article and Find Full Text PDF

Introduction: Neurosurgery is considered the mainstay of treatment for pediatric low-grade glioma (LGG); the extent of resection determines subsequent stratification in current treatment protocols. Yet, surgical radicality must be balanced against the risks of complications that may affect long-term quality of life. We investigated whether this consideration impacted surgical resection patterns over time for patients of the German LGG studies.

View Article and Find Full Text PDF

The one-sample log-rank test is the preferred method for analysing the outcome of single-arm survival trials. It compares the survival distribution of patients with a prefixed reference survival curve that usually represents the expected outcome under standard of care. However, classical one-sample log-rank tests assume that the reference curve is known, ignoring that it is frequently estimated from historical data and therefore susceptible to sampling error.

View Article and Find Full Text PDF
Article Synopsis
  • Pediatric low-grade glioma (pLGG) is mainly caused by genomic changes in the MAPK pathway, particularly KIAA1549::BRAF fusions and BRAF V600E mutations, making it suitable for targeted therapies like tovorafenib instead of traditional treatments.
  • The combination of dabrafenib and trametinib is FDA-approved for BRAF V600E-pLGG but not effective for tumors with BRAF fusions, as it may worsen tumor growth.
  • The LOGGIC/FIREFLY-2 trial is assessing tovorafenib against standard chemotherapy in patients under 25 with pLGG and BRAF mutations, focusing on overall response rate and safety.
View Article and Find Full Text PDF

The one-sample log-rank test is the method of choice for single-arm Phase II trials with time-to-event endpoint. It allows to compare the survival of patients to a reference survival curve that typically represents the expected survival under standard of care. The one-sample log-rank test, however, assumes that the reference survival curve is known.

View Article and Find Full Text PDF

Existing methods concerning the assessment of long-term survival outcomes in one-armed trials are commonly restricted to one primary endpoint. Corresponding adaptive designs suffer from limitations regarding the use of information from other endpoints in interim design changes. Here we provide adaptive group sequential one-sample tests for testing hypotheses on the multivariate survival distribution derived from multi-state models, while making provision for data-dependent design modifications based on all involved time-to-event endpoints.

View Article and Find Full Text PDF

Purpose: Expansion of magnetic resonance imaging T2- or T1-tumor lesion volume after radiation therapy (RT) may indicate pseudoprogression (PsPD). The differentiation between true progression and PsPD is a clinical challenge and underinvestigated in pediatric low-grade glioma (LGG). We evaluated radiologic criteria for PsPD after front-line RT and investigated the frequency and duration of PsPD after 3 RT-modalities within the framework of the German pediatric multicenter LGG-studies.

View Article and Find Full Text PDF
Article Synopsis
  • Osteoporotic fractures of the pelvis (OFP) are becoming a significant concern in orthopedics, prompting the need for a new, simpler, and more reliable classification system (CS) that uses both CT and MRI, as existing systems have limited reliability.
  • A consensus among trauma and orthopedic experts in German-speaking countries led to the creation of the new OF-Pelvis CS over five years, which was validated by having experienced surgeons categorize 25 anonymized cases using imaging scans.
  • The new classification has five subgroups indicating increasing instability and three modifiers that can be used alone or in combination; the inter-rater reliability scores are notably high, showing strong agreement among both the developers and the
View Article and Find Full Text PDF

Objectives: The aim of this study was to compare the second trimester thymus-thorax-ratio (TTR) between fetuses born preterm (study group) and those born after 37 weeks of gestation were completed (control group).

Methods: This study was conducted as a retrospective evaluation of the ultrasound images of 492 fetuses in the three vessel view. The TTR was defined as the quotient of a.

View Article and Find Full Text PDF

Whereas the theory of confirmatory adaptive designs is well understood for uncensored data, implementation of adaptive designs in the context of survival trials remains challenging. Commonly used adaptive survival tests are based on the independent increments structure of the log-rank statistic. This implies some relevant limitations: On the one hand, essentially only the interim log-rank statistic may be used for design modifications (such as data-dependent sample size recalculation).

View Article and Find Full Text PDF

Background: Successive multicenter studies for pediatric low-grade glioma (LGG) in Germany were accompanied by a doubling of annual recruitment over 2 decades. We investigated whether this increase conveyed a change of epidemiologic characteristics or survival.

Methods And Results: Participating centers reported 4634 patients with the radiologic/histologic diagnosis of LGG (1996-2018), rising from 109 to 278/year.

View Article and Find Full Text PDF
Article Synopsis
  • The study analyzed data from 128 pediatric patients with spinal low-grade gliomas to better understand their management and outcomes in clinical trials.
  • The results showed that about 93% of patients survived for at least 10 years, but many experienced disease progression, requiring repeated interventions like surgeries and chemotherapy.
  • Molecular testing identified potential therapeutic targets, indicating that although disease recurrence is common, a combination of treatments can lead to long-term control for many patients.
View Article and Find Full Text PDF

This work investigates a new generation structural health monitoring (SHM) system for fibre metal laminates (FML) based on an embedded thermoplastic film with compounded piezoceramics, termed piezo-active fibre metal laminate (PFML). The PFML is manufactured using near-series processes and its potential as a passive SHM system is being investigated. A commercial Polyvinylidene fluoride (PVDF) sensor film is used for comparative evaluation of the sensor signals.

View Article and Find Full Text PDF

Reports on pediatric low-grade diffuse glioma WHO-grade II (DG2) suggest an impaired survival rate, but lack conclusive results for genetically defined DG2-entities. We analyzed the natural history, treatment and prognosis of DG2 and investigated which genetically defined sub-entities proved unfavorable for survival. Within the prospectively registered, population-based German/Swiss SIOP-LGG 2004 cohort 100 patients (age 0.

View Article and Find Full Text PDF

The one-sample log-rank test allows to compare the survival of a single sample with a prefixed reference survival curve. It naturally applies in single-arm phase IIa trials with time-to-event endpoint. Several authors have described that the original one-sample log-rank test is conservative when sample size is small and have proposed strategies to correct the conservativeness.

View Article and Find Full Text PDF

The surgical procedure for the life-threatening course of a necrotizing soft tissue infection of the leg after minor trauma is described. The necessary consistent resection of extensive fascial and muscular necroses required the reconstruction of soft tissue defects of the knee, the ankle joint and peroneal tendons exposed over a long distance. The functional outcome is presented 1 year after use of MatriDerm® and a split-thickness skin graft for defect coverage.

View Article and Find Full Text PDF

Young children with brain tumours are at high risk of developing treatment-related sequelae. We aimed to assess neuropsychological outcomes 5 years after treatment. This cross-sectional study included children under 4 years of age with medulloblastoma (MB) or ependymoma (EP) enrolled in the German brain tumour trials HIT2000 and HIT-REZ2005.

View Article and Find Full Text PDF
Article Synopsis
  • - Pediatric low-grade glioma (PLGG) is a chronic and progressive condition in children that often requires a combination of treatments, including surgery, chemotherapy, and radiation, with a focus on analyzing disease states using a multi-state model (MSM)! - A study of 1587 patients from the German SIOP-LGG 2004 cohort showed that after five years, a significant portion of patients underwent multiple treatments, with higher instances of highly progressive disease linked to factors such as age, tumor location, and type! - The research indicates that the disease's initial growth patterns during the first two years can predict the likelihood of future progression and mortality, leading to a clearer classification of PLGG into three levels of disease progressiveness!
View Article and Find Full Text PDF

Background: The prognosis of patients with recurrences from stage 4 neuroblastoma is not uniformly dismal. The evaluation of new therapies therefore needs to consider the individual risks of the treated patients. This study aims to define clinically useful risk criteria.

View Article and Find Full Text PDF

Reports on pediatric low-grade glioma (LGG) of the caudal brainstem are retrospective with heterogeneous cohorts, variable treatments and inconsistent outcome data. We analyzed their natural history and asked whether brainstem location proved unfavorable for survival within the framework of the comprehensive SIOP-LGG 2004 management strategy. Within the prospectively registered, population-based German SIOP-LGG 2004 cohort 116 patients (age 0.

View Article and Find Full Text PDF

Background The aim of this study was to compare transabdominal and transcervical chorionic villus sampling (CVS) as well as amniocentesis (AC) with respect to their rates of premature delivery and fetal growth restriction. Methods We retrospectively evaluated the mentioned procedures of invasive prenatal testing performed in a single center between 2001 and 2016. Seven hundred and ninety-nine cases of AC and 719 cases of CVS were included, of which 400 were performed transvaginally.

View Article and Find Full Text PDF

Observed influences of system response delay in spoken human-machine dialogues are rather ambiguous and mainly focus on perceived system quality. Studies that systematically inspect effects on cognitive performance are still lacking, and effects of individual characteristics are also often neglected. Building on benefits of cognitive training for decelerating cognitive decline, this Wizard-of-Oz study addresses both issues by testing 62 elderly participants in a dialogue-based memory training with a virtual agent.

View Article and Find Full Text PDF

Tacrolimus (Tac) is a part of the standard immunosuppressive regimen after renal transplantation (RTx). However, its metabolism rate is highly variable. A fast Tac metabolism rate, defined by the Tac blood trough concentration (C) divided by the daily dose (D), is associated with inferior renal function after RTx.

View Article and Find Full Text PDF