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Wismar, Germany

Berg M.M.,University of Kiel | Berg M.M.,University of Wismar
Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics) | Year: 2015

Spoken Dialogue Systems have enormously improved during the last couple of years and gave rise to voice-controlled mobile assistants. While the abilities of these systems are very sophisticated, there is a lack of tools enabling us to easily describe a natural dialogue that can afterwards be processed by a dialogue engine without having to programme the engine itself. In this paper we present NADIA, a dialogue engine that can process an easy to define XML-based dialogue description. © Springer International Publishing Switzerland 2015.

Wilke T.,University of Wismar | Muller S.,University of Wismar | Neumann K.,University of Wismar | Loder T.,Pharmacy LUX99
Pharmaceutical Medicine | Year: 2011

Introduction: The objective of this study was to discover whether over-the-counter (OTC) package designs differ in their ability to transfer drug-safety-related information to pharmacy customers. The research was intended to answer two questions: (i) how well and quickly do customers comprehend, and what are the main characteristics of customers who have difficulty understanding relevant medical information on a package; and (ii) do alternative package designs provide for significantly different levels of comprehension? Methods: We performed cross-sectional face-to-face interviews with 452 pharmacy customers in 17 German pharmacies. In each of three sequential experiments (one OTC brand per experiment), each participant was shown two packages of the same brand and was asked three drug-related questions per package. The different abilities of the three package designs to transfer information correctly and rapidly were compared by descriptive statistics; the significance of differences was tested by Wilcoxon tests. Results: Older people, those with physical problems, people not in a receptive mood, and those with a poor doctor-patient relationship or a lack of trust in medicines in general, answered the questions with a significantly higher number of errors and/or required significantly more time to do so, than the remainder of the sample. When compared with two other package designs, one of the tested designs with special design characteristics proved superior. Conclusions: The design of a medication package can measurably influence the quality and speed of information transfer to pharmacy customers. Because drug safety and adherence are associated with drug knowledge, the design of packaging should be given more attention. © 2011 Adis Data Information BV. All rights reserved.

Wilke T.,University of Wismar | Groth A.,University of Wismar | Mueller S.,University of Wismar | Pfannkuche M.,Boehringer Ingelheim | And 5 more authors.
Europace | Year: 2013

AimsBased on an analysis of claims-based data of 8.298 million members of two German statutory health insurance funds, the aim of this contribution is to quantify age-/gender-specific prevalence/incidence of atrial fibrillation (AF) in a German setting.Methods and resultsPatients were classified as AF prevalent, if they had received at least two outpatient diagnoses of AF (ICD10-Code I48.1-) in two different quarters of the year and/or had received at least one main AF diagnosis during inpatient treatment between 1 January 2007 and 12 December 2008. They were considered to have had new onset AF in 2008 under the following conditions; first, there was no AF diagnosis in 2007; secondly, patients had not received oral anticoagulant medication in 2007; and thirdly, patients had received either one inpatient/two outpatient diagnoses of AF in 2008. In our sample, a total of 176 891 patients had AF. AF prevalence was 2.132%. The average age of these AF patients was 73.1 years, and 55.5% (98 190 patients) were male. The incidence of AF in our sample was 4.358 cases/1000 person-years in men and 3.868 cases/1000 person-years in women.ConclusionA comparison of the distribution of AF prevalence/incidence in our population with that in already published studies showed that our figures were higher, especially in the age groups above 70 years. Our data show that in a large industrial nation such as Germany care provision structures are going to be challenged by a requirement to treat more AF patients in the future. © The Author 2012.

Mueller S.,University of Wismar | Agostini H.,Albert Ludwigs University of Freiburg | Ehlken C.,Albert Ludwigs University of Freiburg | Bauer-Steinhusen U.,Bayer AG | And 2 more authors.
Ophthalmology | Year: 2016

Purpose The objective of our study was to investigate preferences of patients with neovascular age-related macular degeneration (nAMD) for different anti-vascular endothelial growth factor (VEGF) treatment schemes. Design We used a discrete choice experiment (DCE) design as part of a telephone interview. Participants Patients with nAMD aged at least 50 years were included in the study. Methods Telephone interviews were done between November 2012 and October 2013. Main Outcome Measures In our DCE survey, we measured patient preferences toward specific levels of attributes that describe different options in the everyday intravitreal injection treatment setting: (1) treatment scheme; (2) change of visual acuity (VA); and (3) time the patient needs for each visit to the eye specialist. Results A total of 284 patients with nAMD with a mean age of 77.4±7.1 years (women: 59.9%) completed the DCE interviews. Of them, 22.9% had poor VA at study inclusion, 54.9% had moderate VA, and 14.1% had good VA; VA was not available for 8.1% of the patients. Generally, patients preferred the attribute levels "improvement in VA" and "short time per specialist visit." The results for the attribute "treatment scheme" were inconclusive because none of the attribute levels (injections every 4 weeks, every 8 weeks, and pro re nata) were associated with statistically significant utility differences. This also mirrors the relative importance of the different attributes in patient decisions: "Change of VA" influenced decision making for a treatment option in 73.6% of cases; "waiting, treatment, and travel time" influenced decision making in 21.0% of cases; and "treatment scheme" influenced decision making for a treatment option in 5.4% of cases. To obtain improved VA instead of a worsening VA, patients in our study stated to be willing to accept a very long time needed per physician visit of 21.2 hours (8.5 hours for improved rather than stable VA and 12.7 hours for stable VA rather than worsening VA). Conclusions To prevent deterioration of VA, patients with nAMD seem to be willing to accept a high treatment burden with regular intravitreal injections at short intervals and long periods of waiting, treatment, and traveling for their consultations. © 2016 by the American Academy of Ophthalmology Published by Elsevier Inc.

Wilke T.,University of Wismar | Groth A.,University of Wismar | Pfannkuche M.,Boehringer Ingelheim | Harks O.,GWQ Serviceplus AG | And 3 more authors.
Journal of Thrombosis and Thrombolysis | Year: 2015

Oral anticoagulation (OAC) with either new oral anticoagulants (NOACs) or Vitamin-K antagonists (VKAs) is recommended by guidelines for patients with atrial fibrillation (AF) and a moderate to high risk of stroke. Based on a claims-based data set the aim of this study was to quantify the stroke-risk dependent OAC utilization profile of German AF patients and possible causes of OAC under-use. Our claims-based data set was derived from two German statutory health insurance funds for the years 2007–2010. All prevalent AF-patients in the period 2007–2009 were included. The OAC-need in 2010 was assumed whenever a CHADS2- or CHA2DS2-VASC-score was >1 and no factor that disfavored OAC use existed. Causes of OAC under-use were analyzed using multivariate logistic regression. 108,632 AF-prevalent patients met the inclusion criteria. Average age was 75.43 years, average CHA2DS2-VASc-score was 4.38. OAC should have been recommended for 56.1/62.9 % of the patients (regarding factors disfavouring VKA/NOAC use). For 38.88/39.20 % of the patient-days in 2010 we could not observe any coverage by anticoagulants. Dementia of patients (OR 2.656) and general prescription patterns of the treating physician (OR 1.633) were the most important factors increasing the risk of OAC under-use. Patients who had consulted a cardiologist had a lower risk of being under-treated with OAC (OR 0.459). OAC under-use still seems to be one of the major challenges in the real-life treatment of AF patients. Our study confirms that both patient/disease characteristics and treatment environment/general prescribing behaviour of physicians may explain the OAC under-use in AF patients. © 2014, Springer Science+Business Media New York.

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