Rainer Röhrig

University Hospital RWTH Aachen · Medical Informatics

A systematic review according to the PRISMA reporting standard was performed to identify causes of use errors in mechanical ventilators described in the literature. The PubMed search resulted in the inclusion of 16 papers. The errors described were systematically analyzed with regard to their causes and categorized in an adapted cause-and-effect di...

Einleitung: In CIRS-AINS wurde über zwei Fälle berichtet, bei denen bei einem Notfall- und Transportbeatmungsgerät eine Flowmessleitung zu einer Fehlfunktion des Beatmungsgeräts (Oxylog 3000, Fa. Dräger) führte. Dies wurde von dem Autor des Beitrags als Anwenderfehler eingestuft. Das Ziel dieser Arbeit ist es, an dem Beispiel dieser CIRS-Fälle aufz...

Zusammenfassung Hintergrund Die Notfallversorgung befindet sich im Umbruch. In Notaufnahmen werden Patienten ausgehend von Symptomen und Dringlichkeit versorgt; dies bildet sich jedoch in den etablierten Routinedaten der gesetzlichen Sozialversicherung nicht ab. Ziel des AKTIN-Projekts war der Aufbau einer datenschutzkonformen Registerinfrastruktu...

Background: Population-level survey is an essential standard method used in public health research to quantify sociodemographic events and support public health policy development and intervention designs with evidence. Although all steps in the survey can contribute to the data quality parameters, data collection mechanisms seem the most determin...

Objective We aimed to estimate the incidence of cerebral sinus and venous thrombosis (CVT) within one month from first-dose administration and the frequency of vaccine-induced immune thrombotic thrombocytopenia (VITT) as the underlying mechanism after vaccination with BNT162b2, ChAdOx1, and mRNA-1273, in Germany. Methods A web-based questionnaire...

Metadata is essential for handling medical data according to FAIR principles. Standards are well established for many types of electrophysiological methods but are still lacking for microneurographic recordings of peripheral sensory nerve fibers in humans. We propose a standard for structuring and recording microneurography metadata based on odML a...

Zusammenfassung Hintergrund Die Pandemie hat zu Veränderungen in der Notfallversorgung mit atypischen Schwankungen der Einsatzzahlen geführt. Dies wurde u. a. mit dem veränderten Verhalten und einem gesteigerten Belastungsempfinden der Bevölkerung erklärt. Bestehende Untersuchungen geben Hinweise auf das gesteigerte Auftreten von psychischen Krank...

Background In severe cases, SARS-CoV-2 infection leads to acute respiratory distress syndrome (ARDS), often treated by extracorporeal membrane oxygenation (ECMO). During ECMO therapy, anticoagulation is crucial to prevent device-associated thrombosis and device failure, however, it is associated with bleeding complications. In COVID-19, additional...

Zusammenfassung Hintergrund Ziel ist es, bundesweit und klinikübergreifend altersspezifische Unterschiede in den Charakteristika insbesondere von älteren Notfallpatienten herauszuarbeiten. Methodik Aus 11 sowohl universitären als auch außeruniversitären Notaufnahmen, angeschlossen an das AKTIN (Aktionsbündnis für Informations- und Kommunikationst...

Background: The workload in health care is increasing and hence, mental health issues are on the rise among health care professionals (HCPs). The digitization of patient care could be related to the increase in stress levels. It remains unclear whether the health information system or systems and digital health technologies (DHTs) being used in he...

Background Adverse events (AE) are ubiquitous in home mechanical ventilation (HMV) and can jeopardise patient safety. One particular source of error is human interaction with life-sustaining medical devices, such as the ventilator. The objective is to understand these errors and to be able to take appropriate action. With a systematic analysis of t...

Background Increasing life expectancy is associated with a growing number of people living in nursing homes, while the availability of outpatient medical care, especially from family doctors, is stagnating in this sector. Consequently, numerous and often avoidable, low-threshold hospitalizations of nursing home residents are observed. This results...

Background Autopsies are a valuable tool for understanding disease, including COVID-19.Materials and methodsThe German Registry of COVID-19 Autopsies (DeRegCOVID), established in April 2020, serves as the electronic backbone of the National Autopsy Network (NATON), launched in early 2022 following DEFEAT PANDEMIcs.ResultsThe NATON consortium’s inte...

The emergency department is often the first source of patient data in hospitals. It is therefore the first opportunity to make accurate predictions about patient outcomes such as hospital length of stay (LOS). Those predictions are of high importance as they could significantly improve resource planning processes.

Stromausfälle können die Patientensicherheit gefährden. In der außerklinischen Intensivpflege von Patient*innen, die abhängig sind von einem Beatmungsgerät, sind länger andauernde Stromausfälle mit einer hohen Gefahr für die Gesundheit der Patient*innen verbunden. Notfallkonzepte für solche Situationen beinhalten neben den Handlungsoptionen der Pfl...

Recent advances in machine learning show great potential for automatic detection of abnormalities in electroencephalography (EEG). While simple and interpretable models combined with expert-comprehensible input features offer full control of the decision making process, these methods commonly lag behind complex deep learning and feature extraction...

Background In this retrospective routine data analysis, we investigate the number of emergency department (ED) consultations during the COVID-19 pandemic of 2020 in Germany compared to the previous year with a special focus on numbers of myocardial infarction and acute heart failure. Methods Aggregated case numbers for the two consecutive years 20...

BACKGROUND The workload in healthcare is steadily increasing – healthcare professionals (HCP) report stress and a very demanding environment. As a result, mental health issues are on the rise among HCP, the proneness to errors in tasks could increase. The digitization of patient care is intended to counteract processes of demographic change, that c...

Mental workload and technology acceptance are relevant factors that relate to use behavior and performance. Studies show a potential moderating effect of mental workload on predictors of technology acceptance. Aim of this study was the investigation of predictors of technology acceptance (UTAUT) related to clinical information systems and their rel...

Usability tests of medical devices are mainly conducted on-site, but remote tests can also be suitable for quick feedback. Using the online survey tool SoSci Survey and videos of a ventilator interface prototype, a usability test environment was developed which allows participation independent of time and place.

Secondary use of clinical data is an increasing application that is affected by the data quality (DQ) of its source systems. Techniques such as audits and risk-based monitoring for controlling DQ often rely on source data verification (SDV). SDV requires access to data generating systems. We present an approach to a targeted SDV based on manual inp...

The complexity of emergency cases and the number of emergency patients have increased dramatically. Due to a reduced or even missing specialist medical staff in the emergency departments (EDs), medical knowledge is often used without professional supervision for the diagnosis. The result is a failure in diagnosis and treatment, even death in the wo...

In 2019 the Gemeindenotfallsanitäter was introduced in the area of Oldenburg, and scientific monitoring starting 2021 with Inanspruchnahme, Leistungen und Effekte des Gemeindenotfallsanitäters. Since then, it is possible to track patient journeys, starting from the emergency call to the subsequent treatment. This short communication provides an ove...

The Robert Koch Institute (RKI) monitors the actual number of COVID-19 patients requiring intensive care from aggregated data reported by hospitals in Germany. So far, there is no infrastructure to make use of individual patient-level data from intensive care units for public health surveillance. Adopting concepts and components of the already esta...

BACKGROUND AND AIMS Autopsies are an invaluable tool in medicine for studying the pathophysiology of diseases, including kidney diseases and causes of death. To facilitate multicenter autopsy-based studies and to provide a single point of contact for data analysis and reporting, the German COVID-19 Autopsy Registry (DeRegCOVID) was launched in Apri...

Background : Increasing life expectancy is associated with a growing number of people living in nursing homes, while the availability of outpatient medical care, especially from family doctors, is stagnating in this sector. Consequently, numerous and often avoidable, low-threshold hospitalizations of nursing home residents are observed. This result...

Cough is a very common symptom and the most frequent reason for seeking medical advice. Optimized care goes inevitably through an adapted recording of this symptom and automatic processing. This study provides an updated exhaustive quantitative review of the field of cough sound acquisition, automatic detection in longer audio sequences and automat...

Background Autopsies are an important tool in medicine, dissecting disease pathophysiology and causes of death. In COVID-19, autopsies revealed e.g., the effects on pulmonary (micro)vasculature or the nervous system, systemic viral spread, or the interplay with the immune system. To facilitate multicentre autopsy-based studies and provide a central...

Risks in nursing are omnipresent and often go undetected. When an adverse event occurs, the patient often suffers maximum harm and the nurse is often traumatized. This is where the methods of systematic risk analysis and risk management play a crucial role. Methodological competence about systematic failure analysis and measures of action are neces...

Background: Adverse events are ubiquitous in home ventilation and can jeopardise patient safety. Especially the interaction with life-sustaining medical devices such as the ventilator is a source of potential errors. The goal is to know the errors to be able to react adequately to them. With a systematic analysis of hazards and their causes, measur...

Ziel dieser Arbeit ist, die Auswirkungen der COVID-19-Pandemie auf den Rettungsdienst, insbesondere auf die Veränderung der Anzahl und des Anteils von 1. eingesetzten Einsatzmitteln, 2. Einsätzen mit und ohne Sonderrechte, 3. Einsätzen des Gemeindenotfallsanitäters (GNFS), 4. Transporten vs. ambulanter Versorgung zu untersuchen.

To counteract the exuberant usage of the emergency medical service (EMS) [1] and external reasons for crowding in an emergency department (ED) [2], the project Gemeindenotfallsanitäter (GNFS) was established. The GNFS is a trained paramedic equipped to treat a patient at home rather than calling an EMS or visiting an ED [3]. This concept has been p...

Proceedings of the Joint Conference of the 66th Annual Meeting of the German Association of Medical Informatics, Biometry, and Epidemiology e.V. (gmds) and the 13th Annual Meeting of the TMF – Technology, Methods, and Infrastructure for Networked Medical Research e.V. online conference / Kiel / 2021 / all full paper are open access

Since 2017, the German Society for Medical Informatics, Biometry and Epidemiology e.V. (GMDS) offers the submission of full papers to the annual meetings, optional in Studies in Health Technologies and Informatics (Stud HIT) or in GMS Medical Informatics, Biometrics, and Epidemiology (MIBE). GMDS’ aim is to increase the attractiveness of the confer...

openMNGlab is an open-source software framework for data analysis, tailored for the specific needs of microneurography – a type of electrophysiological technique particularly important for research on peripheral neural fibers coding. Currently, openMNGlab loads data from Spike2 and Dapsys, which are two major data acquisition solutions. By building...

Background: In the initial phase of the COVID-19 pandemic, a lower incidence and death rate was observed in Germany compared to its neighbouring countries, but some studies showed comparatively high death rates in ventilated COVID-19 patients. Methods: In this retrospective analysis, hospital stays of COVID-19 patients at 14 German university hospi...

Medizinprodukte und Gesundheitsanwendungen z. B. aus dem E-Health-Bereich sind heutzutage allgegenwärtig. Aus ihrer Nutzung können sich potentielle Risiken für die Anwendenden (z. B. den Patient*innen) ergeben.

Objective Reports of cerebral sinus and venous thrombosis (CVT) after ChAdOx1 vaccination against SARS-CoV-2 have raised safety concerns. We aimed to estimate the incidence of CVT within one month from first dose administration and the frequency of vaccine-induced immune thrombotic thrombocytopenia (VITT) as the underlying mechanism after vaccinati...

BACKGROUND The workload in healthcare is steadily increasing - physicians and nurses report stress as well as a very demanding environment with complex and multiple tasks. As a result, mental health issues are on the rise among health care professionals, the proneness to errors in tasks could increase. The digitization of patient care is intended t...

Background: The workload in health care is high; physicians and nurses report high stress levels due to a demanding environment where they often have to perform multiple tasks simultaneously. As a result, mental health issues among health care professionals (HCPs) are on the rise and the prevalence of errors in their daily tasks could increase. Pr...

Background Autopsy is an important tool for understanding the pathogenesis of diseases, including COVID-19.Material and methodsOn 15 April 2020, together with the German Society of Pathology and the Federal Association of German Pathologists, the German Registry of COVID-19 Autopsies (DeRegCOVID) was launched (www.DeRegCOVID.ukaachen.de). Building...

Background: Autopsy is an important tool for understanding the pathogenesis of diseases, including COVID-19. Material and methods: On 15 April 2020, together with the German Society of Pathology and the Federal Association of German Pathologists, the German Registry of COVID-19 Autopsies (DeRegCOVID) was launched ( www.DeRegCOVID.ukaachen.de )....

Background A population-level survey (PLS) is an essential and standard method used in public health research that supports the quantification of sociodemographic events, public health policy development, and intervention designs. Data collection mechanisms in PLS seem to be a significant determinant in avoiding mistakes. Using electronic devices s...

Zusammenfassung Hintergrund: In der Anfangsphase der COVID-19-Pandemie konnte in Deutschland zwar eine niedrigere Inzidenz- und Letalitätsrate im Vergleich zu seinen Nachbarländern beobachtet werden, allerdings zeigten Studien zum Teil vergleichsweise hohe Letalitätsraten bei beatmeten COVID-19-Patienten. Methode: Im Rahmen dieser retrospektiven A...

Introduction: Quality of emergency department (ED) care affects patient outcomes substantially. Quality indicators (QIs) for ED care are a major challenge due to the heterogeneity of patient populations, health care structures and processes in Germany. Although a number of quality measures are already in use, there is a paucity of data on the impo...

The autopsy is an important instrument to understand the pathogenesis of diseases, including infectious diseases and novel pathogens like Ebola, SARS or SARS-CoV-2 (Mari Saez et al, 2015; Nicholls et al, 2003). The first autopsy studies already suggested important disease mechanisms in fatal COVID-19 cases with potential therapeutic implications. T...

Modern research projects in healthcare research and medical research are oftentimes multi-centered, multi-disciplinary, and conducted by a consortium of multiple collaborators. Increasingly, the resulting data emanating emerging from different primary and secondary sources is linked on a personal level. The General Data Protection Regulation regula...

The user interface of a mechanical ventilator is safety critical, as use errors can lead to patient harm. A systematic review was conducted to identify published usability issues and contributing factors that can lead to use errors. The findings were grouped in an Ishikawa diagram. Many of the problems mentioned based on inconsistent labeling and m...

BACKGROUND Population-level survey (PLS) is an essential standard method used in public health research. It supports to quantify sociodemographic events and support public health policy development and intervention designs with evidence. Though all steps in the survey can contribute to the data quality parameters, data collection mechanisms seem th...

Background Rescue services and emergency departments are increasingly burdened by patients who are not life-threateningly ill. In England and the USA, a Community Paramedic System has been established for local care. Based on these concepts, a Community Paramedic System (“Gemeindenotfallsanitäter”, G‑NFS) adapted to the German rescue system was dev...

Beatmungspflichtige Patientinnen und Patienten unterliegen besonderen Gefahren. Ein Ausfall, eine Fehlfunktion oder die Fehlbedienung eines Beatmungsgerätes kann binnen kurzer Zeit zur Hypoxie und damit zu irreversiblen Schäden oder dem Tod führen. Daraus resultieren unterschiedliche Anforderungen an die Konstruktion und Herstellung von Beatmungsge...

The digital transformation has influenced medical pathways in clinical routine and research as never before. This transformation requires multiple competencies in digital health from health professionals. To address learning objectives for teaching, the national project group „Teaching Medical Informatics in Medicine“ of the German Association for...

Background. Modern intensive care methods led to an increased survival of critically ill patients over the last decades. But an unreflected application of modern intensive care measures might lead to prolonged treatment for incurable diseases, and an inadaequate or too aggressive therapy can prolong the dying process of patients. In this study, we...

Ca. 30 Prozent der Rettungswagen-Einsätze in Deutschland werden ex-post nicht als Notfall klassifiziert [1]. An dieser Stelle setzt der Gemeindenotfallsanitäter (GNFS) an, um Patienten mit nicht lebensbedrohlichen Krankheitsbildern zu untersuchen und an die richtige Versorgungsstruktur zu verweisen [2]. Eine erste Evaluation soll darstellen, wie di...

Introduction Staphylococci are the most commonly identified pathogens in bloodstream infections. Identification of Staphylococcus aureus in blood culture (SAB) requires a prompt and adequate clinical management. The detection of coagulase-negative staphylococci (CoNS), however, corresponds to contamination in about 75% of the cases. Nevertheless, a...

"Ca. 30 Prozent der Rettungswagen-Einsätze in Deutschland werden ex-post nicht als Notfall klassifiziert [1]. An dieser Stelle setzt der Gemeindenotfallsanitäter (GNFS) an, um Patienten mit nicht lebensbedrohlichen Krankheitsbildern zu untersuchen und an die richtige Versorgungsstruktur zu verweisen [2]. Eine erste Evaluation soll darstellen, wie d...

The Medical Device Directive (MDD) will be replaced on 26.05.2020 by the new Medical Device Regulation (MDR). The European Parliament wants to create a transparent, solid, predictable and sustainable legal framework. One of the major upcoming changes effects the perspective on software as a medical device. This paper describes the fundamental relat...

The German Emergency Department Data Registry (GEDD-registry, AKTIN) provides an infrastructure for collecting and querying up-to-date medical records in a distributed manner. Within this framework, a benchmark report on cross-institutional comparison using the program R is prepared using routine data of participating hospitals. Currently, 16 emerg...

Excessive numbers of clinical alarms reduce the awareness of caregivers. Frequent alarms, many of which are non-actionable, can lead to cognitive overload, stress, and desensitization to alarms, called "Alarm Fatigue", which can severely impact patient safety. Due to the multifactorial nature of excessive alarming quantitative data about many facet...

Many studies use eye-tracker to analyse the socio-technical system, also in medical research. Only a few articles describe the use of eye-tracker to examine human-computer interaction in a critical care environment, especially in the field of anaesthesia or surgery. Therefore, we have tested in a feasibility study head-mounted eye-tracker of three...

Each year, millions of rescue operations occur in Germany. Despite rising numbers, there is a shortfall of systematic quality management (QM). Focusing on finding the required quality parameters, this work aims at linking heterogeneous and distributed data sources on the patient-level. Presented here is necessary IT infrastructure for linking patie...

Background Mechanical ventilation is provided for neurological patients in the following settings: in neurointensive care units, in centers providing weaning and early rehabilitation and in home mechanical ventilation. In the last decade there has been a sharp rise in treatment and bed capacities for mechanically ventilated neurological patients in...

In den Notaufnahmen deutscher Krankenhäuser werden jährlich ca. 21 Millionen Patienten behandelt – Tendenz stetig steigend. Lange Zeit wurden die Behandlungsdaten in den Notaufnahmen nicht standardisiert erhoben. Allgemeingültige Aussagen zu den Patienten und deren Versorgung waren nicht verfügbar. Die Erhebung der Behandlungsdaten war bisher auf r...

Background: Periodic demographic health surveillance and surveys are the main sources of health information in developing countries. Conducting a survey requires extensive use of paper-pen and manual work and lengthy processes to generate the required information. Despite the rise of popularity in using electronic data collection systems to allevia...

Standardisierung und Digitalisierung der Dokumentation in der Medizin schreiten zunehmend voran. In dem Beschluss des Gemeinsamen Bundesauschusses zu einem gestuften System von Notfallstrukturen in Krankenhäusern sowie in dem Gutachten des Sachverständigenrates zur Entwicklung im Gesundheitswesen Bedarfsgerechte Steuerung der Gesundheitsversorgung...

The use of mobile devices for a house to house interview-administered survey data collection is becoming a practice along with the paper-based data collection tools. Though the electronic data capture mechanism is supposed to improve the efficiency of the data collection mechanism and the quality of the data, there is limited evidence on the cost-e...

Background To examine if fibrin-coated collagen fleece (Tachosil) interferes with bone and wound healing when it is used on the cut surface of the sternum after median sternotomy. Methods A total of 25 patients with osteoporotic sternal disorders were treated with fibrin-coated collagen fleece at the cut surface of the sternum after median sternoto...

Despite a vast and growing number of publications on alarm fatigue there seem to be few attempts to quantify in a systematic way the root causes or consequences of alarm fatigue. The paper describes such an attempt, based on the notion of quality dimensions of an alarm system. The concept as well as concrete instances of these dimensions were devel...