@article{WetzelKochPreiseretal.2022, author = {Wetzel, Anna-Jasmin and Koch, Roland and Preiser, Christine and M{\"u}ller, Regina and Klemmt, Malte and Ranisch, Robert and Ehni, Hans-J{\"o}rg and Wiesing, Urban and Rieger, Monika A. and Henking, Tanja and Joos, Stefanie}, title = {Ethical, legal, and social implications of symptom checker Apps in primary Health Care (CHECK.APP)}, series = {JMIR Research Protocols}, volume = {11}, journal = {JMIR Research Protocols}, number = {5}, publisher = {JMIR Research Protocols}, address = {Toronto}, issn = {1929-0748}, doi = {10.2196/34026}, pages = {11}, year = {2022}, abstract = {Background: Symptom checker apps (SCAs) are accessible tools that provide early symptom assessment for users. The ethical, legal, and social implications of SCAs and their impact on the patient-physician relationship, the health care providers, and the health care system have sparsely been examined. This study protocol describes an approach to investigate the possible impacts and implications of SCAs on different levels of health care provision. It considers the perspectives of the users, nonusers, general practitioners (GPs), and health care experts. Objective: We aim to assess a comprehensive overview of the use of SCAs and address problematic issues, if any. The primary outcomes of this study are empirically informed multi-perspective recommendations for different stakeholders on the ethical, legal, and social implications of SCAs. Methods: Quantitative and qualitative methods will be used in several overlapping and interconnected study phases. In study phase 1, a comprehensive literature review will be conducted to assess the ethical, legal, social, and systemic impacts of SCAs. Study phase 2 comprises a survey that will be analyzed with a logistic regression. It aims to assess the user degree of SCAs in Germany as well as the predictors for SCA usage. Study phase 3 will investigate self-observational diaries and user interviews, which will be analyzed as integrated cases to assess user perspectives, usage pattern, and arising problems. Study phase 4 will comprise GP interviews to assess their experiences, perspectives, self-image, and concepts and will be analyzed with the basic procedure by Kruse. Moreover, interviews with health care experts will be conducted in study phase 3 and will be analyzed by using the reflexive thematical analysis approach of Braun and Clark. Results: Study phase 1 will be completed in November 2021. We expect the results of study phase 2 in December 2021 and February 2022. In study phase 3, interviews are currently being conducted. The final study endpoint will be in February 2023. Conclusions: The possible ethical, legal, social, and systemic impacts of a widespread use of SCAs that affect stakeholders and stakeholder groups on different levels of health care will be identified. The proposed methodological approach provides a multifaceted and diverse empirical basis for a broad discussion on these implications.}, language = {en} } @misc{SanchezThomasDeekenetal.2019, author = {S{\´a}nchez, Alba and Thomas, Christine and Deeken, Friederike and Wagner, S{\"o}ren and Kl{\"o}ppel, Stefan and Kentischer, Felix and von Arnim, Chrstine A. F. and Denkinger, Michael and Conzelmann, Lars O. and Biermann-Stallwitz, Janine and Joos, Stefanie and Sturm, Heidrun and Metz, Brigitte and Auer, Ramona and Skrobik, Yoanna and Eschweiler, Gerhard W. and Rapp, Michael A.}, title = {Patient safety, cost-effectiveness, and quality of life}, series = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe}, journal = {Postprints der Universit{\"a}t Potsdam Humanwissenschaftliche Reihe}, number = {535}, issn = {1866-8364}, doi = {10.25932/publishup-42488}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-424883}, pages = {15}, year = {2019}, abstract = {Background Postoperative delirium is a common disorder in older adults that is associated with higher morbidity and mortality, prolonged cognitive impairment, development of dementia, higher institutionalization rates, and rising healthcare costs. The probability of delirium after surgery increases with patients' age, with pre-existing cognitive impairment, and with comorbidities, and its diagnosis and treatment is dependent on the knowledge of diagnostic criteria, risk factors, and treatment options of the medical staff. In this study, we will investigate whether a cross-sectoral and multimodal intervention for preventing delirium can reduce the prevalence of delirium and postoperative cognitive decline (POCD) in patients older than 70 years undergoing elective surgery. Additionally, we will analyze whether the intervention is cost-effective. Methods The study will be conducted at five medical centers (with two or three surgical departments each) in the southwest of Germany. The study employs a stepped-wedge design with cluster randomization of the medical centers. Measurements are performed at six consecutive points: preadmission, preoperative, and postoperative with daily delirium screening up to day 7 and POCD evaluations at 2, 6, and 12 months after surgery. Recruitment goals are to enroll 1500 patients older than 70 years undergoing elective operative procedures (cardiac, thoracic, vascular, proximal big joints and spine, genitourinary, gastrointestinal, and general elective surgery procedures. Discussion Results of the trial should form the basis of future standards for preventing delirium and POCD in surgical wards. Key aims are the improvement of patient safety and quality of life, as well as the reduction of the long-term risk of conversion to dementia. Furthermore, from an economic perspective, we expect benefits and decreased costs for hospitals, patients, and healthcare insurances. Trial registration German Clinical Trials Register, DRKS00013311. Registered on 10 November 2017.}, language = {en} } @article{SanchezThomasDeekenetal.2019, author = {S{\´a}nchez, Alba and Thomas, Christine and Deeken, Friederike and Wagner, S{\"o}ren and Kl{\"o}ppel, Stefan and Kentischer, Felix and von Arnim, Chrstine A. F. and Denkinger, Michael and Conzelmann, Lars O. and Biermann-Stallwitz, Janine and Joos, Stefanie and Sturm, Heidrun and Metz, Brigitte and Auer, Ramona and Skrobik, Yoanna and Eschweiler, Gerhard W. and Rapp, Michael A.}, title = {Patient safety, cost-effectiveness, and quality of life}, series = {Trials}, volume = {20}, journal = {Trials}, number = {71}, publisher = {BioMed Central}, address = {London}, issn = {1468-6694}, doi = {10.1186/s13063-018-3148-8}, pages = {15}, year = {2019}, abstract = {Background Postoperative delirium is a common disorder in older adults that is associated with higher morbidity and mortality, prolonged cognitive impairment, development of dementia, higher institutionalization rates, and rising healthcare costs. The probability of delirium after surgery increases with patients' age, with pre-existing cognitive impairment, and with comorbidities, and its diagnosis and treatment is dependent on the knowledge of diagnostic criteria, risk factors, and treatment options of the medical staff. In this study, we will investigate whether a cross-sectoral and multimodal intervention for preventing delirium can reduce the prevalence of delirium and postoperative cognitive decline (POCD) in patients older than 70 years undergoing elective surgery. Additionally, we will analyze whether the intervention is cost-effective. Methods The study will be conducted at five medical centers (with two or three surgical departments each) in the southwest of Germany. The study employs a stepped-wedge design with cluster randomization of the medical centers. Measurements are performed at six consecutive points: preadmission, preoperative, and postoperative with daily delirium screening up to day 7 and POCD evaluations at 2, 6, and 12 months after surgery. Recruitment goals are to enroll 1500 patients older than 70 years undergoing elective operative procedures (cardiac, thoracic, vascular, proximal big joints and spine, genitourinary, gastrointestinal, and general elective surgery procedures. Discussion Results of the trial should form the basis of future standards for preventing delirium and POCD in surgical wards. Key aims are the improvement of patient safety and quality of life, as well as the reduction of the long-term risk of conversion to dementia. Furthermore, from an economic perspective, we expect benefits and decreased costs for hospitals, patients, and healthcare insurances. Trial registration German Clinical Trials Register, DRKS00013311. Registered on 10 November 2017.}, language = {en} }