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OBJECTIVE Bilateral adrenalectomy (BADX) is an important treatment option for patients with Cushing's syndrome (CS). Our aim is to analyze the long-term outcomes, surgical, biochemical, and clinical as well as morbidity and mortality, of patients who underwent BADX. DESIGN A total of 50 patients who underwent BADX since 1990 in two German centers were(More)
Clinical pathways are an effective instrument to decrease undesired practice variability and improve clinician performance. IT-applications embedded into clinical routine work can help to increase pathway compliance. Successfully implementing such applications requires both a responsive IT infrastructure and a participatory and iterative design process(More)
CONTEXT Successful tumor resection in endogenous Cushing's syndrome (CS) results in tertiary adrenal insufficiency requiring hydrocortisone replacement therapy. OBJECTIVE The aim was to analyze the postsurgical duration of adrenal insufficiency of patients with Cushing's disease (CD), adrenal CS, and ectopic CS. DESIGN We performed a retrospective(More)
To deliver patient-specific advice at the time and place of a consultation is an important contribution to improving clinician performance. Using computer-based decision support on the basis of clinical pathways is a promising strategy to achieve this goal. Thereby integration of IT applications into the clinical workflow is a core precondition for success.(More)
A number of research and development projects in the U.S. and in Europe have shown that novel technologies can open significant perspectives for hospital information systems (HIS). The selection of software products for a HIS, however, is still nontrivial. Generalist vendors promise a broad scope of functionality and integration, while specialist vendors(More)
Today, most large hospital information systems (HIS) comprise many heterogeneous application systems, loosely coupled via interfaces. Integration could offer many advantages, like the support of interdepartmental workflows or a consistent patient record. This cannot be achieved, however, by simply interfacing originally unrelated component systems. In this(More)
Marburg University Medical Center has been introducing a comprehensive health information system since 1999, using a single-vendor application framework with an integrated generator tool for the development of clinical applications. To find out if this architecture and our participative software engineering approach can be considered a step towards a(More)
Recent studies on adverse events in medicine have shown that errors in medicine are not rare and may cause severe harm. Quality problems in discharge letters may be a source of medical error. We have analyzed 150 discharge letters of an outpaitient clinic for casualty surgery in order to identify and to classify typical mistakes. A Failure Mode and Effect(More)
The demethylating agent azacitidine (AZA) is currently the standard of care for patients with higher-risk myelodys-plastic syndromes (MDS) not eligible for allogeneic stem cell transplant (HSCT). Although approximately 50% of patients show a response to AZA it is not currently possible to accurately predict which patients will respond. In addition ,(More)