![](https://www.mgh-ita.org/wp-content/uploads/2021/12/uwe-2021.jpg)
Uwe Siebert, MD, MPH, MSc, ScD
Prof. Uwe Siebert, MD, MPH, MSc, ScD, Professor of Public Health, Medical Decision Making and Health Technology Assessment (HTA), is the Chair of the Department of Public Health, Health Services Research and HTA at UMIT – University for Health Sciences, Medical Informatics and Technology in Austria and the Director of the Division for HTA in the ONCOTYROL – Center for Personalized Cancer Medicine in Austria. He is also Adjunct Professor of Health Policy and Management, and Epidemiology, at the Harvard T.H. Chan School of Public Health and Affiliated Researcher of the Program on Cardiovascular Research at the Institute for Technology Assessment and Department of Radiology at the Massachusetts General Hospital, Harvard Medical School, Boston. He is the course director of the Harvard summer course on ‘Decision Analysis in Clinical Research’ and he has an adjunct teaching appointment at the School of Public Health and Epidemiology at the University of Munich.
After medical school, he worked for several years as a physician in international public health projects in West-Africa, Brazil, and Germany. He then earned an MPH at the Munich School of Public Health, and completed an MSc in Epidemiology and a ScD in Health Policy and Management with a concentration in decision sciences at the Harvard School of Public Health. Before he started his faculty position at Harvard Medical School, he was the Director of the Bavarian Public Health Research and Coordinating Center at the University of Munich, Germany, and completed Visiting Scholarship at the Harvard Center for Risk Analysis.
Prof. Siebert is Past-President of the Society for Medical Decision Making (SMDM), a member of the Latin America Consortium Advisory Committee of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), member of the Oncology Advisory Council of the Federal Ministry of Health in Austria, member of the Advisory Board of the GÖG – National Austrian Public Health Institute, member of the Austrian Cochrane Collaboration Branch, and a member of several national and international Directors Boards (Austrian Society of Epidemiology, German Network of EbM; German Association for Medical Informatics, Biometry and Epidemiology). He has served as Vice President of SMDM, and member of the ISPOR Board of Directors, the Society for Medical Decision Making Board of Trustees; the Harvard Flagship Initiative in Comparative Effectiveness Research, the ‘National HTA Strategy’ Expert Group of the Austrian Federal Ministry of Health, the Advisory Board of the Ludwig Boltzmann Institute for HTA in Austria, the International Expert Committee Advising the Institute for Quality and Efficiency in Health Care (IQWiG) on the Methods for Economic Evaluations of Health Care Interventions, the Directors Board of the German Competence Network Heart Failure, and the Extended Board of Directors of the German Association of Health Economics.
He is the Clinical Guideline Commissioner for the Association of the Scientific Medical Societies in Germany (AWMF), Authorized Expert in the COVID-19 Prognosis Consortium and the Scientific Platform Screening- and Monitoring Programs for COVID-19 of AGES – Austrian Agency for Health and Food Safety and GÖG advising the Austrian Federal Ministry of Social Affairs, Health, Care and Consumer Protection, Member of the Task Force for COVID-19 Vaccination Implementation of the State Government Tyrol, Chair of the Horizontal Initiative in Causal Inference of the German Society for Epidemiology (DGEpi), Chair of the Working Group “Effectiveness and Side Effects of Non-Pharmaceutical Interventions” of the Competence Network for Public Health for COVID-19, and Chair of the Working Groups ‘Health Economics’ and ‘Medical Decision Making’ of the German Society for Medical Informatics, Biometry and Epidemiology (GMDS). He is Co-Chair of the ISPOR-SMDM Modeling Good Research Practices Task Force, Co-Chair of the ‘Issues in Methodology Section’ of the SMDM Policy Initiative, a Leadership Member of the ISPOR Personalized/Precision Medicine Special Interest Group, and member of the SMDM COVID-19 Modeling Special Committee.
He has worked with several HTA Agencies (e.g., DAHTA@DIMDI/Germany, IQWiG/Germany, NICE/UK, ANVISA/Brazil, IATS/Brazil, CADTH/Canada, LBI-HTA/Austria, GÖG/Austria) and he advises public and government agencies, academic institutions and industry regarding the conduction of HTAs and their impact on policy and reimbursement decisions. He has authored more than 400 publications (> 20,000 citations, H index > 50) including HTA reports, textbook chapters, scientific articles, policy briefs and editorials, and is Editor of the European Journal of Epidemiology, Associate Editor of Public Health Reviews as well as editorial board member of several scientific journals.
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Selected Publications
Stadelman-Behar, Anna M; Tiffin, Nicki; Ellis, Jayne; Creswell, Fiona V; Ssebambulidde, Kenneth; Nuwagira, Edwin; Richards, Lauren; Lutje, Vittoria; Hristea, Adriana; Jipa, Raluca Elena; Vidal, José E; Azevedo, Renata G S; de Almeida, Sérgio Monteiro; Kussen, Gislene Botão; Nogueira, Keite; Gualberto, Felipe Augusto Souza; Metcalf, Tatiana; Heemskerk, Anna Dorothee; Dendane, Tarek; Khalid, Abidi; Zeggwagh, Amine Ali; Bateman, Kathleen; Siebert, Uwe; Rochau, Ursula; van Laarhoven, Arjan; van Crevel, Reinout; Ganiem, Ahmad Rizal; Dian, Sofiati; Jarvis, Joseph; Donovan, Joseph; Thuong, Thuong Nguyen Thuy; Thwaites, Guy E; Bahr, Nathan C; Meya, David B; Boulware, David R; Boyles, Tom H
Diagnostic Prediction Model for Tuberculous Meningitis: An Individual Participant Data Meta-Analysis Journal Article
In: Am J Trop Med Hyg, 2024, ISSN: 1476-1645.
@article{pmid39013385,
title = {Diagnostic Prediction Model for Tuberculous Meningitis: An Individual Participant Data Meta-Analysis},
author = {Anna M Stadelman-Behar and Nicki Tiffin and Jayne Ellis and Fiona V Creswell and Kenneth Ssebambulidde and Edwin Nuwagira and Lauren Richards and Vittoria Lutje and Adriana Hristea and Raluca Elena Jipa and Jos\'{e} E Vidal and Renata G S Azevedo and S\'{e}rgio Monteiro de Almeida and Gislene Bot\~{a}o Kussen and Keite Nogueira and Felipe Augusto Souza Gualberto and Tatiana Metcalf and Anna Dorothee Heemskerk and Tarek Dendane and Abidi Khalid and Amine Ali Zeggwagh and Kathleen Bateman and Uwe Siebert and Ursula Rochau and Arjan van Laarhoven and Reinout van Crevel and Ahmad Rizal Ganiem and Sofiati Dian and Joseph Jarvis and Joseph Donovan and Thuong Nguyen Thuy Thuong and Guy E Thwaites and Nathan C Bahr and David B Meya and David R Boulware and Tom H Boyles},
doi = {10.4269/ajtmh.23-0789},
issn = {1476-1645},
year = {2024},
date = {2024-07-01},
journal = {Am J Trop Med Hyg},
abstract = {No accurate and rapid diagnostic test exists for tuberculous meningitis (TBM), leading to delayed diagnosis. We leveraged data from multiple studies to improve the predictive performance of diagnostic models across different populations, settings, and subgroups to develop a new predictive tool for TBM diagnosis. We conducted a systematic review to analyze eligible datasets with individual-level participant data (IPD). We imputed missing data and explored three approaches: stepwise logistic regression, classification and regression tree (CART), and random forest regression. We evaluated performance using calibration plots and C-statistics via internal-external cross-validation. We included 3,761 individual participants from 14 studies and nine countries. A total of 1,240 (33%) participants had "definite" (30%) or "probable" (3%) TBM by case definition. Important predictive variables included cerebrospinal fluid (CSF) glucose, blood glucose, CSF white cell count, CSF differential, cryptococcal antigen, HIV status, and fever presence. Internal validation showed that performance varied considerably between IPD datasets with C-statistic values between 0.60 and 0.89. In external validation, CART performed the worst (C = 0.82), and logistic regression and random forest had the same accuracy (C = 0.91). We developed a mobile app for TBM clinical prediction that accounted for heterogeneity and improved diagnostic performance (https://tbmcalc.github.io/tbmcalc). Further external validation is needed.},
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Suzumura, Erica Aranha; de Oliveira Ascef, Bruna; de Albuquerque Maia, Fernando Henrique; Bortoluzzi, Aline Frossard Ribeiro; Domingues, Sidney Marcel; Farias, Natalia Santos; Gabriel, Franciele Cordeiro; Jahn, Beate; Siebert, Uwe; de Soarez, Patricia Coelho
Methodological guidelines and publications of benefit-risk assessment for health technology assessment: a scoping review Journal Article
In: BMJ Open, vol. 14, no. 6, pp. e086603, 2024, ISSN: 2044-6055.
@article{pmid38851235,
title = {Methodological guidelines and publications of benefit-risk assessment for health technology assessment: a scoping review},
author = {Erica Aranha Suzumura and Bruna de Oliveira Ascef and Fernando Henrique de Albuquerque Maia and Aline Frossard Ribeiro Bortoluzzi and Sidney Marcel Domingues and Natalia Santos Farias and Franciele Cordeiro Gabriel and Beate Jahn and Uwe Siebert and Patricia Coelho de Soarez},
doi = {10.1136/bmjopen-2024-086603},
issn = {2044-6055},
year = {2024},
date = {2024-06-01},
journal = {BMJ Open},
volume = {14},
number = {6},
pages = {e086603},
abstract = {OBJECTIVES: To map the available methodological guidelines and documents for conducting and reporting benefit-risk assessment (BRA) during health technologies' life cycle; and to identify methodological guidelines for BRA that could serve as the basis for the development of a BRA guideline for the context of health technology assessment (HTA) in Brazil.nnDESIGN: Scoping review.nnMETHODS: Searches were conducted in three main sources up to March 2023: (1) electronic databases; (2) grey literature (48 HTA and regulatory organisations) and (3) manual search and contacting experts. We included methodological guidelines or publications presenting methods for conducting or reporting BRA of any type of health technologies in any context of the technology's life cycle. Selection process and data charting were conducted by independent reviewers. We provided a structured narrative synthesis of the findings.nnRESULTS: From the 83 eligible documents, six were produced in the HTA context, 30 in the regulatory and 35 involved guidance for BRA throughout the technology's life cycle. We identified 129 methodological approaches for BRA in the documents. The most commonly referred to descriptive frameworks were the Problem, Objectives, Alternatives, Consequences, Trade-offs, Uncertainty, Risk and Linked decisions and the Benefit-Risk Action Team. Multicriteria decision analysis was the most commonly cited quantitative framework. We also identified the most cited metric indices, estimation and utility survey techniques that could be used for BRA.nnCONCLUSIONS: Methods for BRA in HTA are less established. The findings of this review, however, will support and inform the elaboration of the Brazilian methodological guideline on BRA for HTA.nnTRIAL REGISTRATION NUMBER: https://doi.org/10.17605/OSF.IO/69T3V.},
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Karam, Samer G; Zhang, Yuan; Pardo-Hernandez, Hector; Siebert, Uwe; Koopman, Laura; Noyes, Jane; Tarride, Jean-Eric; Stevens, Adrienne L; Welch, Vivian; Saz-Parkinson, Zuleika; Ens, Brendalynn; Devji, Tahira; Xie, Feng; Hazlewood, Glen; Mbuagbaw, Lawrence; Alonso-Coello, Pablo; Brozek, Jan L; Schünemann, Holger J
ROBVALU: a tool for assessing risk of bias in studies about people's values, utilities, or importance of health outcomes Journal Article
In: BMJ, vol. 385, pp. e079890, 2024, ISSN: 1756-1833.
@article{pmid38866410,
title = {ROBVALU: a tool for assessing risk of bias in studies about people's values, utilities, or importance of health outcomes},
author = {Samer G Karam and Yuan Zhang and Hector Pardo-Hernandez and Uwe Siebert and Laura Koopman and Jane Noyes and Jean-Eric Tarride and Adrienne L Stevens and Vivian Welch and Zuleika Saz-Parkinson and Brendalynn Ens and Tahira Devji and Feng Xie and Glen Hazlewood and Lawrence Mbuagbaw and Pablo Alonso-Coello and Jan L Brozek and Holger J Sch\"{u}nemann},
doi = {10.1136/bmj-2024-079890},
issn = {1756-1833},
year = {2024},
date = {2024-06-01},
journal = {BMJ},
volume = {385},
pages = {e079890},
abstract = {People’s values are an important driver in healthcare decision making. The certainty of an intervention’s effect on benefits and harms relies on two factors: the certainty in the measured effect on an outcome in terms of risk difference and the certainty in its value, also known as utility or importance. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) working group has proposed a set of questions to assess the risk of bias in a body of evidence from studies investigating how people value outcomes. However, these questions do not address risk of bias in individual studies that, similar to risk-of-bias tools for other research studies, is required to evaluate such evidence. Thus, the Risk of Bias in studies of Values and Utilities (ROBVALU) tool was developed. ROBVALU has good psychometric properties and will be useful when assessing individual studies in measuring values, utilities, or the importance of outcomes. As such, ROBVALU can be used to assess risk of bias in studies included in systematic reviews and health guidelines. It also can support health research assessments, where the risk of bias of input variables determines the certainty in model outputs. These assessments include, for example, decision analysis and cost utility or cost effectiveness analysis for health technology assessment, health policy, and reimbursement decision making.},
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Rabayah, Abeer Al; Froukh, Rawan Al; Sawalha, Razan; Shnekat, Maali Al; Jahn, Beate; Siebert, Uwe; Jaddoua, Saad M
In: Value Health Reg Issues, vol. 43, pp. 101004, 2024, ISSN: 2212-1102.
@article{pmid38935989,
title = {Cost-Utility Analysis of Maintenance Pemetrexed Plus Best Supportive Care Compared With Best Supportive Care Alone in Treating Patients With Non-Small Cell Lung Cancer in Jordan},
author = {Abeer Al Rabayah and Rawan Al Froukh and Razan Sawalha and Maali Al Shnekat and Beate Jahn and Uwe Siebert and Saad M Jaddoua},
doi = {10.1016/j.vhri.2024.101004},
issn = {2212-1102},
year = {2024},
date = {2024-06-01},
journal = {Value Health Reg Issues},
volume = {43},
pages = {101004},
abstract = {OBJECTIVES: To assess the cost-effectiveness of maintenance pemetrexed plus best supportive care (BSC) in non-small cell lung cancer patients from a Jordanian healthcare system perspective.nnMETHODS: A Markov model with 4 health states was developed to estimate life years, quality-adjusted life-years (QALY), costs, and the incremental cost-utility ratio of pemetrexed plus BSC versus BSC. A lifelong time horizon was used in the base-case analysis. The transition probabilities were estimated from the PARAMOUNT trial, the utility weights were taken from published literature, and costs were based on data and unit costs at King Hussein Cancer Center and the Jordan Food and Drug Administration. Both costs and outcomes were discounted using a 3%. The parameter uncertainty was tested using deterministic and probabilistic sensitivity analyses.nnRESULTS: The base-case analysis showed that pemetrexed plus BSC increased QALYs and cost compared with BSC. Pemetrexed plus BSC leads to incremental 0.255 QALYs and incremental costs of US $30 826, resulting in an incremental cost-utility ratio of US $120 886/QALY. The results were sensitive to changes in the utility estimates during the progression-free health state, the progression health state, and the cost of postprogression medications The probabilistic sensitivity analysis showed that the probability of pemetrexed plus BSC being a cost-effective option compared with BSC is 0 at a threshold of $56 000.nnCONCLUSIONS: Maintenance pemetrexed for non-small cell lung cancer is not a cost-effective option compared with BSC from a healthcare system perspective based on the listed price at a threshold of $56 000/QALY.},
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Gomes, Manuel; Turner, Alex J; Sammon, Cormac; Dawoud, Dalia; Ramagopalan, Sreeram; Simpson, Alex; Siebert, Uwe
Acceptability of using Real-World Data to Estimate Relative Treatment Effects in Health Technology Assessments: Barriers and Future Steps Journal Article
In: Value Health, vol. 27, iss. 5, pp. 623-632, 2024, ISSN: 1524-4733.
@article{pmid38369282,
title = {Acceptability of using Real-World Data to Estimate Relative Treatment Effects in Health Technology Assessments: Barriers and Future Steps},
author = {Manuel Gomes and Alex J Turner and Cormac Sammon and Dalia Dawoud and Sreeram Ramagopalan and Alex Simpson and Uwe Siebert},
doi = {10.1016/j.jval.2024.01.020},
issn = {1524-4733},
year = {2024},
date = {2024-05-01},
urldate = {2024-05-01},
journal = {Value Health},
volume = {27},
issue = {5},
pages = {623-632},
abstract = {OBJECTIVES: Evidence about the comparative effects of new treatments is typically collected in randomized controlled trials (RCTs). In some instances, RCTs are not possible, or their value is limited by an inability to capture treatment effects over the longer-term or in all relevant population subgroups. In these cases, non-randomized studies (NRS) using real-world data (RWD) are increasingly used to complement trial evidence on treatment effects for health technology assessment (HTA). However, there have been concerns over a lack of acceptability of this evidence by HTA agencies. This paper aims to identify barriers to the acceptance of NRS and steps that may facilitate increases in the acceptability of NRS in the future.nnMETHODS: Opinions of the authorship team based on their experience in real-world evidence research in academic, HTA, and industry settings, supported by a critical assessment of existing studies.nnRESULTS: Barriers were identified that are applicable to key stakeholder groups including HTA agencies (e.g., the lack of comprehensive methodological guidelines for using RWD), evidence-generators (e.g., avoidable deviations from best practices), and external stakeholders (e.g., data controllers providing timely access to high-quality RWD). Future steps that may facilitate future acceptability of NRS include improvements in the quality, integration, and accessibility of RWD, wider use of demonstration projects to highlight the value and applicability of non-randomized designs, living and more detailed HTA guidelines, and improvements in HTA infrastructure relating to RWD.nnCONCLUSION: NRS can represent a crucial source of evidence on treatment effects for use in HTA when RCT evidence is limited.},
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Haslwanter, Mag Veronika; Rochau, Ursula; Hallsson, Lára R; Siebert, Uwe; Schönherr, Hans-Robert; Lechleitner, Monika; Oberaigner, Willi
The assessment of quality of care of patients with type 2 diabetes mellitus in a population-based cohort in the District of Landeck in Austria Journal Article
In: Prim Care Diabetes, vol. 18, no. 2, pp. 163-168, 2024, ISSN: 1878-0210.
@article{pmid38336533,
title = {The assessment of quality of care of patients with type 2 diabetes mellitus in a population-based cohort in the District of Landeck in Austria},
author = {Mag Veronika Haslwanter and Ursula Rochau and L\'{a}ra R Hallsson and Uwe Siebert and Hans-Robert Sch\"{o}nherr and Monika Lechleitner and Willi Oberaigner},
doi = {10.1016/j.pcd.2024.01.011},
issn = {1878-0210},
year = {2024},
date = {2024-04-01},
urldate = {2024-02-01},
journal = {Prim Care Diabetes},
volume = {18},
number = {2},
pages = {163-168},
abstract = {INTRODUCTION: Structured diabetes care based on evidence-based guidelines is one of the main strategies to improve glycemic control and to reduce long-term complications in diabetes mellitus.nnMETHODS: This study is based on the "Diabetes-Landeck Cohort", a population-based cohort of patients with diabetes mellitus type 2 (T2DM). We assessed the quality of diabetes care and compared it between three groups of care units, that is, general practitioners (GP), diabetes specialists in private practice (DSPP), and hospitals (HOSP).nnRESULTS: The total study population comprised 1616 patients with T2DM, including 378 patients of GP, 281 of DSPP, and 957 from HOSP. We identified statistically significant differences: DSPP showed the highest percentage of structured training, sufficient training, eye examinations and foot examinations. The group HOSP showed the highest proportion for increased HbA1c≥ 7.5 and almost all long-term complications surveyed, that is, nephropathy (23.2%), neuropathy (14.4%), diabetic foot (5.1%), and cerebrovascular diseases (10.9%).nnCONCLUSION: This population-based cohort study on patients with T2DM in Austria showed significant differences in important quality-of-care process and outcome parameters across different groups of care units. Future research should also include prediction modeling for early warning and monitoring systems as well as adjustment for patient characteristics and duration and severity of disease.},
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Homayra, Fahmida; Enns, Benjamin; Min, Jeong Eun; Kurz, Megan; Bach, Paxton; Bruneau, Julie; Greenland, Sander; Gustafson, Paul; Karim, Mohammad Ehsanul; Korthuis, P Todd; Loughin, Thomas; MacLure, Malcolm; McCandless, Lawrence; Platt, Robert William; Schnepel, Kevin; Shigeoka, Hitoshi; Siebert, Uwe; Socias, Eugenia; Wood, Evan; Nosyk, Bohdan
Comparative Analysis of Instrumental Variables on the Assignment of Buprenorphine/Naloxone or Methadone for the Treatment of Opioid Use Disorder Journal Article
In: Epidemiology, vol. 35, no. 2, pp. 218–231, 2024, ISSN: 1531-5487.
@article{pmid38290142,
title = {Comparative Analysis of Instrumental Variables on the Assignment of Buprenorphine/Naloxone or Methadone for the Treatment of Opioid Use Disorder},
author = {Fahmida Homayra and Benjamin Enns and Jeong Eun Min and Megan Kurz and Paxton Bach and Julie Bruneau and Sander Greenland and Paul Gustafson and Mohammad Ehsanul Karim and P Todd Korthuis and Thomas Loughin and Malcolm MacLure and Lawrence McCandless and Robert William Platt and Kevin Schnepel and Hitoshi Shigeoka and Uwe Siebert and Eugenia Socias and Evan Wood and Bohdan Nosyk},
doi = {10.1097/EDE.0000000000001697},
issn = {1531-5487},
year = {2024},
date = {2024-03-01},
journal = {Epidemiology},
volume = {35},
number = {2},
pages = {218--231},
abstract = {BACKGROUND: Instrumental variable (IV) analysis provides an alternative set of identification assumptions in the presence of uncontrolled confounding when attempting to estimate causal effects. Our objective was to evaluate the suitability of measures of prescriber preference and calendar time as potential IVs to evaluate the comparative effectiveness of buprenorphine/naloxone versus methadone for treatment of opioid use disorder (OUD).nnMETHODS: Using linked population-level health administrative data, we constructed five IVs: prescribing preference at the individual, facility, and region levels (continuous and categorical variables), calendar time, and a binary prescriber's preference IV in analyzing the treatment assignment-treatment discontinuation association using both incident-user and prevalent-new-user designs. Using published guidelines, we assessed and compared each IV according to the four assumptions for IVs, employing both empirical assessment and content expertise. We evaluated the robustness of results using sensitivity analyses.nnRESULTS: The study sample included 35,904 incident users (43.3% on buprenorphine/naloxone) initiated on opioid agonist treatment by 1585 prescribers during the study period. While all candidate IVs were strong (A1) according to conventional criteria, by expert opinion, we found no evidence against assumptions of exclusion (A2), independence (A3), monotonicity (A4a), and homogeneity (A4b) for prescribing preference-based IV. Some criteria were violated for the calendar time-based IV. We determined that preference in provider-level prescribing, measured on a continuous scale, was the most suitable IV for comparative effectiveness of buprenorphine/naloxone and methadone for the treatment of OUD.nnCONCLUSIONS: Our results suggest that prescriber's preference measures are suitable IVs in comparative effectiveness studies of treatment for OUD.},
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Buchberger, Wolfgang; Schmied, Marten; Schomaker, Michael; Rio, Anca Del; Siebert, Uwe
Implementation of a comprehensive clinical risk management system in a university hospital Journal Article
In: Z Evid Fortbild Qual Gesundhwes, vol. 184, pp. 18–25, 2024, ISSN: 2212-0289.
@article{pmid38199940b,
title = {Implementation of a comprehensive clinical risk management system in a university hospital},
author = {Wolfgang Buchberger and Marten Schmied and Michael Schomaker and Anca Del Rio and Uwe Siebert},
doi = {10.1016/j.zefq.2023.11.008},
issn = {2212-0289},
year = {2024},
date = {2024-03-01},
journal = {Z Evid Fortbild Qual Gesundhwes},
volume = {184},
pages = {18--25},
abstract = {BACKGROUND: Adverse events during hospital treatment are common and can lead to serious harm. This study reports the implementation of a comprehensive clinical risk management system in a university hospital and assesses the impact of clinical risk management on patient harms.nnMETHODS: The clinical risk management system was rolled out over a period of eight years and consisted of a training of interdisciplinary risk management teams, external and internal risk audits, and the implementation of a critical incident reporting system (CIRS). The risks identified during the audits were analyzed according to the type, severity, and implementation of preventive measures. Other key figures of the risk management system were obtained from the annual risk reports. The number of liability cases was used as primary outcome measurement.nnRESULTS: Of the 1,104 risks identified during the risk audits, 56.2% were related to organization, 21.3% to documentation, 15.3% to treatment, and 7.2% to patient information and consent. The highest proportion of serious risks was found in the category organization (22.7%), the lowest in the category documentation (13.6%). Critical incident reporting identified between 241 and 370 critical incidents per year, for which in 79.5% to 83% preventive measures were implemented within twelve months. The frequency of incident reports per department correlated with the number of active risk managers and risk team meetings. Compared with the years prior to the introduction of the clinical risk management system, an average annual reduction of harms by 60.1% (95% CI: 57.1; 63.1) was observed two years after the implementation was completed. On average, the rate of harms dropped by 5% per year for each 10% increase in roll-out of the clinical risk management system (incidence rate ratio: 0.95; 95% CI: 0.93; 0.97) .nnCONCLUSION: The results of this project demonstrate the effectiveness of clinical risk management in detecting treatment-related risks and in reducing harm to patients.},
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van den Beukel, Tim C; Wolters, Frank J; Siebert, Uwe; Spiering, Wilko; Ikram, M Arfan; Vernooij, Meike W; de Jong, Pim A; Bos, Daniel
Intracranial arteriosclerosis and the risk of dementia: A population-based cohort study Journal Article
In: Alzheimers Dement, vol. 20, iss. 2, pp. 869-879, 2024, ISSN: 1552-5279.
@article{pmid37814499,
title = {Intracranial arteriosclerosis and the risk of dementia: A population-based cohort study},
author = {Tim C van den Beukel and Frank J Wolters and Uwe Siebert and Wilko Spiering and M Arfan Ikram and Meike W Vernooij and Pim A de Jong and Daniel Bos},
doi = {10.1002/alz.13496},
issn = {1552-5279},
year = {2024},
date = {2024-02-20},
urldate = {2023-10-01},
journal = {Alzheimers Dement},
volume = {20},
issue = {2},
pages = {869-879},
abstract = {BACKGROUND: The impact of intracranial arteriosclerosis on dementia remains largely unclear.nnMETHODS: In 2339 stroke-free and dementia-free participants (52.2% women, mean age 69.5 years) from the general population, we assessed intracranial carotid artery calcification (ICAC) and vertebrobasilar artery calcification (VBAC) as proxy for arteriosclerosis. Associations with dementia were assessed using Cox models. In addition, indirect effects through cerebral small vessel disease (cSVD) and subcortical brain structure volumes were assessed using causal mediation analyses.nnRESULTS: During a median of 13.4 years (25th-75th percentiles 9.9-14.5) of follow-up, 282 participants developed dementia. Both ICAC presence (hazard ratio [HR]: 1.53, 95% confidence interval [CI]: 1.00-2.32]) and volume (HR per standard deviation: 1.19, 95% CI: 1.01-1.40) increased dementia risk. For VBAC, severe calcifications increased dementia risk (HR for third vs first volume tertile: 1.89, 95% CI: 1.00-3.59). These effects were mediated partly through increased cSVD (percentage mediated for ICAC: 13% and VBAC: 24%).nnDISCUSSION: Intracranial arteriosclerosis increases the risk of dementia.},
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Egelseer-Bruendl, T; Jahn, B; Arvandi, M; Puntscher, S; Santamaria, J; Brunelli, L; Weissenegger, K; Pfeifer, B; Neururer, S; Rissbacher, C; Huber, A; Fetz, B; Kleinheinz, C; Modre-Osprian, R; Kreiner, K; Siebert, U; Poelzl, G
In: Clin Res Cardiol, 2024, ISSN: 1861-0692.
@article{pmid38353683,
title = {Cost-effectiveness of a multidimensional post-discharge disease management program for heart failure patients-economic evaluation along a one-year observation period},
author = {T Egelseer-Bruendl and B Jahn and M Arvandi and S Puntscher and J Santamaria and L Brunelli and K Weissenegger and B Pfeifer and S Neururer and C Rissbacher and A Huber and B Fetz and C Kleinheinz and R Modre-Osprian and K Kreiner and U Siebert and G Poelzl},
doi = {10.1007/s00392-024-02395-5},
issn = {1861-0692},
year = {2024},
date = {2024-02-14},
urldate = {2024-02-14},
journal = {Clin Res Cardiol},
abstract = {OBJECTIVE: This study aimed to assess the cost-effectiveness of the telemedically assisted post-discharge management program (DMP) HerzMobil Tirol (HMT) for heart failure (HF) patients in clinical practice in Austria.nnMETHODS: We conducted a cost-effectiveness analysis along a retrospective cohort study (2016-2019) of HMT with a propensity score matched cohort of 251 individuals in the HMT and 257 in the usual care (UC) group and a 1-year follow-up. We calculated the effectiveness (hospital-free survival, hospital-free life-years gained, and number of avoided rehospitalizations), costs (HMT, rehospitalizations), and the incremental cost-effectiveness ratio (ICER). We performed a nonparametric sensitivity analysis with bootstrap sampling and sensitivity analyses on costs of HF rehospitalizations and on costs per disease-related diagnosis (DRG) score for rehospitalizations.nnRESULTS: Base-case analysis showed that HMT resulted in an average of 42 additional hospital-free days, 40 additional days alive, and 0.12 avoided hospitalizations per patient-year compared with UC during follow-up. The average HMT costs were EUR 1916 per person. Mean rehospitalization costs were EUR 5551 in HMT and EUR 6943 in UC. The ICER of HMT compared to UC was EUR 4773 per life-year gained outside the hospital. In a sensitivity analysis, HMT was cost-saving when "non-HF related costs" related to the DMP were replaced with average costs.nnCONCLUSIONS: The economic evaluation along the cohort study showed that the HerzMobil Tirol is very cost-effective compared to UC and cost-saving in a sensitivity analysis correcting for "non-HF related costs." These findings promote a widespread adoption of telemedicine-assisted DMP for HF.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}