Wendelin Schramm

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Verified

Wendelin verified their affiliation via an institutional email.

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• Doctor of Medicine
• Professor at Heilbronn University

Introduction In Germany, statutory insured persons are entitled to a stool test (faecal immunochemical test (FIT)) or colonoscopy for colorectal cancer (CRC) screening, depending on age and sex, yet participation rates are rather low. Sigmoidoscopy is a currently not available screening measure that has a strong evidence base for incidence and mort...

To date, more than 160 million people have been infected with COVID-19 worldwide. In the present study, we investigated the history of SARS-CoV-2 infection among 3067 healthcare workers (HCW) in a German COVID-19 treatment center during the early phase of the pandemic (July 2020) based on the seroprevalence of SARS-CoV-2 antibodies and self-reporte...

Objectives The cardiovascular outcomes challenge examined the predictive accuracy of 10 diabetes models in estimating hard outcomes in 2 recent cardiovascular outcomes trials (CVOTs) and whether recalibration can be used to improve replication. Methods Participating groups were asked to reproduce the results of the Empagliflozin Cardiovascular Out...

Fragestellung: Die Wirksamkeit von iPDM, einem digital unterstützten, strukturierten Behandlungskonzept, wurde im PDM-ProValue Studienprogramm bei insulinbehandelten Patienten mit Typ-2 Diabetes (T2D) untersucht. Neben klinischen Parametern wurden die Therapiezufriedenheit von Patienten, die Behandlungszufriedenheit der Ärzte sowie die Adhärenz der...

Health Technology Assessment is one of the standard instruments in support of the decision-making to define the public health services both internationally and in the German health care system. Besides systematic reviews, benefit-harm-analyses, health economic evaluations, and, decision-analytic modelling, especially epidemiological and biometrical...

Background In Germany, a colorectal cancer (CRC) screening programme is in place that entitles individuals to a stool test or colonoscopy. However, less than half of those eligible participate. The inclusion of an additional screening option, such as the evidence-based sigmoidoscopy, could lead to a higher overall participation rate, but also to in...

Plain language summary Is it worthwhile to use next generation liquid biopsy for cancer recurrence detection on patients with colorectal cancer? Colon cancer is common. Worldwide, almost one million people die from it every year. Next Generation Sequencing Liquid Biopsy is a very sensitive technology for detecting cancer cells and their genetic inf...

Background: Next-generation sequencing liquid biopsy (NGS-LB) for colorectal cancer (CRC) detection and surveillance remains an expensive technology as economies of scale have not yet been realized. Nevertheless, the cost of sequencing has decreased while sensitivity has increased, raising the question of whether cost-effectiveness (CE) has already...

Introduction Screening for colorectal cancer (CRC) is effective in reducing both incidence and mortality. Colonoscopy and stool tests are most frequently used for this purpose. Sigmoidoscopy is an alternative screening measure with a strong evidence base. Due to its distinct characteristics, it might be preferred by subgroups. The aim of this syste...

Background Psoriasis is a chronic disease characterized by inflammation, increased scaling, itching, and other symptoms. Psoriasis is not contagious, but patients have often felt shunned. Therefore, in addition to psoriasis symptoms, stress, anxiety, and depression can also affect quality of life (QoL). Surveys show that only a quarter of patients...

Background and Objectives: Tonsillar infections are a common reason to see a physician and lead to a reduction in the patients’ health-related quality of life (HRQoL). HRQoL may be an important criterion in decision science and should be taken into account when deciding when to perform tonsillectomy, especially for chronic tonsillitis. The aim of t...

Objectives Health economic (HE) models are routinely used to support health policy and resource allocation decisions but are often considered “black boxes” that may be prone to error and bias. Open source models (OSMs) have been advocated to increase the transparency, credibility, and reuse of HE models. Previous studies have demonstrated interest...

Background: Structural uncertainty can affect model-based economic simulation estimates and study conclusions. Unfortunately, unlike parameter uncertainty, relatively little is known about its magnitude of impact on life-years (LYs) and quality-adjusted life-years (QALYs) in modeling of diabetes. We leveraged the Mount Hood Diabetes Challenge Netw...

BACKGROUND Psoriasis is a chronic disease characterized by inflammation, increased scaling, itching, and other symptoms. Psoriasis is not contagious, but patients have often felt shunned. Therefore, in addition to psoriasis symptoms, stress, anxiety, and depression can also affect quality of life (QoL). Surveys show that only a quarter of patients...

Parkinson’s disease (PD) is a progressive neurodegenerative movement disorder with a complex set of motor and non-motor symptoms and a diverse disease progression. Subtyping PD patients is required for personalized therapies but stratification approaches based on intermediate phenotypes such as clinical assessment scores lack reproducibility and st...

Decision models (DM), especially Markov Models, play an essential role in the economic evaluation of new medical interventions. The process of DM generation requires expert knowledge of the medical domain and is a time-consuming task. Therefore, the authors propose a new model generation software PrositNG that is connectable to database systems of...

Background Integrated personalized diabetes management (iPDM) is a digitally supported therapeutic concept to improve patient-physician interaction to overcome the aspects of clinical inertia. Integrated personalized diabetes management can support decision making and improve therapeutic outcomes of suboptimally controlled persons with insulin-trea...

Transparency in health economic decision modelling is important for engendering confidence in the models and in the reliability of model-based cost-effectiveness analyses. The Mount Hood Diabetes Challenge Network has taken a lead in promoting transparency through validation with biennial conferences in which diabetes modelling groups meet to compa...

Aims: Globally, many patients with insulin-treated type-2 diabetes are suboptimally controlled. The PDM-ProValue study program evaluated whether integrated personalized diabetes management (iPDM) has the potential to improve clinical outcomes. Methods: 101 practices with 907 patients participated in the 12-month, prospective, controlled, cluster...

Aim: The PDM-ProValue study program showed the benefit of iPDM for people with type 2 diabetes mellitus (T2D) on insulin therapy. Here, we analyze which treatment process conditions may be key for this success. Methods: The study program was conducted over 12 months in a prospective, controlled, cluster-randomized setting. 101 medical practices wer...

The way diabetes patients cope with their disease in day-to-day routines is decisive for the development or the prevention of medical complications. Smartphones have created the ubiquitous environment to support health care with mobile applications (mHealth). This article comments on the publication by Offringa et al in JDST, which is one of few st...

Fragestellung: Viele Patienten mit insulinbehandeltem Typ-2 Diabetes (T2D) erreichen nicht ihre Behandlungsziele. Das PDM-ProValue Studienprogramm untersuchte die Wirksamkeit eines digital unterstützen, strukturierten Behandlungsprozesses (integriertes Personalisiertes Diabetes-Management, iPDM) auf glykämische Einstellung und andere Parameter bei...

Fragestellung: Viele Menschen mit insulinbehandeltem Typ-2 Diabetes (T2D) erreichen nicht ihre Behandlungsziele. Das PDM-ProValue Studienprogramm untersuchte, inwieweit ein digital unterstütztes, strukturiertes Behandlungskonzept (integriertes, personalisiertes Diabetes-Management, iPDM) durch Förderung gemeinsamer Therapieentscheidungen von Arzt u...

Introduction: Chlamydia is a very common bacterial sexual transmitted infection (STI) among young adults. High numbers of asymptomatic cases hamper a timely treatment start, whereas the treatment itself is efficient and cheap. Proactive screening can decrease this mismatch. There are many models which are able to evaluate and simulate different scr...

Method: Being "healthy" can be interpreted as a norm state, being "sick" as a temporary state and "dead" as an absorbing state. Transitions with accompanying transition probabilities that allow a cohort of model objects "to flow" between the cumulative exhaustive and mutually exclusive states complete the model structure. Half-cycle correction hel...

Disease Modelling of chronic diseases such as diabetes or asthma plays an important role in medical decision making. State transition models are the most frequently used method. The objective is to illustrate the elements and the most important underlying procedures for designing a decision analytic Markov model with only three-states. Method: Bein...

Clinical cancer registries are a valuable data source for health services research (HSR). HSR is in need of high quality routine care data for its evaluations. However, the secondary use of routine data – such as documented cancer cases in a disease registry – poses new challenges in terms of data quality, IT-management, documentation processes and...

There has been legitimate criticism with regard to the quality and the transparency of health economic modelling studies. For that reason, the aim of the PROSIT Disease Modelling Community is to develop transparent open source health economic disease models for diabetes mellitus. RESULTS: Markov type models were developed in the open source spread...

Records of female breast cancer patients were selected from a clinical cancer registry and separated into three cohorts according to HER2-status (human epidermal growth factor receptor 2) and treatment with or without Trastuzumab (a humanized monoclonal antibody). Propensity score matching was used to balance the cohorts. Afterwards, documented inf...

Objectives: Today, hospitals and other health care-related institutions are accumulating a growing bulk of real world clinical data. Such data offer new possibilities for the generation of disease models for the health economic evaluation. In this article, we propose a new approach to leverage cancer registry data for the development of Markov mod...

Background: Collaborative use of structured self-monitoring of blood glucose (SMBG) data and data management software, utilized within a 6-step cycle enables integrated Personalized Diabetes Management (PDM). The 2 PDM-ProValue studies shall assess the effectiveness of this approach in improving patient outcomes and practice efficiencies in outpat...

Survival time prediction at the time of diagnosis is of great importance to make decisions about treatment and long-term follow-up care. Cancer survival rates and median survival times are estimated from a large group of cancer patients and mostly based on the TNM-staging system. While these estimates do apply to the population in general, they are...

Survival time prediction at the time of diagnosis is of great importance to make decisions about treatment and long-term follow-up care. However, predicting the outcome of cancer on the basis of clinical information is a challenging task. We now examined the ability of ten different data mining algorithms (Perceptron, Rule Induction, Support Vector...

Einleitung: Die Aufgabe epidemiologischer Krebsregister (EKR) ist die Erfassung und Untersuchung von Häufigkeiten der Krebserkrankungen in fest definierten Bevölkerungsgruppen. Die Datenqualität eines EKR wird i.d.R. mit Kennzahlen zur Vollzähligkeit und Vollständigkeit belegt [1]. Für Klinische Krebsregister (KKR) gibt es keinen derartigen festges...

Survival time prediction at the time of diagnosis is of great importance to make decisions about treatment and long-term follow-up care. However, predicting the outcome of cancer on the basis of clinical information is a challenging task. We now examined the ability of ten different data mining algorithms (Perceptron, Rule Induction, Support Vector...

OBJECTIVES: Health economic disease models are often build with data from clinical trials and thus do not necessarily reflect the routine care situation in hospitals. For this scenario, we outline a method to generate disease models using data mining algorithms on patient records from a regional clinical cancer registry. METHODS: Markov models are...

Hospital cancer registries can be a reliable source for comparative effectiveness research. We used an expanded Markov model to estimate breast cancer prevalence for a distinct region in Germany. Thereby, transition probabilities were computed with patient information gained directly from the dataset. A first validation was executed by comparing th...

There is an increasing trend of diabetes prevalence. Taking into account the findings of studies with common estimation methods, it is assumed that 5.2 million people in Germany have the disease. This number is mainly based on extensive health surveys and data from single health insurances. The secondary use of prescription data of statutory health...

Background and aim: Diabetes mellitus is a widespread chronic disease. Diabetes prevalence was already analyzed in multiple complex studies. The goal of this analysis was the determination of the regional drug treatment prevalence and medication of diabetes mellitus in Germany. Simultaneously, we examined and validated the applicability of prescri...

In times of short health care budgets, reimbursement for self-monitoring of blood glucose (SMBG) in diabetes patients without insulin treatment is subject to debate. The Structured Testing Program (STeP) trial found a positive correlation of test frequency and improved hemoglobin A1c (HbA1c) levels in poorly controlled type 2 diabetes patients not...

Dieser Beitrag beschreibt die Arbeit und Ziele einer Open Source - Entwicklungsgruppe zur Erstellung gesundheitsökonomischer Erkrankungsmodelle, die von der Hochschule Heilbronn federführend begleitet wird. Es wird auf die Vorteile einer solchen Entwicklung, aber auch auf die damit zusammenhängenden Probleme eingegangen.

Einleitung und Fragestellung Die PROSIT Diesease Modelling Community ist eine Open Source Entwicklungsgemeinschaft zur Erstellung gesundheitsökonomischer Erkrankungsmodelle für die Kosten-Nutzen Bewertung der Behandlung von Diabetes mellitus [1]. Im Januar 2008 wurde der erste Release Candidate des PROSIT Modells für Nephropathie bei Typ 2 Diabetes...

OBJECTIVES: Most of the available disease models are “black box” software. Even with published methods and structure, users are in most cases not able to proof how a model really works. Mislead intellectual property concerns and powerful interests behind disease models are leading to substantial criti- cism in terms of quality and credibility [1]....

To determine the occurrence of complications and treatment costs in the first 6 years from diagnosis of Type 2 diabetes in the primary care level. The German multi-centre, retrospective epidemiological cohort study ROSSO observed patients from diagnosis in 1995-1999 until the end of 2003 or loss to follow-up. 192 randomly contacted primary care pra...

Quality-controlled mammography screening programs (MSP) have led to a reduction in breast cancer mortality. The purpose of this economic analysis was to assess the cost-effectiveness of MSP compared with an established opportunistic screening strategy (OS) in Switzerland, to identify the major factors influencing the economic outcome. Using cancer...

The economic value of tiotropium in patients with moderate to severe COPD was analysed in a cost-effectiveness study for the Swiss public health insurance system. The results show a drop in COPD exacerbations in comparison to Ipratropium, Salmeterol and standard care (without use of anticholinergics and beta-adrenergics). The numbers-needed-to-trea...

Disease modelling increasingly plays an important role in planning and implementing medical decision making in diabetes care. For a general practitioner it is difficult to find access to application, benefit, arithmetic background and quality criteria of modelling. This review provides a comprehensive overview about the current methods in disease m...

Background: Pioglitazone has been approved in Europe for oral combination therapy for type 2 diabetes mellitus. Along with other agents of the thiazolidinedione class, it has a novel intracellular mechanism of action. Clinical trials with pioglitazone have confirmed a strong product profile in terms of control of blood glucose and lipids. However,...

OBJECTIVES: Health economic assessment of cost-effectiveness parameters for the comparison of typical (Haloperidol), partially atypical depot (Flupentixol) and atypical neuroleptics (Olanzapin, Risperidon) in the treatment of schizophrenia from the perspective of German health insurance. METHODS: A published markov model was rebuilt and calibrated...

OBJECTIVES: Optimization of type 2 diabetes intervention strategies in Germany based on stepwise prognoses of expected medical and economic outcomes in population subgroups. METHODS: A published, editable diabetes model was used to assess the outcomes of different degrees of secondary prevention measures for different diabetes type 2 patient sub-gr...

The PROSIT (Proteinuria Screening and Intervention) Project started in 1993 in order to obtain data on the prevalence of micro- and macroalbuminuria in diabetic patients treated in primary care, to establish an easy screening programme for microalbuminuria, in which also diabetic patients can participate in self-responsibility, and to implement a s...