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[Barriers for the use of traditional clinical data].

https://arctichealth.org/en/permalink/ahliterature271869
Source
Ugeskr Laeger. 2013 Oct 21;175(43):2546-9
Publication Type
Article
Date
Oct-21-2013
Author
Søren Neermark
Morten Bay-Nielsen
Source
Ugeskr Laeger. 2013 Oct 21;175(43):2546-9
Date
Oct-21-2013
Language
Danish
Publication Type
Article
Keywords
Databases, Factual - legislation & jurisprudence - standards
Denmark
Humans
Information Systems - legislation & jurisprudence - standards
Medical Records Systems, Computerized - legislation & jurisprudence - standards
Quality Assurance, Health Care
Registries - standards
Abstract
Data from electronic medical records can be used in describing clinical problems not covered by traditional clinical databases or traditional quality assurance systems. In this article three main barriers for the use of these data are identified: system knowledge, legislation and technical barriers. Legislative deregulation and implementation of strategic initiatives to further the use of the data is suggested.
Notes
Comment In: Ugeskr Laeger. 2013 Oct 21;175(43):254524629148
PubMed ID
24629149 View in PubMed
Less detail
Source
Ugeskr Laeger. 2012 Oct 15;174(42):2522
Publication Type
Article
Date
Oct-15-2012
Author
Lars Nannestad Jørgensen
Hans Friis-Andersen
Morten Bay-Nielsen
Henrik Kehlet
Author Affiliation
Kirurgisk Afdeling K, Bispebjerg Hospital, Bispebjerg Bakke 23, Copenhagen. larsnjorgensen@hotmail.com
Source
Ugeskr Laeger. 2012 Oct 15;174(42):2522
Date
Oct-15-2012
Language
Danish
Publication Type
Article
Keywords
Databases, Factual
Denmark - epidemiology
Hernia - epidemiology - pathology
Hernia, Ventral - epidemiology - pathology
Herniorrhaphy - statistics & numerical data
Humans
Quality Assurance, Health Care
Registries
PubMed ID
23079425 View in PubMed
Less detail

Danish Hernia Database recommendations for the management of inguinal and femoral hernia in adults.

https://arctichealth.org/en/permalink/ahliterature137275
Source
Dan Med Bull. 2011 Feb;58(2):C4243
Publication Type
Article
Date
Feb-2011
Author
Jacob Rosenberg
Thue Bisgaard
Henrik Kehlet
Pål Wara
Torsten Asmussen
Poul Juul
Lasse Strand
Finn Heidmann Andersen
Morten Bay-Nielsen
Author Affiliation
Department of Surgical Gastroenterology, Herlev Hospital, Denmark. jaro@heh.regionh.dk
Source
Dan Med Bull. 2011 Feb;58(2):C4243
Date
Feb-2011
Language
English
Publication Type
Article
Keywords
Age Factors
Algorithms
Databases, Factual
Denmark
Female
Hernia, Femoral - diagnosis - surgery
Hernia, Inguinal - diagnosis - surgery
Humans
Laparoscopy - instrumentation - methods
Male
Pain, Postoperative - prevention & control
Sex Factors
Thromboembolism - prevention & control
Abstract
The nationwide Danish Hernia Database, recording more than 10,000 inguinal and 400 femoral hernia repairs annually, provides a unique opportunity to present valid recommendations in the management of Danish patients with groin hernia. The cumulated data have been discussed at biannual meetings and guidelines have been approved by the Danish Surgical Society. Diagnosis of groin hernia is based on clinical examination. Ultrasonography, CT or MRI are rarely needed, while herniography is not recommended. In patients with indicative symptoms of hernia, but no detectable hernia, diagnostic laparoscopy may be an option. Once diagnosed, hernia repair is recommended in the presence of symptoms affecting daily life. In male patients with minimal or absent symptoms watchful waiting is recommended. In females, however, repair is recommended also in asymptomatic patients. In male patients with primary unilateral or bilateral groin hernia the preferred method is mesh repair, either at open surgery (Lichtenstein) or laparoscopically, irrespective of age. Conventional tension-producing methods like Bassini, McVay or Shouldice are no longer recommended in a routine elective setting. Whether repair should be done by open or laparoscopic technique, depends on local expertise, economical considerations and patient preference. Compared to the Lichtenstein operation laparoscopic repair is associated with less acute pain and faster recovery. Furthermore, available data suggest less chronic long-term pain after laparoscopic repair. In female patients laparoscopic repair is the recommended method. In patients with recurrent hernia laparoscopic repair is preferred in patients with a previous open repair, while patients with recurrence after laparoscopic repair should undergo open mesh repair. In open repair it is recommended to use a mesh secured with a nonabsorbable monofilament suture. In laparoscopic repair a mesh without a slit and with a minimum size of 15 by 10 cm is used. For mesh fixation absorbable or nonabsorbable tacks or glue can be used. Elective surgery for groin hernia should be performed in an outpatient setting, using cost-effective local anaesthesia in open mesh repair and general anaesthesia for laparoscopic repair. Spinal anaesthesia is not recommended. Routine prophylactic antibiotics are not indicated. In the early convalescence period there are no physical restrictions. These guidelines will also be available at the website for the Danish Hernia Database (www.herniedatabasen.dk). The guidelines will be updated when new substantial evidence becomes available.
PubMed ID
21299930 View in PubMed
Less detail

Direct and recurrent inguinal hernias are associated with ventral hernia repair: a database study.

https://arctichealth.org/en/permalink/ahliterature118608
Source
World J Surg. 2013 Feb;37(2):306-11
Publication Type
Article
Date
Feb-2013
Author
Nadia A Henriksen
Lars T Sorensen
Morten Bay-Nielsen
Lars N Jorgensen
Author Affiliation
Department of Surgery K, University of Copenhagen, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark. nadiahenriksen@gmail.com
Source
World J Surg. 2013 Feb;37(2):306-11
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Cohort Studies
Databases, Factual
Denmark
Female
Hernia, Inguinal - complications - surgery
Hernia, Ventral - etiology - surgery
Herniorrhaphy
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Recurrence
Risk factors
Young Adult
Abstract
A systemically altered connective tissue metabolism has been demonstrated in patients with abdominal wall hernias. The most pronounced connective tissue changes are found in patients with direct or recurrent inguinal hernias as opposed to patients with indirect inguinal hernias. The aim of the present study was to assess whether direct or recurrent inguinal hernias are associated with an elevated rate of ventral hernia surgery.
In the nationwide Danish Hernia Database, a cohort of 92,457 patients operated on for inguinal hernias was recorded from January 1998 until June 2010. Eight-hundred forty-three (0.91 %) of these patients underwent a ventral hernia operation between January 2007 and June 2010. A multivariate logistic regression analysis was applied to assess an association between inguinal and ventral hernia repair.
Direct (Odds Ratio [OR] = 1.28 [95 % CI, 1.08-1.51]) and recurrent (OR = 1.76, [95 % CI, 1.39-2.23]) inguinal hernias were significantly associated with ventral hernia repair after adjustment for age, gender, and surgical approach (open or laparoscopic).
Patients with direct and recurrent inguinal herniation are more prone to ventral hernia repair than patients with indirect inguinal herniation. This is the first study to show that herniogenesis is associated with type of inguinal hernia.
Notes
Comment In: World J Surg. 2013 Feb;37(2):31223238798
PubMed ID
23188528 View in PubMed
Less detail

Gastrointestinal bleedings during therapy with new oral anticoagulants are rarely reported.

https://arctichealth.org/en/permalink/ahliterature264624
Source
Dan Med J. 2014 Nov;61(11):A4952
Publication Type
Article
Date
Nov-2014
Author
Morten Bay-Nielsen
Jens Peter Kampmann
Thue Bisgaard
Source
Dan Med J. 2014 Nov;61(11):A4952
Date
Nov-2014
Language
English
Publication Type
Article
Keywords
Adverse Drug Reaction Reporting Systems
Aged
Aged, 80 and over
Anticoagulants - adverse effects
Denmark
Female
Gastrointestinal Hemorrhage - chemically induced - epidemiology
Humans
Incidence
Male
Retrospective Studies
Abstract
Post-marketing surveillance of drugs relies on spontaneous reporting of adverse drug events to the Danish Health and Medicines Authority. A number of new oral anticoagulants (NOAC) have recently been marketed in Denmark. The purpose of this study was to evaluate the reporting of serious adverse drug events in patients treated with a NOAC and admitted for gastrointestinal bleeding.
This study is based on an electronic free text search in patient records and a search in the electronic medication records of all patients admitted to the Department of Gastroenterology, Surgical Section, Hvidovre Hospital, during a one-year-period. Patients in treatment with NOAC and admitted for gastrointestinal bleeding were identified. Relevant patients were cross-checked for a reported adverse drug event in the Danish Health and Medi-cines Authority's database on adverse medical events.
A total of 20 patients were acutely admitted for gastrointestinal bleeding while in treatment with a NOAC, an adverse medical event was reported for one of these patients (5%; 95% confidence interval: 0-25%).
Serious adverse events in patients treated with NOAC are underreported which questions the current effectiveness of post-marketing surveillance of adverse drug effects.
not relevant.
The study was registered with clin-icaltrials.gov (NCT02107651).
PubMed ID
25370961 View in PubMed
Less detail

[Growing need for surgery as the number of elderly rises in Denmark].

https://arctichealth.org/en/permalink/ahliterature271865
Source
Ugeskr Laeger. 2013 Oct 7;175(41):2399-401
Publication Type
Article
Date
Oct-7-2013
Author
Søren Neermark
Morten Bay-Nielsen
Thue Bisgaard
Source
Ugeskr Laeger. 2013 Oct 7;175(41):2399-401
Date
Oct-7-2013
Language
Danish
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Denmark - epidemiology
Health services needs and demand
Humans
Life Expectancy - trends
Surgical Procedures, Operative - statistics & numerical data - trends
Abstract
In Denmark, the elderly population is growing. In the article, data from the Danish Healthcare Registry (2005-2012) was summarized for hospital admissions and outpatient contacts with surgery in patients above 75 years. Also, the number of surgical procedures and surgical-related costs in 2020 were estimated based on demographic data and the rates surgery in 2012. The number of surgical procedures and surgical-related hospital costs will increase by 27.8% from 2012 to 2020, corresponding to the increase in the number of elderly citizens. New strategies and further political prioritization is needed to meet the rising age-related challenges.
PubMed ID
24630192 View in PubMed
Less detail

Impact of occupational mechanical exposures on risk of lateral and medial inguinal hernia requiring surgical repair.

https://arctichealth.org/en/permalink/ahliterature121127
Source
Occup Environ Med. 2012 Nov;69(11):802-9
Publication Type
Article
Date
Nov-2012
Author
Marie Vestergaard Vad
Poul Frost
Morten Bay-Nielsen
Susanne Wulff Svendsen
Author Affiliation
Danish Ramazzini Centre, Department of Occupational Medicine, Herning Regional Hospital, Gl. Landevej 61, DK-7400 Herning, Denmark.
Source
Occup Environ Med. 2012 Nov;69(11):802-9
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Denmark - epidemiology
Hernia, Inguinal - epidemiology - etiology - surgery
Humans
Incidence
Lifting
Male
Middle Aged
Movement
Occupational Diseases - epidemiology - etiology - surgery
Occupational Exposure - adverse effects
Risk factors
Stress, mechanical
Stress, Physiological
Walking
Young Adult
Abstract
We undertook a register-based cohort study to evaluate exposure-response relations between cumulative occupational mechanical exposures, and risk of lateral and medial inguinal hernia repair.
Among all men born in Denmark between 1938 and 1988, we established a cohort comprising those aged 18-65 years of age, who had at least 1 year of full-time employment between 1993 and 2007. Using information from a Job Exposure Matrix based on expert judgement and year-by-year information on Danish International Standard Classification of Occupations codes for each individual since 1993, we established time-varying cumulative estimates of exposure to daily lifting activities and standing/walking. Cumulative exposures for lagged 5-year time windows were expressed in a way that corresponds to the pack-year concept of smoking (ton-years, frequent-heavy-lifting years, and standing-years). First-time inguinal hernia repairs in the period 1998-2008 were identified in the Danish Hernia Database. We used a logistic regression technique equivalent to survival analysis, adjusting for age, socioeconomic status, region of residence and calendar year.
Within the cohort of 1 545 987 men, we identified 22 926 lateral, 15 877 medial and 1592 pantaloon or unspecified first-time inguinal hernia repairs. The risk of lateral hernia repair increased with ton-years, frequent-heavy-lifting-years, and standing-years, with ORs of up to around 1.4. The exposures correlated, but standing-years remained as the most robust risk factor after adjustment for lifting exposures. In general, the risk of medial hernia repair was unrelated to the exposures.
Our findings suggest an increased risk of lateral inguinal hernia repair in relation to occupational mechanical exposures and a preventive potential of around 15% of all cases.
PubMed ID
22935954 View in PubMed
Less detail

[Inguinal herniotomy in outpatient clinics and in hospital departments].

https://arctichealth.org/en/permalink/ahliterature184680
Source
Ugeskr Laeger. 2003 Jun 2;165(23):2373-6
Publication Type
Article
Date
Jun-2-2003
Author
Finn Heidemann Andersen
Morten Bay-Nielsen
Anders Bak-Christensen
Kaare Nielsen
Jan Reinhold Struckmann
Henrik Kehlet
Author Affiliation
H:S Hvidovre Hospital.
Source
Ugeskr Laeger. 2003 Jun 2;165(23):2373-6
Date
Jun-2-2003
Language
Danish
Publication Type
Article
Keywords
Adult
Aged
Ambulatory Surgical Procedures - economics - standards - utilization
Denmark
Hernia, Inguinal - surgery
Humans
Middle Aged
Private Sector
Reimbursement Mechanisms
Reoperation - statistics & numerical data
Surgery Department, Hospital - economics - standards - utilization
Abstract
The purpose of the investigation was to examine the use of ambulatory surgery, anesthetic technique, reoperation rates, and reembursement fees after inguinal herniotomy in private outpatients clinics compared to herniotomy in hospital departments.
Information on number of operations performed, choice of anesthetic and surgical technique in private outpatients clinics and hospital departments was extracted from the Danish Hernia Data Base. Information on reembursement fees was obtained from the relevant health authorities and the Danish Medical Association.
7.4% of the inguinal herniotomies in Denmark were performed in private outpatients clinics. There was an extended use of local infiltration anesthesia (99%) and ambulatory procedures (99%) compared with 12% and 57% in the hospital departments. The reembursement fee for a herniotomy is approximately 3700 DKK in private outpatients clinics vs. 11,000 DKK in hospital departments.
The results of the study showed that the quality of inguinal herniotomy in private outpatients clinics is comparable to herniotomy in hospital departments, but the reembursement fees are lower in private outpatients clinics.
Notes
Comment In: Ugeskr Laeger. 2003 Jun 2;165(23):237112840992
PubMed ID
12840993 View in PubMed
Less detail

[The Danish Hernia Database--four years' results].

https://arctichealth.org/en/permalink/ahliterature179607
Source
Ugeskr Laeger. 2004 May 10;166(20):1894-8
Publication Type
Article
Date
May-10-2004

[The epidemiology of heart failure from a Danish perspective]

https://arctichealth.org/en/permalink/ahliterature53404
Source
Ugeskr Laeger. 2004 Jan 19;166(4):243-7
Publication Type
Article
Date
Jan-19-2004

10 records – page 1 of 1.