Integrated personalized diabetes management goes Europe: A multi-disciplinary approach to innovating type 2 diabetes care in Europe.

Type 2 diabetes mellitus represents a multi-dimensional challenge for European and global societies alike. Building on an iterative six-step disease management process that leverages feedback loops and utilizes commodity digital tools, the PDM-ProValue study program demonstrated that integrated personalized diabetes management, or iPDM, can improve the standard of care for persons living with diabetes in a sustainable way. The novel "iPDM Goes Europe" consortium strives to advance iPDM adoption by (1) implementing the concept in a value-based healthcare setting for the treatment of persons living with type 2 diabetes, (2) providing tools to assess the patient's physical and mental health status, and (3) exploring new avenues to take advantage of emerging big data resources.

Internet Presentation of Departments of Pediatric Surgery in Germany and Their Compliance with Recommended Criteria for Promoting Services and Offering Professional Information for Patients.

Introduction The presentation of health institutions in the internet is highly variable concerning marketing features and medical information. We aimed to investigate the structure and the kind of information provided on the Web sites of all departments of pediatric surgery in Germany. Furthermore, we aimed to identify the degree to which these Web sites comply with internet marketing recommendations for generating business. Method The Web sites of all pediatric surgery units referred to as departments on the official Web site of the German Society of Pediatric Surgery (GSPS) were assessed. The search engine Google was used by entering the terms "pediatric surgery" and the name of the city. Besides general data eight content characteristics focusing on ranking, accessibility, use of social media, multilingual sites, navigation options, selected images, contact details, and medical information were evaluated according to published recommendations. Results A total of 85 departments of pediatric surgery were included. On Google search results 44 (52%) ranked number one and 34 (40%) of the department's homepages were accessible directly through the homepage link of the GSPS. A link to own digital and/or social media was offered on 11 (13%) homepages. Nine sites were multilingual. The most common navigation bar item was clinical services on 74 (87%) homepages. Overall, 76 (89%) departments presented their doctors and 17 (20%) presented other staff members with images of doctors on 53 (62%) and contact data access from the homepage on 68 (80%) Web sites. On 25 (29%) Web sites information on the medical conditions treated were presented, on 17 (20%) details of treating concepts, and on 4 (5%) numbers of patients with specific conditions treated in the own department per year. Conclusion We conclude that numerous of the investigated online presentations do not comply with recommended criteria for offering professional information for patients and for promoting services. Only less than one-third of the departments of pediatric surgery in Germany offer information about the medical conditions they treat. Features, which may influence the decision of patients and parents such as ranking, accessibility, use of social media, multilingual sites, navigation options, selected images, and contact information were differently lacking on many Web sites.

General practitioners assessment highlights excellent patient satisfaction following bar removal after Nuss procedure in children and adolescents.

BACKGROUND: We recently demonstrated that minimally invasive repair of pectus excavatum (MIRPE) achieves a lasting patient satisfaction after bar removal. This correlated with parent ratings. It has been postulated that patient ratings may be biased by high preoperative patient expectations. The aim of this study was to compare patient self-assessment with general practitioners (GPs) assessment. METHODS: Of the 39 patients who underwent bar removal after MIRPE between 2002 and 2006, 39 GPs were asked to answer a modified version of a former single-step questionnaire to evaluate their opinion on psychosocial and physical well-being of their patients. The subjective patient ratings were compared with the GP ratings. RESULTS: Of the 39 GPs, 22 (56%) completed a questionnaire and assessed the outcome of the Nuss procedure. There was a highly significant correlation between GP and patient ratings (p<0.001; correlation coefficient=0.437). Mean total scores obtained from GPs were similar to patient scores (63.4±2.6 SEM vs. 67.5±2.4 SEM; not significant [NS]). Detailed analysis revealed that GPs scored several items differently to their patients: GPs scored social activity (p<0.05) and preoperative self-esteem (p<0.05) significantly lower, but pain episodes (p<0.05) and impairment of daily activities (p<0.05) during the period with the implanted bar significantly higher than their patients. Comparison of the 17 nonassessed cases, with the self-assessment of 22 patients with GP assessment, revealed no significant difference, making an analytical bias unlikely (67.5±2.4 SEM vs. 67.3±2.8 SEM; NS). CONCLUSION: GPs found a higher impairment of patient well-being during the period with an implanted bar, which might be related to the high patient motivation to cope with bar impairment. However, the all over GP and patient satisfaction was similar and excellent.

[Myocardial perfusion scintigraphy. Exact and cost-effective coronary disease imaging--secondary publication]. / Myokardieskintigrafi. Praecis og omkostningseffektiv billeddiagnostik ved koronarsygdom--sekundaerpublikation.

Mortality rates due to coronary arterial disease (CAD) have declined as result of improved prevention, diagnosis and management, but CAD remains the leading cause of death. Myocardial perfusion scintigraphy (MPS) provides a cost-effective tool for early detection of CAD in symptomatic individuals and can stratify patients according to risk of cardiac events. MPS also provides valuable information to assist clinical decision-making. A large body of evidence supports the current applications of MPS, which has become integral to several guidelines for clinical practice.

Clinical value, cost-effectiveness, and safety of myocardial perfusion scintigraphy: a position statement.

Mortality rates due to coronary artery disease (CAD) have declined in recent years as result of improved prevention, diagnosis, and management. Nonetheless, CAD remains the leading cause of death worldwide with most casualties expected to occur in developing nations. Myocardial perfusion scintigraphy (MPS) provides a highly cost-effective tool for the early detection of obstructive CAD in symptomatic individuals and contributes substantially to stratification of patients according to their risk of cardiac death or nonfatal myocardial infarction. MPS also provides valuable information that assists clinical decision-making with regard to medical treatment and intervention. A large body of evidence supports the current applications of MPS, which has become integral to several guidelines for clinical practice.

Self and parental assessment after minimally invasive repair of pectus excavatum: lasting satisfaction after bar removal.

BACKGROUND: Improvement of quality of life by minimally invasive repair of pectus excavatum (MIRPE) has been demonstrated only for the period with implanted pectus bar. The aim of this study was to demonstrate the effects of MIRPE on psychosocial and physical well-being after removal of the pectus bar. METHODS: Forty patients (26 boys and 14 girls; mean age, 17 years; range, 10 to 24 years) were assessed. Follow-up was performed for a mean of 54 months after pectus repair (range, 25 to 73 months). Patients were interviewed at 6 months after MIRPE with the bar in place, and patients and parents were assessed a mean of 23 months after bar removal (range, 2 to 48 months). A single-step questionnaire that evaluates psychosocial and physical well-being was independently used by patients and their parents. RESULTS: There was a high level of persistent satisfaction with MIRPE after bar removal (mean total score = 67; maximal score = 80) and a highly significant correlation between self and external assessment (p < 0.001; Spearman correlation coefficient = 0.77). Analysis of specific and total scores revealed a significant improvement of psychosocial and physical well-being after bar implantation, which persisted up to 4 years after bar removal (p < 0.001). Age and sex had no significant impact on the mean specific and total scores either in patients or in parents. Persistent pectus excavatum was noticed in 1 patient after bar removal (2.5%) as a result of treatment failure. CONCLUSIONS: The positive impact of MIRPE on psychosocial and physical well-being in children and adolescents persists after bar removal. Thus we consider MIRPE to be justified for cosmetic reasons.