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C Veit

Publications and source records attributed to C Veit.

12 recordsLinked to original sources
PubMed1999

[Quality documentation with an Anaesthesia Information Management System (AIMS)].

OBJECTIVE: In 1994 the Department of Anaesthesiology and Intensive Care Medicine of the Justus Liebig University of Giessen decided to implement an Anaesthesia Information Management System (AIMS) to replace the previous hand-written documentation on paper. From 1997 until the end of 1998 the data sets of 41,393 anaesthesia procedures were recorded with the help of computers and imported into a data bank. Individual aspects and results of this data pool are presented under the aspect of how the system in its present form is able to guarantee documentation of quality according to the requirements of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI). METHODS: Since 1997 information on all anaesthesia procedures has been documented "online" with the anaesthesia documentation software NarkoData 4 (ProLogic GmbH, Erkrath). The data sets have been stored in a relational data bank (Oracle Corporation) and statistically processed with the help of the SQL-based program Voyant (Brossco Systems, Espoo, Finland). As an example of two adverse perioperative events (AVB) we compared incidences of "hypotension" and "nausea/vomiting", recorded by staff members into the AIMS, with the incidence of comparable events that were recorded with the help of online data during anaesthesia procedures, such as blood pressure and drug application. Since 1998 data recording has been revised constantly in department meetings; advanced training has been given. The results have been analysed critically. RESULTS: In 1997 the incidence of adverse perioperative events entered manually into the system was 3.6% (grade III and higher 0.9%) and increased during 1998 to 22.2% (grade III and higher 1.9%). The frequency of anaesthesia procedures with manually documented AVBs was significantly below the incidence (determined with the help of online data) of comparable events: "hypotension" (1.8% vs. 8.5%) and "nausea/vomiting" (4.9% vs. 8.3%). CONCLUSION: The current documentation of AVBs in almost any hospital is incomplete. In contrast to the hand-written procedure, the AIMS provides recorded data for evaluation and guarantees more detailed and complete quality documentation. In addition, the effort needed for documentation is reduced. Whether these data sets really describe and measure quality or not has to be evaluated. In addition it has to be considered whether different requirements (such as automatic AVB recognition for an AIMS) are advantageous for quality documentation regarding the data raster and the AVB recognition, with respect to different documentation procedures.

Anesthesia↗
PubMed1999

[Aspects of external quality assurance in anesthesiology--experiences in Hamburg].

In 1994, external quality assurance in anaesthesia according to the German Society of Anaesthesiology and Intensive Care (DGAI) was obligatory introduced in Hamburg. Since 1992 in a pilot project and since 1994 compulsory nearly 500,000 anaesthesias were documented by 39 institutions with a standard data set issued by the DGAI and transferred to the project office of the Association for Quality Assurance (EQS) Hamburg. Comparative statistics of these data were produced at the project office. In the controlling committee and in meetings of the project participants the contents, policy and results of the project were critically analyzed and adjustments initiated whenever necessary. With an incidence of 14.1% of all anaesthesias with special occurrences (AVB), the results are in the same range compared to most other studies. To evaluate the concept of documentation the predictory power of single and combined risk assessments for the incidence of particular AVBs in elective anaesthesias were compared to the predictory power of ASA-Classification in order to reduce the parameters that had to be collected. This should lead to a positive influence on the quality of documentation. Besides one exception, no superior prediction power for AVB incidence could be demonstrated for any special risk assessment as compared with the ASA-classification. This is also true for the AVBs which are associated with high lethality. Thus, the documentation of risk factors in the core data set as predictors can be abandoned without major loss of information. The participants consider the project to be a useful support for internal improvement projects. Besides the reduction of the amount of data in quality assurance to get a core of particularly meaningful parameters the classification of the surgical procedure by the ICPM- or OPS 301-Code should be integrated into the core data set of the DGAI. It would lead to an increase in acceptance of the method and thus to an increase in the validity of its results and valuations.

Anesthesiology↗
PubMed1998

[Four year's experience with quality assurance in anesthesiology in Hamburg].

PURPOSE: Since 1992 421,851 anaesthesias were documented by 39 institutes with a standard dataset issued by the German Society of Anaesthesiology and Intensive Care (DGAI). The project was run by the Association for Quality Assurance (EQS) in Hamburg. Some results of the evaluation of this datapool are presented questioning the feasibility of the project to support improvement processes within the participating institutions and which adjustments should be done considering these experiences. METHODS: Data from machine-readable protocols and documentation software representing all anaesthesia cases were recorded since 1992 in a pilot project and since 1994 compulsory with a standard dataset issued by the DGAI. Comparing statistics of these data was produced at the EQS project office. In the steering committee and in meetings of the project participants the contents, policy and results of the project office. In the steering committee and in meetings of the project were critically analysed and adjustments initiated whenever necessary. Validity of data and feasibility of the method used was also questioned on the background of comparable studies. RESULTS: With an incidence of 14.1% of all anaesthesias with special occurrences (AVB) the results are in the same range if compared with most other studies. However, documentation of data is not complete. This is assumed to be due to the large size of the dataset with 112 items and the additional workload associated with it. Nevertheless the participants mostly consider the project to be a very useful support for internal improvement projects. CONCLUSION: The project method used so far is not mature yet. The data set must be streamlined and rendered more concise, quality indicators should be defined and tested, and the availability of statistically proven limits of tolerance should be the immediate aims in the further development of the project.

Adult↗
PubMed1998

[Continuous improvement in anesthesiological quality documentation].

OBJECTIVE: The analysis of result variation in quality benchmarking projects in anaesthesia showed that ASA classification was often the most relevant parameter in distinction of risk groups. Thus the parallel description of the risk level of a patient both with the ASA classification and with particular risk parameters was examined critically. The hypothesis was tested that the documentation of both parameter groups in the running quality benchmarking projects does not lead to relevant information gain. As a pragmatic consequence we see the possibility to reduce the core dataset with significant reduction of the documentation workload. METHODS: With machine readable protocols or online computer documentation nearly all anaesthesias in hospitals in Hamburg were documented with the DGAI core data set and transferred to the project office of EQS Hamburg since 1992. We compared the predictory power of single and combined risk assessments for the incidence of particular AVBs (grade 3 to 5) in elective anaesthesias with that of ASA-classification. RESULTS: In 257,878 elective anaesthesias AVBs were documented in 14.5% of cases. Besides one exception no superior prediction power for AVB incidence could be demonstrated for any special risk assessment as compared with the ASA-classification. This is also true for the AVBs decompensated cardiac insufficiency, myocardial infarction, pulmonary embolism and cardiac arrest which are associated with high lethality. CONCLUSION: We assume that the documentation of risk factors in the core data set as predictors can be abandoned without major loss of information. This would be a first step towards reduction of the amount of data in quality assurance to get a core of especially meaningful parameters. It would lead to an increase in acceptance of the method and thus to an increase in the validity of its results.

Anesthesia↗
PubMed1992

Computing tools for quality assurance.

Computing systems for quality assessment in the operative departments, in anaesthesia and intensive care were developed at the Altona General Hospital, Hamburg. The main goals were to support quality assurance as a tool for the medical staff which they can use actively in their routine work and to reorganize uneconomical forms of clinical data handling. The most important characteristics of the tools presented here are flexibility of the databases and applications, openness to individual configurations and integration of quality assessment, activity audits and clinical routine under the primacy of medical documentation. Research is aimed at new forms of medical documentation, problem-oriented presentation and focusing of clinical data in the context of quality assurance programs.

Anesthesia↗
PubMed1989

[Morphometric studies of radiographic pictures of lumbar vertebrae of healthy Boxers and Boxers with spondylosis].

Length and height measurement of the third lumbar vertebra in 286 radiographs of 140 male and 146 female Boxers was carried out to defect differences between dogs with and dogs without spondylosis. No differences could be established. However, there were statistically significant differences in the length of the vertebra between male and female dogs within the age groups (below two years and above 5 years) and between bitches younger than two years and bitches older than 5 years. Length-height-proportions did not change. Female Boxers were more often affected with spondylosis than males.

Animals↗
PubMed1986

Circadian rhythm in mammary cytoplasmic estrogen receptor content of Balb/C female mice with and without pituitary isografts.

Cytoplasmic estrogen receptors were determined by the dextran-coated charcoal method in inguinal breast tissue of three groups of Balb/C female mice 6-8 weeks following subcutaneous implantation into the intact animals of three pituitary glands and three pieces of skeletal muscle (group I), three pituitary glands and three segments of hypothalamic tissue (group II), or three pieces of skeletal muscle (group III) obtained from animals of the same inbred strain as control. A circadian rhythm in estrogen receptor content was statistically quantified by cosinor analysis in the muscle implanted control and the pituitary and hypothalamic implant groups. In the pituitary and muscle implant group the circadian rhythm is of borderline significance with a P-value between 0.05 and 0.10. The timing (acrophase) and extent of change (amplitude) are similar in all three treatment groups. The average receptor content (MESOR) in the two pituitary-implanted groups, which in previous studies were shown to have an increased breast cancer incidence is about twice that of the control group. The reduction in the pituitary induced breast cancer rate by hypothalamic tissue addition to a cancer incidence between the animals with pituitary and muscle isograft and the mice carrying no pituitary at all has also been shown previously in this strain of mice and is not reflected in receptor content.

Animals↗
PubMed1981

DNA methylation by N-nitrosomethylbenzylamine in target and non-target tissues of NMRI mice.

Adult female NMRI mice received a single i.p injection of N-nitroso(methyl-14C)methylbenzylamine (2.5 mg/kg body weight). Multiple weekly applications of such a dose, by this route, have previously been shown to induce lung adenomas and forestomach carcinomas in all experimental animals. After a survival time of 6 h, DNA was isolated from various tissues and analysed for methylated purines by separation of the acid hydrolysate on Sephasorb columns. Highest concentrations of 7-methylguanine and 06-methylguanine were present in hepatic DNA, followed by lung and forestomach. DNA methylation in the oesophagus was only 21% less than in forestomach. Since both tissues develop a high tumour incidence after oral administration of N-nitrosomethylbenzylamine (MBN), this observation suggests that despite their anatomical similarities the level of DNA modification required for malignant transformation differs considerably in these tissue. In the remaining organs, DNA alkylation was either considerably less (colon, glandular stomach, kidney) or not detectable (small intestine, spleen). These date indicate that following i.p. injection in mice, MBN is preferentially metabolised in a non-target organ (liver). Among the various other tissues investigated, highest levels of initial DNA methylation were present in forestomach and lung, i.e., the principal target organs of MBN for this route of application.

Animals↗
PubMed1977

[The apoplexy of the labyrinth (author's transl)].

Owing to the morphological, physiological and pathophysiological similarities in the vasculature of the brain and the inner ear, the term apoplexy can also be applied to the inner ear. The apoplexy of the labyrinth is defined as an acute and severe panlabyrinthic disturbance with sudden hearing loss or deafness in association with vestibular functional disorders. The apoplexy may occur after hemorrhage as a result of inner ear blood vessel ruptures or after malacias following localised ischemias just as it occurs in the brain. Treatment of such cases were carried out by application of high doses of cortison. The prognosis of these inner ear disturbances is unfavourable.

Animals↗