Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
Case Reports[What should physicians know about diagnostic testing?].
Many diagnostic tests ordered by physicians cannot be justified by rational criteria. However, this is not necessarily a problem of knowledge or lack thereof. The rational use of diagnostic tests must also be understood as a behavioural problem. ⋯ Working environments should be examined as to the feedback they provide for clinicians. Remuneration and utilization patterns may be more important determinants of test-ordering than a clinicians' knowledge. Nevertheless, a basic understanding of Bayes' theorem and likelihood ratios are an essential part of the medical curriculum.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
Comparative Study[Regulations concerning data transparency- a comparison between the USA and Europe].
Since 2007 a far-reaching obligation to register and publish clinical trials of pharmaceuticals on the generally accessible website www.clinicaltrials.gov has applied under the US Food and Drug Administration Amendment Act ("FDAAA") section 801. This obligation also comprises clinical trials results. In the EU clinical trials are registered with the EudraCT data base. ⋯ Since 2011, § 42b of the German Drugs Act provides that the results of clinical trials need to be reported (on the "PharmNet. Bund" website) in order to improve information for doctors and patients. The US regulations serve as a role model for an approach to keeping the general public fully informed about the start and the results of clinical drug trials and to avoiding publication bias.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Implementing population-based integrated care for a region: a work-in-progress report on the project "Gesundes Kinzigtal"].
The regional integrated care model "Gesundes Kinzigtal" pursues the idea of integrated health care with special focus on increasing the health gain of the served population. Physicians (general practitioners) and psychotherapists, physiotherapists, hospitals, nursing services, non-profit associations, fitness centers, and health insurance companies work closely together with a regional management company and its programs on prevention and care coordination and enhancement. ⋯ The article describes the special funding model of the project, the engagement of patients, and the different health and prevention programmes. The programmes and projects are developed, implemented, and evaluated by multidisciplinary teams.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Which criteria affect the cooperation between general practitioners and specialists in ambulatory care? A qualitative study about general practitioners' perception].
Good cooperation between physicians is an essential requirement for quality health care. General practitioners (GPs) have a key role in coordinating the various levels of care and physician contacts. Within the scope of the "InteraKtion" study of the Competence Centre of General Practice Baden-Wuerttemberg GPs were interviewed about their experiences and opinions regarding their cooperation with specialists. The aim of this study was to identify criteria and barriers of the referral process. ⋯ These results indicate that GPs have clear criteria for referral to specialists. These findings should find their way into future quantitative studies to explore the weighting of the criteria and barriers discussed here. Joint training activities or quality circles could improve the personal contact between GPs and specialists working in the same region.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Results of the evaluation of German benchmarking networks funded by the Ministry of Health].
Nine out of ten demonstration projects on clinical benchmarking funded by the German Ministry of Health were evaluated. Project reports and interviews were uniformly analysed using a list of criteria and a scheme to categorize the realized benchmarking approach. ⋯ The improvement of outcome quality cannot yet be assessed. Factors promoting the introduction of benchmarking networks with regard to organisational and process aspects of benchmarking implementation were derived.