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  1. Artikel: Short-term blood pressure variability – variation between arm side, body position and successive measurements: a population-based cohort study

    Kuss, Oliver

    BMC cardiovascular disorders, 17:31

    2017  

    Abstract: BACKGROUND: Precise blood pressure (BP) measurements are central for the diagnosis of hypertension in clinical and epidemiological studies. The purpose of this study was to quantify the variability in BP associated with arm side, body position, and ... ...

    Körperschaft Deutsches Diabetes-Zentrum
    Abstract BACKGROUND: Precise blood pressure (BP) measurements are central for the diagnosis of hypertension in clinical and epidemiological studies. The purpose of this study was to quantify the variability in BP associated with arm side, body position, and successive measurements in the setting of a population-based observational study. Additionally, we aimed to evaluate the influence of different measurement conditions on prevalence of hypertension. METHODS: The sample included 967 men and 812 women aged 45 to 83 years at baseline. BP was measured according to a standardized protocol with oscillometric devices including three sitting measurements at left arm, one simultaneous supine measurement at both arms, and four supine measurements at the arm with the higher BP. Hypertension was defined as systolic BP (SBP) ≥140 mmHg and/or diastolic BP (DBP) ≥90 mmHg. Variability in SBP and DBP were analysed with sex-stratified linear covariance pattern models. RESULTS: We found that overall, no mean BP differences were measured according to arm-side, but substantial higher DBP and for men also higher SBP was observed in sitting than in supine position and there was a clear BP decline by consecutive measurement. Accordingly, the prevalence of hypertension depends strongly on the number and scheme of BP measurements taken to calculate the index values. CONCLUSIONS: Thus, BP measurements should only be compared between studies applying equal measurement conditions and index calculation. Moreover, the first BP measurement should not be used to define hypertension since it overestimates BP. The mean of second and third measurement offers the advantage of better reproducibility over single measurements.
    Schlagwörter (3–5) arm-side ; Body position ; Blood pressure variability ; Hypertension ; Successive measurements
    Sprache Englisch
    Dokumenttyp Artikel
    Datenquelle Fachrepositorium Lebenswissenschaften

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  2. Artikel: Anthropometric markers and their association with incident type 2 diabetes mellitus: which marker is best for prediction? Pooled analysis of four German population-based cohort studies and comparison with a nationwide cohort study

    Kuss, Oliver

    BMJ open, 6(1):e009266

    2016  

    Abstract: OBJECTIVE: To compare the association between different anthropometric measurements and incident type 2 diabetes mellitus (T2DM) and to assess their predictive ability in different regions of Germany. METHODS: Data of 10 258 participants from 4 ... ...

    Körperschaft Deutsches Diabetes-Zentrum
    Abstract OBJECTIVE: To compare the association between different anthropometric measurements and incident type 2 diabetes mellitus (T2DM) and to assess their predictive ability in different regions of Germany. METHODS: Data of 10 258 participants from 4 prospective population-based cohorts were pooled to assess the association of body weight, body mass index (BMI), waist circumference (WC), waist-to-hip-ratio (WHR) and waist-to-height-ratio (WHtR) with incident T2DM by calculating HRs of the crude, adjusted and standardised markers, as well as providing receiver operator characteristic (ROC) curves. Differences between HRs and ROCs for the different anthropometric markers were calculated to compare their predictive ability. In addition, data of 3105 participants from the nationwide survey were analysed separately using the same methods to provide a nationally representative comparison. RESULTS: Strong associations were found for each anthropometric marker and incidence of T2DM. Among the standardised anthropometric measures, we found the strongest effect on incident T2DM for WC and WHtR in the pooled sample (HR for 1 SD difference in WC 1.97, 95% CI 1.75 to 2.22, HR for WHtR 1.93, 95% CI 1.71 to 2.17 in women) and in female DEGS participants (HR for WC 2.24, 95% CI 1.91 to 2.63, HR for WHtR 2.10, 95% CI 1.81 to 2.44), whereas the strongest association in men was found for WHR among DEGS participants (HR 2.29, 95% CI 1.89 to 2.78). ROC analysis showed WHtR to be the strongest predictor for incident T2DM. Differences in HR and ROCs between the different markers confirmed WC and WHtR to be the best predictors of incident T2DM. Findings were consistent across study regions and age groups (<65 vs ≥65 years). CONCLUSIONS: We found stronger associations between anthropometric markers that reflect abdominal obesity (ie, WC and WHtR) and incident T2DM than for BMI and weight. The use of these measurements in risk prediction should be encouraged.
    Sprache Englisch
    Dokumenttyp Artikel
    Datenquelle Fachrepositorium Lebenswissenschaften

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  3. Artikel: A novel method for identifying settings for well‐motivated ecologic studies of cancer

    Kuss, Oliver

    International journal of cancer, 138(8): 1887-1893

    2015  

    Abstract: A low within‐country variability and a large between‐country variability in cancer incidence may indicate that ecologic factors are involved in the etiology of the disease. The aim of this study is to explore the within‐ and between‐country variability ... ...

    Körperschaft Deutsches Diabetes-Zentrum
    Abstract A low within‐country variability and a large between‐country variability in cancer incidence may indicate that ecologic factors are involved in the etiology of the disease. The aim of this study is to explore the within‐ and between‐country variability of cancer incidence to motivate high‐quality ecologic studies. We extracted age‐standardized incidence rate estimates (world standard population) from 135 regions for the ten most frequent invasive cancers in Europe for non‐Hispanic white populations from Cancer Incidence in Five Continents, Volume X. We fitted weighted multilevel Poisson regression models with random country effects for each cancer and sex. We estimated intraclass correlation coefficients (ICCs) and 95% confidence intervals (95% CIs). A high ICC indicates a low within‐ and a high between‐country variability of rates. The two cancer sites with the highest ICC among men were prostate cancer (0.96, 95% CI: 0.92–0.99) and skin melanoma (0.78, 0.64–0.93). Among women, high ICCs were observed for lung cancer (0.84, 0.73–0.95) and breast cancer (0.80, 0.69–0.91). The two most prominent sex differences for ICC occurred for cancers of the head and neck (men: 0.70, 0.55–0.85, women: 0.19, 0.08–0.30) and breast cancer (men: 0.04, 0.01–0.07, women: 0.80, 0.69–0.91). ICCs were relatively low for pancreatic cancer (men: 0.23, 0.10–0.35; women: 0.13, 0.04–0.21) and leukemia (men: 0.12, 0.04–0.21; women: 0.08, 0.02–0.14). For cancers with high ICC for which systematic factors of the health care system, screening and diagnostic activities are not plausible explanations for between‐country variations in incidence, cross‐country sex‐specific ecologic studies may be especially promising.
    Schlagwörter cancer registries ; etiology ; incidence ; neoplasms
    Sprache Englisch
    Dokumenttyp Artikel
    Datenquelle Fachrepositorium Lebenswissenschaften

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  4. Artikel: Methods to estimate the between‐study variance and its uncertainty in meta‐analysis†

    Kuss, Oliver

    Research synthesis methods, 1(7):55–79

    2015  

    Abstract: Meta‐analyses are typically used to estimate the overall/mean of an outcome of interest. However, inference about between‐study variability, which is typically modelled using a between‐study variance parameter, is usually an additional aim. The ... ...

    Körperschaft Deutsches Diabetes-Zentrum
    Abstract Meta‐analyses are typically used to estimate the overall/mean of an outcome of interest. However, inference about between‐study variability, which is typically modelled using a between‐study variance parameter, is usually an additional aim. The DerSimonian and Laird method, currently widely used by default to estimate the between‐study variance, has been long challenged. Our aim is to identify known methods for estimation of the between‐study variance and its corresponding uncertainty, and to summarise the simulation and empirical evidence that compares them. We identified 16 estimators for the between‐study variance, seven methods to calculate confidence intervals, and several comparative studies. Simulation studies suggest that for both dichotomous and continuous data the estimator proposed by Paule and Mandel and for continuous data the restricted maximum likelihood estimator are better alternatives to estimate the between‐study variance. Based on the scenarios and results presented in the published studies, we recommend the Q‐profile method and the alternative approach based on a ‘generalised Cochran between‐study variance statistic’ to compute corresponding confidence intervals around the resulting estimates. Our recommendations are based on a qualitative evaluation of the existing literature and expert consensus. Evidence‐based recommendations require an extensive simulation study where all methods would be compared under the same scenarios.
    Schlagwörter coverage probability ; confidence interval ; bias ; heterogeneity ; mean squared error
    Sprache Englisch
    Dokumenttyp Artikel
    Datenquelle Fachrepositorium Lebenswissenschaften

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  5. Artikel: Changes of individual perception in psychosocial stressors related to German reunification in 1989/1990 and cardiovascular risk factors and cardiovascular diseases in a population-based study in East Germany

    Bohley, Dr. Stefanie / Kuss, Oliver

    BMJ open, 6(1):e008703

    2016  

    Abstract: OBJECTIVES: Aim was to examine the relationship between individually perceived changes in psychosocial stressors associated with German reunification and cardiovascular effects. We hypothesised that higher levels of psychosocial stress related to German ... ...

    Körperschaft Deutsches Diabetes-Zentrum
    Abstract OBJECTIVES: Aim was to examine the relationship between individually perceived changes in psychosocial stressors associated with German reunification and cardiovascular effects. We hypothesised that higher levels of psychosocial stress related to German reunification were associated with an increase in cardiovascular risk factors and cardiovascular diseases (CVDs). DESIGN: Cross-sectional data from 2 cohort studies in East Germany were used: Cardiovascular Disease, Living and Ageing in Halle Study (CARLA), and Study of Health in Pomerania (SHIP). SETTING: 2 populations in East Germany. PARTICIPANTS: CARLA study: 1779 participants, aged 45–83 years at baseline (812 women), SHIP study: 4308 participants, aged 20–79 years at baseline (2193 women). PRIMARY AND SECONDARY OUTCOME MEASURES: Psychosocial stressors related to reunification were operationalised by the Reunification Stress Index (RSI; scale from 0 to 10). This index was composed of questions that were related to individually perceived changes in psychosocial stressors (occupational, financial and personal) after reunification. To examine the associations between the RSI and each stressor separately with cardiovascular risk factors and CVD, regression models were used. RESULTS: RSI was associated with CVD in women (RR=1.15, 95% CI 1.00 to 1.33). Cardiovascular risk factors were associated with RSI for both men and women, with strongest associations between RSI and diabetes in women (RR=1.10, 95% CI 1.01 to 1.20) and depressive disorders in men (RR=1.15, 95% CI 1.07 to 2.77). The change in occupational situation related to reunification was the major contributing psychosocial stressor. We observed a strong association with CVD in women who experienced occupational deterioration after reunification (RR=4.04, 95% CI 1.21 to 13.43). CONCLUSIONS: Individually perceived deterioration of psychosocial stressors (occupational, financial and personal) related to German reunification was associated with cardiovascular risk factors and CVD. The associations were stronger for women than for men. An explanation for these findings could be that women were more often affected by unemployment after reunification. Morbidity and mortality follow-up of both cohorts could enhance the results.
    Sprache Englisch
    Dokumenttyp Artikel
    Datenquelle Fachrepositorium Lebenswissenschaften

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  6. Artikel: Incidence of lower extremity amputation in the diabetic compared to the non-diabetic population: a systematic review protocol

    Kuss, Oliver / Icks, Andrea

    Systematic Reviews, 4:74

    2015  

    Abstract: BACKGROUND: Diabetic individuals have a largely increased risk of lower extremity amputation (LEA) compared with non-diabetic patients. Prior systematic reviews of incidence of LEA have some limitations with respect to lack of consensus in the definition ...

    Körperschaft Deutsches Diabetes-Zentrum
    Abstract BACKGROUND: Diabetic individuals have a largely increased risk of lower extremity amputation (LEA) compared with non-diabetic patients. Prior systematic reviews of incidence of LEA have some limitations with respect to lack of consensus in the definition of LEA, level of LEA (all, major, minor), and definition of source population (general population or population with diabetes at risk). The purpose of our review is to evaluate the incidence of LEA in the diabetic population and its differences with regard to sex, ethnicity, age, and regions; to compare the incidence rate (IR) in the diabetic and non-diabetic population; and to investigate time trends. METHODS/ DESIGN: We will perform a systematic literature search in MEDLINE, Embase, Web of Knowledge, and publisher databases such as Journals@OVID and ScienceDirect. We will develop comprehensive systematic search strategies according to established guidelines for meta-analyses of observational studies in epidemiology (the MOOSE group). Two authors will independently screen abstracts and full text of all references on the basis of inclusion criteria with respect to types of study, types of population, and the main outcome. We will exclude studies if they report solely incidences of LEA among persons with diabetes mellitus when referring to the total population (diabetic and non-diabetic) and not exclusively to the diabetic population. Data extraction and assessment of risk of bias will be undertaken by two review authors working independently. We will assess incidence rate (IR) or cumulative incidence (CumI), relative risk of amputations comparing the diabetic to non-diabetic populations, cause of LEA, and type of diabetes. If we find subsets of studies to be homogeneous enough, we will perform meta-analyses for incidence rates by Poisson generalized linear mixed models (GLMM).SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42015017809
    Schlagwörter Diabetes ; Incidences ; Lower extremity amputations (LEA) ; Systematic review ; Population-based study ; Protocol
    Sprache Englisch
    Dokumenttyp Artikel
    Datenquelle Fachrepositorium Lebenswissenschaften

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  7. Artikel: Comparison of surveillance-based metrics for the assessment and monitoring of disease detection: simulation study about type 2 diabetes

    Brinks, Ralph / Hoyer, Annika / Kuss, Oliver

    BMC medical research methodology, 17:54

    2017  

    Abstract: BACKGROUND: Screening and detection of cases are a common public health priority for treatable chronic conditions with long subclinical periods. However, the validity of commonly-used metrics from surveillance systems for rates of detection (or case- ... ...

    Körperschaft Deutsches Diabetes-Zentrum
    Abstract BACKGROUND: Screening and detection of cases are a common public health priority for treatable chronic conditions with long subclinical periods. However, the validity of commonly-used metrics from surveillance systems for rates of detection (or case-finding) have not been evaluated. METHODS: Using data from a Danish diabetes register and a recently developed illness-death model of chronic diseases with subclinical conditions, we simulate two scenarios of different performance of case-finding. We report different epidemiological indices to assess case-finding in both scenarios and compare the validity of the results. RESULTS: The commonly used ratio of detected cases over total cases may lead to misleading conclusions. Instead, the ratio of undetected cases over persons without a diagnosis is a more valid index to distinguish the quality of case-finding. However, incidence-based measures are preferable to prevalence based indicators. CONCLUSION: Prevalence-based indices for assessing case-finding should be interpreted with caution. If possible, incidence-based indices should be preferred.
    Schlagwörter Compartment model ; Case-finding ; Chronic disease ; Diabetes ; Incidence ; Screening ; Prevalence ; Undiagnosed disease
    Sprache Englisch
    Dokumenttyp Artikel
    Datenquelle Fachrepositorium Lebenswissenschaften

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  8. Artikel: The Prevalence and Incidence of Diabetes in Germany: An Analysis of Statutory Health Insurance Data on 65 Million Individuals From the Years 2009 and 2010 (An analysis of statutory health insurance data on 65 million individuals from the years 2009 and 2010)

    Brinks, Ralph / Hoyer, Annika / Kuss, Oliver / Rathmann, Wolfgang

    Deutsches Ärzteblatt international, 113(11):177-182

    2016  

    Abstract: BACKGROUND: The database of the German Institute of Medical Documentation and Information makes it possible for the first time to compute statistics on diabetes for all insurees of the statutory health insurance scheme in Germany. Data from this ... ...

    Körperschaft Deutsches Diabetes-Zentrum
    Abstract BACKGROUND: The database of the German Institute of Medical Documentation and Information makes it possible for the first time to compute statistics on diabetes for all insurees of the statutory health insurance scheme in Germany. Data from this comprehensive source are less likely to be biased by differences in the membership structures of individual insurance carriers or by the underrepresentation of persons over age 80 that is seen in most population-based studies. METHODS: International Classification of Diseases (ICD)–coded diagnosis data from the inpatient and outpatient sectors were used to define persons as having diabetes. Incidences were estimated from differences in prevalence from one year to the next and the expected mortality of persons with and without diabetes. RESULTS: A diabetes diagnosis was present in 6.4 million out of a total of 65.6 million insurees in 2009 and in 6.7 million out of 64.9 million insures in 2010. The corresponding age and sex standardized prevalences of diabetes were 9.7% in 2009 and 9.9% in 2010, respectively. The number of persons with type 2 diabetes was 4.6 million in 2009 and 4.7 million in 2010. The prevalence and incidence of type 2 diabetes rose steeply from age 50 to age 80. Peak incidence was at age 85, with 24 newly diagnosed cases of diabetes per 1000 person-years. CONCLUSION: On the basis of these data, we estimate that 5.8 million persons with type 2 diabetes are living in Germany today. The database used in this study is a valuable complement to population-based studies for monitoring the prevalence of diabetes, particularly in persons over age 80.
    Sprache Englisch
    Dokumenttyp Artikel
    Datenquelle Fachrepositorium Lebenswissenschaften

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  9. Artikel: The Incidence of End-Stage Renal Disease in the Diabetic (Compared to the Non-Diabetic) Population: A Systematic Review

    Kvitkina, Tatjana / Kuss, Oliver / Icks, Andrea

    PLOS ONE, 11(1):e0147329

    2016  

    Abstract: End-stage renal disease (ESRD) in diabetes is a life threatening complication resulting in a poor prognosis for patients as well as high medical costs. The aims of this systematic review were (1) to evaluate the incidence of ESRD due to all causes and ... ...

    Körperschaft Deutsches Diabetes-Zentrum
    Abstract End-stage renal disease (ESRD) in diabetes is a life threatening complication resulting in a poor prognosis for patients as well as high medical costs. The aims of this systematic review were (1) to evaluate the incidence of ESRD due to all causes and due to diabetic nephropathy in the diabetic population and differences between incidences of ESRD with respect to sex, ethnicity, age and regions, (2) to compare incidence rates in the diabetic and non-diabetic population, and (3) to investigate time trends. The systematic review was conducted according to the PRISMA group guidelines by performing systematic literature searches in the biomedical databases until January 3rd 2015; thirty-two studies were included. Among patients with incident type 1 diabetes the 30-year cumulative incidence ranged from 3.3% to 7.8%. Among patients with prevalent diabetes, incidence rates of ESRD due to all causes ranged from 132.0 to 167.0 per 100,000 person-years, whereas incidence rates of ESRD due to diabetic nephropathy varied from 38.4 to 804.0 per 100,000 person-years. The incidence of ESRD in the diabetic population was higher compared to the non-diabetic population, and relative risks varied from 6.2 in the white population to 62.0 among Native Americans. The results regarding time trends were inconsistent. The review conducted demonstrates the considerable variation of incidences of ESRD among the diabetic population. Consistent findings included an excess risk when comparing the diabetic to the non-diabetic population and ethnic differences. We recommend that newly designed studies should use standardized methods for the determination of ESRD and population at risk.
    Schlagwörter Census ; Chronic kidney disease ; Antigen-presenting cells ; Database searching ; Diabetes mellitus ; Medical dialysis ; Type 1 diabetes ; Type 2 diabetes
    Sprache Englisch
    Dokumenttyp Artikel
    Datenquelle Fachrepositorium Lebenswissenschaften

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  10. Artikel ; Online: Comment on "Drug-Drug Interaction of the Sodium Glucose Co-Transporter 2 Inhibitors with Statins and Myopathy: A Disproportionality Analysis Using Adverse Events Reporting Data".

    Kuss, Oliver / Rathmann, Wolfgang

    Drug safety

    2023  Band 46, Heft 5, Seite(n) 509–512

    Mesh-Begriff(e) Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects ; Sodium-Glucose Transporter 2 Inhibitors/adverse effects ; Drug Interactions ; Muscular Diseases/chemically induced ; Symporters ; Glucose ; Sodium
    Chemische Substanzen Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Sodium-Glucose Transporter 2 Inhibitors ; Symporters ; Glucose (IY9XDZ35W2) ; Sodium (9NEZ333N27)
    Sprache Englisch
    Erscheinungsdatum 2023-04-15
    Erscheinungsland New Zealand
    Dokumenttyp Letter ; Comment
    ZDB-ID 1018059-x
    ISSN 1179-1942 ; 0114-5916
    ISSN (online) 1179-1942
    ISSN 0114-5916
    DOI 10.1007/s40264-023-01292-6
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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