Biomedical subjects
Publications and source records attributed to O Scheibe.
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In the hospitals of Baden-Württemberg quality assurance is performed by means of tracers e.g. with standardized guidelines for diagnosis and therapy in femur fractures, appendectomies, cholelithiasis/cholecystitis, cancer of the rectum. In the first part datas of each patient are collected, examined and evaluated. One part of the evaluation includes all patients, the other part only patients of one clinic. This particular clinic has thus the possibility to compare its results with the average results of all clinics. A Consilium Chirurgicum (Surgical Study Group) defines the reference scope and determines certain quality indicators, such as septic complications, damages caused by inadequate positioning of the patient, rate of innocent appendectomies. These indicators are based on scientific background. In an important second part, the clinic must then react to the deficiencies, must eliminate and prevent them. The Consilium Chirurgicum observes the quality assurance and quality improvement. It has the possibility to remind the clinic anonymously or in case of massive or long lasting deficiencies to ask officially for an explanation.
The quality assurance in surgery is supported by the Surgical Society. The progress report after 3 years demonstrated an increase of quality in surgery. This regional study of Baden-Württemberg includes all points of health laws.
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A new edition of the TNM classification of malignant tumours will be published in spring 1987 by UICC. This 4th edition is an internationally uniform and updated classification of tumours by their anatomical extent and is indispensable for treatment planning and evaluation of treatment results in cancer patients.
Decision to use a particular key system depends mainly on whether it it used regularly and whether it is possible to translate it into another key system. A study is being made on the translation of the surgical therapy key system VESKA and others. The ICD and Immich systems are among the diagnostic key systems available. Oncology relies mainly upon the TNM system developed by UICC; the key for tumour localisation is used and the most important data can be recorded on the basic investigation sheet.
The example of a historic comparative study on the value of the application of inhibitions on thrombocyte aggregation (inhibition of thrombocyte function) was used to prove how important such data can be. Mistakes can also be discovered. Clinical comparisons can only be made when investigations have been made using a planned form to note anamnesis and other data. Special pre-illness history, the findings and course of the illness are not noted on a planned form. These conditions also allow an opinion to be formed from retrospective study of a case. The results help to build a prospective and randomized work.
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