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Federico Germini

Federico Germini

MD

About

63
Publications
6,656
Reads
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1,267
Citations
Additional affiliations
June 2016 - present
Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico
Position
  • Medical Doctor
July 2015 - June 2016
Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico
Position
  • Medical Doctor
May 2010 - May 2015
Università degli Studi di Perugia
Position
  • Resident in Emergency Medicine

Publications

Publications (63)
Article
Background: Knowledge about the risk for bleeding in patients with hemophilia (PWH) would be relevant for patients, stakeholders, and policy makers. Objectives: to perform a systematic review of the literature on risk assessment models (RAMs) and risk factors for bleeding in PWH on regular prophylaxis. Methods: We searched MEDLINE, EMBASE, the...
Article
Full-text available
Objective To systematically compare the effect of direct oral anticoagulants and low molecular weight heparin for thromboprophylaxis on the benefits and harms to patients undergoing non-cardiac surgery. Design Systematic review and network meta-analysis of randomised controlled trials. Data sOurces Medline, Embase, and the Cochrane Central Register...
Article
Full-text available
Predicting individual effects of switching from standard half-life (SHL) to extended half-life (EHL) FVIII/FIX concentrates is pivotal in clinical care, but large-scale individual data are scarce. The aim of this study was to assess individual changes in terminal half-life (THL) after switching to EHL concentrates and identifying determinants of a...
Article
Full-text available
Background: The Canadian Bleeding Disorders Registry (CBDR) captures data from 24 hemophilia treatment centers and patients directly. Nonacog beta pegol (N9-GP) was approved in Canada in 2018. Objectives: To assess treatment outcomes following switching to N9-GP in a real-world setting. Methods: CBDR data for Canadian male patients (aged 7-72...
Article
Introduction There are evidence-based protocols for the diagnosis and exclusion of pulmonary embolism (PE) and deep vein thrombosis (DVT) which include clinical probability scoring along with selective D-dimer testing and diagnostic imaging. D-dimer assessment in VTE (venous thromboembolism) testing tends to be omitted in patients with cancer, part...
Article
Background: The Canadian Hemophilia Bleeding Disorders Registry (CBDR) is a clinical database including data from all Canadian Hemophilia Treatment Centers (HTCs) to assist in the management of hemophilia and other bleeding disorders. The CBDR launched on July 1, 2015 and integrates the data entry platform for patients, myCBDR, allowing direct entr...
Article
Background Knowledge about sexual health, difficulty with sexual activity and intimacy (sexual difficulty), in people with hemophilia is little understood. Objectives The objectives were to determine the prevalence of sexual difficulty in people living with hemophilia (PWH) compared to people with no bleeding disorders (PWNoBD), and to determine f...
Preprint
Full-text available
BACKGROUND Numerous wrist-wearable devices to measure physical activity are currently available, but little is known about how they compare in terms of acceptability and accuracy. OBJECTIVE We performed a systematic review of the literature to assess the acceptability (defined as the level to which a device is tolerated and used by the user) and a...
Preprint
BACKGROUND The Patient Reported Outcomes Burdens and Experiences (PROBE) questionnaire is a tool for assessing the quality of life and burden of the disease in people leaving with hemophilia. OBJECTIVE The objective of our study were 1) to assess the needs of relevant stakeholders involved in the use of PROBE, 2) to develop the software infrastruc...
Article
Background: The Patient-Reported Outcomes, Burdens, and Experiences (PROBE) questionnaire is a tool for assessing the quality of life and disease burden in people living with hemophilia. Objective: The objectives of our study were (1) to assess the needs of relevant stakeholders involved in the use of PROBE, (2) to develop the software infrastru...
Article
Background: Numerous wrist-wearable devices to measure physical activity are currently available, but there is a need to unify the evidence on how they compare in terms of acceptability and accuracy. Objective: The aim of this study is to perform a systematic review of the literature to assess the accuracy and acceptability (willingness to use t...
Article
Full-text available
Background Real-life data on pharmacokinetics of FVIII/IX concentrates, especially extended half-life (EHL), concentrates in large cohorts of persons with hemophilia are currently lacking. Objectives This cross-sectional study aimed to establish reference values for terminal half-life (THL) for FVIII/IX concentrates according to concentrate type,...
Preprint
BACKGROUND The rapid growth of the biomedical literature makes identifying strong evidence a time-consuming task. Applying machine learning to the process could be a viable solution that limits effort while maintaining accuracy. OBJECTIVE To summarize the nature and comparative performance of machine learning approaches that have been applied to r...
Article
Full-text available
Background The rapid growth of the biomedical literature makes identifying strong evidence a time-consuming task. Applying machine learning to the process could be a viable solution that limits effort while maintaining accuracy. Objective The goal of the research was to summarize the nature and comparative performance of machine learning approache...
Preprint
UNSTRUCTURED Due to the continued rapid growth in published biomedical literature, it is increasingly difficult to identify and retrieve high-quality evidence. Machine learning approaches have been applied to address this issue. Some models developed using supervised machine learning approaches have achieved high sensitivity or recall, however prec...
Article
Background A barrier to practicing evidence-based medicine is the rapidly increasing body of biomedical literature. Use of method terms to limit the search can help reduce the burden of screening articles for clinical relevance; however, such terms are limited by their partial dependence on indexing terms and usually produce low precision, especial...
Article
Introduction Management strategies and hemostatic treatments to achieve control of bleeding are relevant across many disease areas. Identification of primary outcomes for studies assessing hemostatic intervention was the objective of a National Heart, Lung and Blood Institute (NHLBI) sponsored multidisciplinary initiative. The aim of this report is...
Article
Full-text available
Background Many evidence-based clinical decision tools are available for the diagnosis of pulmonary embolism (PE). However, these clinical decision tools have had suboptimal uptake in the everyday clinical practice in emergency departments (EDs), despite numerous implementation efforts. We aimed to test the feasibility of a multi-faceted interventi...
Article
Introduction: Extended Half-Life (EHL) concentrates were recently introduced to increase trough levels, decrease infusion frequency and potentially limiting the burden of treatment in patients with haemophilia (PWH) and their caregivers. Group-based studies have reported increased terminal half-life (THL) after switching from standard half-life (SH...
Article
Introduction: Extended half-life concentrates were recently introduced and limited data have shown extended terminal half-life (THL). However, real-life data on pharmacokinetics in large cohorts of patients with haemophilia (PWH) and information on the effects of age, body composition and blood group (THL) are lacking. Aim: to assess THL for standa...
Article
BACKGROUND: The Canadian Hemophilia Bleeding Disorders Registry (CBDR) is a clinical database for patients in Canada with bleeding disorders. It was launched on July 1, 2015 and is used by all Canadian Hemophilia Treatment Centers (HTCs) to assist in managing the treatment of hemophilia and other bleeding disorders. CBDR integrates with the patient...
Article
Background There is an impression that North American emergency department (ED) patients tested for pulmonary embolism (PE) differ from European ones. Objectives We compared the PE prevalence, frequency of use, and positive yield of imaging among ED patients tested for PE in Europe and North America. Methods We searched for studies reporting cons...
Article
Full-text available
Introduction: There are limited data on the impact of haemophilia on health status and health-related quality of life (HRQL) in people with non-severe (mild and moderate) haemophilia. Aim: To evaluate the health status of people living with mild or moderate haemophilia. Methods: Data on respondents with no bleeding disorder (NoBD), mild and mo...
Preprint
Full-text available
Background: Many evidence-based clinical decision tools are available for the diagnosis of pulmonary embolism (PE). However, these clinical decision tools have had suboptimal uptake in the everyday clinical practice in emergency departments (EDs), despite numerous implementation efforts. We aimed to test the feasibility of a multi-faceted intervent...
Preprint
Full-text available
Background: Many evidence-based clinical decision tools are available for the diagnosis of pulmonary embolism (PE). However, these clinical decision tools have had suboptimal uptake in the everyday clinical practice in emergency departments (EDs), despite numerous implementation efforts. We aimed to test the feasibility of a multi-faceted intervent...
Preprint
Full-text available
Background: Many evidence-based clinical decision tools are available for the diagnosis of pulmonary embolism (PE). However, these clinical decision tools have had suboptimal uptake in the everyday clinical practice in emergency departments (EDs), despite numerous implementation efforts. We aimed to test the feasibility of a multi-faceted intervent...
Article
Full-text available
Background Physicians commonly judge whether a myocardial infarction (MI) is type 1 (thrombotic) versus type 2 (supply/demand mismatch) based on clinical information. Little is known about the accuracy of physicians’ clinical judgement. We aimed to determine the accuracy of physician’s judgment in the classification of type 1 versus type 2 MI in pe...
Article
Full-text available
Risk assessment models (RAMs) for venous thromboembolism (VTE) and bleeding in hospitalized medical patients inform appropriate use of thromboprophylaxis. Our aim was to use a novel approach for selecting risk factors for VTE and bleeding to be included in RAMs. First, we used the results of a systematic review of all candidate factors. Second, we...
Article
Full-text available
Introduction: It is unclear whether anticoagulant or antiplatelet medications increase the risk for intracranial bleeding in older adults after a fall. Our aim was to report the incidence of intracranial bleeding among older adults presenting to the emergency department (ED) with a fall, among patients taking anticoagulants, antiplatelet medication...
Article
Background: Emergency physicians (EPs) can choose from several evidence-based pathways to diagnose pulmonary embolism (PE), however literature suggests that EPs frequently use computer tomography (CT) scanning as a stand-alone test for PE. This is a program of research to improve adherence to evidence-based PE diagnosis in the emergency department...
Article
Full-text available
Many predictors for venous thromboembolism (VTE) and bleeding in hospitalized medical patients may exist but until now systematic reviews and assessments of the certainty of the evidence do not exist. We conducted a systematic review to identify prognostic factors for VTE and bleeding in hospitalized medical patients and searched Medline and EMBASE...
Article
Objective We investigated the association between the publication of the Consolidated Standards of Reporting Trials extension for abstracts (CONSORT-EA) and other variables of interest on the quality of reporting of abstracts of randomised controlled trials (RCTs) published in emergency medicine (EM) journals. Methods We performed a survey of the...
Article
Background: The large observed variability in hemophilia prevalence prevents robust estimation of burden of disease.Objective: To estimate the prevalence and prevalence at birth of hemophilia and the associated life expectancy disadvantage.Design: Random-effects meta-analysis of registry data.Setting: Australia, Canada, France, Italy, New Zealand,...
Article
Introduction Pulmonary embolism (PE) has an incidence of 0.75-2.69 cases per 1,000 individuals in Western Europe and North America (NA), with no significant differences between these two regions. In the United States, there is evidence of PE overdiagnosis, with increased incidence of PE over time and minimal changes in the mortality rate. It is pos...
Article
Full-text available
Background: Age-related frailty is a multidimensional dynamic condition associated with adverse patient outcomes and high costs for health systems. Several interventions have been proposed to tackle frailty. This correspondence article describes the journey through the development of evidence- and consensus-based guidelines on interventions aimed...
Article
Full-text available
Background: The large observed variability in hemophilia prevalence prevents robust estimation of burden of disease. Objective: To estimate the prevalence and prevalence at birth of hemophilia and the associated life expectancy disadvantage. Design: Random-effects meta-analysis of registry data. Setting: Australia, Canada, France, Italy, New...
Article
Full-text available
Background Performing individual pharmacokinetics (PK) studies in clinical practice can be simplified by adopting population PK-based profiling on limited post-infusion samples. The objective of this study was to assess the impact of population PK in tailoring prophylaxis in patients with haemophilia A. Patients and Methods Individual weekly treatm...
Article
Exacerbations of chronic obstructive pulmonary disease (COPDE) frequently require hospitalizations, may necessitate of invasive mechanical ventilation (IMV), and are associated with a remarkable in-hospital mortality. The BAP-65 score is a risk assessment model (RAM) based on simple variables, that has been proposed for the prediction of these adve...
Article
Full-text available
Acute exacerbations of chronic obstructive pulmonary disease (AECOPDs) frequently cause patients with COPD to access the emergency department and have a negative impact on the course of the disease. The objectives of our study were: 1) describing the socio-demographic and clinical characteristics, and the clinical management, of patients with AECOP...
Article
Full-text available
Objective: To summarize the best available evidence regarding the effectiveness of interventions for preventing frailty progression in older adults. Introduction: Frailty is an age-related state of decreased physiological reserves characterized by an increased risk of poor clinical outcomes. Evidence supporting the malleability of frailty, its p...
Article
Background: Ultra-micronized palmitoylethanolamide (um-PEA) represents an attractive option for chronic pain control in complex older patients at higher risk of adverse effects with traditional analgesics. Objective: The aim of this study was to determine the effectiveness of um-PEA versus placebo on chronic pain intensity and function in indivi...
Article
Background: A scoping search identified systematic reviews on diagnostic accuracy and predictive ability of frailty measures in older adults. In most cases, research was confined to specific assessment measures related to a specific clinical model. Objectives: To summarize the best available evidence from systematic reviews in relation to reliabil...
Article
Full-text available
Introduction: The quality of reporting of abstracts of randomised controlled trials (RCTs) in major general medical journals and in some category-specific journals was shown to be poor before the publication of the ConsolidatedStandards of ReportingTrials (CONSORT) extension for abstracts in 2008, and an improvement in the quality of reporting of...
Article
Background: Electrocardiogram (ECG) interpretation is widely performed by emergency physicians. We aimed to determine the accuracy of interpretation of potential ST-segment elevation myocardial infarction (STEMI) ECGs by emergency physicians. Methods: Thirty-six ECGs resulted in putative STEMI diagnoses were selected. Participants were asked to...
Article
Full-text available
Background: Chronic pain in older people is highly prevalent, often underestimated, and associated with adverse outcomes. Most available analgesic drugs are often either ineffective or not tolerated, with many side effects. Palmitoylethanolamide (PEA) is an endogenous widely distributed N-acylethanolamina involved in neuroinflammation and pain-gen...
Article
The Padua prediction score (PPS) has been suggested as the best available model for the assessment of the risk of venous thromboembolism (VTE) in hospitalized medical patients. The impact of its use in clinical practice has never been prospectively evaluated. According to a quasi-randomized study design, consecutive patients admitted to Internal Me...
Article
Background Direct oral anticoagulants (DOA) have been shown to be as effective and at least as safe as conventional anticoagulation for the prevention of recurrences in patients with venous thromboembolism (VTE). Whether this is the case in patients with cancer-associated VTE remains undefined. Methods We performed a meta-analysis of randomized con...
Article
The aim of this study was to evaluate whether right ventricle dilation at computed tomography (CT) angiography can be used to assess the risk of death in patients with acute pulmonary embolism.Medline and EMBASE were searched up to April 30, 2013. Studies reporting on the association between right ventricle dilation (right-to-left ventricle diamete...
Article
In patients with acute pulmonary embolism (PE), risk stratification is indicated for tailoring both diagnostic strategies and acute treatment. Whether the embolic burden assessed at computed tomography (CT)-angiography has a role in risk stratification in these patients is debated. To systematically review and perform a meta-analysis to evaluate th...

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