Refine
Year of publication
Document Type
- Article (181) (remove)
Has Fulltext
- yes (181)
Is part of the Bibliography
- no (181)
Keywords
- Student (11)
- Knowledge (10)
- Mumbai (10)
- Wissen (10)
- India (9)
- Germany (8)
- Software (7)
- Epidemiologie (6)
- HIV (6)
- Indien (6)
- Informations- und Dokumentationswissenschaft (6)
- Klinisches Experiment (6)
- Künstliche Intelligenz (6)
- University students (6)
- clinical research (6)
- Antibiotikum (5)
- Bibliothek (5)
- Forschungsdaten (5)
- Antibiotic resistance (4)
- Attitude (4)
- Bibliothekswissenschaft (4)
- Computer (4)
- Deutschland (4)
- Einstellung (4)
- Kommunikation (4)
- Medizinische Informatik (4)
- Nigeria (4)
- Online-Medien (4)
- Pakistan (4)
- Public reporting (4)
- clinical trial (4)
- public reporting (4)
- Arzneimittelresistenz (3)
- C-arm (3)
- Claims data (3)
- Computerunterstütztes Lernen (3)
- Digitalisierung (3)
- Dritte-Person-Effekt (3)
- Education (3)
- Hochschule Hannover (3)
- Impfstoff (3)
- Incidence (3)
- Informationskompetenz (3)
- Interne Kommunikation (3)
- Inzidenz <Medizin> (3)
- Karachi (3)
- Krankenhaus (3)
- Management (3)
- Mitarbeiter (3)
- Pharmacy (3)
- Pharmazie (3)
- Pharmaziestudent (3)
- Prevalence (3)
- Rivalität (3)
- Self-medication (3)
- Therapie (3)
- Third-Person-Effekt (3)
- USA (3)
- Wissenschaftliche Bibliothek (3)
- Wissenschaftskommunikation (3)
- Zufriedenheit (3)
- meta-analysis (3)
- African socio-cultural context (2)
- Afrika (2)
- Aids (2)
- Antibiotic (2)
- Antibiotics (2)
- App <Programm> (2)
- Arbeitsbedingungen (2)
- Architecture (2)
- Ausbildung (2)
- Awareness (2)
- Bachelorstudium (2)
- Befragung (2)
- Bibliotheks- und Informationswissenschaft (2)
- C-Bogen (2)
- Change Management (2)
- Claims data analysis (2)
- Datenmodell (2)
- Depression (2)
- Diabetes mellitus (2)
- Didaktik (2)
- Digitale Radiographie (2)
- E-Learning (2)
- Entwicklungsländer (2)
- Epidemiology (2)
- Expertensystem (2)
- Fachangestellter für Medien- und Informationsdienste (2)
- Fachinformationsdienst (2)
- Fachreferent (2)
- Fachreferentin (2)
- Fragebogen (2)
- Führung (2)
- Gesundheitsinformationssystem (2)
- Gesundheitswesen (2)
- Gruppenidentität (2)
- HIV-Infektion (2)
- Hannover (2)
- Hospital (2)
- Hospital report cards (2)
- Hygiene (2)
- Informationsmanagement (2)
- Inhaltserschließung (2)
- Karatschi (2)
- Knochenbruch (2)
- Krankenpflege (2)
- Leadership (2)
- Lebensqualität (2)
- Medical Informatics (2)
- Medizin (2)
- Metaanalyse (2)
- Methode (2)
- Mumbai, India (2)
- Mundhöhlenkrebs (2)
- Occupational safety climate (2)
- Open Access (2)
- Open Science (2)
- Oral cancer (2)
- Osteoporose (2)
- Patient (2)
- Patient safety climate (2)
- Patient satisfaction (2)
- Postmenopause (2)
- Rauchen (2)
- Research Data Management (2)
- Schlaganfall (2)
- Selbstmedikation (2)
- Sicherheitsklima (2)
- Smoking (2)
- Social Media (2)
- Sportfan (2)
- Strahlenschutz (2)
- Streustrahlung (2)
- Students (2)
- Sturz (2)
- Tabakkonsum (2)
- Teilstudium (2)
- Tobacco (2)
- Transformational leadership (2)
- USFDA (2)
- Weiterbildung (2)
- Working conditions (2)
- clinical trials (2)
- computer based training (2)
- cost-effectiveness (2)
- developing countries (2)
- developing country (2)
- direct benefit (2)
- education (2)
- epidemiology (2)
- identity threat (2)
- modifiable characteristics of the vulnerable patients (2)
- online media (2)
- patient benefit (2)
- questionnaire (2)
- radiation protection (2)
- scattered radiation (2)
- social benefit (2)
- transparency (2)
- virtual radiography (2)
- 18F-FET-PET/CT (1)
- AIDS (1)
- ASD (1)
- Absolvent (1)
- Absolvent*innenbefragung (1)
- Absolventenbefragung (1)
- Acute stroke care (1)
- Administrative data (1)
- Adult Vaccines (1)
- Adverse drug event (1)
- Adverse drug reaction (1)
- Aerobes Training (1)
- Aerobic exercise (1)
- African countries (1)
- Aggressivität (1)
- Allergie (1)
- Alternative Medicine (1)
- Alternative Medizin (1)
- Altersgruppe (1)
- Ambulatory Monitoring (1)
- Amino acid PET (1)
- Analgesics (1)
- Analgetikum (1)
- Anforderungsprofil (1)
- Anschlussheilbehandlung (1)
- Antidiabetic (1)
- Antidiabetikum (1)
- Antiretroviral therapy (1)
- Aphasia (1)
- Aphasie (1)
- Approval (1)
- Approvals (1)
- Arbeitsweise (1)
- Architektur (1)
- Arcuate fasciculus (1)
- Art History (1)
- Arzneimittel (1)
- Arzneimittelnebenwirkung (1)
- Arzneimittelüberwachung (1)
- Assessment (1)
- Atopic (1)
- Atopie (1)
- Autism (1)
- Autism spectrum disorder (1)
- Autismus (1)
- Automatische Identifikation (1)
- Automatische Klassifikation (1)
- Automobile spray painters (1)
- BASIC (1)
- BOBCATSSS (1)
- Bachelor (1)
- Bachelor's programme "library and information management" (1)
- Bachelorstudiengang (1)
- Bachelor’s degree program (1)
- Balanced Scorecard (1)
- Barcamp (1)
- Baustatik (1)
- Bauökologie (1)
- Beeinflussung (1)
- Benutzerfreundlichkeit (1)
- Berichterstattung (1)
- Berufliche Qualifikation (1)
- Berufsaussicht (1)
- Berufsbild (1)
- Berufsfeld (1)
- Berufskrankheit (1)
- Berufsunfähigkeit (1)
- Bestandsaufbau (1)
- Bewegungstherapie (1)
- Bewertung (1)
- Bewertungsportale (1)
- Bibliotheksausbildung (1)
- Bibliotheksorganisation (1)
- Bildkommunikation (1)
- Bildpublizistik (1)
- Bildredaktion (1)
- Bildredaktionsforschung (1)
- Bildung (1)
- Biomedical Informatics (1)
- Biometrie (1)
- Blackboard <Expertensystem> (1)
- Blutspende (1)
- Body composition (1)
- Bone mineral density (1)
- Book Sprint (1)
- Bortedella (1)
- Brain tumor (1)
- Buch (1)
- Building Informatics and Construction Operation (1)
- Building and Construction History (1)
- CBR Express (1)
- CBT (1)
- CD4+ cell count (1)
- COPD (1)
- COVID-19 (1)
- Capacity strengthening (1)
- Cardiorespiratory function (1)
- Case finding (1)
- Causal inference (1)
- Cell phone (1)
- Cement workers (1)
- Censorship (1)
- Centaurea behen (1)
- Childhood febrile conditions (1)
- Children (1)
- Choi (1)
- Cholera (1)
- Chronic low back pain (1)
- Chronic obstructive pulmonary disease (1)
- Chronic pain (1)
- Chronische Niereninsuffizienz (1)
- Chronischer Schmerz (1)
- Classification (1)
- Cleaners (1)
- Clinical Pathway (1)
- Clinical Trials (1)
- Clinical trial (1)
- Clinical trials (1)
- Comet Assay (1)
- Communication (1)
- Community-dwelling older adults (1)
- Comparative effectiveness (1)
- Complementary Medicine (1)
- Composite measures (1)
- Construction Research (1)
- Corticosteroide (1)
- Corticosteroids (1)
- Cost-effectiveness (1)
- Costs (1)
- Cultural Heritage (1)
- Curriculumentwicklung (1)
- Cyber-Knife (1)
- CyberKnife (1)
- Cyberknife (1)
- DALY (1)
- DNA damage (1)
- DNA repair (1)
- DNS-Reparatur (1)
- DNS-Schädigung (1)
- DTI (1)
- Dairy cow (1)
- Dance Studies (1)
- Data Model (1)
- Data quality control (1)
- Data-Warehouse-Konzept (1)
- Datenqualität (1)
- Datentransparenzverordnung (1)
- Datenverarbeitung (1)
- Decision Support (1)
- Decision Support Systems (1)
- Declaration of Helsinki (1)
- Dermatitis (1)
- Developing Countries (1)
- Diabetes mellitus Typ 2 (1)
- Diabetic wound healing (1)
- Diagnose (1)
- Diagnosis (1)
- Diagnostic delay (1)
- Diagnostik (1)
- Diffusionsgewichtete Magnetresonanztomografie (1)
- Digital Humanities (1)
- Digital Library (1)
- Diphosphonate (1)
- Discrete choice experiment (1)
- Discriminatory power (1)
- Disease Burden (1)
- Disease burden (1)
- Dokumentarfilm (1)
- Drogenmissbrauch (1)
- Dynamic 18F-FET-PET/CT (1)
- E-cadherin (1)
- ELIZA (1)
- EMA (1)
- ESTEEM (1)
- Ebola-Virus (1)
- Economic and political/governmental infrastructural factors (1)
- Educational intervention (1)
- Effizienz (1)
- Eigengruppe (1)
- Elderly (1)
- Electronic health records (1)
- Elektronische Bibliothek (1)
- Endemic countries (1)
- Entscheidungsfindung (1)
- Entscheidungsunterstützung (1)
- Entscheidungsunterstützungssystem (1)
- Enugu (1)
- Epidemiologic methods (1)
- Epilepsie (1)
- Epilepsy (1)
- Erfahrungsberichte (1)
- Erlebnisbericht (1)
- Erwerbung (1)
- Erziehung (1)
- European Union (1)
- Evaluation (1)
- Exercise training (1)
- Experience reports (1)
- Expert consensus (1)
- Experteninterview (1)
- Fachkräftemangel (1)
- Fachreferat (1)
- Fahrzeuglackierer (1)
- Falls (1)
- Fasciculus arcuatus (1)
- Feedback (1)
- Feeding management (1)
- Film (1)
- Filmarchiv (1)
- Filmmuseum (1)
- Flüchtlingslager (1)
- Focus groups (1)
- Forschungsdatenzentrum (1)
- Forschungsfreundlicher Datenzugang (1)
- Forschungsinformationen (1)
- Forschungsprojekt (1)
- Forschungssemester (1)
- Fraktionierung (1)
- Framework (1)
- Fremdgruppe (1)
- FurB (1)
- Fütterung (1)
- Ga-68 DOTATATE (1)
- Ga-68 DOTATOC (1)
- Gehobener Dienst (1)
- Genauigkeit (1)
- Gender (1)
- Genehmigung (1)
- Genetik (1)
- Geriatrie (1)
- German data transparency regulation (1)
- Germanistik (1)
- Geschichte (1)
- Gesetzliche Krankenversicherung (1)
- Gesundheit (1)
- Gesundheitsdaten (1)
- Gesundheitsfürsorge (1)
- Gesundheitspolitik (1)
- Gesundheitsschaden (1)
- Gliom (1)
- Glioma (1)
- Graft Rejection (1)
- Grand mean (1)
- Guideline (1)
- HAART (1)
- HIV/AIDS (1)
- HPV (1)
- Hackathon (1)
- Haematological parameters (1)
- Handy (1)
- Hannover University of Applied Sciences and Arts (1)
- Health Care (1)
- Health Informatics (1)
- Health Information Systems (1)
- Health Information Technology (1)
- Health care utilization (1)
- Health management (1)
- Health promotion (1)
- Health services (1)
- Healthcare resource utilization (1)
- Healthy aging (1)
- Hearsay (1)
- Heil- und Hilfsmittel (1)
- Hereditary angioedema (1)
- Hereditäres Angioödem (1)
- Herzmuskelkrankheit (1)
- Hilfeleistung (1)
- Hirntumor (1)
- Hochschulausbildung (1)
- Hochschulbibliothek (1)
- Hochschule (1)
- Hochschule Hannover. Fakultät III - Medien, Information und Design (1)
- Hochschule für den Öffentlichen Dienst in Bayern (1)
- Hochschulpolitik (1)
- Holzarbeiter (1)
- Hospital Cost (1)
- Hospital choice (1)
- Hospital quality (1)
- Hospital referrals (1)
- Hostile-Media-Effekt (1)
- Housing (1)
- Humanes Papillomavirus (1)
- Huntington's disease (1)
- Huntington-Chorea (1)
- Hämatologie (1)
- ICD (1)
- ICD code (1)
- ICH-GCP (1)
- Identitätsentwicklung (1)
- Immune checkpoint inhibitors (1)
- Impfung (1)
- Income (1)
- Indonesia (1)
- Infarction (1)
- Infektionskrankheit (1)
- Influence-of-Presumed-Media Influence-Approach (1)
- Influence-of-Presumed-Media-Influence-Ansatz (1)
- Influence-of-Presumed-Media-Influence-Approach (1)
- Information materials (1)
- Informationsethik (1)
- Informationswissenschaft (1)
- Infrastruktur (1)
- Infrastrukturplanung (1)
- Intensivstation (1)
- Interne Unternehmenskommunikation (1)
- Internet (1)
- Inverse probability weighting (1)
- Joseph (1)
- Journalist (1)
- Journalistische Bildkommunikation (1)
- Kakuma (1)
- Kalobeyei (1)
- Kardiopulmonale Leistungsfähigkeit (1)
- Katalog (1)
- Keyword Extraction (1)
- Kidney (1)
- Kinderheilkunde (1)
- Klinischer Behandlungspfad (1)
- Knochendichte (1)
- Knochenmineraldichte (1)
- Kommunikationspolitik (1)
- Konferenz (1)
- Konflikt (1)
- Kongress (1)
- Konsultation <Medizin> (1)
- Krafttraining (1)
- Krampf (1)
- Krankheitskosten (1)
- Kreuzschmerz (1)
- Kulturerbe (1)
- Kunstgeschichte <Fach> (1)
- Kurs (1)
- Körperbau (1)
- Körperfett (1)
- Körperliche Leistungsfähigkeit (1)
- LCSH (1)
- LIS-Studium (1)
- Lactose intolerance (1)
- Lactoseintoleranz (1)
- Landscape Planning (1)
- Landschaftsplanung (1)
- Language pathways (1)
- Lassa fever vaccines (1)
- Lassa-Fieber (1)
- Laßberg, Joseph von (1)
- Learning Circle (1)
- Lebanon (1)
- Lebensmittelgroßhandel (1)
- Leber (1)
- Lehre (1)
- Lehrplanentwicklung (1)
- Leitfadeninterview (1)
- Lernen (1)
- Lernziel (1)
- Lessons Learned (1)
- Library and Information Science study program (1)
- Library of Congress (1)
- Lindauer Evangeliar (1)
- Literaturauswertung (1)
- Literature Review (1)
- Literaturrecherche (1)
- Longitudinal data (1)
- Luftqualität (1)
- Ländlicher Raum (1)
- Machine Learning (1)
- Maharashtra (1)
- Malnutrition (1)
- Mannschaftssport (1)
- Marke (1)
- Marketing (1)
- Maschinelles Lernen (1)
- Matunga (1)
- Mechanism (1)
- Media Studies (1)
- Medical Ethics (1)
- Medical devices (1)
- Medical expertise (1)
- Medication adherence (1)
- Medienwissenschaft (1)
- Mediothek (1)
- Medizinische Dokumentation (1)
- Medizinische Versorgung (1)
- Mental health (1)
- Metalloregulator (1)
- Mikrocomputer (1)
- Milchkuh (1)
- Misstrauen (1)
- Mitarbeiterbindung (1)
- Mitarbeitermanagement (1)
- Mitarbeiterzufriedenheit (1)
- Mitigation plan (1)
- Monitoring (1)
- Mortality (1)
- Mothers’ perception of recovery (1)
- Mothers’ satisfaction (1)
- Motorisches Gleichgewicht (1)
- Multicenter clinical trials (1)
- Multimedia Retrieval (1)
- Multiple Sklerose (1)
- Muscle strength (1)
- Musculoskeletal disorders (1)
- Musicology (1)
- Musikwissenschaft (1)
- Muskelkraft (1)
- Mycobacteria (1)
- NFDI (1)
- NFDI4Culture – Konsortium für Forschungsdaten materieller und immaterieller Kulturgüter (1)
- Nanomedicine (1)
- Nanotechnology (1)
- Nanotoxicity (1)
- Neuralgie (1)
- Neuropathic pain (1)
- Norddeutschland (1)
- Nursing Robotic (1)
- Nursing care (1)
- Nutztierhaltung (1)
- Obstruktive Ventilationsstörung (1)
- Occupational-specific variations (1)
- Offene Hochschule Niedersachsen (1)
- Offener Unterricht (1)
- Online Learning (1)
- Open Data (1)
- Open Education (1)
- Orales Arzneimittel (1)
- Organversagen (1)
- Orthopädische Chirurgie (1)
- Osteoarthritis (1)
- P2P (1)
- PEGIDA-Bewegung (1)
- PET/CT (1)
- Palliative care (1)
- Palliativmedizin (1)
- Participation (1)
- Patent medicine dealers (1)
- Patient care (1)
- Patient counselling (1)
- Patient experience (1)
- Patient identification (1)
- Patient referral (1)
- Patient-reported outcomes (1)
- Patientenzufriedenheit (1)
- Peer Learning (1)
- Peer-to-Peer-Learning (1)
- Pegida (1)
- Perception (1)
- Persistenz (1)
- Personalentwicklung (1)
- Pflegeinformatik (1)
- Pharmacists (1)
- Pharmacovigilance (1)
- Pharmazeut (1)
- Pharmazeutische Industrie (1)
- Physical activity level (1)
- Physical exercise adherence (1)
- Physician rating website (1)
- Physician rating websites (1)
- Physician-rating website (1)
- Physikalische Therapie (1)
- Physiotherapeut (1)
- Pierpont Morgan Library (1)
- Pierpont Morgan Library Ms 1 (1)
- Piper crocatum Ruiz & Pav (1)
- Podcast (1)
- Politik (1)
- Politiker (1)
- Pool Effect (1)
- Postmenopausal women (1)
- Poststroke depression (1)
- PowerSim (1)
- Praxisbezug (1)
- Prevention (1)
- Primary Study (1)
- Professional practice (1)
- Profilierung (1)
- Programm (1)
- Programmed-death ligand 1 (1)
- Programmierung (1)
- Prämenopause (1)
- Psychische Gesundheit (1)
- Public health (1)
- Qualifikation (1)
- Qualitative research (1)
- Quality measures (1)
- Quality of Life (1)
- Quality of care (1)
- Quality of health care (1)
- Quality of life (1)
- RECIST (1)
- Radiation necrosis (1)
- Radiochirurgie (1)
- Raigad (1)
- Rare disease (1)
- Rational drug use (1)
- Raumordnung (1)
- Reaktanz <Psychologie> (1)
- Recommendation (1)
- Registrierung (1)
- Registry data (1)
- Regulation (1)
- Regulations (1)
- Rehabilitand (1)
- Rehabilitation (1)
- Reliability (1)
- Renal cell carcinoma (1)
- Research Information (1)
- Research Infrastructure (1)
- Research practice (1)
- Research sabbatical (1)
- Resistance (1)
- Resistance exercise (1)
- Resistenz (1)
- Review sites (1)
- Richtlinie (1)
- Risikoanalyse (1)
- Risk methodology assessment (1)
- Risk stratification (1)
- Risk-based monitoring (1)
- Roboter (1)
- Robotic radiosurgery (1)
- Routine data (1)
- Routinedaten (1)
- Rural community (1)
- SMS <Telekommunikation> (1)
- SOD1 (1)
- SUVmax (1)
- Schlaganfallpatient (1)
- Schlagwort (1)
- Schlüsselfaktor (1)
- Schulung (1)
- Scorecard (1)
- Secondary data (1)
- Seizures (1)
- Sekundärkrankheit (1)
- Selbstmanagement (1)
- Seltene Krankheit (1)
- Sensor (1)
- Sepsis (1)
- Simulation (1)
- Site assessment (1)
- Site selection (1)
- Skills shortage (1)
- Social participation (1)
- Spanien (1)
- Spatial Planning (1)
- Specialised Information Service (1)
- Sports rivalry (1)
- Stadt (1)
- Sterblichkeit (1)
- Stereotactic radiosurgery (1)
- Strategic Information Management (1)
- Stroke (1)
- Structural Engineering (1)
- Studiengang Bibliotheks- und Informationsmanagement (1)
- Studiengang Informationsmanagement berufsbegleitend (1)
- Stuttgart 21 (1)
- Survey (1)
- Sustainable Building Technology (1)
- Symptom (1)
- Symptoms of post-stroke depression (1)
- Synononym (1)
- Systematic review (1)
- TNNI3 (1)
- Tagung (1)
- Tagungsbericht (1)
- Tala (1)
- Tanzwissenschaft (1)
- Target groups (1)
- Target trial (1)
- Teaching Librarian (1)
- Technische Innovation (1)
- Teilhabe (1)
- Text Segmentation (1)
- Text-message (1)
- Theaterwissenschaft (1)
- Theatre Studies (1)
- Therapietreue (1)
- Thesaurus (1)
- Tiergesundheit (1)
- Timed-up-and-go test (1)
- Tractography (1)
- Transplant (1)
- Transplantat (1)
- Transplantatabstoßung (1)
- Transportation and Infrastructure Planning (1)
- Trigeminal neuralgia (1)
- Trigeminus (1)
- Turing-Test (1)
- Type 2 diabetes mellitus (1)
- UTAUT (1)
- Unerwünschte Arzneimittelwirkung (1)
- Unfallchirurgie (1)
- Unfallrisiko (1)
- University Students (1)
- University of Mumbai (1)
- Unsicherheit (1)
- Unternehmensführung (1)
- Unterscheidungskraft (1)
- Urbanism (1)
- Urbanität (1)
- User Generated Content (1)
- VDB-Kommission für Fachreferatsarbeit (1)
- Vaccine (1)
- Validity (1)
- Velocity field diagram (1)
- Venous tumor thrombi (1)
- Veranstaltung (1)
- Verbraucher (1)
- Vergleich (1)
- Verkehrsplanung (1)
- Vertrauen in Medien (1)
- Verweildauer (1)
- Veränderungsbereitschaft (1)
- Veränderungsprozess (1)
- Video Segmentation (1)
- Visualisierung (1)
- Visuelle Kommunikation (1)
- Voluntary blood donation (1)
- WaSH (1)
- Walking balance (1)
- Weighted Mean Difference (1)
- Weizenbaum (1)
- Wertschöpfungsprozess (1)
- Wissensmanagement (1)
- Woodworkers (1)
- Wundheilung (1)
- Yogyakarta (1)
- Young adult (1)
- ZX 81 (1)
- Zensur (1)
- Zinc homeostasis (1)
- Zukunftsfelder (1)
- Zur (1)
- Zusammengehörigkeit (1)
- academic libraries (1)
- accidental falls (1)
- administrative data (1)
- adult vaccines (1)
- aeroallergen (1)
- aerosol exposure (1)
- age group (1)
- aggressive behavior (1)
- antibiotics (1)
- antidiabetic (1)
- antihypertensive (1)
- antimicrobials (1)
- antioxidants (1)
- antiviral therapy (1)
- asthma (1)
- author (1)
- bacterial pathogens (1)
- belief (1)
- bioethics (1)
- biomedicine (1)
- biometry (1)
- bivariate endpoint (1)
- blood (1)
- body fat mass (1)
- bone mineral density (1)
- brand distinctiveness (1)
- brand rivalry (1)
- broth microdilution (1)
- cardiomyopathy (1)
- catalogs (1)
- childhood (1)
- chronic kidney disease (1)
- citizens (1)
- clinical documentation (1)
- clinical hematology (1)
- communication (1)
- communication policy (1)
- comorbidity (1)
- competencies (1)
- compliance (1)
- conflict (1)
- consumer distinctiveness (1)
- corrective actions (1)
- culture (1)
- curricula (1)
- cytomegalovirus (1)
- data mining (1)
- data model (1)
- data protection (1)
- decision support systems (1)
- dentist (1)
- diabetes mellitus (1)
- diagnostic accuracy studies (1)
- didactic (1)
- digitalization (1)
- digitization (1)
- disidentification (1)
- doctor-patient communication (1)
- drug-monitoring (1)
- editor (1)
- ethanolic extract (1)
- ethics indirect benefit (1)
- ethnomedicine (1)
- expert interview (1)
- fracture (1)
- fracture risk (1)
- free radicals (1)
- future fields (1)
- gait output (1)
- gastrointestinal infection (1)
- genetics (1)
- geriatric assessment (1)
- guided interview (1)
- hand grip strength (1)
- healing (1)
- health (1)
- health data (1)
- health information systems (1)
- health services research (1)
- healthcare IT (1)
- healthcare communications (1)
- healthcare systems (1)
- healthdata (1)
- higher education (1)
- human resources development (1)
- hurdle model (1)
- hypertension (1)
- immunomonitoring (1)
- immunosuppression (1)
- income (1)
- indirect benefit (1)
- infectious desease (1)
- influence of presumed media influence approach (1)
- influence of presumed influence (1)
- information management (1)
- information presentation (1)
- intensive care units (1)
- intergroup processes (1)
- internet (1)
- kidney transplantation (1)
- knowledge organization (1)
- korrigierende Handlungen (1)
- learning objectives (1)
- library and information science (1)
- linear regression analysis (1)
- longitudinal study (1)
- mHealth (1)
- maldigestion (1)
- malnutrition (1)
- management (1)
- mediatization of politics (1)
- medical data (1)
- medical devices (1)
- medical informatics (1)
- medicine (1)
- medicine registrations (1)
- menopause (1)
- mobile health apps (1)
- model selection (1)
- multiple cut-offs (1)
- multiple thresholds (1)
- multivariate data (1)
- musculoskeletal disorders, (1)
- non-prescription (1)
- nursing informatics (1)
- nursing innovation (1)
- nursing technology (1)
- occupational disorders (1)
- occupational profile (1)
- online ratings (1)
- openEHR (1)
- oral bisphosphonates (1)
- organ failure (1)
- orthopaedic surgery (1)
- osteoporosis (1)
- outbreak (1)
- outcome measurement (1)
- over-immunosuppression (1)
- overdispersion (1)
- p53 (1)
- part-time degree program (1)
- participation management (1)
- patient empowerment (1)
- patient narratives (1)
- patient satisfaction (1)
- pediatric diagnostic accuracy (1)
- pediatric transplantation (1)
- pediatrics (1)
- peer review (1)
- peptide receptor radionuclide therapy (PRRT) (1)
- performance of the pharmaceutical industry (1)
- persistence (1)
- personalized immunosuppressive therapy (1)
- pharmacy (1)
- physician choice making (1)
- physician-rating website (1)
- placebo (1)
- poisson regression (1)
- politicians (1)
- politics (1)
- publication bias (1)
- pulmonary inflammation (1)
- reactance (1)
- reciprocity (1)
- reducing ability (1)
- refugees (1)
- report cards (1)
- research data center (1)
- research information (1)
- research-friendly data access (1)
- respiratory infection (1)
- rivals (1)
- roads to health (1)
- routine data (1)
- sarcomere (1)
- scientific societies (1)
- self-management (1)
- self-medication (1)
- self-prescription (1)
- semiparametric (1)
- sensitivity (1)
- sensor-based mobile gait analysis (1)
- social comparison (1)
- social identity (1)
- socioeconomic demographic determinants (1)
- specificity (1)
- sports ability (1)
- standard of care (1)
- standardisierte Befragung (1)
- strategic outgroup help (1)
- stride ratio (1)
- superordinate identity (1)
- survey (1)
- swine (1)
- symptoms of post-stroke depression (1)
- systematic review (1)
- testing (1)
- third-person effect (1)
- total knee arthroplasty (1)
- trauma surgery (1)
- ultrafine particles (1)
- underdispersion (1)
- university for civil service in Bavaria (1)
- university students (1)
- usability assessment (1)
- vaccine (1)
- veterinary epidemiology (1)
- violence (1)
- viral infections (1)
- virtX (1)
- virus-specific T cells (1)
- wissenschaftliche Bibliotheken (1)
- zero inflation (1)
- Älterer Mensch (1)
- Änderung (1)
- Öffentlichkeitsarbeit (1)
Institute
- Fakultät III - Medien, Information und Design (181) (remove)
Aim
Musculoskeletal disorders are a major public health problem in most developed countries. As a main cause of chronic pain, they have resulted in an increasing prescription of opioids worldwide. With regard to the situation in Germany, this study aimed at estimating the prevalence of musculoskeletal diseases such as chronic low back pain (CLBP) and hip/knee osteoarthritis (OA) and at depicting the applied treatment patterns.
Subject and methods
German claims data from the InGef Research Database were analyzed over a 6-year period (2011–2016). The dataset contains over 4 million people, enrolled in German statutory health insurances. Inpatient and outpatient diagnoses were considered for case identification of hip/knee OA and CLBP. The World Health Organization (WHO) analgesic ladder was applied to categorize patients according to their pain management interventions. Information on demographics, comorbidities, and adjuvant medication was collected.
Results
In 2016, n = 2,693,481 individuals (50.5% female, 49.5% male) were assigned to the study population; 62.5% of them were aged 18–60 years. In 2016, n = 146,443 patients (5.4%) with CLBP and n = 307,256 patients (11.4%) with hip/knee OA were identified. Of those with pre-specified pain management interventions (CLBP: 66.3%; hip/knee OA: 65.1%), most patients received WHO I class drugs (CLBP: 73.6%; hip/knee OA: 68.7%) as the highest level.
Conclusion
This study provides indications that CLBP and hip/knee OA are common chronic pain conditions in Germany, which are often subjected to pharmacological pain management. Compared to non-opioid analgesic prescriptions of the WHO I class, the dispensation of WHO class II and III opioids was markedly lower, though present to a considerable extent.
For the introduction of technical nursing care innovations, a usability assessment survey is conducted by nursing staff. The questionnaire is used before and after the introduction of technical products. This poster contribution shows the latest comparison of pre- and post-surveys on selected products.
Catalogs of competency-based learning objectives (CLO) were introduced and promoted as a prerequisite for high-quality, systematic curriculum development. While this is common in medicine, the consistent use of CLO is not yet well established in epidemiology, biometry, medical informatics, biomedical informatics, and nursing informatics especially in Germany. This paper aims to identify underlying obstacles and give recommendations in order to promote the dissemination of CLO for curricular development in health data and information sciences. To determine these obstacles and recommendations a public online expert workshop was organized. This paper summarizes the findings.
Social comparison theories suggest that ingroups are strengthened whenever important outgroups are weakened (e.g., by losing status or power). It follows that ingroups have little reason to help outgroups facing an existential threat. We challenge this notion by showing that ingroups can also be weakened when relevant comparison outgroups are weakened, which can motivate ingroups to strategically offer help to ensure the outgroups' survival as a highly relevant comparison target. In three preregistered studies, we showed that an existential threat to an outgroup with high (vs. low) identity relevance affected strategic outgroup helping via two opposing mechanisms. The potential demise of a highly relevant outgroup increased participants’ perceptions of ingroup identity threat, which was positively related to helping. At the same time, the outgroup’s misery evoked schadenfreude, which was negatively related to helping. Our research exemplifies a group's secret desire for strong outgroups by underlining their importance for identity formation.
Forschungsdatenzentrum Gesundheit – Vision für eine Weiterentwicklung aus Sicht der Forschung
(2023)
Das Forschungsdatenzentrum (FDZ) Gesundheit nach der Datentransparenzverordnung (DaTraV), angesiedelt am Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM) wird Routinedaten der Gesetzlichen Krankenversicherung für die Forschung bereitstellen. Die Bereitstellung der Daten von knapp 90% der Bevölkerung in Deutschland dient dem übergeordneten Ziel, die gesundheitliche Versorgung im Hinblick auf Unter-, Über- und Fehlversorgung zu evaluieren und daraus Handlungsempfehlungen für eine evidenzbasierte Gesundheitsversorgung abzuleiten. Der gesetzliche Rahmen wird im Sozialgesetzbuch (§§ 303a-f SBG V) und zwei dazu gehörigen Verordnungen gesteckt, lässt jedoch hinreichend großen Spielraum für die Ausgestaltung auf der Organisations- und Arbeitsebene. Hier setzt das vorliegende Papier an. Aus Forscher*innensicht wurden zehn Statements für eine Weiterentwicklung formuliert, die das Potential eines Forschungsdatenzentrums aufzeigen und Ideen für die weitere zukunftsfähige Ausgestaltung und Entwicklung mit Bestandskraft darlegen.
Das Gesundheitsdatennutzungsgesetz – Potenzial für eine bessere Forschung und Gesundheitsversorgung
(2023)
Im Koalitionsvertrag der Ampel-Koalition wird für die laufende Legislaturperiode ein Gesundheitsdatennutzungsgesetz (GDNG) angekündigt. Dieses Gesetz soll „zu einer besseren wissenschaftlichen Nutzung in Einklang mit der DSGVO“ führen. Bekanntermaßen steht unser Gesundheitssystem vor großen Herausforderungen (Demografie, Digitalisierung, Fachkräftemangel, Klimakrise, regionale Unterschiede, etc.) und ist jetzt schon das teuerste in Europa bei mittelmäßiger Leistung. Diese Herausforderungen können effizienter und evidenzgeleitet bewältigt werden, wenn wie im geplanten GDNG angedacht, die Datenressourcen für die Evaluierung und Weiterentwicklung des Gesundheitssystems und der Gesundheitsversorgung optimal genutzt werden. In den folgenden Ausführungen werden aus Sicht von Versorgungsforscher*innen Voraussetzungen und Desiderata für eine optimale Ausgestaltung des Gesetzes formuliert. Das Papier wurde durch das Deutsche Netzwerk Versorgungsforschung (DNVF) und die Arbeitsgruppe Erhebung und Nutzung von Sekundärdaten (AGENS) der Deutschen Gesellschaft für Sozialmedizin und Prävention (DGSMP) und der Deutschen Gesellschaft für Epidemiologie (DGEpi) erstellt und wird von den unterzeichnenden Fachgesellschaften getragen. Das vorliegende Positionspapier und die hier aufgestellten Forderungen sind vor der Veröffentlichung und damit in Unkenntnis des Referentenentwurfs zum GDNG formuliert worden.
Digital data on tangible and intangible cultural assets is an essential part of daily life, communication and experience. It has a lasting influence on the perception of cultural identity as well as on the interactions between research, the cultural economy and society. Throughout the last three decades, many cultural heritage institutions have contributed a wealth of digital representations of cultural assets (2D digital reproductions of paintings, sheet music, 3D digital models of sculptures, monuments, rooms, buildings), audio-visual data (music, film, stage performances), and procedural research data such as encoding and annotation formats. The long-term preservation and FAIR availability of research data from the cultural heritage domain is fundamentally important, not only for future academic success in the humanities but also for the cultural identity of individuals and society as a whole. Up to now, no coordinated effort for professional research data management on a national level exists in Germany. NFDI4Culture aims to fill this gap and create a usercentered, research-driven infrastructure that will cover a broad range of research domains from musicology, art history and architecture to performance, theatre, film, and media studies.
The research landscape addressed by the consortium is characterized by strong institutional differentiation. Research units in the consortium's community of interest comprise university institutes, art colleges, academies, galleries, libraries, archives and museums. This diverse landscape is also characterized by an abundance of research objects, methodologies and a great potential for data-driven research. In a unique effort carried out by the applicant and co-applicants of this proposal and ten academic societies, this community is interconnected for the first time through a federated approach that is ideally suited to the needs of the participating researchers. To promote collaboration within the NFDI, to share knowledge and technology and to provide extensive support for its users have been the guiding principles of the consortium from the beginning and will be at the heart of all workflows and decision-making processes. Thanks to these principles, NFDI4Culture has gathered strong support ranging from individual researchers to highlevel cultural heritage organizations such as the UNESCO, the International Council of Museums, the Open Knowledge Foundation and Wikimedia. On this basis, NFDI4Culture will take innovative measures that promote a cultural change towards a more reflective and sustainable handling of research data and at the same time boost qualification and professionalization in data-driven research in the domain of cultural heritage. This will create a long-lasting impact on science, cultural economy and society as a whole.
FID Civil Engineering, Architecture and Urbanism digital - A platform for science (BAUdigital)
(2022)
University Library Braunschweig (UB Braunschweig), University and State Library Darmstadt (ULB Darmstadt), TIB – Leibniz Information Centre for Technology and Natural Sciences and the Fraunhofer Information Centre for Planning and Building (Fraunhofer IRB) are jointly establishing a specialised information service (FID, "Fachinformationsdienst") for the disciplines of civil engineering, architecture and urbanism. The FID BAUdigital, which is funded by the German Research Foundation (DFG, "Deutsche Forschungsgemeinschaft"), will provide researchers working on digital design, planning and production methods in construction engineering with a joint information, networking and data exchange platform and support them with innovative services for documentation, archiving and publication in their data-based research.
Eine durch die Digitalisierung veränderte und auf Open Science ausgerichtete Wissenschaftspraxis benötigt angepasste Infrastrukturen und Services. Daraus ergeben sich verschiedene neue oder veränderte Aktionsfelder für wissenschaftliche Bibliotheken und Infrastruktureinrichtungen. Zu nennen sind zum Beispiel die nicht-textuellen Materialien wie Forschungsdaten, AV-Medien oder Software und die Umsetzung der FAIR-Prinzipien. Hinzu kommen neue Aufgaben im Bereich der Forschungsinformationen, zum Beispiel in der Unterstützung institutioneller Forschungsinformationssysteme, die Gestaltung von Open Access, die Unterstützung kollaborativen wissenschaftlichen Arbeitens sowie die Schaffung von offenen Infrastrukturen. In diesem Artikel werden diese Felder kurz vorgestellt und sich daraus abzeichnende Anforderungen an das bibliothekarische Berufsbild skizziert.
Indirekte Medienwirkungen, wie sie im Rahmen des Influence-of-Presumed-Media-Influence-Approachs und des Third-Person-Effekts diskutiert werden, sind im Hinblick auf einzelne politische Ereignisse und für Online-Medien bislang nur selten geprüft worden. Aus diesem Grund wurde der unterstellte Einfluss verschiedener On- und Offline-Medien auf Meinungsbildung und Mobilisierung im Kontext der Volksabstimmung zum Umbau des Stuttgarter Hauptbahnhofes im November 2011 („Stuttgart 21“) untersucht. Daneben stehen Konsequenzen der Einflusswahrnehmungen im Fokus des Beitrags. Als Grundlage dient eine Online-Befragung der baden-württembergischen Bevölkerung mit Internetanschluss (n = 502). Die Befragten schreiben Zeitungen und Fernsehen einen stärkeren politischen Einfluss zu als den in der Studie berücksichtigten Online-Medien, und zwar sowohl auf die Meinungsbildung als auch auf die Mobilisierung. Zudem führt ein unterstellter großer und negativ bewerteter Medieneinfluss auf die Bevölkerung bei einigen Befragtengruppen zu einer Verstärkung von Kommunikationsaktivitäten – verbunden mit dem Ziel, diesen unterstellten Einfluss zu korrigieren. Die vermuteten negativen Einflüsse führen aber auch dazu, dass eine schärfere Kontrolle des Internets befürwortet wird.
Der Bedeutungszuwachs von Online-Medien hat eine gesellschaftliche Debatte über mögliche Folgen dieser Entwicklung ausgelöst. Weit verbreitet ist zum Beispiel die Wahrnehmung, dass Online-Medien maßgeblich beeinflussen, wie insbesondere jüngere Menschen politische Prozesse sehen und bewerten. Vor dem Hintergrund theoretischer Ansätze wie dem Influence-of-Presumed-Media-Influence-Approach wurde untersucht, welche kommunikationspolitischen Maßnahmen von der Bevölkerung als Reaktion auf solche Wahrnehmungen als angemessen eingeschätzt werden. Hierzu wurde im Kontext der Landtagswahl in Nordrhein-Westfalen 2012 eine Online-Befragung durchgeführt (n = 485). Die Befunde zeigen, dass die Wahrnehmung starker politischer Online-Einflüsse auf jüngere Menschen vor allem zu einer gesteigerten Akzeptanz von Aufklärung und Erziehung führt, weniger aber zu einer gesteigerten Akzeptanz restriktiver Maßnahmen zur Einflussbeschränkung.
Studien zeigen, dass Anhänger der PEGIDA-Bewegung die Medienberichterstattung als unangemessen wahrnehmen und ihr misstrauen. Diese Wahrnehmung und daraus resultierende kognitive, affektive und konative Konsequenzen wurden in einer standardisierten Online-Befragung untersucht (n= 800). Es zeigt sich, dass Anhänger der PEGIDA-Bewegung der Berichterstattung über PEGIDA mehr misstrauen als PEGIDA-Gegner. Diese Wahrnehmung wiederum hat politisch relevante Konsequenzen: Je stärker PEGIDA-Anhänger und neutral Eingestellte der Berichterstattung misstrauen, desto weniger Vertrauen bringen sie den Medien allgemein entgegen, desto unzufriedener sind sie mit der Demokratie in Deutschland und desto wütender sind sie auf die Berichterstattung. Die wütenden Reaktionen korrelieren mit einer Zustimmung zu radikalen Protestformen, was wiederum die Beteiligung an den Protestmärschen erhöht. Somit zeigen die Befunde, dass das Misstrauen in die Berichterstattung über PEGIDA auch über deren Anhängerkreis hinaus eng verbunden ist mit erodierendem Vertrauen in Medien und Politik sowie mit der Bereitschaft zu radikalen Protestformen.
According to the third-person effect or the influence of presumed media influence approach, the presumption that the media has strong effects on other people can affect individuals’ attitudes and behavior. For instance, if people believe in strong media influences on others, they are more likely to increase their communication activities or support demands for restrictions on media. A standardized online survey among German journalists (N = 960) revealed that the stronger the journalists perceive the political online influence on the public to be, the more frequently they contradict unwanted political views in their articles. Moreover, even journalists are more likely to approve of restrictions on the Internet’s political influence, the stronger they believe the effects of online media to be. The data reveal no connections between communication activities and demands for restrictions.
Research question: In order to reduce fan aggression surrounding rivalry games, team sport organizations often try to placate fans by downplaying the importance of the game (e.g. ‘the derby is not a war’). Drawing on the intergroup conflict literature, this research derives dual identity statements and examines their effectiveness in reducing fan aggressiveness compared to the managerial practice of downplaying rivalry.
Research methods: Three field experimental studies (one face-to-face survey and two online surveys) tested the hypotheses. Established rivalries in the German soccer league Bundesliga served as the empirical setting of the studies. The data were analyzed using ANCOVA and linear regression analyses.
Results and findings: Dual identity statements reduce fan aggressiveness compared to both downplay statements and a no-statement control condition, independent of team identification and trait aggression. Importantly, the managerial practice of downplaying rivalry appears to be counterproductive. It produces even higher levels of fan aggressiveness than making no statement, an effect caused by psychological reactance.
Implications: Sport organizations should not alienate their fan base by attempting to play down the importance of rivalry, which is an integral part of fan identity. Instead, they should strengthen the supporters’ unique identity (as fans of a particular team) while at the same time facilitating identification with the rival at a superordinate level (e.g. as joint fans of a region).
Research question: Rivalries in team sports are commonly conceptualized as a threat to the fans’ identity. Therefore, past research has mainly focused on the negative consequences. However, theoretical arguments and empirical evidence suggest that rivalry has both negative and positive effects on fans’ self-concept. This research develops and empirically tests a model which captures and integrates these dual effects of rivalry.
Research methods: Data were collected via an on-site survey at home games of eight German Bundesliga football teams (N = 571). Structural equation modeling provides strong support for the proposed model.
Results and findings: In line with previous research, the results show that rivalry threatens fans’ identity as reflected in lower public collective self-esteem in relation to supporters of the rival team. However, the results also show that there are crucial positive consequences, such as higher perceptions of public collective self-esteem in relation to supporters of non-rival opponents, perceived ingroup distinctiveness and ingroup cohesion. These positive effects are mediated through increases in disidentification with the rival and perceived reciprocity of rivalry.
Implications: We contribute to the literature by providing a more balanced view of one of team sports’ key phenomena. Our results indicate that the prevalent conceptualization of rivalry as an identity threat should be amended by the positive consequences. Our research also offers guidance for the promotion of rivalries, where the managerial focus should be on creating a perception that a rivalry is reciprocal.
Marketing, get ready to rumble — How rivalry promotes distinctiveness for brands and consumers
(2018)
Scholars typically advise brands to stay away from public conflict with competitors as research has focused on negative consequences - e.g., price wars, escalating hostilities, and derogation. This research distinguishes between rivalry between firms (inter-firm brand rivalry) and rivalry between consumers (inter-consumer brand rivalry). Four studies and six samples show both types of rivalry can have positive consequences for both firms and consumers. Inter-firm brand rivalry boosts perceived distinctiveness of competing brands independent of consumption, attitude, familiarity, and involvement. Inter-consumer brand rivalry increases consumer group distinctiveness, an effect mediated by brand identification and rival brand disidentification. We extend social identity theory by demonstrating that: 1) outside actors like firms can promote inter-consumer rivalry through inter-firm rivalry and 2) promoting such conflict can actually provide benefits to consumers as well as firms. The paper challenges the axiom “never knock the competition,” deriving a counter-intuitive way to accomplish one of marketing's premier objectives.
A semiparametric approach for meta-analysis of diagnostic accuracy studies with multiple cut-offs
(2022)
The accuracy of a diagnostic test is often expressed using a pair of measures: sensitivity (proportion of test positives among all individuals with target condition) and specificity (proportion of test negatives among all individuals without targetcondition). If the outcome of a diagnostic test is binary, results from different studies can easily be summarized in a meta-analysis. However, if the diagnostic test is based on a discrete or continuous measure (e.g., a biomarker), several cut-offs within one study as well as among different studies are published. Instead of taking all information of the cut-offs into account in the meta-analysis, a single cut-off per study is often selected arbitrarily for the analysis, even though there are statistical methods for the incorporation of several cut-offs. For these methods, distributional assumptions have to be met and/or the models may not converge when specific data structures occur. We propose a semiparametric approach to overcome both problems. Our simulation study shows that the diagnostic accuracy is underestimated, although this underestimation in sensitivity and specificity is relatively small. The comparative approach of Steinhauser et al. is better in terms of coverage probability, but may lead to convergence problems. In addition to the simulation results, we illustrate the application of the semiparametric approach using a published meta-analysis for a diagnostic test differentiating between bacterial and viral meningitis in children.
Objective
Cyberknife robotic radiosurgery (RRS) provides single-session high-dose radiotherapy of brain tumors with a steep dose gradient and precise real-time image-guided motion correction. Although RRS appears to cause more radiation necrosis (RN), the radiometabolic changes after RRS have not been fully clarified. 18F-FET-PET/CT is used to differentiate recurrent tumor (RT) from RN after radiosurgery when MRI findings are indecisive. We explored the usefulness of dynamic parameters derived from 18F-FET PET in differentiating RT from RN after Cyberknife treatment in a single-center study population.
Methods
We retrospectively identified brain tumor patients with static and dynamic 18F-FET-PET/CT for suspected RN after Cyberknife. Static (tumor-to-background ratio) and dynamic PET parameters (time-activity curve, time-to-peak) were quantified. Analyses were performed for all lesions taken together (TOTAL) and for brain metastases only (METS). Diagnostic accuracy of PET parameters (using mean tumor-to-background ratio >1.95 and time-to-peak of 20 min for RT as cut-offs) and their respective improvement of diagnostic probability were analyzed.
Results
Fourteen patients with 28 brain tumors were included in quantitative analysis. Time-activity curves alone provided the highest sensitivities (TOTAL: 95%, METS: 100%) at the cost of specificity (TOTAL: 50%, METS: 57%). Combined mean tumor-to-background ratio and time-activity curve had the highest specificities (TOTAL: 63%, METS: 71%) and led to the highest increase in diagnosis probability of up to 16% p. – versus 5% p. when only static parameters were used.
Conclusions
This preliminary study shows that combined dynamic and static 18F-FET PET/CT parameters can be used in differentiating RT from RN after RRS.
Aim:
The most suitable method for assessment of response to peptide receptor radionuclide therapy (PRRT) of neuroendocrine tumors (NET) is still under debate. In this study we aimed to compare size (RECIST 1.1), density (Choi), Standardized Uptake Value (SUV) and a newly defined ZP combined parameter derived from Somatostatin Receptor (SSR) PET/CT for prediction of both response to PRRT and overall survival (OS).
Material and Methods:
Thirty-four NET patients with progressive disease (F:M 23:11; mean age 61.2 y; SD ± 12) treated with PRRT using either Lu-177 DOTATOC or Lu-177 DOTATATE and imaged with Ga-68 SSR PET/CT approximately 10–12 weeks prior to and after each treatment cycle were retrospectively analyzed. Median duration of follow-up after the first cycle was 63.9 months (range 6.2–86.2). A total of 77 lesions (2–8 per patient) were analyzed. Response assessment was performed according to RECIST 1.1, Choi and modified EORTC (MORE) criteria. In addition, a new parameter named ZP, the product of Hounsfield unit (HU) and SUVmean (Standard Uptake Value) of a tumor lesion, was tested. Further, SUV values (max and mean) of the tumor were normalized to SUV of normal liver parenchyma. Tumor response was defined as CR, PR, or SD. Gold standard for comparison of baseline parameters for prediction of response of individual target lesions to PRRT was change in size of lesions according to RECIST 1.1. For prediction of overall survival, the response after the first and second PRRT were tested.
Results:
Based on RECIST 1.1, Choi, MORE, and ZP, 85.3%, 64.7%, 61.8%, and 70.6% achieved a response whereas 14.7%, 35.3%, 38.2%, and 29.4% demonstrated PD (progressive disease), respectively. Baseline ZP and ZPnormalized were found to be the only parameters predictive of lesion progression after three PRRT cycles (AUC ZP 0.753; 95% CI 0.6–0.9, p 0.037; AUC ZPnormalized 0.766; 95% CI 0.6–0.9; p 0.029). Based on a cut-off-value of 1201, ZP achieved a sensitivity of 86% and a specificity of 67%, while ZPnormalized reached a sensitivity of 86% and a specificity of 76% at a cut-off-value of 198. Median OS in the total cohort was not reached. In univariate analysis amongst all parameters, only patients having progressive disease according to MORE after the second cycle of PRRT were found to have significantly shorter overall survival (median OS in objective responders not reached, in PD 29.2 months; p 0.015). Patients progressive after two cycles of PRRT according to ZP had shorter OS compared to those responding (median OS for responders not reached, for PD 47.2 months, p 0.066).
Conclusions:
In this explorative study, we showed that Choi, RECIST 1.1, and SUVmax-based response evaluation varied significantly from each other. Only patients showing progressive disease after two PRRT cycles according to MORE criteria had a worse prognosis while baseline ZP and
ZPnormalized performed best in predicting lesion progression after three cycles of PRRT.