(Press-News.org) In a series of commissions awarded by the Federal Joint Committee (G-BA) to the Institute for Quality and Efficiency in Health Care (IQWiG), the question is whether for certain surgical procedures, a correlation can be shown between the volume of services provided per hospital and the quality of treatment results. IQWiG's rapid report on heart transplantations is now available.
According to the findings, a positive correlation can be inferred between the volume of services and the quality of treatment results for heart transplantations in adults: In hospitals with larger case volumes, fewer of the transplanted patients die, both in timely association with the intervention and in respect of total mortality. However, the three observational studies included in the report show only a low informative value of results.
318 heart transplantations in Germany in 2018
Heart transplantation may be medically indicated in the event of severe cardiac failure that, despite the use of all other treatment options, is progressing and endangers the life of the patient concerned or extremely restricts his or her quality of life. After transplantation, lifelong immunosuppression is required to prevent organ loss due to transplant rejection. In the Eurotransplant region, the average survival time after surgery is currently eleven years.
According to the Eurotransplant statistics, a total of 318 heart transplantations were performed in Germany in 2018. The demand was considerably higher, but could not be met due to the shortage of donor organs.
For heart transplantations in adults in Germany, the G-BA has not yet established minimum volume standards for the provision of services in hospitals.
Positive correlation between case volumes and survival probabilities
In its worldwide literature searches, IQWiG identified three observational studies containing usable data for investigating the correlation between volume of services and quality of treatment results for heart transplantations. All three studies analyse this correlation exclusively at the hospital level and not at the level of the surgeons involved in the transplantation.
For the outcome category "mortality", data are available for two outcomes: "all-cause mortality" and "intra- and perioperative mortality" (mortality before, during and immediately after surgery). For both outcomes, a reduction in the number of deaths in hospitals with more heart transplants per year can be inferred from the data.
For the outcomes "in-hospital mortality", "need for retransplantation", "health-related quality of life" (including activities of daily living and dependence on the help of others), as well as "length of hospital stay", the studies evaluated did not contain any data. Data were available for the outcome "adverse effects of treatment", but no statistically significant results could be inferred.
For heart transplantations in adults, IQWiG found no meaningful studies examining the effects of specific minimum case volumes introduced into the health care system on the quality of treatment results.
INFORMATION:
Process of report production
In June 2019, the G-BA commissioned IQWiG to conduct a systematic literature search and assess the evidence on the correlation between the volume of services and the quality of treatment results for heart transplantations in adults. The work on this report, which was prepared in an accelerated procedure as a so-called rapid report, started in April 2020. This rapid report was sent to the contracting agency, the G-BA, in November 2020 and has now been published.
An English-language extract of the rapid report will be available soon. If you would like to be informed when this document is available, please send an e-mail to info@iqwig.de.
Quantum computer: One of the obstacles for progress in the quest for a working quantum computer has been that the working devices that go into a quantum computer and perform the actual calculations, the qubits, have hitherto been made by universities and in small numbers. But in recent years, a pan-European collaboration, in partnership with French microelectronics leader CEA-Leti, has been exploring everyday transistors--that are present in billions in all our mobile phones--for their use as qubits. The French company Leti makes giant ...
Imaging techniques enable a detailed look inside an organism. But interpreting the data is time-consuming and requires a great deal of experience. Artificial neural networks open up new possibilities: They require just seconds to interpret whole-body scans of mice and to segment and depict the organs in colors, instead of in various shades of gray. This facilitates the analysis considerably.
How big is the liver? Does it change if medication is taken? Is the kidney inflamed? Is there a tumor in the brain and did metastases already develop? ...
December 28, 2020 - Platelet-rich plasma (PRP) treatment, which involves injecting a small amount of a patient's own blood to release various growth factors from platelets, continues to increase in popularity. The American Society of Plastic Surgeons has tracked the procedure since 2015 and reports a 25 percent increase in cosmetic PRP use in the last four years.
That increase in popularity could in part trace back to celebrities extolling the procedure's cosmetic benefits. Yet with so much information coming from so many different sources about the treatment's ...
Cells, the basic unit of life, are surrounded by a limiting membrane called the plasma membrane. Inside cells, there are various membrane-bounded organelles, each of which has various and distinctive functions. How these organelles, which individually boast different functions, have been developed during evolution remains unknown. This phenomenon has fascinated many researchers.
In the study published in Nature Communications, the evolutionary relationship between two different organelles in liverwort cells has been revealed: the cell plate, which divides ...
Two new studies from the University of Rochester Medical Center (URMC) have uncovered an association between vaping and mental fog. Both adults and kids who vape were more likely to report difficulty concentrating, remembering, or making decisions than their non-vaping, non-smoking peers. It also appeared that kids were more likely to experience mental fog if they started vaping before the age of 14.
While other studies have found an association between vaping and mental impairment in animals, the URMC team is the first ...
Researchers from Yokohama National University in Japan have developed a prototype microprocessor using superconductor devices that are about 80 times more energy efficient than the state-of-the-art semiconductor devices found in the microprocessors of today's high-performance computing systems.
As today's technologies become more and more integrated in our daily lives, the need for more computational power is ever increasing. Because of this increase, the energy use of that increasing computational power is growing immensely. For example, so much energy is used by modern day data centers that some are built near rivers so that the flowing water ...
COLUMBUS, Ohio - A single positive experience on a psychedelic drug may help reduce stress, depression and anxiety symptoms in Black, Indigenous and people of color whose encounters with racism have had lasting harm, a new study suggests.
The participants in the retrospective study reported that their trauma-related symptoms linked to racist acts were lowered in the 30 days after an experience with either psilocybin (Magic Mushrooms), LSD or MDMA (Ecstasy).
"Their experience with psychedelic drugs was so powerful that they could recall and report on changes in symptoms from racial trauma that they had experienced in their lives, and they ...
Cancer cells are known for spreading genetic chaos. As cancer cells divide, DNA segments and even whole chromosomes can be duplicated, mutated, or lost altogether. This is called chromosomal instability, and scientists at Memorial Sloan Kettering have learned that it is associated with cancer's aggressiveness. The more unstable chromosomes are, the more likely that bits of DNA from these chromosomes will end up where they don't belong: outside of a cell's central nucleus and floating in the cytoplasm.
Cells interpret these rogue bits of DNA as evidence ...
BOSTON - Some police departments in the United States continue to teach officers that neck restraints are a safe method for controlling agitated or aggressive people, but that's a dangerous myth, according to a Viewpoint written by three neurologists at Massachusetts General Hospital (MGH) in JAMA Neurology.
The killing of George Floyd, a Black man who died while being arrested in May 2020 after a police officer pressed a knee to his neck for more than eight minutes, helped spark a national conversation about racial ...
Certain bacteria, known as plant-growth-promoting bacteria (PGPB), can improve plant health or protect them from pathogens and are used commercially to help crops. To further improve agricultural yields, it is helpful to identify factors that can improve PGPB behavior.
Many PGPB form sticky communities of cells, known as biofilms, that help them adhere to plant roots. A group of scientists in North Carolina and Massachusetts were interested in finding other plant-associated bacteria that could help PGPB better adhere to plant roots, with the hope that increasing the number of PGPB cells attached to roots would increase their beneficial activities. ...
