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Book ; Thesis: Intraindividueller Vergleich der inflammatorischen Weichteilreaktion in der Umgebung von Stahl- und Titan-Implantaten

Krummrey, Gert

eine immunhistochemische Studie

2002

Author's details	von Gert Krummrey
Language	German
Size	87 Bl. : Ill., graph. Darst.
Edition	[Mikrofiche-Ausg.]
Publishing country	Germany
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Berlin, Humboldt-Univ., Diss., 2002
HBZ-ID	HT013748593
Database	Catalogue ZB MED Medicine, Health

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Article ; Online: Medical Extended Reality in der digitalen Notfallmedizin : Von der Ausbildung zur klinischen Anwendung.

Sauter, Thomas C / Krummrey, Gert / Hautz, Wolf E / Birrenbach, Tanja

Medizinische Klinik, Intensivmedizin und Notfallmedizin

2023 Volume 119, Issue 3, Page(s) 208–213

Abstract: Background: Emergency medicine faces the challenge of providing optimal care with limited resources. Especially in rare but critical situations (high-acuity low occurrence [HALO] situations), sound expertise is essential. Previous training approaches ... ...

Title translation	Medical extended reality in digital emergency medicine : From education to clinical application.
Abstract	Background: Emergency medicine faces the challenge of providing optimal care with limited resources. Especially in rare but critical situations (high-acuity low occurrence [HALO] situations), sound expertise is essential. Previous training approaches are time-limited and resource-intensive. Aim of the work: Medical extended reality (MXR) offers promising solutions. This article gives insight into the different areas of MXR and shows the application of MXR in emergency medicine using the HALO-MXR concept as an example. Results and discussion: MXR encompasses augmented reality (AR), virtual reality (VR) and mixed reality (MR). AR overlays digital information on the real world, enhancing perception and enabling interactive elements. VR creates an artificial three-dimensional (3D) environment in which the user is immersed. MR combines real and virtual elements. MXR offers advantages such as location-independent learning, virtual mentoring and scalability. However, it cannot replace existing training formats, but should be embedded in an overall concept. The HALO-MXR concept at Inselspital Bern includes e‑learning, simulation-based training in VR and on-site, and HALO-Assist support through augmented reality. HALO-Assist provides around-the-clock AR support for HALO procedures via audio and video communication as well as overlayed annotations, objects and flowcharts. Conclusion: The integration of MXR into emergency medicine promises more efficient use of resources and enhanced training opportunities. The HALO-MXR concept demonstrates how MXR effectively combines simulation-based training in VR and AR assist to enhance the application of HALO procedures.
MeSH term(s)	Humans ; Virtual Reality
Language	German
Publishing date	2023-12-12
Publishing country	Germany
Document type	English Abstract ; Journal Article ; Review
ZDB-ID	2636018-4
ISSN	2193-6226 ; 1435-1420 ; 0723-5003 ; 2193-6218 ; 0175-3851
ISSN (online)	2193-6226 ; 1435-1420
ISSN	0723-5003 ; 2193-6218 ; 0175-3851
DOI	10.1007/s00063-023-01095-8
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Is language an issue? Accuracy of the German computerized diagnostic decision support system ISABEL and cross-validation with the English counterpart.

Marcin, Thimo / Lüthi, Ailin / Graf, Ronny R / Krummrey, Gert / Schauber, Stefan K / Breakey, Neal / Hautz, Wolf E / Hautz, Stefanie C

Diagnosis (Berlin, Germany)

2023 Volume 10, Issue 4, Page(s) 398–405

Abstract: Objectives: Existing computerized diagnostic decision support tools (CDDS) accurately return possible differential diagnoses (DDx) based on the clinical information provided. The German versions of the CDDS tools for clinicians (Isabel Pro) and patients ...

Abstract	Objectives: Existing computerized diagnostic decision support tools (CDDS) accurately return possible differential diagnoses (DDx) based on the clinical information provided. The German versions of the CDDS tools for clinicians (Isabel Pro) and patients (Isabel Symptom Checker) from ISABEL Healthcare have not been validated yet. Methods: We entered clinical features of 50 patient vignettes taken from an emergency medical text book and 50 real cases with a confirmed diagnosis derived from the electronic health record (EHR) of a large academic Swiss emergency room into the German versions of Isabel Pro and Isabel Symptom Checker. We analysed the proportion of DDx lists that included the correct diagnosis. Results: Isabel Pro and Symptom Checker provided the correct diagnosis in 82 and 71 % of the cases, respectively. Overall, the correct diagnosis was ranked in 71 , 61 and 37 % of the cases within the top 20, 10 and 3 of the provided DDx when using Isabel Pro. In general, accuracy was higher with vignettes than ED cases, i.e. listed the correct diagnosis more often (non-significant) and ranked the diagnosis significantly more often within the top 20, 10 and 3. On average, 38 ± 4.5 DDx were provided by Isabel Pro and Symptom Checker. Conclusions: The German versions of Isabel achieved a somewhat lower accuracy compared to previous studies of the English version. The accuracy decreases substantially when the position in the suggested DDx list is taken into account. Whether Isabel Pro is accurate enough to improve diagnostic quality in clinical ED routine needs further investigation.
MeSH term(s)	Humans ; Dichlorodiphenyl Dichloroethylene ; Research Design ; Diagnosis, Differential ; Electronic Health Records ; Language
Chemical Substances	Dichlorodiphenyl Dichloroethylene (4M7FS82U08)
Language	English
Publishing date	2023-07-24
Publishing country	Germany
Document type	Journal Article
ISSN	2194-802X
ISSN (online)	2194-802X
DOI	10.1515/dx-2023-0047
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Barriers to seeking emergency care during the COVID-19 pandemic may lead to higher morbidity and mortality - a retrospective study from a Swiss university hospital.

Hautz, Wolf E / Sauter, Thomas C / Exadakytlos, Aristomenis K / Krummrey, Gert / Schauber, Stefan / Müller, Martin

Swiss medical weekly

2020 Volume 150, Page(s) w20331

Abstract: Aims of the study: While COVID-19 significantly overburdens emergency rooms (ERs) and hospitals in affected areas, ERs elsewhere report a marked decrease in patient numbers. This study aimed to investigate the assumption that patients with urgent ... ...

Abstract	Aims of the study: While COVID-19 significantly overburdens emergency rooms (ERs) and hospitals in affected areas, ERs elsewhere report a marked decrease in patient numbers. This study aimed to investigate the assumption that patients with urgent problems currently avoid the ER. Methods: Electronic health records from the ER of a large Swiss university hospital were extracted for three periods: first, the awareness phase (ap) from the publication of the national government’s initiative “How to protect ourselves” on 1 March 2020 to the lockdown of the country on 16 March; second, the mitigation phase (mp) from 16–30 March; finally, patients presenting in March 2019 were used as a control group. We compared parameters including a critical illness as the discharge diagnosis (e.g., myocardial infarction, stroke, sepsis and ER death) using logistic and linear regression, as well as 15-day bootstrapped means and 95% confidence intervals for the control group. Results: In the three periods, a total of 7143 patients were treated. We found a 24.9% (42.5%) significant decline in the number of patients presenting during the ap (mp). Patients presenting during the mp were more likely to be critically ill. There was an increase of 233% and 367% (ap and mp, respectively) of ER deaths (none related to COVID-19) compared with the control period. Apart from polytrauma (increase of 5% in the mp), all other critical illnesses as discharge diagnosis showed a lower incidence in descriptive analysis. Significantly more patients died in the ER in both the ap and mp. Conclusions: Barriers to seeking emergency care during COVID-19 pandemic may lead to higher morbidity and mortality. Healthcare authorities and hospitals must ensure low barriers to treatment and business as usual for all patients.
MeSH term(s)	Adult ; Aged ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Critical Illness/epidemiology ; Emergency Medical Services/statistics & numerical data ; Emergency Service, Hospital/statistics & numerical data ; Female ; Health Services Accessibility/trends ; Hospitals, University/statistics & numerical data ; Humans ; Incidence ; Male ; Middle Aged ; Pandemics ; Patient Acceptance of Health Care/statistics & numerical data ; Pneumonia, Viral/epidemiology ; Regression Analysis ; Retrospective Studies ; SARS-CoV-2 ; Switzerland/epidemiology
Keywords	covid19
Language	English
Publishing date	2020-08-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2036179-8
ISSN	1424-3997 ; 1424-7860
ISSN (online)	1424-3997
ISSN	1424-7860
DOI	10.4414/smw.2020.20331
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Automated identification of diagnostic labelling errors in medicine.

Hautz, Wolf E / Kündig, Moritz M / Tschanz, Roger / Birrenbach, Tanja / Schuster, Alexander / Bürkle, Thomas / Hautz, Stefanie C / Sauter, Thomas C / Krummrey, Gert

Diagnosis (Berlin, Germany)

2021 Volume 9, Issue 2, Page(s) 241–249

Abstract: Objectives: Identification of diagnostic error is complex and mostly relies on expert ratings, a severely limited procedure. We developed a system that allows to automatically identify diagnostic labelling error from diagnoses coded according to the ... ...

Abstract	Objectives: Identification of diagnostic error is complex and mostly relies on expert ratings, a severely limited procedure. We developed a system that allows to automatically identify diagnostic labelling error from diagnoses coded according to the international classification of diseases (ICD), often available as routine health care data. Methods: The system developed (index test) was validated against rater based classifications taken from three previous studies of diagnostic labeling error (reference standard). The system compares pairs of diagnoses through calculation of their distance within the ICD taxonomy. Calculation is based on four different algorithms. To assess the concordance between index test and reference standard, we calculated the area under the receiver operating characteristics curve (AUROC) and corresponding confidence intervals. Analysis were conducted overall and separately per algorithm and type of available dataset. Results: Diagnoses of 1,127 cases were analyzed. Raters previously classified 24.58% of cases as diagnostic labelling errors (ranging from 12.3 to 87.2% in the three datasets). AUROC ranged between 0.821 and 0.837 overall, depending on the algorithm used to calculate the index test (95% CIs ranging from 0.8 to 0.86). Analyzed per type of dataset separately, the highest AUROC was 0.924 (95% CI 0.887-0.962). Conclusions: The trigger system to automatically identify diagnostic labeling error from routine health care data performs excellent, and is unaffected by the reference standards' limitations. It is however only applicable to cases with pairs of diagnoses, of which one must be more accurate or otherwise superior than the other, reflecting a prevalent definition of a diagnostic labeling error.
MeSH term(s)	Algorithms ; Diagnostic Errors/prevention & control ; Humans
Language	English
Publishing date	2021-10-21
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2194-802X
ISSN (online)	2194-802X
DOI	10.1515/dx-2021-0039
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Effects of a computerised diagnostic decision support tool on diagnostic quality in emergency departments: study protocol of the DDx-BRO multicentre cluster randomised cross-over trial.

Marcin, Thimo / Hautz, Stefanie C / Singh, Hardeep / Zwaan, Laura / Schwappach, David / Krummrey, Gert / Schauber, Stefan K / Nendaz, Mathieu / Exadaktylos, Aristomenis Konstantinos / Müller, Martin / Lambrigger, Cornelia / Sauter, Thomas C / Lindner, Gregor / Bosbach, Simon / Griesshammer, Ines / Hautz, Wolf E

BMJ open

2023 Volume 13, Issue 3, Page(s) e072649

Abstract: Introduction: Computerised diagnostic decision support systems (CDDS) suggesting differential diagnoses to physicians aim to improve clinical reasoning and diagnostic quality. However, controlled clinical trials investigating their effectiveness and ... ...

Abstract	Introduction: Computerised diagnostic decision support systems (CDDS) suggesting differential diagnoses to physicians aim to improve clinical reasoning and diagnostic quality. However, controlled clinical trials investigating their effectiveness and safety are absent and the consequences of its use in clinical practice are unknown. We aim to investigate the effect of CDDS use in the emergency department (ED) on diagnostic quality, workflow, resource consumption and patient outcomes. Methods and analysis: This is a multicentre, outcome assessor and patient-blinded, cluster-randomised, multiperiod crossover superiority trial. A validated differential diagnosis generator will be implemented in four EDs and randomly allocated to a sequence of six alternating intervention and control periods. During intervention periods, the treating ED physician will be asked to consult the CDDS at least once during diagnostic workup. During control periods, physicians will not have access to the CDDS and diagnostic workup will follow usual clinical care. Key inclusion criteria will be patients' presentation to the ED with either fever, abdominal pain, syncope or a non-specific complaint as chief complaint. The primary outcome is a binary diagnostic quality risk score composed of presence of an unscheduled medical care after discharge, change in diagnosis or death during time of follow-up or an unexpected upscale in care within 24 hours after hospital admission. Time of follow-up is 14 days. At least 1184 patients will be included. Secondary outcomes include length of hospital stay, diagnostics and data regarding CDDS usage, physicians' confidence calibration and diagnostic workflow. Statistical analysis will use general linear mixed modelling methods. Ethics and dissemination: Approved by the cantonal ethics committee of canton Berne (2022-D0002) and Swissmedic, the Swiss national regulatory authority on medical devices. Study results will be disseminated through peer-reviewed journals, open repositories and the network of investigators and the expert and patients advisory board. Trial registration number: NCT05346523.
MeSH term(s)	Humans ; Cross-Over Studies ; Research Design ; Hospitalization ; Emergency Service, Hospital ; Randomized Controlled Trials as Topic ; Multicenter Studies as Topic
Language	English
Publishing date	2023-03-29
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-072649
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Predictors of High Resource Consumption in Alcohol Intoxicated Patients in the Emergency Department.

Rönz, Katharina / Hirschi, Trevor / Becker, Sebastian / Krummrey, Gert / Exadaktylos, Aristomenis K / Sauter, Thomas C / Hautz, Wolf E / Müller, Martin

International journal of environmental research and public health

2020 Volume 17, Issue 11

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Adult ; Alcoholic Intoxication/epidemiology ; Blood Alcohol Content ; Emergency Service, Hospital ; Female ; Health Resources ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Switzerland/epidemiology ; Young Adult
Chemical Substances	Blood Alcohol Content
Language	English
Publishing date	2020-06-09
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph17114122
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Development, implementation and first insights of a time- and location-independent longitudinal postgraduate curriculum in emergency medicine.

Sauter, Thomas C / Exadaktylos, Aristomenis / Krummrey, Gert / Lehmann, Beat / Brodmann-Maeder, Monika / Hautz, Wolf E

GMS journal for medical education

2018 Volume 35, Issue 4, Page(s) Doc44

Abstract: Introduction, background and context: ...

Abstract	Introduction, background and context:
MeSH term(s)	Curriculum/trends ; Education, Medical, Graduate/methods ; Education, Medical, Graduate/standards ; Emergency Medicine/education ; Humans ; Needs Assessment ; Outcome and Process Assessment (Health Care)/methods ; Outcome and Process Assessment (Health Care)/standards ; Schools, Medical/organization & administration ; Simulation Training/methods ; Simulation Training/standards ; Surveys and Questionnaires ; Switzerland
Language	English
Publishing date	2018-11-15
Publishing country	Germany
Document type	Journal Article
ISSN	2366-5017
ISSN (online)	2366-5017
DOI	10.3205/zma001190
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Strengthening Emergency Care Systems to Mitigate Public Health Challenges Arising from Influxes of Individuals with Different Socio-Cultural Backgrounds to a Level One Emergency Center in South East Europe.

Twomey, Michèle / Šijački, Ana / Krummrey, Gert / Welzel, Tyson / Exadaktylos, Aristomenis K / Ercegovac, Marko

International journal of environmental research and public health

2018 Volume 15, Issue 3

Abstract: Emergency center visits are mostly unscheduled, undifferentiated, and unpredictable. A standardized triage process is an opportunity to obtain real-time data that paints a picture of the variation in acuity found in emergency centers. This is ... ...

Abstract	Emergency center visits are mostly unscheduled, undifferentiated, and unpredictable. A standardized triage process is an opportunity to obtain real-time data that paints a picture of the variation in acuity found in emergency centers. This is particularly pertinent as the influx of people seeking asylum or in transit mostly present with emergency care needs or first seek help at an emergency center. Triage not only reduces the risk of missing or losing a patient that may be deteriorating in the waiting room but also enables a time-critical response in the emergency care service provision. As part of a joint emergency care system strengthening and patient safety initiative, the Serbian Ministry of Health in collaboration with the Centre of Excellence in Emergency Medicine (CEEM) introduced a standardized triage process at the Clinical Centre of Serbia (CCS). This paper describes four crucial stages that were considered for the integration of a standardized triage process into acute care pathways.
MeSH term(s)	Culture ; Emergency Service, Hospital/standards ; Humans ; Public Health/standards ; Serbia ; Triage/standards
Language	English
Publishing date	2018-03-12
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph15030501
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Article ; Online: Six degrees of separation: the small world of medical education.

Hautz, Wolf E / Krummrey, Gert / Exadaktylos, Aristomenis / Hautz, Stefanie C

Medical education

2016 Volume 50, Issue 12, Page(s) 1274–1279

Abstract: Context: Conventional wisdom has it that everyone on earth is on average only six steps away from knowing any other person through 'a friend of a friend'. On a local level, however, many people experience that most of their acquaintances know each other. ...

Abstract	Context: Conventional wisdom has it that everyone on earth is on average only six steps away from knowing any other person through 'a friend of a friend'. On a local level, however, many people experience that most of their acquaintances know each other. It is thus hard to imagine how such a highly clustered group could be so well connected to the rest of the world. In this paper, we investigate how co-authorship connects scholars in medical education and whether the six degrees of separation hypothesis also applies to the network of authors in the field. Methods: We constructed a mathematical graph from publication data obtained on the top three journals in the field and analysed it using social network analysis methods. We found Lorelei Lingard to be one centre of the network of co-authors and determined the numbers of authors who were one, two or more steps away from her. We further created a website that makes it possible to identify the shortest path from any author in the field to any other, including links to the connecting papers. Results: The analysis covered 16 653 papers by a total of 24 258 different authors. Co-authorship connected authors into 68 663 unique pairs, of which 61 937 had co-authored only one article; 67.43% of all authors were linked to each other through a 'co-author of a co-author'. The average shortest path between any two authors in this network was 5.98 (min 1, max 17); the average distance to Lorelei Lingard was 4.17 (min 1, max 10). Conclusion: The field of medical education represents what social network analysts term 'a small world network'. Making the connections between its actors visible may provide a new perspective on social phenomena that occur in this world, including peer review, citation and conference invitations.
MeSH term(s)	Authorship ; Education, Medical ; Humans ; Publishing ; Social Support
Language	English
Publishing date	2016-12
Publishing country	England
Document type	Journal Article
ZDB-ID	195274-2
ISSN	1365-2923 ; 0308-0110
ISSN (online)	1365-2923
ISSN	0308-0110
DOI	10.1111/medu.13102
Database	MEDical Literature Analysis and Retrieval System OnLINE

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