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Biomedical subjects

Sascha Köpke

Publications and source records attributed to Sascha Köpke.

12 recordsLinked to original sources
PubMed2006

The Tinetti test: Babylon in geriatric assessment.

The Tinetti test has been recommended and widely used in the elderly to assess mobility, balance and gait, and predict falls. Different versions can be found. A systematic literature search identified 37 publications on the Tinetti test and falls. Wide variations were found concerning name of the instrument, test items, scoring, and cut-off values. This heterogeneity interferes with evaluations of the test's validity, reliability and generalisability. Researcher and clinicians should be aware of this fact, when dealing with the Tinetti test.

Accidental Falls↗
PubMed2005

Predicting the risk of falling--efficacy of a risk assessment tool compared to nurses' judgement: a cluster-randomised controlled trial [ISRCTN37794278].

BACKGROUND: Older people living in nursing homes are at high risk of falling because of their general frailty and multiple pathologies. Prediction of falls might lead to an efficient allocation of preventive measures. Although several tools to assess the risk of falling have been developed, their impact on clinically relevant endpoints has never been investigated. The present study will evaluate the clinical efficacy and consequences of different fall risk assessment strategies. STUDY DESIGN: Cluster-randomised controlled trial with nursing home clusters randomised either to the use of a standard fall risk assessment tool alongside nurses' clinical judgement or to nurses' clinical judgement alone. Standard care of all clusters will be optimised by structured education on best evidence strategies to prevent falls and fall related injuries. 54 nursing home clusters including 1,080 residents will be recruited. Residents must be > or = 70 years, not bedridden, and living in the nursing home for more than three months. The primary endpoint is the number of participants with at least one fall at 12 months. Secondary outcome measures are the number of falls, clinical consequences including side effects of the two risk assessment strategies. Other measures are fall related injuries, hospital admissions and consultations with a physician, and costs.

Accidental Falls↗
PubMed2005

Evidence-based patient information about treatment of multiple sclerosis--a phase one study on comprehension and emotional responses.

OBJECTIVE: This study analysis the comprehension and emotional responses of people suffering from multiple sclerosis when provided with an evidence-based information module. It is a core module of a comprehensive decision aid about immunotherapy. The core module is designed to enable patients to process scientific uncertainty without adverse effects. It considers existing standards for risk communication and presentation of data. METHODS: Using a mailing approach we investigated 169 patients with differing courses of disease in a before-after design. Items addressed the competence in processing relative and absolute risk information and patients' emotional response to the tool, comprising grade of familiarity with the information, understanding, relevance, emotional arousal, and certainty. RESULTS: Overall, numeracy improved (p < 0.001), although 99 of 169 patients did not complete the numeracy task correctly. Understanding depended on the relevance related to the course of disease. A moderate level of uncertainty was induced. No adverse emotional responses could be shown, neither in those who did comprehend the information, nor in those who did not develop numeracy skills. CONCLUSION: In conclusion, the tool supports people suffering from multiple sclerosis to process evidence-based medical information and scientific uncertainty without burdening them emotionally. PRACTICE IMPLICATIONS: This study is an example for the documentation of an important step in the development process of a complex intervention.

Adult↗
PubMed2005

[Criteria for evidence-based patient information].

Evidence-based patient information (EBPI) is a prerequisite for informed patient choice. However, there is as yet no discussion as to what can be expected of EBPI. The present paper provides an overview of the criteria presently used or discussed for the development of EBPI. Ethics guidelines demand that EBPI are offered and made available to all patients. The presentation of information should be clear and consider risk communication as a source of framing of data. Patients should be involved in the process of development and evaluation.

Evidence-Based Medicine↗
PubMed2005

[Evaluation tools for patient information commonly used in Germany--a critical analysis].

The value of instruments for the evaluation of health- or patient information is a controversial issue. This article examines instruments that evaluate information materials on the basis of predefined quality criteria for evidence-based patient information. The aim is to prove whether the instruments commonly used in Germany can be recommended. A review of the literature and an internet search engine search were conducted to identify relevant international systematic reviews and instruments commonly used in Germany. Four instruments were identified for Germany: The quality seals "AFGIS" and "HON" and the checklists "Discern" and "Check-In". These were evaluated on the basis of the predefined criteria. The instruments predominantly address structural aspects. Aspects of content and content presentation are rarely considered. The instruments neglect relevant quality criteria for evidence-based patient information.

Evidence-Based Medicine↗
PubMed2004

Decisional role preferences, risk knowledge and information interests in patients with multiple sclerosis.

OBJECTIVE: Shared decision making is increasingly recognized as the ideal model of patient-physician communication especially in chronic diseases with partially effective treatments as multiple sclerosis (MS). To evaluate prerequisite factors for this kind of decision making we studied patients' decisional role preferences in medical decision making, knowledge on risks, information interests and the relations between these factors in MS. METHODS: After conducting focus groups to generate hypotheses, 219 randomly selected patients from the MS Outpatient Clinic register (n = 1374) of the University Hospital Hamburg received mailed questionnaires on their knowledge of risks in MS, their perception of their own level of knowledge, information interests and role preferences. RESULTS: Most patients (79%) indicated that they preferred an active role in treatment decisions giving the shared decision and the informed choice model the highest priority. MS risk knowledge was low but questionnaire results depended on disease course, disease duration and ongoing immune therapy. Measured knowledge as well as perceived knowledge was only weakly correlated with preferences of active roles. Major information interests were related to symptom alleviation, diagnostic procedures and prognosis. CONCLUSION: Patients with MS claimed autonomous roles in their health care decisions. The weak correlation between knowledge and preferences for active roles implicates that other factors largely influence role preferences.

Adult↗