Alexander Katalinic

• MD
• Managing Director at University of Lübeck

Predicting the survival of cancer patients is of high importance for the medical community, e.g. for evaluating therapy strategies. This study is based on lung cancer data retrieved from seven German cancer registries according to the German basic oncology dataset. After data integration and preprocessing, we predicted the survival for 6, 12, 18 an...

Introduction Housing and access to healthcare pose particular challenges to asylum seekers and refugees. The main study aim was to assess their frequency of SARS-CoV-2 infection during the COVID-19 pandemic. Methods We provide a prospective study on SARS-CoV-2 cases among adult asylum seekers/refugees in Europe over 18 months. Acute SARS-CoV-2 inf...

Cutaneous melanoma is a common cancer in Australia and New Zealand, Europe, and North America, and its incidence is still increasing in many regions. Ultraviolet (UV) radiation exposure (for example, through excessive sunlight exposure) remains the primary risk factor for melanoma; however, public awareness campaigns have led to a marked reduction...

Objective People with a difference of sex development (DSD) have to deal with complex medical and psychosocial challenges making it difficult to provide treatment adapted to their needs and in line with guidelines. Within the project DSDCare in Germany quality of care of people with DSD is evaluated regularly focusing on patient satisfaction as an...

Zusammenfassung Hintergrund In Deutschland wurde 2008 ein flächendeckendes Hautkrebsscreening eingeführt. Welche nachfolgend beobachteten Veränderungen in der Epidemiologie des malignen Melanoms (MM), Plattenepithelkarzinoms (SCC) und Basalzellkarzinoms (BCC) auf das Screening zurückzuführen sind, ist unklar. Mit Simulationsmodellen werden verschi...

Artificial intelligence (AI) in mammography screening has shown promise in retrospective evaluations, but few prospective studies exist. PRAIM is an observational, multicenter, real-world, noninferiority, implementation study comparing the performance of AI-supported double reading to standard double reading (without AI) among women (50–69 years ol...

Background Employees at the Ihlenberg toxic waste landfill in northern Germany were found to have an increased risk of cancer and cancer-related deaths in previous analyses covering the time period from 1983 to 2008. The present study aimed to quantify cancer risk and all-cause mortality in the employee cohort in 2009 to 2021. Methods In this retr...

Zusammenfassung Hintergrund Eine SARS-CoV-2-Infektion kann zu über Monate anhaltenden gesundheitlichen Einschränkungen führen, dem sogenannten Post-COVID-Syndrom (PCS). Um das regionale Versorgungsgeschehen mit der akuten COVID-19-Erkrankung/dem PCS, mögliche Krankheitsfolgen und die aktuelle Bedarfslage besser zu verstehen und beurteilen zu können...

Background Comprehensive skin cancer screening was introduced in Germany in 2008. It is unclear whether subsequently observed changes in the epidemiology of malignant melanoma (MM), squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are due to the screening. Simulation models are used to compare different screening scenarios with each oth...

Importance Studies on the epidemiology of retinoblastoma (RB) could lead to improvement in management. Objective To estimate the incidence and survival of RB in European children and the occurrence of second primary tumors (other than RB) in these patients. Design, Setting, and Participants This cohort study used population-based data from 81 can...

Disclosure: S.O. Hiort: None. M. Schnoor: None. U. Doehnert: None. M. Juergensen: None. J. Scherf: None. A. Heidenreich: None. M. Rapp: None. A. Katalinic: None. People with Differences of Sex Development (DSD) pose a challenge for healthcare. Lifelong holistic care requires a broad range of diagnostic approaches, qualified psychosocial, peer, fert...

In the context of the COVID-19 pandemic, protective measures had to be taken to minimize the rate of infection. Many pediatric services ran at a reduced scale during this time. Families in general, and especially families with chronically ill children, were particularly affected. The aim was to investigate the medical care of children in Schleswig-...

Background In Germany, around 2.250 children and adolescents are diagnosed with cancer each year. Despite generally positive long-term survival rates, many patients must cope with late effects of the disease and its treatment. This highlights the need for a well-structured, long-term approach addressing both physical and mental health issues. Curre...

Introduction: Survival analysis based on cancer registry data is of paramount importance for monitoring the effectiveness of health care. As new methods arise, the compendium of statistical tools applicable to cancer registry data grows. In recent years, machine learning approaches for survival analysis were developed. The aim of this study is to c...

Introduction Achieving evidence-based, high quality medical care is the overarching goal of healthcare quality management. Quality indicators (QI) serve as proxies to show whether good quality is reached or not. This article describes the development of QI for the evaluation of healthcare quality in the area of Differences of Sex Development (DSD)....

Background The network theory of mental disorders asserts the pivotal role of feedback loops in psychopathology. We investigated intra-individual dynamics and potential feedback loops in psychological networks and their association with long-term outcomes. Methods At the beginning of the COVID-19 pandemic, data from a population-based cohort (N =...

Background: Infection with human papillomavirus (HPV) is one of the more common sexually transmitted diseases in Germany. Vaccination against HPV was introduced in Germany in 2007. In this study, we sought to detect a population-based decline in the incidence of cervical cancer in women under age 30 who were eligible for vaccination in the first 1...

Non-pharmaceutical interventions (NPI) have been proven successful in a population-based approach to protect from SARS-CoV-2 transmission during the COVID-19 pandemic. As a consequential-effect, a reduction in the spread of all respiratory viruses has been observed, but the primary factors behind this phenomenon have yet to be identified. We conduc...

Background Generating synthetic patient data is crucial for medical research, but common approaches build up on black-box models which do not allow for expert verification or intervention. We propose a highly available method which enables synthetic data generation from real patient records in a privacy preserving and compliant fashion, is interpre...

Cancer registries systematically collect data on the occurrence, treatment, and progression of cancer in order to further improve the care of cancer patients. In the AI-CARE joint project funded by the German Federal Ministry of Health, in which cancer registries from eight federal states are involved, artificial intelligence (AI) methods for analy...

Recurrence after colorectal cancer resection is rarely documented in the general population while a key clinical determinant for patient survival. We identified 8785 patients with colorectal cancer diagnosed between 2010 and 2013 and clinically followed up to 2020 in 15 cancer registries from seven European countries (Bulgaria, Switzerland, Germany...

Simple Summary An important component in the study of survival in breast cancer patients is how the tumor is detected. This involves examining whether and to what extent survival differs when the tumor is detected, for example, by screening or by symptoms. In such an analysis, it is important to note that survival times are influenced by several bi...

With the establishment of nationwide cancer registration in Germany based on the Act for the Implementation of the Early Detection of Cancer and Cancer Registries of 2013 (now SGB V, § 65c), the prerequisite for comprehensive oncological quality assurance through state cancer registries has been established. The nationally uniformly structured data...

Zusammenfassung Hintergrund Kinder und Jugendliche mit sozialpädiatrischen Versorgungsbedarfen stellen eine Gruppe mit besonderen Herausforderungen dar. Ziel der qualitativen Studie war, die sozialpädiatrische Versorgung in der Pandemie aus Expert*innensicht zu beschreiben. Hieraus sollten Rückschlüsse für möglicherweise entstandene sozialpädiatri...

Background: Obtaining large amounts of real patient data involves great efforts and expenses, and processing this data is fraught with data protection concerns. Consequently, data sharing might not always be possible, particularly when large, open science datasets are needed, as for AI development. For such purposes, the generation of realistic syn...

Simple Summary The incidence of keratinocyte skin cancer has rapidly been increasing over the last five decades in fair skinned populations throughout the world. About 20% account for squamous cell carcinoma (SCC), and mainly the elderly are affected. Although the mortality rate is low, keratinocyte skin cancer is associated with a high morbidity,...

Background: New treatment options for cutaneous melanomas with a poor prognosis have been available since 2011, including immune therapies and targeted drugs. Randomized controlled trials have demonstrated that these treatments improve survival, but no population-level studies have been available to date. Methods: All patients in the database of...

STUDY QUESTION Is exposure to dydrogesterone a risk factor for congenital anomalies when given in the first trimester for recurrent/threatened pregnancy loss or as luteal support in assisted reproductive technologies? SUMMARY ANSWER Dydrogesterone, when given in the first trimester for recurrent/threatened pregnancy loss or as luteal support in as...

Background: We used the comprehensive definition of AYA (age 15 to 39 years) to update 5-year relative survival (RS) estimates for AYAs in Europe and across countries and to evaluate improvements in survival over time. Methods: We used data from EUROCARE-6. We analysed 700,000 AYAs with cancer diagnosed in 2000-2013 (follow-up to 2014). We focused...

Background A national colorectal cancer (CRC) screening programme was launched in 2002 in Germany. A comprehensive evaluation of the programme effectiveness using real-world data is still lacking. In addition, there are regional reports on increasing colorectal cancer incidence in younger populations. Therefore, we aimed to describe and compare the...

Background And Aims The evidence for the benefit of the skin cancer screening introduced in Germany in 2008 is weak. We investigate to what extent data from the German epidemiological cancer registries are suitable to contribute to the evaluation of skin cancer screening and report these evaluation results. Material And Methods Skin cancer‐related...

Background There are regional differences in skin cancer screening uptake in Germany. So far, it is unclear whether a high uptake of screening services leads to a reduction in mortality. This article presents study results on the investigation of spatiotemporal associations between skin cancer screening and mortality. The methods used are discussed...

Background Germany‐wide skin cancer screening was introduced in 2008 to reduce skin cancer mortality and morbidity. However, the effectiveness of the program is still unclear. We explore the relationship between early‐stage melanoma incidence and melanoma mortality in subsequent years, using early‐stage melanoma incidence as surrogate for screening...

Zusammenfassung Hintergrund und Ziele Die Evidenz für einen Nutzen des 2008 in Deutschland eingeführten Hautkrebsscreenings ist schwach. Wir untersuchen, inwieweit Daten der deutschen epidemiologischen Krebsregister geeignet sind zur Evaluation des Hautkrebsscreenings beizutragen, und berichten diese Evaluationsergebnisse. Material und Methodik D...

Zusammenfassung Hintergrund und Ziele Die steigende Hautkrebshäufigkeit in Deutschland hat den Bedarf an sekundärpräventiven Maßnahmen erhöht. Hierfür wurde zum 01.07.2008 ein gesetzliches Hautkrebsscreening für Versicherte ab 35 Jahren eingeführt. Ziel dieses Arbeitspakets im Innovationsfonds‐Projekt „Perspektiven einer multimodalen Evaluation de...

Background and goals The rising incidence of skin cancer in Germany has increased the need for secondary prevention measures. For this purpose, a statutory skin cancer screening for insured persons aged 35 and older was introduced on 1 June 2008. The aim of this work package in the Innovation Fund project “Perspectives of a multimodal evaluation of...

Zusammenfassung Hintergrund In Deutschland wurde 2008 ein flächendeckendes Hautkrebsscreening eingeführt, um die Hautkrebsmortalität und ‐morbidität zu senken. Noch unklar ist jedoch die Wirksamkeit des Programms. Wir untersuchen den Zusammenhang zwischen der Inzidenz von Melanom‐Frühstadien und Melanom‐Mortalität in den Folgejahren, wobei die Inz...

Zusammenfassung Hintergrund Es bestehen regionale Unterschiede in der Hautkrebsfrüherkennungsinanspruchnahme in Deutschland. Bislang ist ungeklärt, ob eine hohe Inanspruchnahme von Früherkennungsleistungen zu einer Senkung der Mortalität führt. Dieser Beitrag präsentiert Studienergebnisse zur Untersuchung raumzeitlicher Assoziationen von Hautkrebs...

Background: Approximately 27% of female breast cancer patients are diagnosed before the age of 55, a group often comprising mothers with young children. Maternal psychosocial well-being significantly impacts these children’s psychosocial well-being. This study assesses the well-being of children with mothers who have early-onset breast cancer. Meth...

Zusammenfassung Hintergrund Eine der Aufgaben der Landeskrebsregister ist die Bereitstellung von Daten für Forschung oder eigene Forschung. Daten werden im Krebsregister nicht primär für Forschung, sondern mit Meldepflicht und ohne Einwilligung der Betroffenen für die Erfüllung gesetzlicher Aufgaben erhoben. Sind Daten der Krebsregister für Forsch...

Purpose Elderly cancer patients are less likely to be treated in accordance with evidence-based guideline recommendations. This study examines patient-related factors associated with deviations from guideline recommendations. Methods Using medical documentation and cancer registry data, we investigated the treatment courses of female breast cancer...

Simple Summary This study reports updates on colon and rectum cancer survival differences in the German–Danish border region and investigates the effects of tumor stage at diagnosis and first-line treatment on cancer survival. Based on cancer registry data from 2004 to 2016, we estimated the risk of dying from all causes after a colon or rectum can...

Background: Novel artificial intelligence computer-assisted detection (AI-CAD) systems based on deep learning (DL) promise to support screen reading. Purpose: To test a DL-AI-CAD system compared to human reading on consecutive screening mammograms. Material and methods: In this retrospective study, 17,884 consecutive anonymized screening mammo...

Purpose Despite the need to generate valid and reliable estimates of protection levels against SARS-CoV-2 infection and severe course of COVID-19 for the German population in summer 2022, there was a lack of systematically collected population-based data allowing for the assessment of the protection level in real time. Methods In the IMMUNEBRIDGE...

Introduction: In 2013, a new federal law obligated all German federal states to collect additional clinical data in population-based cancer registries as an active tool for monitoring and improving the quality of cancer care, increasing transparency and promoting health research. Now, 10 years later, the current status of the expanded cancer regis...

Introduction: Urine cytology (UC) is a recommended tool for the diagnosis of urothelial malignancies. Thus far, no specific recommendations regarding the role of washing cytology (WC) have been included in the guidelines. The goal of our study was to analyse the relationship between the histology of transurethrally (transurethral resection of the...

Purpose Clinical communication and facilitating informed and sound medical decisions become challenging as patients age and suffer from age-associated impairments. Family caregivers are perceived as essential actors in addressing these challenges. Here, we explore physicians’ perspectives on family caregivers’ roles and their involvement in consult...

The COVID-19 pandemic remains a significant challenge to global health despite the application of vaccines to approximately 70% of the world's population [1]. Unresolved questions include the duration of immunity after infection and vaccination, the effectiveness of vaccines against new virus variants, the relationship between antibody levels and i...

Introduction Comparable indicators on complete cancer prevalence are increasingly needed in Europe to support survivorship care planning. Direct measures can be biased by limited registration time and estimates are needed to recover long term survivors. The completeness index method, based on incidence and survival modelling, is the standard most v...

Aim of the study: Cutaneous squamous cell carcinoma (cSCC) incidences are increasing but scarcely available separated. We analysed incidence rates of cSCC over three decades with an extrapolation to 2040. Methods: Cancer registries from the Netherlands, Scotland and two federal states of Germany (Saarland/Schleswig-Holstein) were sourced for sep...

Purpose Psychosocial health (PH) and quality of life (QoL) are important health outcomes. We compared PH and QoL of adolescents conceived with intrazytoplasmatic sperm injection (ICSI) and of naturally conceived controls. The impact of disclosure of ICSI-conception on QoL and PH was quantified. Methods The cross-sectional sample consisted of 545 I...

A known cut-off problem hampers the interpretation of quality of life (QOL) scores. The purpose of this study was to apply a novel approach for the EORTC QLQ-C30 instrument to identify the proportion of breast cancer (BC) patients in need of supportive care. Changes in QOL during the COVID-19 pandemic were evaluated, as well as changes over time (a...

Background. Several retrospective studies have illustrated the potential clinical benefit of artificial intelligence (AI) systems for breast cancer screening. Some systems optimize normal mammography examination triaging, while others aim to improve cancer detection. However, no AI system has shown specificity high enough to replace human radiologi...

Despite the need to generate valid and reliable estimates of protection against SARS-CoV-2 infection and severe course of COVID-19 for the German population in summer 2022, there was a lack of systematically collected population-based data allowing for the assessment of the protection level in real-time. In the IMMUNEBRIDGE project, we harmonised d...

Background Scientists, physicians, and the general public legitimately expect scholarly publications to give true answers to study questions raised. We investigated whether findings from studies published in journals with higher Journal Impact Factors (JIFs) are closer to truth than findings from studies in less-cited journals via a meta-epidemiolo...

Right from the start of the COVID pandemic in January 2020, the entire tourism sector was put under immense pressure because of its assumed role in SARS-CoV-2 transmission and infection dynamics. Based on reports of single superspreading events in the early days of the pandemic, the hotel industry appeared in a bad light that impaired a strategic r...

Background The EUROCARE-5 study revealed disparities in childhood cancer survival among European countries, giving rise to important initiatives across Europe to reduce the gap. Extending its representativeness through increased coverage of eastern European countries, the EUROCARE-6 study aimed to update survival progress across countries and years...

Background In Germany, CRT devices with defibrillator capability (CRT-D) have become the predominant treatment strategy for patients with heart failure and cardiac dyssynchrony. However, according to current guidelines, most patients would also be eligible for the less expensive CRT pacemaker (CRT-P). We conducted a cost-effectiveness analysis for...

Zusammenfassung Hintergrund Mit dem Ausbruch der Corona-Pandemie wurde im Großraum Lübeck ab Mai 2020 die LübEcker Längsschnittuntersuchung zu Infektionen mit SARS-CoV-2 (ELISA-Studie) durchgeführt, die Aufschluss über Prävalenz, Dunkelziffer und Symptome von SARS-CoV-2-Infektionen geben sollte. Ziel der vorliegenden Arbeit ist die Bewertung defin...

Background Considering the insufficiently controlled spread of new SARS-CoV-2 variants, partially low vaccination rates, and increased risk of a post-COVID syndrome, well-functioning, targeted intervention measures at local and national levels are urgently needed to contain the SARS-CoV-2 pandemic. Surveillance concepts (cross-sectional, cohorts, c...

With newly rising coronavirus disease 2019 (COVID-19) cases, important data gaps remain on (i) long-term dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates in fixed cohorts (ii) identification of risk factors, and (iii) establishment of effective surveillance strategies. By polymerase chain reaction and antibod...

Aims: Cardiac resynchronization therapy (CRT) is an established treatment for heart failure. There is contradictory evidence whether defibrillator capability improves prognosis in patients receiving CRT. We compared the survival of patients undergoing de novo implantation of a CRT with defibrillator (CRT-D) option and CRT with pacemaker (CRT-P) in...

No data support the suggestion that first-trimester dydrogesterone use increases the risk of foetal abnormalities; however, two low-quality retrospective studies (one retracted by the journal) have suggested such a link. A scoping review and meta-analysis were carried out to address this discrepancy. We reviewed the literature and were unable to id...

Objectives Revision of the priority list for incidence date to incorporate modern diagnostic methods, including but not limited to flow cytometry, molecular testing, screening tests and new radiological/imaging techniques. The revision should not preclude comparison of survival estimates with tumours registered using the existing priority list, to...

Introduction: This study investigates the runtime and costs of biventricular defibrillators (CRT-D) and biventricular pacemakers (CRT-P). Accurate estimates of cardiac resynchronization therapy (CRT) device runtime across all manufactures are rare, especially for CRT-P. Methods: Health claims data of a large nationwide German health insurance was u...

Purpose To date, over 4.2 million Germans and over 235 million people worldwide have been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Uro-oncology (UO) patients are particularly vulnerable but in urgent need of life-saving systemic treatments. Our multicentric study examined the impact of the COVID-19 crisis on the m...

Zusammenfassung Trotz der ernsten gesundheitlichen Gefahren von UV-Strahlung ist bis heute der Schutz vor UV-Strahlung keine Selbstverständlichkeit. Die Einschätzung der Gesundheitsrisiken durch UV-Strahlung in der Bevölkerung ist zwar weitestgehend realistisch, scheint aber nicht zu einer veränderten Einschätzung des persönlichen Risikos und zu ei...

Aims The Virtual Diabetes Outpatient Clinic for Children and Adolescents (VIDIKI) study was a 6-month quasi-randomized, multicentre study followed by an extension phase to evaluate the effects of monthly video consultations in addition to regular care. A health economic analysis was conducted to assess the direct costs. Methods The cost data of 240...

Zusammenfassung Hintergrund In den letzten Jahren wird verstärkt gefordert, Forschungsdaten gemäß den sog. FAIR-Prinzipien für eine Nachnutzung aufzubereiten. Dadurch könnten zukünftige Projekte auf einer breiteren Datengrundlage durchgeführt sowie durch Verknüpfung verschiedener Datenquellen neue Fragestellungen untersucht werden. Fragestellung...

Background The number of cancer patients and cancer survivors will increase in Germany due to demographic change and advances in medicine.Objective The current article presents a description of cancer epidemiology in the elderly. What are the most common cancers, what is the prognosis and what are the temporal trends of incidence and mortality of o...