Koschack, Janka

[["dc.bibliographiccitation.artnumber","14"],["dc.bibliographiccitation.journal","BMC Family Practice"],["dc.bibliographiccitation.volume","9"],["dc.contributor.author","Koschack, Janka"],["dc.contributor.author","Scherer, Martin"],["dc.contributor.author","Luers, Claus"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Wetzel, Dirk"],["dc.contributor.author","Kleta, Sibylle"],["dc.contributor.author","Pouwels, Claudia"],["dc.contributor.author","Wachter, R. Rolf"],["dc.contributor.author","Herrmann-Lingen, Christoph"],["dc.contributor.author","Pieske, Burkert M."],["dc.contributor.author","Binder, Lutz"],["dc.date.accessioned","2018-11-07T11:18:13Z"],["dc.date.available","2018-11-07T11:18:13Z"],["dc.date.issued","2008"],["dc.description.abstract","Background: Screening of primary care patients at risk for left ventricular systolic dysfunction by a simple blood-test might reduce referral rates for echocardiography. Whether or not natriuretic peptide testing is a useful and cost-effective diagnostic instrument in primary care settings, however, is still a matter of debate. Methods: N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, clinical information, and echocardiographic data of left ventricular systolic function were collected in 542 family practice patients with at least one cardiovascular risk factor. We determined the diagnostic power of the NT-proBNP assessment in ruling out left ventricular systolic dysfunction and compared it to a risk score derived from a logistic regression model of easily acquired clinical information. Results: 23 of 542 patients showed left ventricular systolic dysfunction. Both NT-proBNP and the clinical risk score consisting of dyspnea at exertion and ankle swelling, coronary artery disease and diuretic treatment showed excellent diagnostic power for ruling out left ventricular systolic dysfunction. AUC of NT-proBNP was 0.83 (95% CI, 0.75 to 0.92) with a sensitivity of 0.91 (95% CI, 0.71 to 0.98) and a specificity of 0.46 (95% CI, 0.41 to 0.50). AUC of the clinical risk score was 0.85 (95% CI, 0.79 to 0.91) with a sensitivity of 0.91 (95% CI, 0.71 to 0.98) and a specificity of 0.64 (95% CI, 0.59 to 0.67). 148 misclassifications using NT-proBNP and 55 using the clinical risk score revealed a significant difference (McNemar test; p < 0.001) that was based on the higher specificity of the clinical risk score. Conclusion: The evaluation of clinical information is at least as effective as NT-proBNP testing in ruling out left ventricular systolic dysfunction in family practice patients at risk. If these results are confirmed in larger cohorts and in different samples, family physicians should be encouraged to rely on the diagnostic power of the clinical information from their patients."],["dc.identifier.doi","10.1186/1471-2296-9-14"],["dc.identifier.isi","000254051900001"],["dc.identifier.pmid","18298821"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/8928"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/54989"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","1471-2296"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","Natriuretic peptide vs. clinical information for diagnosis of left ventricular systolic dysfunction in primary care"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","1"],["dc.bibliographiccitation.issue","69"],["dc.bibliographiccitation.journal","BioMed Central family practice"],["dc.bibliographiccitation.lastpage","6"],["dc.bibliographiccitation.volume","7"],["dc.contributor.author","Scherer, Martin"],["dc.contributor.author","Sobek, Cordula"],["dc.contributor.author","Wetzel, Dirk"],["dc.contributor.author","Koschack, Janka"],["dc.contributor.author","Kochen, Michael M."],["dc.date.accessioned","2019-07-09T11:41:54Z"],["dc.date.available","2019-07-09T11:41:54Z"],["dc.date.issued","2006"],["dc.description.abstract","Background: To date, evidence-based recommendations help doctors to manage patients with heart failure (HF). However, the implementation of these recommendations in primary care is still problematic as beneficial drugs are infrequently prescribed. The aim of the study was to determine whether admission to hospital increases usage of beneficial HF medication and if this usage is maintained directly after discharge. Methods: The study was conducted from November 2002 until January 2004. In 77 patients hospitalised with heart failure (HF), the medication prescribed by the referring general practitioner (GP) and drug treatment directed by the hospital physicians was documented. Information regarding the post-discharge (14 d) therapy by the GP was evaluated via a telephone interview. Ejection fraction values, comorbidity and specifics regarding diagnostic or therapeutic intervention were collected by chart review. Results: When compared to the referring GPs, hospital physicians prescribed more ACEinhibitors (58.4% vs. 76.6%; p = 0.001) and beta-blockers of proven efficacy in HF (metoprolol, bisoprolol, carvedilol; 58.4% vs. 81.8%). Aldosterone antagonists were also administered more frequently in the hospital setting compared to general practice (14.3% vs. 37.7%). The New York Heart Association classification for heart failure did not influence whether aldosterone antagonists were administered either in primary or secondary care. Fourteen days after discharge, there was no significant discontinuity in discharge medication."],["dc.identifier.doi","10.1186/1471-2296-7-69"],["dc.identifier.fs","53189"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?goescholar/1256"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/58544"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","CC BY 2.0"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.subject.ddc","610"],["dc.subject.ddc","616"],["dc.subject.ddc","616.1"],["dc.title","Changes in heart failure medications in patients hospitalised and discharged"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","Doc02"],["dc.bibliographiccitation.journal","GMS Psycho-Social Medicine"],["dc.bibliographiccitation.volume","5"],["dc.contributor.author","Scherer, Martin"],["dc.contributor.author","Himmel, Wolfgang"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Koschack, Janka"],["dc.contributor.author","Ahrens, Dirk"],["dc.contributor.author","Chenot, Jean-Francois"],["dc.contributor.author","Simmenroth-Nayda, Anne"],["dc.contributor.author","Herrmann-Lingen, Christoph"],["dc.date.accessioned","2021-09-14T13:26:41Z"],["dc.date.available","2021-09-14T13:26:41Z"],["dc.date.issued","2008-04-02"],["dc.description.abstract","Psychosocial symptoms are common in patients with heart failure. Little research, however, has been done to determine which psychosocial factors influence primary care patients' consultation frequency in the case of heart failure."],["dc.identifier.pmid","19742279"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/89395"],["dc.language.iso","en"],["dc.relation.issn","1860-5214"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","CC BY-NC-ND 3.0"],["dc.title","Psychosocial determinants for frequent primary health care utilisation in patients with heart failure"],["dc.title.alternative","Psychosoziale Determinanten für häufige Hausarztkontakte bei Patienten mit Herzinsuffizienz"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","217"],["dc.bibliographiccitation.issue","4"],["dc.bibliographiccitation.journal","Clinical Research in Cardiology"],["dc.bibliographiccitation.lastpage","226"],["dc.bibliographiccitation.volume","99"],["dc.contributor.author","Luers, Claus"],["dc.contributor.author","Wachter, R. Rolf"],["dc.contributor.author","Kleta, Sibylle"],["dc.contributor.author","Uhlir, Marc"],["dc.contributor.author","Koschack, Janka"],["dc.contributor.author","Scherer, Martin"],["dc.contributor.author","Binder, Lutz"],["dc.contributor.author","Herrmann-Lingen, Christoph"],["dc.contributor.author","Zapf, Antonia"],["dc.contributor.author","Kulle, Bettina"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Pieske, Burkert M."],["dc.date.accessioned","2018-11-07T08:44:25Z"],["dc.date.available","2018-11-07T08:44:25Z"],["dc.date.issued","2010"],["dc.description.abstract","The diagnostic value of natriuretic peptides in asymptomatic patients at risk for diastolic or systolic HF is controversial. We tested (1) the prevalence of preclinical LV dysfunction in an at-risk cohort; (2) the diagnostic accuracy of natriuretic peptides alone or in combination with clinical parameters for predicting asymptomatic left ventricular systolic or diastolic dysfunction. 542 primary care patients (mean age 63 +/- A 11 years, 42% female) without prediagnosed HF, but with risk factors for left ventricular dysfunction, underwent thorough cardiological workup, including echocardiography and analysis of natriuretic peptides. 23 patients (4%) showed reduced systolic function (EF < 50%), and 15 patients (3%) had severe diastolic dysfunction. All natriuretic peptides significantly increased with decreasing ejection fraction and with increasing degree of diastolic dysfunction. For natriuretic peptides, receiver operating characteristics analysis yielded good results for the detection of systolic dysfunction or severe diastolic dysfunction. Combining clinical parameters with natriuretic peptide data improved the diagnostic accuracy and largely reduced the number of needed screening echoes to identify patients with LV systolic or diastolic dysfunction. The prevalence of preclinical diastolic dysfunction is high in primary care patients at risk, but the relative prevalence of severe diastolic dysfunction and systolic dysfunction is only 7%. High-risk individuals may be screened most efficiently by using a score system incorporating clinical data and NT-proBNP."],["dc.description.sponsorship","German Federal Ministry of Education and Research [FKZ 01GI0205]"],["dc.identifier.doi","10.1007/s00392-009-0108-z"],["dc.identifier.isi","000275788300002"],["dc.identifier.pmid","20052479"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?goescholar/4174"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/20192"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","1861-0684"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","Natriuretic peptides in the detection of preclinical diastolic or systolic dysfunction"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]