@article{HeneghanWardPereraetal.2012, author = {Heneghan, Carl and Ward, Alison and Perera, Rafael and Bankhead, Clare and Fuller, Alice and Stevens, Richard and Bradford, Kairen and Tyndel, Sally and Alonso-Coello, Pablo and Ansell, Jack and Beyth, Rebecca and Bernardo, Artur and Christensen, Thomas Decker and Cromheecke, Manon and Edson, Robert G and Fitzmaurice, David and Gadisseur, Alain PA and Garcia-Alamino, Josep M and Gardiner, Chris and Hasenkam, Michael and Jacobson, Alan and Kaatz, Scott and Kamali, Farhad and Khan, Tayyaba Irfan and Knight, Eve and Kortke, Heinrich and Levi, Marcel and Matchar, David Bruce and Menendez-Jandula, Barbara and Rakovac, Ivo and Schaefer, Christian and Siebenhofer, Andrea and Souto, Juan Carlos and Sunderji, Rubina and Gin, Kenneth and Shalansky, Karen and V{\"o}ller, Heinz and Wagner, Otto and Zittermann, Armin}, title = {Self-monitoring of oral anticoagulation systematic review and meta-analysis of individual patient data}, series = {The lancet}, volume = {379}, journal = {The lancet}, number = {9813}, publisher = {Elsevier}, address = {New York}, organization = {Self-Monitoring Trialist Collabora}, issn = {0140-6736}, doi = {10.1016/S0140-6736(11)61294-4}, pages = {322 -- 334}, year = {2012}, abstract = {Background Uptake of self-testing and self-management of oral coagulation has remained inconsistent, despite good evidence of their effectiveness. To clarify the value of self-monitoring of oral anticoagulation, we did a meta-analysis of individual patient data addressing several important gaps in the evidence, including an estimate of the effect on time to death, first major haemorrhage, and thromboembolism. Methods We searched Ovid versions of Embase (1980-2009) and Medline (1966-2009), limiting searches to randomised trials with a maximally sensitive strategy. We approached all authors of included trials and requested individual patient data: primary outcomes were time to death, first major haemorrhage, and first thromboembolic event. We did prespecified subgroup analyses according to age, type of control-group care (anticoagulation-clinic care vs primary care), self-testing alone versus self-management, and sex. We analysed patients with mechanical heart valves or atrial fibrillation separately. We used a random-effect model method to calculate pooled hazard ratios and did tests for interaction and heterogeneity, and calculated a time-specific number needed to treat. Findings Of 1357 abstracts, we included 11 trials with data for 6417 participants and 12 800 person-years of follow-up. We reported a significant reduction in thromboembolic events in the self-monitoring group (hazard ratio 0.51; 95\% CI 0.31-0.85) but not for major haemorrhagic events (0.88, 0.74-1.06) or death (0.82, 0.62-1.09). Participants younger than 55 years showed a striking reduction in thrombotic events (hazard ratio 0.33, 95\% CI 0.17-0.66), as did participants with mechanical heart valve (0.52, 0.35-0.77). Analysis of major outcomes in the very elderly (age >= 85 years, n=99) showed no significant adverse effects of the intervention for all outcomes. Interpretation Our analysis showed that self-monitoring and self-management of oral coagulation is a safe option for suitable patients of all ages. Patients should also be offered the option to self-manage their disease with suitable health-care support as back-up.}, language = {en} } @misc{SalzwedelNosperRoehrigetal.2012, author = {Salzwedel, Annett and Nosper, Manfred and R{\"o}hrig, Bernd and Linck-Eleftheriadis, Sigrid and Strandt, Gert and V{\"o}ller, Heinz}, title = {Outcome quality of in-patient cardiac rehabilitation in elderly patients - identification of relevant parameters}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {390}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-404151}, pages = {9}, year = {2012}, abstract = {Background Outcome quality management requires the consecutive registration of defined variables. The aim was to identify relevant parameters in order to objectively assess the in-patient rehabilitation outcome. Methods From February 2009 to June 2010 1253 patients (70.9 ± 7.0 years, 78.1\% men) at 12 rehabilitation clinics were enrolled. Items concerning sociodemographic data, the impairment group (surgery, conservative/interventional treatment), cardiovascular risk factors, structural and functional parameters and subjective health were tested in respect of their measurability, sensitivity to change and their propensity to be influenced by rehabilitation. Results The majority of patients (61.1\%) were referred for rehabilitation after cardiac surgery, 38.9\% after conservative or interventional treatment for an acute coronary syndrome. Functionally relevant comorbidities were seen in 49.2\% (diabetes mellitus, stroke, peripheral artery disease, chronic obstructive lung disease). In three key areas 13 parameters were identified as being sensitive to change and subject to modification by rehabilitation: cardiovascular risk factors (blood pressure, low-density lipoprotein cholesterol, triglycerides), exercise capacity (resting heart rate, maximal exercise capacity, maximal walking distance, heart failure, angina pectoris) and subjective health (IRES-24 (indicators of rehabilitation status): pain, somatic health, psychological well-being and depression as well as anxiety on the Hospital Anxiety and Depression Scale). Conclusion The outcome of in-patient rehabilitation in elderly patients can be comprehensively assessed by the identification of appropriate key areas, that is, cardiovascular risk factors, exercise capacity and subjective health. This may well serve as a benchmark for internal and external quality management.}, language = {en} } @inproceedings{NitardySalzwedelWegscheideretal.2012, author = {Nitardy, Aischa and Salzwedel, Annett and Wegscheider, Karl and Jawari, Amir and Buhlert, Hermann and V{\"o}ller, Heinz}, title = {Effect of cardiac rehabilitation on functional and emotional status in patients after transcatheter aortic-valve replacement}, series = {Circulation : an American Heart Association journal}, volume = {126}, booktitle = {Circulation : an American Heart Association journal}, number = {21}, publisher = {Lippincott Williams \& Wilkins}, address = {Philadelphia}, issn = {0009-7322}, pages = {1}, year = {2012}, language = {en} }