Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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The Corona pandemic is a clear demonstration of the need for an alternative to face-to-face medicine. This demand makes telemedicine the tool of choice. In the preliminary stage of the Virtual Hospital North Rhine-Westphalia (VKh), tele-intensive care consultation services have contributed to both a benefit in terms of care and a benefit for individual patients. ⋯ Medical expertise and also intensive care data, both from care and research, could thus be used throughout Europe. In October 2021, the Aachen Expert Center reported on its first 112 telemedically co-managed COVID-19 patients as part of the preliminary stage of the virtual hospital. With a lethality rate of 34.2% in the group of ventilated severely ill COVID-19 patients and a transfer rate of 8%, high-quality care close to the patient's home was achieved through tele-intensive medical consultation services.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2022
[Artificial Intelligence: Infrastructures and Prerequisites at European Level].
The application of artificial intelligence (AI) is often associated with the use of large amounts of data for the construction of AI models and algorithms. This data should ideally comply with the FAIR Data principles, i.e. being findable, accessible, interoperable and reusable. However, the handling of health data poses a particular challenge in this context. ⋯ We discuss the current situation but also the obstacles for a wider application of AI in medicine in Europe and give suggestions how to solve the different issues. The article covers different subjects like data protection, research data infrastructures and approval of medical products. Finally, this article shows how it can nevertheless be possible to establish a secure and at the same time effective handling of data for use in AI at the European level despite its unneglectable difficulties.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2022
Review[Assessment of Patient-reported Outcomes in Routine Medical Care: Patient-reported Outcome Measures (PROMs) and Patient-reported Experience Measures (PREMs)].
Information from patients about their own quality of life, experiences in care, and individual assessments of treatment processes and outcomes are becoming increasingly important. Patient-reported characteristics can refer to subjective information about their own health (Patient-Reported Outcome Measures [PROMs]) or to objective information about their experience during the treatment process (Patient-Reported Experience Measures [PREMs]). ⋯ Subsequently, ways to collect PROMs and PREMs are presented and in doing so, an insight into probabilistic testing theory (item response theory) and computer adaptive testing is given. Using national and international initiatives as examples, the implementation of PROMs and PREMs in health care systems is presented and future implementation strategies are discussed within an outlook.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2022
[Peri- and Postoperative Anaemia Management].
Patient Blood Management (PBM) aims to diagnose and treat preoperative anaemia, avoid unnecessary blood loss, and enable rational use of blood products. Due to various limitations, treatment of preoperative anaemia has been successful in only a few German hospitals to date. Thus, the peri- and postoperative phase is increasingly becoming important for implementing various preventive and therapeutic measures for the treatment of (postoperative) anaemia. These will be comprehensively presented in the following.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2022
[Role of Dexamethasone for Pain Management in Intervertebral Disc Surgery].
Intervertebral disc operations are already among the most common and their frequency is increasing. The pain associated with these operations is one of the most common postoperative discomforts, has a significant impact on psychosocial aspects, and should therefore be treated effectively. Therefore, we present the importance of dexamethasone for multimodal pain management after intervertebral disc surgery.