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Biomedical subjects

M Lelgemann

Publications and source records attributed to M Lelgemann.

6 recordsLinked to original sources

[Online continuing medical education based on national disease management guidelines. The e-learning platform leitlinien-wissen.de].

Effective translation of relevant knowledge into clinical practice is essential for modern health care systems. National Disease Management Guidelines (NDMG) are considered relevant instruments to support this transfer. To implement NDMG Internet-based continuing medical education (CME), modules and online case-based learning objects were designed and published. To ensure high quality the contents are based on NDMG and subjected to multi-step review processes. Presentation on the web was realized through a modified content management system. To obtain a CME certificate, completing an online questionnaire using a four-point Likert scale was mandatory. Between June 2003 and April 2005, 3,105 physicians were registered and used the platform: 95% of the physicians expressed positive feedback in the evaluation questionnaire, and 35% actually used the corresponding NDMG in practice. This prompted the development of interactive medical case-based learning objects as a second learning pathway. An Internet platform for CME including case-based learning objects can be a helpful tool to assure the provision of scientific knowledge for patient care.

Certification↗

[Evidence based guidelines and clinical pathways: complementation or contradiction?].

Even methodological sound guidelines will only achieve their goals when the recommendations are transferred into practice. Guideline introduction and dissemination must therefore be accompanied by active implementation measures. For inpatient care clinical pathways can serve as tools, especially taking advantage of their sequential character. Complementary evidence based guidelines can serve as an optimal source of systematically appraised evidence in developing clinical pathways. Considering them is of major help to assure that the content of clinical pathways is in accordance with evidence. The article highlights methodological requirements in guideline and pathway development and gives prospects on how both tools can be used together.

Biomedical Research↗

An e-learning platform for guideline implementation--evidence- and case-based knowledge translation via the Internet.

OBJECTIVES: Effective knowledge translation in medicine is an essential element of a modern health care system. Evidence-based clinical practice guidelines (CPGs) are considered relevant instruments for the transfer of knowledge into clinical practice. To improve this transfer we have created Internet-based continuing medical education (CME) modules and online case-based learning objects. METHODS: Building upon existing CPGs, an e-learning platform including a multi-step review process was developed to generate CME modules. These CME modules were presented through a modified content management system (CMS) that fulfils specific requirements of CME. An online questionnaire using a four-point Likert scale was designed to receive mandatory feedback from participating physicians. In the second step of development, case-based learning objects were added to the CMS. RESULTS: Existing clinical practice guidelines allowed a rapid development of CME modules specific to individual clinical indications. The modified CMS proved to be technically stable but also resource-intensive. 3105 physicians registered and used the platform between June 2003 and April 2005. 95% of the physicians expressed positive feedback in an evaluation questionnaire; only 35% of physicians actually used the corresponding CPGs in practice. Suggestions from the CME users led to the development of interactive medical case-based learning objects related to the main topics of the CPGs. CONCLUSIONS: To support the implementation of CPGs, an Internet platform for CME including case-based learning objects and examination tests was developed. An interactive online CME platform can support active learning and may establish an additional stimulus for knowledge translation into daily medical practice.

Computer-Assisted Instruction↗

[Clinical guidelines. What do doctors and patients get from them].

Now more than ever physicians need effective management of the constantly increasing flood of medical information. The authors discuss possibilities for developing clinical guidelines as a core element of this information management and the requirements of these possibilities. The development of clinical guidelines is a process also suitable for involving patient and consumer expertise in health care. Models of involving patients are described and how these processes can build an important base for shared decision making of physicians and patients.

Drug Information Services↗

[Value of inpatient care in rheumatoid arthritis-an evidence based report].

Our aim was to analyze the existing body of evidence about inpatient care of patients suffering from rheumatoid arthritis (RA). The report was induced by the executive board of the German Society of Rheumatology which assigned the "Oliver-Sangha committee" to dissect and point out the tasks of inpatient care during the next few years. A systemic search of the literature was performed covering the years 1966 to 2001. A total of 16 studies were selected and thoroughly appraised in a systematic way. Four randomized controlled trials addressing the question could be identified. All of them included only patients in a clinical condition allowing outpatient care as well. Two studies indicate some advantage of inpatient care in comparison to outpatient treatment. Two studies, both equivalence studies from design, reveal that RA patients do not generally experience additional benefit from hospitalization. Consideration of two additional cohort studies demonstrates the increased need of inpatient care in RA patients. None of the studies was derived from the German health care system. Emergency cases were not the subject of any of these trials. General statements about the value of inpatient care of RA patients can not be drawn from the analyzed studies. The committee makes suggestions for future investigations that may help to answer this important question considering the special circumstances of the German health care system.

Ambulatory Care↗

[Evidence-based guidelines--what is the present situation?].

Guidelines have proven to be an important tool for improving quality of health care. Evidence-based guidelines are particularly well accepted and have a high degree of credibility based on the transparent process of their development and the explicit use of clinical patient-oriented research, on which the recommendations are based. The goal of the guidelines "Management of early rheumatoid arthritis", currently developed by an interdisciplinary working group, is to minimize out existing deficiencies in the provision of health care.

Arthritis, Rheumatoid↗