Sepsis incidence, suspicion, prediction and mortality in emergency medical services: a cohort study related to the current international sepsis guideline.

Purpose: Sepsis suspicion by Emergency Medical Services (EMS) is associated with improved patient outcomes. This study assessed sepsis incidence and recognition by EMS and analyzed which of the screening tools recommended by the Surviving Sepsis Campaign best facilitates sepsis prediction.

Methods: Retrospective cohort study of claims data from health insurances (n = 221,429 EMS cases), and paramedics' and emergency physicians' EMS documentation (n = 110,419); analyzed outcomes were: sepsis incidence and case fatality compared to stroke and myocardial infarction, the extent of documentation for screening-relevant variables and sepsis suspicion, tools' intersections for screening positive in identical EMS cases and their predictive ability for an inpatient sepsis diagnosis.

"We never lived together either": Couples' housing (re-) arrangements in later life.

Social gerontology mainly addresses couples' housing arrangements in later life by focusing on partner's care, related adaptations in place, and changing role expectations within the couple relationship. Thereby, the resulting image does not fully represent today's diversity of couples' housing arrangements. This article considers housing arrangement and relationship orientation of older couples as entangled in social practice, providing a broader perspective on the diversity and dynamics of couples living arrangements in later life.

Evaluation of a Digital Decision Support System to Integrate Type 2 Diabetes Mellitus and Periodontitis Care: Case-Vignette Study in Simulated Environments.

Background: As highlighted by the recent World Health Organization Oral Health Resolution, there is an urgent need to better integrate primary and oral health care. Despite evidence and guidelines substantiating the relevance of integrating type 2 diabetes mellitus (T2DM) and periodontitis care, the fragmentation of primary and oral health care persists.

Objective: This paper reports on the evaluation of a prototype digital decision support system (DSS) that was developed to enhance the integration of T2DM and periodontitis care.

Attributes in stated preference elicitation studies on colorectal cancer screening and their relative importance for decision-making among screenees: a systematic review.

Introduction: The SIGMO study (Sigmoidoscopy as an evidence-based colorectal cancer screening test - a possible option?) examines screening eligible populations' preferences for colorectal cancer (CRC) screening in Germany using a discrete choice experiment (DCE). Attribute identification and selection are essential for the construction of choice tasks and should be evidence-based. As a part of the SIGMO study this systematic review provides an overview of attributes included in studies eliciting stated preferences for CRC screening tests and their relative importance for decision-making.

Heterogeneous Preferences for Colorectal Cancer Screening in Germany: Results of a Discrete Choice Experiment.

Objectives: Colorectal cancer (CRC) screening tests differ in benefits, harms, and processes, making individual informed decisions preference based. The objective was to analyze the preferences of insurees in Germany for characteristics of CRC screening modalities.

Methods: A generic discrete choice experiment with 2-alternative choice sets and 6 attributes (CRC mortality, CRC incidence, complications, preparation, need for transportation, and follow-up; 3 levels each) depicting characteristics of fecal testing, sigmoidoscopy, and colonoscopy was generated.

Feasibility assessment of patient-controlled EEG home-monitoring: More results from the HOME study.

Objective: The feasibility phase of the HOME (Home-Monitoing and Education) project aims to show the practical feasibility of Electroencephalography (EEG)home-monitoring using a patient-controlled mobile system. Its objective is to assess the potential diagnostic and therapeutic yields of home-monitoring compared to conventional healthcare.

Methods: 16 office-based practitioners chose 97 patients and recorded standard 20-minute EEGs using conventional recorders.

Apart from the Medical Complaints, Why do Patients Use Emergency Medical Services? Results of a Patient Survey.

Introduction: Many countries face an increased use of emergency medical services (EMS) with a decreasing percentage of life-threatening complaints. Though there is a broad discussion among experts about the cause, patients' self-perceived, non-medical reasons for using EMS remain largely unknown.

Methods: The written survey included EMS patients who had≥1 case of prehospital emergency care in 2016.

Public Preferences for Exit Strategies From COVID-19 Lockdown in Germany-A Discrete Choice Experiment.

To decrease the rapid growth of SARS-CoV-2 in Germany, a stepped lockdown was conducted. Acceptance and compliance regarding entering and exiting lockdown measures are key for their success. The aim of the present study was to analyse the population's preferences for exiting lockdown measures.

Finding common (research) ground between general practitioners and neuroscientists: the vital role of knowledge circulation in closing the evidence-to-practice gap.

Background: It may take 15 years or longer before research evidence is integrated into clinical practice. This evidence-to-practice gap has deleterious effects on patients as well as research and clinical processes. Bringing clinical knowledge into the research process, however, has the potential to close the evidence-to-practice gap.

How do specialist surgeons treat the atrophic tooth gap? A vignette-based study among maxillofacial and oral surgeons.

Background: There is little information available regarding the decision-making process of clinicians, especially in the choice of therapy for a severely atrophic tooth gap. The aim of this research was to use case vignettes to determine the influence of possible factors on the decision making of maxillofacial and oral surgeons.

Methods: A total of 250 maxillofacial (MFS) and oral (OS) surgeons in southern Germany were surveyed for atrophic single- or multiple-tooth gap with the help of case vignettes.

Harms and Benefits of Cancer Screening.

In recommending and offering screening, health services make a health claim ('it's good for you'). This article considers ethical aspects of establishing the case for cancer screening, building a service programme, monitoring its operation, improving its quality and integrating it with medical progress. The value of (first) screening is derived as a function of key parameters: prevalence of the target lesion in the detectable pre-clinical phase, the validity of the test and the respective net utilities or values attributed to four health states-true positives, false positives, false negatives and true negatives.

Decision-Making in Implantology-A Cross-Sectional Vignette-Based Study to Determine Clinical Treatment Routines for the Edentulous Atrophic Mandible.

This cross-sectional study aimed to investigate the influence of possible factors in the patient history on decision making in the therapy for a severely atrophied edentulous mandible. A vignette-based survey among 250 maxillofacial and oral surgeons was conducted. Determinants that could influence the therapy decision were patient age, smoking, fear of surgery, and radiotherapy in the head and neck area (the implant region is not in the direct radiation area).

General populations' preferences for colorectal cancer screening: rationale and protocol for the discrete choice experiment in the SIGMO study.

Introduction: In Germany, the organised colorectal cancer (CRC) screening programme includes the immunologic faecal occult blood test and colonoscopy. The sigmoidoscopy is recommended for individuals rejecting colonoscopy but is not included into the screening programme. To examine whether the evidence based sigmoidoscopy should be additionally offered, the first objective of this study is to evaluate the demand for sigmoidoscopy by analysing the German general populations' preferences for CRC screening.

Pre-implantological treatment routines for alveolar ridge atrophy - an investigation among maxillofacial and oral surgeons in southern Germany.

Background: It is not well-known which pre-implantological procedures are preferred by maxillofacial (MFS) and oral surgeons (OS) for the narrow atrophic alveolar ridge under practice based conditions and, if different training paths in surgery lead to other pre-implantological techniques being preferred. This study aims to identify which procedures are preferred by the respective specialists in which indication.

Methods: A questionnaire was sent to a total of 300 MFS and OS in southern Germany.

The Effects of Intensive Versus Routine Treatment in Patients with Acute Kidney Injury.

Background: In patients with acute kidney injury (AKI), specialized treatment-initiated in response to an early-warning system- may be beneficial compared with routine treatment.

Method: To explore effect estimators in a pilot trial (DRKS00010530), patients with AKI on regular wards of a university hospital were treated either in the usual way (control group) or more intensively (intervention group). The subjects were allotted randomly to the two treatment groups.

[Manfred Pflanz (1923-1980), Health Services Researcher: his Early Contribution to the Medical Care Pattern of Appendectomy].

This article is a reminder of an early example of health services research and quality assurance in Germany. The occasion for this was the 50th anniversary of the opening of the Institute of Social Medicine and Epidemiology at Hannover Medical School in 1968. The founding director of the institute, Prof.

What understanding of economics do medical students have?

Economic topics appear in the medical studies curriculum at different times. Despite socio-political relevance, there is hardly any information about the degree of understanding that medical students have of "economics in medicine". The present study addresses the questions: What understanding of "economics in medicine" do medical students have before the start of the Practical Year? To what extent is economic teaching content understood as "economization" from outside the profession? Magdeburg medical students in the 5 year of study, who participated in preparatory seminars for the Practical Year (PY) in 2014 and 2015 (60 participants each), assessed the relevance of various seminar topics four months prior to the start of the semester.

Assessment of the technical usability and efficacy of a new portable dry-electrode EEG recorder: First results of the HOME study.

Objectives: The HOME project is intended to provide evidence of diagnostic and therapeutic yield of a patient-controlled EEG home-monitoring for neurological outpatients.

Methods: This study evaluated the technical and practical usability and efficacy of a new portable dry-electrode EEG recorder in comparison to conventional EEG devices based on technical assessments and inter-rater comparisons of EEG record examinations of office-based practitioners and two experienced neurologists.

Results: The technical assessment was based on channel-wise comparisons of band power values derived from power spectra as observed in two recording modalities.

Health care utilisation and medication one year after myocardial infarction in Germany - a claims data analysis.

Background: After myocardial infarction, guidelines recommend pharmaceutical treatment with a combination of five different types of drugs for prevention in patients. However, studies from different countries have shown that this goal is not achieved in many patients. The aim of this study was to assess both healthcare and prescribed pharmaceutical treatment in the fourth quarter after index myocardial infarction.

[Treatment, clinical course, and cross-sectoral information transmission in patients with acute-on-chronic kidney injury].

Background: Delayed diagnosis and undertherapy of acute-on-chronic kidney injury (AKI-on-CKD) may trigger multiple organ injury and worsen clinical outcome.

Objectives: This study focused on description of in-hospital care and cross-sectoral information transmission of patients with AKI-on-CKD including subgroup analyses (under surgical vs. non-surgical and nephrology vs.

From HAM-Nat to the "Physikum" - Analysis of the study success parameters before and after the introduction of a science test in the approval procedure.

For the winter semester 2012/13, the Medical School of Otto-von-Guericke University Magdeburg introduced the HAM-Nat test (Hamburg Assessment Test for Medical Degrees - Natural Sciences Section) for the selection of its study applicants with the aim of improving the academic success of their students in the pre-clinical part which has a heavy emphasis on natural sciences. The study examines the extent to which the new University Selection Procedure (AdH) influences two criteria for measuring students' success, compliance with the standard period of study up until the first part of the medical state exam (M1) and its result. A comparison of above-mentioned parameters for measuring student success for the matriculation years 2008-2011 (no HAM-Nat test, Pre-Matriculation) and those of the matriculation years 2012-2014 (Nat-Matriculation), whose students have passed the HAM-Nat test in the selection process of the university.

Diagnostic and therapeutic yield of a patient-controlled portable EEG device with dry electrodes for home-monitoring neurological outpatients-rationale and protocol of the HOME pilot study.

Background: The HOME study is part of the larger project, which aims to provide evidence of diagnostic and therapeutic yield ("change of management") of a patient-controlled portable EEG device with dry electrodes for the purposes of EEG home-monitoring neurological outpatients.

Methods: The HOME study is the first step in the process of investigating whether outpatient EEG home-monitoring changes the diagnosis and treatment of patients in comparison to conventional EEG ("change of management"). Both EEG devices (conventional and portable) will be systematically compared via a two-phase intra-individual assessment.