@article{SchibornSchulze2020, author = {Schiborn, Catarina and Schulze, Matthias B.}, title = {Diabetes risk scores}, series = {Der Diabetologe}, volume = {16}, journal = {Der Diabetologe}, number = {3}, publisher = {Springer}, address = {Heidelberg}, issn = {1860-9716}, doi = {10.1007/s11428-020-00592-0}, pages = {226 -- 233}, year = {2020}, abstract = {Risk scores are used to identify high-risk individuals for type 2 diabetes (T2DM) who benefit from preventive measures. The DIfE-DEUTSCHER DIABETES-RISIKO-TEST (R) (DRT) is used to determine the absolute 5-year risk for T2DM. Since the calculation is based on non-clinical information, the test can be used independently of a doctor's visit. Data from prospective population-based long-term studies serve as the basis for the development of risk scores. As in the case of the DRT, the very good predictive quality of a score should be confirmed in independent populations. In addition to the use by doctors and for individual self-anamnesis, non-clinical risk scores can be used in the context of broader, population-based prevention concepts and information offers to reduce the risk of disease. Prevention services billable by health insurance companies should support the integration of health-promoting behavior into everyday life within the meaning of the German Prevention Act. Although obesity and diet are relevant lifestyle risk factors for T2DM, the proportion of preventive courses taken on this topic is only 3\% of the courses billed. Appropriate recommendations in medical examinations could promote more extensive use. The use of risk scores as the basis for systematic and targeted recommendations for behavioral prevention could also support this, as is already established in guidelines for cardiovascular prevention. The further development of implementation research is also important for the efficient use of risk scores.}, language = {de} } @misc{MuehlenbruchKuxhausPencinaetal.2015, author = {M{\"u}hlenbruch, Kristin and Kuxhaus, Olga and Pencina, Michael J. and Boeing, Heiner and Liero, Hannelore and Schulze, Matthias Bernd}, title = {A confidence ellipse for the Net Reclassification Improvement}, series = {Postprints der Universit{\"a}t Potsdam : Mathematisch Naturwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam : Mathematisch Naturwissenschaftliche Reihe}, number = {825}, issn = {1866-8372}, doi = {10.25932/publishup-42737}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-427371}, pages = {299 -- 304}, year = {2015}, abstract = {The Net Reclassification Improvement (NRI) has become a popular metric for evaluating improvement in disease prediction models through the past years. The concept is relatively straightforward but usage and interpretation has been different across studies. While no thresholds exist for evaluating the degree of improvement, many studies have relied solely on the significance of the NRI estimate. However, recent studies recommend that statistical testing with the NRI should be avoided. We propose using confidence ellipses around the estimated values of event and non-event NRIs which might provide the best measure of variability around the point estimates. Our developments are illustrated using practical examples from EPIC-Potsdam study.}, language = {en} } @misc{SiegVogelMerzetal.2019, author = {Sieg, Tobias and Vogel, Kristin and Merz, Bruno and Kreibich, Heidi}, title = {Seamless Estimation of Hydrometeorological Risk Across Spatial Scales}, series = {Postprints der Universit{\"a}t Potsdam Mathematisch-Naturwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam Mathematisch-Naturwissenschaftliche Reihe}, number = {743}, issn = {1866-8372}, doi = {10.25932/publishup-43534}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-435341}, pages = {574 -- 581}, year = {2019}, abstract = {Hydrometeorological hazards caused losses of approximately 110 billion U.S. Dollars in 2016 worldwide. Current damage estimations do not consider the uncertainties in a comprehensive way, and they are not consistent between spatial scales. Aggregated land use data are used at larger spatial scales, although detailed exposure data at the object level, such as openstreetmap.org, is becoming increasingly available across the globe.We present a probabilistic approach for object-based damage estimation which represents uncertainties and is fully scalable in space. The approach is applied and validated to company damage from the flood of 2013 in Germany. Damage estimates are more accurate compared to damage models using land use data, and the estimation works reliably at all spatial scales. Therefore, it can as well be used for pre-event analysis and risk assessments. This method takes hydrometeorological damage estimation and risk assessments to the next level, making damage estimates and their uncertainties fully scalable in space, from object to country level, and enabling the exploitation of new exposure data.}, language = {en} } @article{SiegVogelMerzetal.2019, author = {Sieg, Tobias and Vogel, Kristin and Merz, Bruno and Kreibich, Heidi}, title = {Seamless Estimation of Hydrometeorological Risk Across Spatial Scales}, series = {Earth's Future}, volume = {7}, journal = {Earth's Future}, number = {5}, publisher = {Wiley-Blackwell}, address = {Hoboken, NJ}, issn = {2328-4277}, doi = {10.1029/2018EF001122}, pages = {574 -- 581}, year = {2019}, abstract = {Hydrometeorological hazards caused losses of approximately 110 billion U.S. Dollars in 2016 worldwide. Current damage estimations do not consider the uncertainties in a comprehensive way, and they are not consistent between spatial scales. Aggregated land use data are used at larger spatial scales, although detailed exposure data at the object level, such as openstreetmap.org, is becoming increasingly available across the globe.We present a probabilistic approach for object-based damage estimation which represents uncertainties and is fully scalable in space. The approach is applied and validated to company damage from the flood of 2013 in Germany. Damage estimates are more accurate compared to damage models using land use data, and the estimation works reliably at all spatial scales. Therefore, it can as well be used for pre-event analysis and risk assessments. This method takes hydrometeorological damage estimation and risk assessments to the next level, making damage estimates and their uncertainties fully scalable in space, from object to country level, and enabling the exploitation of new exposure data.}, language = {en} } @phdthesis{Reeg2019, author = {Reeg, Jette}, title = {Simulating the impact of herbicide drift exposure on non-target terrestrial plant communities}, doi = {10.25932/publishup-42907}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-429073}, school = {Universit{\"a}t Potsdam}, pages = {178}, year = {2019}, abstract = {In Europe, almost half of the terrestrial landscape is used for agriculture. Thus, semi-natural habitats such as field margins are substantial for maintaining diversity in intensively managed farmlands. However, plants located at field margins are threatened by agricultural practices such as the application of pesticides within the fields. Pesticides are chemicals developed to control for undesired species within agricultural fields to enhance yields. The use of pesticides implies, however, effects on non-target organisms within and outside of the agricultural fields. Non-target organisms are organisms not intended to be sprayed or controlled for. For example, plants occurring in field margins are not intended to be sprayed, however, can be impaired due to herbicide drift exposure. The authorization of plant protection products such as herbicides requires risk assessments to ensure that the application of the product has no unacceptable effects on the environment. For non-target terrestrial plants (NTTPs), the risk assessment is based on standardized greenhouse studies on plant individual level. To account for the protection of plant populations and communities under realistic field conditions, i.e. extrapolating from greenhouse studies to field conditions and from individual-level to community-level, assessment factors are applied. However, recent studies question the current risk assessment scheme to meet the specific protection goals for non-target terrestrial plants as suggested by the European Food Safety Authority (EFSA). There is a need to clarify the gaps of the current risk assessment and to include suitable higher tier options in the upcoming guidance document for non-target terrestrial plants. In my thesis, I studied the impact of herbicide drift exposure on NTTP communities using a mechanistic modelling approach. I addressed main gaps and uncertainties of the current risk assessment and finally suggested this modelling approach as a novel higher tier option in future risk assessments. Specifically, I extended the plant community model IBC-grass (Individual-based community model for grasslands) to reflect herbicide impacts on plant individuals. In the first study, I compared model predictions of short-term herbicide impacts on artificial plant communities with empirical data. I demonstrated the capability of the model to realistically reflect herbicide impacts. In the second study, I addressed the research question whether or not reproductive endpoints need to be included in future risk assessments to protect plant populations and communities. I compared the consequences of theoretical herbicide impacts on different plant attributes for long-term plant population dynamics in the community context. I concluded that reproductive endpoints only need to be considered if the herbicide effect is assumed to be very high. The endpoints measured in the current vegetative vigour and seedling emergence studies had high impacts for the dynamic of plant populations and communities already at lower effect intensities. Finally, the third study analysed long-term impacts of herbicide application for three different plant communities. This study highlighted the suitability of the modelling approach to simulate different communities and thus detecting sensitive environmental conditions. Overall, my thesis demonstrates the suitability of mechanistic modelling approaches to be used as higher tier options for risk assessments. Specifically, IBC-grass can incorporate available individual-level effect data of standardized greenhouse experiments to extrapolate to community-level under various environmental conditions. Thus, future risk assessments can be improved by detecting sensitive scenarios and including worst-case impacts on non-target plant communities.}, language = {en} } @article{ChungVongpatanasinBonaventuraetal.2014, author = {Chung, Oliver and Vongpatanasin, Wanpen and Bonaventura, Klaus and Lotan, Yair and Sohns, Christian and Haverkamp, Wilhelm and Dorenkamp, Marc}, title = {Potential cost-effectiveness of therapeutic drug monitoring in patients with resistant hypertension}, series = {Journal of hypertension}, volume = {32}, journal = {Journal of hypertension}, number = {12}, publisher = {Lippincott Williams \& Wilkins}, address = {Philadelphia}, issn = {0263-6352}, doi = {10.1097/HJH.0000000000000346}, pages = {2411 -- 2421}, year = {2014}, abstract = {Background: Nonadherence to drug therapy poses a significant problem in the treatment of patients with presumed resistant hypertension. It has been shown that therapeutic drug monitoring (TDM) is a useful tool for detecting nonadherence and identifying barriers to treatment adherence, leading to effective blood pressure (BP) control. However, the cost-effectiveness of TDM in the management of resistant hypertension has not been investigated. Results: In the age group of 60-year olds, TDM gained 1.07 QALYs in men and 0.97 QALYs in women at additional costs of (sic)3854 and (sic)3922, respectively. Given a willingness-to-pay threshold of (sic)35 000 per QALY gained, the probability of TDM being cost-effective was 95\% or more in all age groups from 30 to 90 years. Results were influenced mostly by the frequency of TDM testing, the rate of nonresponders to TDM, and the magnitude of effect of TDM on BP. Conclusion: Therapeutic drug monitoring presents a potential cost-effective healthcare intervention in patients diagnosed with resistant hypertension. Importantly, this finding is valid for a wide range of patients, independent of sex and age.}, language = {en} }