TY - JOUR A1 - Schiborn, Catarina A1 - Schulze, Matthias Bernd T1 - Diabetes risk scores T1 - Diabetesrisikoscores BT - use in diabetes prevention BT - Einsatz in der Diabetesprävention JF - Der Diabetologe N2 - 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. N2 - Risikoscores werden zur Identifizierung von Hochrisikopersonen für Typ-2-Diabetes (T2DM) eingesetzt, die von Präventionsmaßnahmen profitieren. Der DIfE – DEUTSCHER DIABETES-RISIKO-TEST® (DRT [DIfE: Deutsches Institut für Ernährungsforschung Potsdam‐Rehbrücke]) wird genutzt, um das absolute 5‑Jahres-Risiko für T2DM zu bestimmen. Da die Berechnung auf nichtklinischen Informationen basiert, kann der Test unabhängig von einem Arztbesuch genutzt werden. Als Grundlage für die Entwicklung von Risikoscores dienen Daten aus prospektiven populationsbezogenen Langzeitstudien. Die sehr gute Vorhersagegüte eines Scores sollte, wie im Fall des DRT, in unabhängigen Populationen bestätigt werden. Neben dem Einsatz durch Ärzte/‑innen und zur individuellen Selbstanamnese können nichtklinische Risikoscores im Kontext breiterer, bevölkerungsbezogener Präventionskonzepte und Informationsangebote zur Senkung des Erkrankungsrisikos Anwendung finden. Durch Krankenkassen abrechenbare Präventionsleistungen sollen im Sinne des deutschen Präventionsgesetzes die Integration von gesundheitsförderndem Verhalten in den Alltag unterstützen. Obwohl Übergewicht und Ernährung relevante Lebensstilrisikofaktoren für T2DM sind, beträgt der Anteil der in Anspruch genommenen Präventionskurse in diesem Bereich nur 3 % der abgerechneten Kurse. Entsprechende Empfehlungen in ärztlichen Untersuchungen könnten eine umfangreichere Inanspruchnahme fördern. Die Verwendung von Risikoscores als Grundlage für systematische und gezielte Handlungsempfehlungen hinsichtlich einer Verhaltensprävention könnte dies, wie es bereits in Richtlinien der kardiovaskulären Prävention etabliert ist, darüber hinaus unterstützen. Auch die Weiterentwicklung der Implementationsforschung ist für den effizienten Einsatz von Risikoscores von Bedeutung. KW - Type 2 diabetes KW - preventive measures KW - risk assessment KW - life style KW - behavior KW - screening KW - Typ-2-Diabetes KW - Prävention KW - Risikoeinschätzung KW - Lebensstil KW - Verhalten Y1 - 2020 U6 - https://doi.org/10.1007/s11428-020-00592-0 SN - 1860-9716 SN - 1860-9724 VL - 16 IS - 3 SP - 226 EP - 233 PB - Springer CY - Heidelberg ER - TY - JOUR A1 - Sieg, Tobias A1 - Vogel, Kristin A1 - Merz, Bruno A1 - Kreibich, Heidi T1 - Seamless Estimation of Hydrometeorological Risk Across Spatial Scales JF - Earth's Future N2 - 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. KW - spatial scales KW - risk assessment KW - hydro-meterological hazards KW - object-based damage modeling KW - uncertainty KW - probabilistic approaches Y1 - 2019 U6 - https://doi.org/10.1029/2018EF001122 SN - 2328-4277 VL - 7 IS - 5 SP - 574 EP - 581 PB - Wiley-Blackwell CY - Hoboken, NJ ER - TY - JOUR A1 - Chung, Oliver A1 - Vongpatanasin, Wanpen A1 - Bonaventura, Klaus A1 - Lotan, Yair A1 - Sohns, Christian A1 - Haverkamp, Wilhelm A1 - Dorenkamp, Marc T1 - Potential cost-effectiveness of therapeutic drug monitoring in patients with resistant hypertension JF - Journal of hypertension N2 - 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. KW - cardiovascular diseases KW - cost and cost analysis KW - cost-benefit analysis KW - drug monitoring KW - hypertension KW - medication adherence KW - probability KW - risk assessment Y1 - 2014 U6 - https://doi.org/10.1097/HJH.0000000000000346 SN - 0263-6352 SN - 1473-5598 VL - 32 IS - 12 SP - 2411 EP - 2421 PB - Lippincott Williams & Wilkins CY - Philadelphia ER -