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Impact of atrial fibrillation on productivity in working-age patients: an analysis of Swiss-AF prospective cohort study data.
IF 2.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-02 DOI: 10.57187/s.3669
Helena Aebersold, Fabienne Foster-Witassek, Sina Amberg, Miquel Serra-Burriel, Giorgio Moschovitis, Raffaele Zannoni, Stefanie Aeschbacher, Giulio Conte, Jürg H Beer, Eva Blozik, Leo H Bonati, David Conen, Stefan Felder, Moa L Haller, Philipp Krisai, Michael Kühne, Rebecca E Paladini, Tobias Reichlin, Nicolas Rodondi, Christian Sticherling, Thomas Szucs, Yuki Tomonaga, Stefan Osswald, Matthias Schwenkglenks

Aims: We aimed to explore atrial fibrillation (AF)-induced productivity losses in working-age atrial fibrillation patients and to estimate atrial fibrillation-related indirect costs.

Methods: Between 2014 and 2017, the Swiss Atrial Fibrillation prospective cohort study (Swiss-AF) enrolled 217 working-age patients with documented atrial fibrillation. Self-reported changes in professional activity and the reasons thereof were descriptively analysed over 8 years of follow-up or until patients reached the retirement age. Results were put into perspective, and indirect costs were planned to be estimated, through comparison with a general population-based, age-, sex- and year-matched comparison sample from the Swiss labour force survey (SLFS).

Results: Of 217 analysed Swiss-AF patients, 14.7% reported a professional activity change (9.2% stop, 5.5% reduction) due to atrial fibrillation before the end of observation. Of those working at enrolment (n = 157), 3.8% had a subsequent professional activity change due to atrial fibrillation, 11.6% due to other reasons. Patients were more likely to report an impact of atrial fibrillation on professional activity if they had had atrial fibrillation longer and were closer to the retirement age. Slightly fewer Swiss-AF patients were employed (75%) than in the comparison sample (77%). For those working however, the degree of employment was higher (88% vs 83%). Lack of differences between the Swiss-AF patients and the comparison sample indicated no relevant indirect costs of atrial fibrillation due to lost productivity.

Conclusion: Only a minority of atrial fibrillation patients reported a negative impact of atrial fibrillation on their professional activity. Professional activity changes due to other reasons were reported more frequently. Compared with the general population, atrial fibrillation did not cause distinct differences.

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引用次数: 0
SAFEty assessment of a REdirection process after TRIage (SAFE RETRI) by a triage nurse in an emergency department: a monocentric cohort study.
IF 2.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-20 DOI: 10.57187/s.4030
Alexandre Déglise, Youcef Guechi, Christophe Le Terrier, Vincent Ribordy, Anne-Laure Feral-Pierssens, Thomas Schmutz

Aims of the study: As emergency department consultations rise across Europe, patients must be guided to obtain appropriate care at the right time and place.In Switzerland, the absence of a unique health number that would enable the avoidance of emergency services through telephone medical advice, and the shortage of general practitioners, redirecting low-severity patients from the emergency department before medical consultation to other healthcare facilities could help reduce emergency department overload. This study assessed the safety of a newly implemented redirection process by examining the rate of unexpected returns to any healthcare facility.

Methods: This monocentric cohort study included patients aged 18 or older who presented to the emergency department of a regional hospital in Switzerland between 1 January and 31 May 2023 and who accepted redirection before medical consultation. Patients were identified from our electronic medical registry and retrospectively enrolled after telephone interviews. The primary outcome was the rate of unexpected returns to any healthcare facility within 2 days of redirection. The secondary outcomes were the rate of returns within 7 days, hospital admissions, and patient satisfaction.

Results: Among 16,362 patients who came to the emergency department during the study period, 688 (4%) were redirected. A total of 321 patients were included in the final analysis after telephone interviews. The rate of unexpected returns to any healthcare facility after redirection was 4% within 2 days and 16% within 7 days. The rate of returns to any hospital was 1.2% within 2 days and 4.7% within 7 days after redirection. Six patients (2%) required hospitalisation, and no fatalities were reported. The mean satisfaction score was 3.9/5 (standard deviation [SD] = 1.1) for triage experience, 4.4/5 (SD = 1) for care received in partner clinics, and 3.7/5 (SD = 1) for the redirection process.

Conclusion: The rate of unexpected returns to any healthcare facility after redirection was 4% within 2 days and 16% within 7 days. The implementation of this protocol appeared to provide safe redirection to nearby clinics for redirected low-acuity patients. Satisfaction with care received in partner clinics was high, although it was lower for the redirection process and triage experience.

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引用次数: 0
Economic evaluation in the treatment of unruptured intracranial aneurysms in the Swiss healthcare system: a retrospective cost evaluation. 瑞士医疗系统治疗颅内未破裂动脉瘤的经济评估:回顾性成本评估。
IF 2.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-10 DOI: 10.57187/s.3727
Ulf C Schneider, Stephan Bohlhalter, Florian Wüthrich, Dirk Lehnick, Alexander Von Hessling

The choice of modality of treatment for unruptured intracranial aneurysms is based on various clinical aspects and the patient's preference. Financial considerations should not be among these. To evaluate any financial variations between endovascular and microsurgical treatment of unruptured intracranial aneurysms in the Swiss healthcare system, we retrospectively reviewed 100 consecutive aneurysm cases treated as inpatients in our institution. Case-based financial data were collected (revenues, costs, net earnings) and compared between the treatments. Among 100 consecutive aneurysm cases treated at our institution (2021-2023), 58 were unruptured intracranial aneurysm. Treatment was endovascular in 33, microsurgery in 23 and conservative/antibiotic in 2 cases. Length of stay (but not duration in the intensive care unit) was longer after microsurgical treatment. Total median revenues (public insurance, private insurance, material reimbursement) were Swiss Francs (CHF) 30,012.25 with a maximum of CHF 125,337.20 and a minimum of CHF 9543.25. No marked difference was found between the treatment groups (endovascular and microsurgery). Despite the fact that median net earnings per patient were positive (CHF 3655.03), more than one third of all cases led to a net loss for the hospital with a tendency for more stable net earnings in microsurgery cases. The only factor associated with a higher risk of net loss per case was higher implant costs in endovascular cases. Reimbursement within the Swiss healthcare system does not promote financial bias for decision-making in treatment modality for unruptured intracranial aneurysm. The fact that one third of all cases does not result in positive net earnings (even in the highly paid unruptured intracranial aneurysm sector), although overall net earnings were positive, should be monitored - especially in times of rising costs.

颅内未破裂动脉瘤的治疗方式的选择是基于各种临床方面和患者的偏好。财政方面的考虑不应该是其中之一。为了评估瑞士医疗系统中血管内和显微手术治疗未破裂颅内动脉瘤之间的经济差异,我们回顾性分析了我院连续治疗的100例动脉瘤病例。收集了基于病例的财务数据(收入、成本、净收入),并对两种治疗方法进行了比较。在我院(2021-2023)连续治疗的100例动脉瘤病例中,58例为未破裂的颅内动脉瘤。血管内治疗33例,显微手术治疗23例,保守+抗生素治疗2例。显微外科治疗后患者的住院时间(但不是在重症监护病房的时间)更长。总收入中位数(公共保险、私人保险、材料报销)为30,012.25瑞士法郎(CHF),最高为125,337.20瑞士法郎,最低为9543.25瑞士法郎。两组间(血管内和显微手术)无明显差异。尽管每位患者的净收益中位数为正(3655.03瑞士法郎),但超过三分之一的病例导致医院净亏损,显微外科病例的净收益趋于稳定。与每个病例净损失风险较高相关的唯一因素是在血管内病例中较高的植入费用。瑞士医疗保健系统内的报销不会促进未破裂颅内动脉瘤治疗方式决策的财务偏见。尽管总体净利润为正,但有三分之一的病例(即使在收入较高的未破裂颅内动脉瘤领域)没有带来正净利润,这一事实应该受到关注——尤其是在成本上升的时期。
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引用次数: 0
Improving sex and gender equity in research protocols: the new SAGER-swissethics recommendations. 改善研究方案中的性别和性别平等:新的sage -瑞士伦理建议。
IF 2.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-09 DOI: 10.57187/s.4051
Angèle Gayet-Ageron, Carole Clair, Joëlle Schwarz, Shirin Heidari, Emilie Bovet, Raphaël Bize, Petra Stute, David Nadal, Annette Magnin, Nicole Kalberer, Pierre-André Michaud

No abstract available.

没有摘要。
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引用次数: 0
Patient and public involvement in academic clinical research in Switzerland - a mixed methods study. 患者和公众参与学术临床研究在瑞士-混合方法研究。
IF 2.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-06 DOI: 10.57187/s.3563
Deborah Eberle, Annina Bauer, Cordula Landgraf, Joëlle Roos, Regina Grossmann

Background: While patient and public involvement (PPI) in clinical research contributes substantially to research ethics, feasibility and quality, the uptake and implementation of PPI-based approaches in Switzerland remain unknown. This study aimed to evaluate the current state and acceptance of PPI in academic clinical research in Switzerland, with the goal of developing recommendations for its future implementation and development.

Methods: A sequential explanatory mixed-methods study was conducted to assess the current landscape and acceptance of PPI in academic clinical research across different stakeholder groups in Switzerland. The groups were "Patients and Public", "Researchers", "Staff Members of Academic Research Infrastructure (ARI)" and representatives from "Regulatory and Funding Bodies". Data was collected through a combination of surveys and semi-structured interviews. The survey results were analysed descriptively, while interview data was analysed qualitatively. The results were further synthesised into a SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis.

Results:  A total of 123 survey responses were collected.Surveys revealed great support and acceptance for PPI in academic clinical research in Switzerland across all stakeholder groups. Despite this support, several challenges were identified, including gaps in training, limited funding opportunities and insufficient infrastructure to facilitate PPI.

Conclusion: The current framework for PPI in Switzerland is in an early stage of development. A joint effort by all stakeholders is needed to catch up with international progress to reach high-level ethical and quality standards. A basic framework for PPI in academic clinical research in Switzerland should be implemented, including guidelines for qualification and collaboration, best practices as well as widespread information for patients, the public and researchers. Further needed are training opportunities in "PPI in clinical research" for all stakeholders as well as sustainable sources of funding.

背景:虽然临床研究中的患者和公众参与(PPI)对研究伦理、可行性和质量做出了重大贡献,但在瑞士,基于PPI的方法的吸收和实施仍然未知。本研究旨在评估瑞士学术临床研究中PPI的现状和接受程度,目的是为其未来的实施和发展提出建议。方法:进行了一项顺序解释性混合方法研究,以评估瑞士不同利益相关者群体在学术临床研究中PPI的现状和接受程度。这些小组分别是“患者和公众”、“研究人员”、“学术研究基础设施(ARI)的工作人员”和“监管和资助机构”的代表。数据是通过调查和半结构化访谈相结合的方式收集的。对调查结果进行描述性分析,对访谈数据进行定性分析。结果进一步合成为SWOT(优势,劣势,机会和威胁)分析。结果:共收集调查问卷123份。调查显示,在瑞士所有利益相关者群体的学术临床研究中,PPI得到了极大的支持和接受。尽管有这些支持,但仍发现了一些挑战,包括培训差距、资金机会有限以及促进PPI的基础设施不足。结论:目前瑞士的PPI框架尚处于早期发展阶段。需要所有利益攸关方共同努力,以赶上国际进展,达到高水平的道德和质量标准。应该在瑞士实施临床学术研究中PPI的基本框架,包括资格和合作指南、最佳实践以及为患者、公众和研究人员提供广泛的信息。进一步需要的是为所有利益攸关方提供“临床研究中的PPI”培训机会,以及可持续的资金来源。
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引用次数: 0
Self-reported perceptions of adults with diabetes regarding their care and health in the time of COVID-19 pandemic in a Swiss region: a cross-sectional study. 瑞士地区2019冠状病毒病大流行期间糖尿病成年人自我报告对其护理和健康的看法:一项横断面研究
IF 2.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-05 DOI: 10.57187/s.3578
Christophe Kosinski, Emilie Zuercher, Tania Carron, Julie Chevallereau, Marie-Annick Le Pogam, Chiara Storari, Anne Wojtusciszyn, Isabelle Peytremann-Bridevaux

Aim: To assess the perceptions of adults with diabetes regarding their care and health during the COVID-19 pandemic in the canton of Vaud, Switzerland.

Methods: Cross-sectional data was analysed from the 2021 follow-up questionnaire of the CoDiab-VD survey, a cohort of adults living with diabetes in the canton of Vaud. Various aspects of diabetes care and issues relating to the COVID-19 pandemic were assessed. Descriptive analyses were conducted to detail access to care, self-management, and psychosocial burden during the pandemic. Regression analyses were then performed to explore the relationship between these domains and factors associated with COVID-19 outcomes.

Results: Respondents (n = 566; 79%) had a mean age of 70 years (range: 22-94), and most had type 2 diabetes (73%). The COVID-19 pandemic did not appear to have strongly affected their care. Indeed, access to diabetes care remained similar to before the pandemic: only 10% of respondents reported having diabetes-related care postponed or cancelled. While 16% experienced increased difficulty in managing physical activity, the majority were able to continue diabetes self-management, with minimal changes in glucose control. In terms of psychosocial burden, only 33% expressed high levels of worry about the pandemic.

Conclusion: Diabetes self-management, glucose control, and access to diabetes care were not severely affected for the CoDiab-VD cohort during the COVID-19 pandemic. Despite some reported postponements in care and increased difficulty in physical activity management, the majority maintained their diabetes management practices with minimal impact on glucose control. Overall, psychosocial worry about the pandemic was relatively low, highlighting the resilience of individuals in managing their diabetes despite challenging circumstances.

Clinicaltrials: gov number: NCT01902043.

目的:评估瑞士沃州成人糖尿病患者在2019冠状病毒病大流行期间对其护理和健康的看法。方法:横断面数据分析来自2021年codiabd - vd调查的随访问卷,这是一组沃州患有糖尿病的成年人。评估了糖尿病护理的各个方面以及与COVID-19大流行相关的问题。对大流行期间获得护理、自我管理和心理社会负担的详细情况进行了描述性分析。然后进行回归分析,探讨这些域与COVID-19结局相关因素之间的关系。结果:调查对象(n = 566;79%)平均年龄为70岁(范围:22-94),大多数患有2型糖尿病(73%)。COVID-19大流行似乎并未严重影响他们的护理。事实上,获得糖尿病护理的情况与大流行之前类似:只有10%的答复者报告推迟或取消了与糖尿病有关的护理。虽然16%的人在管理身体活动方面遇到了困难,但大多数人能够继续进行糖尿病自我管理,血糖控制变化很小。在社会心理负担方面,只有33%的人对大流行表示高度担忧。结论:在COVID-19大流行期间,codiabd - vd队列的糖尿病自我管理、血糖控制和糖尿病护理可及性没有受到严重影响。尽管有报道称一些患者推迟了治疗,增加了身体活动管理的难度,但大多数患者仍坚持他们的糖尿病管理方法,对血糖控制的影响最小。总体而言,对大流行的社会心理担忧相对较低,这突显了个人在面临挑战的情况下管理糖尿病的韧性。临床试验:政府编号:NCT01902043。
{"title":"Self-reported perceptions of adults with diabetes regarding their care and health in the time of COVID-19 pandemic in a Swiss region: a cross-sectional study.","authors":"Christophe Kosinski, Emilie Zuercher, Tania Carron, Julie Chevallereau, Marie-Annick Le Pogam, Chiara Storari, Anne Wojtusciszyn, Isabelle Peytremann-Bridevaux","doi":"10.57187/s.3578","DOIUrl":"https://doi.org/10.57187/s.3578","url":null,"abstract":"<p><strong>Aim: </strong>To assess the perceptions of adults with diabetes regarding their care and health during the COVID-19 pandemic in the canton of Vaud, Switzerland.</p><p><strong>Methods: </strong>Cross-sectional data was analysed from the 2021 follow-up questionnaire of the CoDiab-VD survey, a cohort of adults living with diabetes in the canton of Vaud. Various aspects of diabetes care and issues relating to the COVID-19 pandemic were assessed. Descriptive analyses were conducted to detail access to care, self-management, and psychosocial burden during the pandemic. Regression analyses were then performed to explore the relationship between these domains and factors associated with COVID-19 outcomes.</p><p><strong>Results: </strong>Respondents (n = 566; 79%) had a mean age of 70 years (range: 22-94), and most had type 2 diabetes (73%). The COVID-19 pandemic did not appear to have strongly affected their care. Indeed, access to diabetes care remained similar to before the pandemic: only 10% of respondents reported having diabetes-related care postponed or cancelled. While 16% experienced increased difficulty in managing physical activity, the majority were able to continue diabetes self-management, with minimal changes in glucose control. In terms of psychosocial burden, only 33% expressed high levels of worry about the pandemic.</p><p><strong>Conclusion: </strong>Diabetes self-management, glucose control, and access to diabetes care were not severely affected for the CoDiab-VD cohort during the COVID-19 pandemic. Despite some reported postponements in care and increased difficulty in physical activity management, the majority maintained their diabetes management practices with minimal impact on glucose control. Overall, psychosocial worry about the pandemic was relatively low, highlighting the resilience of individuals in managing their diabetes despite challenging circumstances.</p><p><strong>Clinicaltrials: </strong>gov number: NCT01902043.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3578"},"PeriodicalIF":2.1,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Family planning, reproductive health and pregnancy after bariatric surgery: a survey of bariatric healthcare professionals in Switzerland.
IF 2.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-04 DOI: 10.57187/s.3841
Ioannis I Lazaridis, Sofya Lukovnikova, Georgios Peros, Andreas Andreou, Diana Mattiello, Thomas Köstler, Dimitrios Schizas, Urs Zingg, Claudia Cavelti-Weder, Tarik Delko

Aims: A wide range of reproductive health issues, including fertility, pregnancy outcomes and contraceptive practices can be affected by morbid obesity and weight loss subsequent to bariatric surgery. This study aimed to explore the attitudes and practices of bariatric healthcare professionals in Switzerland regarding reproductive health counselling in the context of bariatric surgery.

Methods: We conducted a national, cross-sectional, 36-question online survey among bariatric professionals in Switzerland. Survey topics included demographic factors, baseline characteristics of bariatric patients, perioperative reproductive health practices, attitudes and knowledge about contraception and recommendations regarding pregnancy. The survey was open from 1 October 2022 to 30 April 2023.

Results: A total of 75 healthcare professionals participated in the survey. The majority of participants responded that female patients of reproductive age constitute more than half of the referred bariatric patients. Forty participants (57%) recommended contraception for a duration of 18-24 months following a bariatric operation. Only twenty-three respondents (31%) stated that they always refer their female bariatric patients of reproductive age to a gynaecologist prior to bariatric surgery. Fifty-six participants (75%) replied that they always discuss family planning prior to surgery. There was high variation regarding the recommended methods of contraception after surgery.Only thirty-nine participants (52%) reported that they always inform their patients about the occurrence of possible surgery-related complications during future pregnancies. More than half of the participants reported inadequate knowledge regarding absorption and safety of contraceptive pills after bariatric surgery. Although most professionals routinely follow up and provide counselling on maternal and foetal risks in pregnant women with previous bariatric surgery, forty-nine participants (65%) have no standardised protocol for such patients who present with acute abdominal pain in their practice.

Conclusion: Despite acknowledging the importance of reproductive health counselling, bariatric professionals address perioperative and contraception issues inconsistently and mostly reported a lack of adequate knowledge in the latter. Therefore, a stronger collaboration between bariatric professionals and women's healthcare providers is needed to improve care of female bariatric patients of reproductive age.

{"title":"Family planning, reproductive health and pregnancy after bariatric surgery: a survey of bariatric healthcare professionals in Switzerland.","authors":"Ioannis I Lazaridis, Sofya Lukovnikova, Georgios Peros, Andreas Andreou, Diana Mattiello, Thomas Köstler, Dimitrios Schizas, Urs Zingg, Claudia Cavelti-Weder, Tarik Delko","doi":"10.57187/s.3841","DOIUrl":"https://doi.org/10.57187/s.3841","url":null,"abstract":"<p><strong>Aims: </strong>A wide range of reproductive health issues, including fertility, pregnancy outcomes and contraceptive practices can be affected by morbid obesity and weight loss subsequent to bariatric surgery. This study aimed to explore the attitudes and practices of bariatric healthcare professionals in Switzerland regarding reproductive health counselling in the context of bariatric surgery.</p><p><strong>Methods: </strong>We conducted a national, cross-sectional, 36-question online survey among bariatric professionals in Switzerland. Survey topics included demographic factors, baseline characteristics of bariatric patients, perioperative reproductive health practices, attitudes and knowledge about contraception and recommendations regarding pregnancy. The survey was open from 1 October 2022 to 30 April 2023.</p><p><strong>Results: </strong>A total of 75 healthcare professionals participated in the survey. The majority of participants responded that female patients of reproductive age constitute more than half of the referred bariatric patients. Forty participants (57%) recommended contraception for a duration of 18-24 months following a bariatric operation. Only twenty-three respondents (31%) stated that they always refer their female bariatric patients of reproductive age to a gynaecologist prior to bariatric surgery. Fifty-six participants (75%) replied that they always discuss family planning prior to surgery. There was high variation regarding the recommended methods of contraception after surgery.Only thirty-nine participants (52%) reported that they always inform their patients about the occurrence of possible surgery-related complications during future pregnancies. More than half of the participants reported inadequate knowledge regarding absorption and safety of contraceptive pills after bariatric surgery. Although most professionals routinely follow up and provide counselling on maternal and foetal risks in pregnant women with previous bariatric surgery, forty-nine participants (65%) have no standardised protocol for such patients who present with acute abdominal pain in their practice.</p><p><strong>Conclusion: </strong>Despite acknowledging the importance of reproductive health counselling, bariatric professionals address perioperative and contraception issues inconsistently and mostly reported a lack of adequate knowledge in the latter. Therefore, a stronger collaboration between bariatric professionals and women's healthcare providers is needed to improve care of female bariatric patients of reproductive age.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3841"},"PeriodicalIF":2.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advancements in lung cancer: a comprehensive perspective on diagnosis, staging, therapy and follow-up from the SAKK Working Group on Imaging in Diagnosis and Therapy Monitoring. 肺癌的进展:SAKK诊断和治疗监测影像工作组对诊断、分期、治疗和随访的综合看法。
IF 2.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-02 DOI: 10.57187/s.3843
Lisa Jungblut, Stefania Maria Rizzo, Lukas Ebner, Adrian Kobe, Thi Dan Linh Nguyen-Kim, Katharina Martini, Justus Roos, Carla Puligheddu, Ali Afshar-Oromieh, Andreas Christe, Patrick Dorn, Manuela Funke-Chambour, Andreas Hötker, Thomas Frauenfelder

In 2015, around 4400 individuals received a diagnosis of lung cancer, and Switzerland recorded approximately 3200 deaths related to lung cancer. Advances in detection, such as lung cancer screening and improved treatments, have led to increased identification of early-stage lung cancer and higher chances of long-term survival. This progress has introduced new considerations in imaging, emphasising non-invasive diagnosis and characterisation techniques like radiomics. Treatment aspects, such as preoperative assessment and the implementation of immune response evaluation criteria in solid tumours (iRECIST), have also seen advancements. For those undergoing curative treatment for lung cancer, guidelines propose follow-up with computed tomography (CT) scans within a specific timeframe. However, discrepancies exist in published guidelines, and there is a lack of universally accepted recommendations for follow-up procedures. This white paper aims to provide a certain standard regarding the use of imaging on the diagnosis, staging, treatment and follow-up of patients with lung cancer.

2015年,约有4400人被诊断为肺癌,瑞士记录的与肺癌相关的死亡人数约为3200人。检测方面的进步,如肺癌筛查和治疗方法的改进,增加了对早期肺癌的识别,提高了长期生存的机会。这一进展引入了影像学的新考虑,强调非侵入性诊断和特征技术,如放射组学。治疗方面,如术前评估和实体瘤免疫反应评价标准(iRECIST)的实施,也取得了进展。对于正在接受根治性治疗的肺癌患者,指南建议在特定的时间框架内进行计算机断层扫描(CT)随访。然而,出版的指南中存在差异,并且缺乏普遍接受的后续程序建议。本白皮书旨在为影像学在肺癌患者的诊断、分期、治疗和随访方面的应用提供一定的标准。
{"title":"Advancements in lung cancer: a comprehensive perspective on diagnosis, staging, therapy and follow-up from the SAKK Working Group on Imaging in Diagnosis and Therapy Monitoring.","authors":"Lisa Jungblut, Stefania Maria Rizzo, Lukas Ebner, Adrian Kobe, Thi Dan Linh Nguyen-Kim, Katharina Martini, Justus Roos, Carla Puligheddu, Ali Afshar-Oromieh, Andreas Christe, Patrick Dorn, Manuela Funke-Chambour, Andreas Hötker, Thomas Frauenfelder","doi":"10.57187/s.3843","DOIUrl":"https://doi.org/10.57187/s.3843","url":null,"abstract":"<p><p>In 2015, around 4400 individuals received a diagnosis of lung cancer, and Switzerland recorded approximately 3200 deaths related to lung cancer. Advances in detection, such as lung cancer screening and improved treatments, have led to increased identification of early-stage lung cancer and higher chances of long-term survival. This progress has introduced new considerations in imaging, emphasising non-invasive diagnosis and characterisation techniques like radiomics. Treatment aspects, such as preoperative assessment and the implementation of immune response evaluation criteria in solid tumours (iRECIST), have also seen advancements. For those undergoing curative treatment for lung cancer, guidelines propose follow-up with computed tomography (CT) scans within a specific timeframe. However, discrepancies exist in published guidelines, and there is a lack of universally accepted recommendations for follow-up procedures. This white paper aims to provide a certain standard regarding the use of imaging on the diagnosis, staging, treatment and follow-up of patients with lung cancer.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3843"},"PeriodicalIF":2.1,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sociodemographic and regional differences in neonatal and infant mortality in Switzerland in 2011-2018: the Swiss National Cohort. 2011-2018年瑞士新生儿和婴儿死亡率的社会人口统计学和地区差异:瑞士国家队列。
IF 2.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-28 DOI: 10.57187/s.3682
Veronika W Skrivankova, Leonie D Schreck, Claudia Berlin, Radoslaw Panczak, Kaspar Staub, Marcel Zwahlen, Sven M Schulzke, Matthias Egger, Claudia E Kuehni
<p><strong>Background and aims: </strong>Despite a well-funded healthcare system with universal insurance coverage, Switzerland has one of the highest neonatal and infant mortality rates among high-income countries. Identifying avoidable risk factors targeted by evidence-based policies is a public health priority. We describe neonatal and infant mortality in Switzerland from 2011 to 2018 and explore associations with neonatal- and pregnancy-related variables, parental sociodemographic information, regional factors and socioeconomic position (SEP) using data from a long-term nationwide cohort study.</p><p><strong>Methods: </strong>We included 680,077 live births, representing 99.3% of all infants born in Switzerland between January 2011 and December 2018. We deterministically linked the national live birth register with the mortality register and with census and survey data to create a longitudinal dataset of neonatal- and pregnancy-related variables; parental sociodemographic information, such as civil status, age, religion, education, nationality; regional factors, such as urbanity, language region; and the Swiss neighbourhood index of socioeconomic position (Swiss-SEP index). Information on maternal education was available for a random subset of 242,949 infants. We investigated associations with neonatal and infant mortality by fitting multivariable Poisson regression models with robust standard errors. Several sensitivity analyses assessed the robustness of our findings.</p><p><strong>Results: </strong>Overall, neonatal mortality rates between 2011 and 2018 were 3.0 per 1000 live births, with regional variations: 3.2 in German-speaking, 2.4 in French-speaking and 2.1 in Italian-speaking Switzerland. For infant mortality, the rates were 3.7 per 1000 live births overall, and 3.9 in the German-speaking, 3.3 in the French-speaking and 2.9 in the Italian-speaking region. After adjusting for sex, maternal age, multiple birth and birth rank, neonatal mortality remained significantly associated with language region (adjusted rate ratio [aRR] 0.72, 95% confidence interval [CI]: 0.64-0.80 for the French-speaking region and aRR 0.66, 95% CI: 0.51-0.87 for the Italian-speaking region vs German-speaking region), with marital status (aRR 1.55, 95% CI: 1.40-1.71 for unmarried vs married), nationality (aRR 1.40, 95% CI: 1.21-1.62 for non-European Economic Area vs Swiss) and the Swiss-SEP index (aRR 1.17, 95% CI: 1.00-1.36 for lowest vs highest SEP quintile). In the subset, we showed a possible association of neonatal mortality with maternal education (aRR 1.24, 95% CI: 0.95-1.61 for compulsory vs tertiary education).</p><p><strong>Conclusion: </strong>We provide detailed evidence about the social patterning of neonatal and infant mortality in Switzerland and reveal important regional differences with about 30% lower risks in French- and Italian-speaking compared with German-speaking regions. Underlying causes for such regional differences, such as cultural, l
背景和目的:尽管瑞士拥有资金充足的医疗保健系统和全民保险,但瑞士仍是高收入国家中新生儿和婴儿死亡率最高的国家之一。确定以证据为基础的政策所针对的可避免的风险因素是一项公共卫生优先事项。我们描述了2011年至2018年瑞士新生儿和婴儿死亡率,并利用一项长期全国队列研究的数据,探讨了新生儿和妊娠相关变量、父母社会人口统计信息、地区因素和社会经济地位(SEP)之间的关系。方法:我们纳入了680,077例活产婴儿,占2011年1月至2018年12月在瑞士出生的所有婴儿的99.3%。我们确定地将全国活产登记与死亡率登记以及人口普查和调查数据联系起来,以创建新生儿和妊娠相关变量的纵向数据集;父母的社会人口信息,如公民身份、年龄、宗教、教育程度、国籍;地域因素,如城市程度、语言地域等;瑞士社会经济地位邻里指数(Swiss- sep index)。对随机抽取的242,949名婴儿提供了关于产妇教育的资料。我们通过拟合具有稳健标准误差的多变量泊松回归模型来研究与新生儿和婴儿死亡率的关系。一些敏感性分析评估了我们研究结果的稳健性。结果:总体而言,2011年至2018年期间,新生儿死亡率为每1000例活产3.0例,地区差异为:德语区为3.2例,法语区为2.4例,意大利语区为2.1例。婴儿死亡率为每1000名活产3.7人,德语地区为3.9人,法语地区为3.3人,意大利语地区为2.9人。在对性别、产妇年龄、多胎分娩和出生等级进行调整后,新生儿死亡率仍与语言地区(法语地区的调整率比[aRR] 0.72, 95%可信区间[CI]: 0.64-0.80,意大利语地区与德语地区的调整率比[aRR] 0.66, 95%可信区间[CI]: 0.51-0.87)、婚姻状况(aRR 1.55,未婚vs已婚95% CI: 1.40-1.71)、国籍(aRR 1.40, 95% CI:非欧洲经济区与瑞士的比值为1.21-1.62)和瑞士-SEP指数(最低与最高SEP五分位数的比值为1.17,95% CI: 1.00-1.36)。在这个子集中,我们发现新生儿死亡率可能与母亲教育有关(义务教育与高等教育的aRR为1.24,95% CI为0.95-1.61)。结论:我们提供了关于瑞士新生儿和婴儿死亡率的社会模式的详细证据,并揭示了重要的地区差异,法语和意大利语地区的风险比德语地区低约30%。造成这种地区差异的根本原因,如文化、生活方式或保健相关因素,值得进一步探讨,以便为公共卫生政策提供信息和证据基础。
{"title":"Sociodemographic and regional differences in neonatal and infant mortality in Switzerland in 2011-2018: the Swiss National Cohort.","authors":"Veronika W Skrivankova, Leonie D Schreck, Claudia Berlin, Radoslaw Panczak, Kaspar Staub, Marcel Zwahlen, Sven M Schulzke, Matthias Egger, Claudia E Kuehni","doi":"10.57187/s.3682","DOIUrl":"https://doi.org/10.57187/s.3682","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aims: &lt;/strong&gt;Despite a well-funded healthcare system with universal insurance coverage, Switzerland has one of the highest neonatal and infant mortality rates among high-income countries. Identifying avoidable risk factors targeted by evidence-based policies is a public health priority. We describe neonatal and infant mortality in Switzerland from 2011 to 2018 and explore associations with neonatal- and pregnancy-related variables, parental sociodemographic information, regional factors and socioeconomic position (SEP) using data from a long-term nationwide cohort study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We included 680,077 live births, representing 99.3% of all infants born in Switzerland between January 2011 and December 2018. We deterministically linked the national live birth register with the mortality register and with census and survey data to create a longitudinal dataset of neonatal- and pregnancy-related variables; parental sociodemographic information, such as civil status, age, religion, education, nationality; regional factors, such as urbanity, language region; and the Swiss neighbourhood index of socioeconomic position (Swiss-SEP index). Information on maternal education was available for a random subset of 242,949 infants. We investigated associations with neonatal and infant mortality by fitting multivariable Poisson regression models with robust standard errors. Several sensitivity analyses assessed the robustness of our findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, neonatal mortality rates between 2011 and 2018 were 3.0 per 1000 live births, with regional variations: 3.2 in German-speaking, 2.4 in French-speaking and 2.1 in Italian-speaking Switzerland. For infant mortality, the rates were 3.7 per 1000 live births overall, and 3.9 in the German-speaking, 3.3 in the French-speaking and 2.9 in the Italian-speaking region. After adjusting for sex, maternal age, multiple birth and birth rank, neonatal mortality remained significantly associated with language region (adjusted rate ratio [aRR] 0.72, 95% confidence interval [CI]: 0.64-0.80 for the French-speaking region and aRR 0.66, 95% CI: 0.51-0.87 for the Italian-speaking region vs German-speaking region), with marital status (aRR 1.55, 95% CI: 1.40-1.71 for unmarried vs married), nationality (aRR 1.40, 95% CI: 1.21-1.62 for non-European Economic Area vs Swiss) and the Swiss-SEP index (aRR 1.17, 95% CI: 1.00-1.36 for lowest vs highest SEP quintile). In the subset, we showed a possible association of neonatal mortality with maternal education (aRR 1.24, 95% CI: 0.95-1.61 for compulsory vs tertiary education).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;We provide detailed evidence about the social patterning of neonatal and infant mortality in Switzerland and reveal important regional differences with about 30% lower risks in French- and Italian-speaking compared with German-speaking regions. Underlying causes for such regional differences, such as cultural, l","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"154 ","pages":"3682"},"PeriodicalIF":2.1,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Estimating the burden of disease attributable to non-assisted suicide in Switzerland from 2009 to 2021: a secondary data analysis. 估计2009年至2021年瑞士非协助自杀导致的疾病负担:二级数据分析。
IF 2.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-25 DOI: 10.57187/s.3522
Annora Mack, Sarah Rajkumar, Jacob Kofler, Kaspar Wyss
<p><strong>Context and goal: </strong>This research addresses the issue of suicide and attempted suicide, which have a significant impact on global premature mortality and disability. Particularly noteworthy is the prevalence among adolescents, in whom suicide ranks among the top four causes of death according to the World Health Organization (WHO). In Switzerland, suicide has remained the leading cause of death in individuals under 50 since 1990. At the same time, the burden of attempted suicides remains poorly understood. Although the legality of assisted suicide in Switzerland influences the overall suicide data, this analysis focuses solely on non-assisted suicides, as they are relevant for accurately assessing the burden of disease of suicide and attempted suicide. Amid challenges posed by limited reporting infrastructure, this analysis aims to contribute to the existing literature by investigating the cumulative impact of non-assisted suicide and attempted suicide on the population living in Switzerland.</p><p><strong>Methodology: </strong>Pre-existing data from 2009 to 2021 were collected and analysed, drawing from a variety of sources including official health records from the federal offices of statistics and public health, surveys and retrospective studies. From this data, years of life lost (YLLs), years lived with disability (YLDs) and disability-adjusted life-years (DALYs) were calculated in order to estimate the burden of disease. Sensitivity analyses were conducted to determine the robustness of the data and the effect of variables (suicide attempt incidence, sex distribution, disability weight, average duration) on the DALYs.</p><p><strong>Results: </strong>The analysis of the data spanning from 2009 to 2021 revealed a decrease in suicide. The present study determined that, in 2021, 32,771 DALYs were attributable to non-assisted suicide and attempted suicide and 6.4% of all years of life lost (n = 30,516) were attributable to suicide, not including assisted suicide. Using a reference incidence of 33,000 attempted suicides per year in Switzerland, the morbidity associated with attempted suicides was 2255 YLDs (range: 552-6557 YLDs). Further analysis of the data highlighted a stark sex gap in the prevalence of non-assisted suicide: male suicides account for around 2% of all male deaths, whereas female suicides account for approximately 0.8% of all female deaths. Sensitivity analyses found that incidence and sex distribution of attempted suicide were the most impactful factors, while disability weights and average duration of disability had little impact on the variation in YLD estimates.</p><p><strong>Conclusion: </strong>In conclusion, this study provides a detailed analysis of the burden of non-assisted suicide and attempted suicide in Switzerland. With non-assisted suicide accounting for 6.4% of all years of life lost and 30% of deaths in people aged 20-24 in Switzerland in 2021, it emerges that suicide contributes significantly
背景和目的:本研究探讨了自杀和自杀未遂问题,这对全球过早死亡和残疾有重大影响。特别值得注意的是自杀在青少年中的流行,根据世界卫生组织(卫生组织)的统计,自杀是青少年死亡的四大原因之一。在瑞士,自1990年以来,自杀一直是50岁以下个人死亡的主要原因。与此同时,人们对企图自杀的负担仍然知之甚少。尽管瑞士协助自杀的合法性影响了总体自杀数据,但本分析仅侧重于非协助自杀,因为它们与准确评估自杀和企图自杀的疾病负担有关。在有限的报告基础设施所带来的挑战中,本分析旨在通过调查非辅助自杀和自杀未遂对居住在瑞士的人口的累积影响,为现有文献做出贡献。方法:收集和分析了2009年至2021年的已有数据,这些数据来自各种来源,包括联邦统计局和公共卫生部的官方健康记录、调查和回顾性研究。根据这些数据,计算生命损失年数(YLLs)、残疾生活年数(YLDs)和残疾调整生命年(DALYs),以估计疾病负担。进行敏感性分析以确定数据的稳健性和变量(自杀未遂发生率、性别分布、残疾体重、平均持续时间)对DALYs的影响。结果:对2009年至2021年数据的分析显示,自杀率有所下降。本研究确定,在2021年,32,771例伤残调整年可归因于非辅助自杀和自杀未遂,6.4%的生命损失年数(n = 30,516)可归因于自杀,不包括辅助自杀。使用瑞士每年33,000例自杀未遂的参考发生率,与自杀未遂相关的发病率为2255 YLDs(范围:552-6557 YLDs)。对数据的进一步分析突出了非协助自杀流行率的明显性别差异:男性自杀约占男性死亡总数的2%,而女性自杀约占女性死亡总数的0.8%。敏感性分析发现,自杀未遂的发生率和性别分布是影响最大的因素,而残疾权重和平均残疾持续时间对YLD估计的变化影响不大。结论:总之,本研究详细分析了瑞士非协助自杀和企图自杀的负担。2021年,非辅助自杀占瑞士20-24岁人群死亡总数的6.4%,占死亡总数的30%。由此可见,自杀对瑞士的总体疾病负担,特别是对死亡人数的影响很大。自杀率的明显性别差异进一步强调了采取性别敏感方法的必要性。这些见解可以帮助指导政策制定和资源分配,以减少自杀和自杀未遂的发生率和影响,无论是在瑞士还是在更广泛的国际背景下,类似的模式普遍存在。
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Swiss medical weekly
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