Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

{"title":"Using artificial intelligence (AI) for form and content checks of medical reports: Proofreading by ChatGPT4.0 in a neurology department","authors":"Maximilian Habs ,&nbsp;Stefan Knecht ,&nbsp;Tobias Schmidt-Wilcke","doi":"10.1016/j.zefq.2025.02.007","DOIUrl":"10.1016/j.zefq.2025.02.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Medical reports contain critical information and require concise language, yet often display errors despite advances in digital tools. This study compared the effectiveness of ChatGPT 4.0 in reporting orthographic, grammatical, and content errors in German neurology reports to a human expert.</div></div><div><h3>Materials and Methods</h3><div>Ten neurology reports were embedded with ten linguistic errors each, including typographical and grammatical mistakes, and one significant content error. The reports were reviewed by ChatGPT 4.0 using three prompts: (1) check the text for spelling and grammatical errors and report them in a list format without altering the original text, (2) identify spelling and grammatical errors and generate a revised version of the text, ensuring content integrity, (3) evaluate the text for factual inaccuracies, including incorrect information and treatment errors, and report them without modifying the original text. Human control was provided by an experienced medical secretary. Outcome parameters were processing time, percentage of identified errors, and overall error detection rate.</div></div><div><h3>Results</h3><div>Artificial intelligence (AI) accuracy in error detection was 35% (median) for Prompt 1 and 75% for Prompt 2. The mean word count of erroneous medical reports was 980 (SD = 180). AI-driven report generation was significantly faster than human review (AI Prompt 1: 102.4 s; AI Prompt 2: 209.4 s; Human: 374.0 s; <em>p</em> &lt; 0.0001). Prompt 1, a tabular error report, was faster but less accurate than Prompt 2, a revised version of the report (<em>p</em> = 0.0013). Content analysis by Prompt 3 identified 70% of errors in 34.6 seconds.</div></div><div><h3>Conclusions</h3><div>AI-driven text processing for medical reports is feasible and effective. ChatGPT 4.0 demonstrated strong performance in detecting and reporting errors. The effectiveness of AI depends on prompt design, significantly impacting quality and duration. Integration into medical workflows could enhance accuracy and efficiency. AI holds promise in improving medical report writing. However, proper prompt design seems to be crucial. Appropriately integrated AI can significantly enhance supervision and quality control in health care documentation.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 36-41"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Herausforderungen in der Versorgung außerklinischer Intensivpflegepatient*innen – eine Beobachtungsstudie zur Perspektive von Pflegepersonen","authors":"Alena Lübben ,&nbsp;Nathalie Englert ,&nbsp;Andreas Büscher","doi":"10.1016/j.zefq.2025.02.008","DOIUrl":"10.1016/j.zefq.2025.02.008","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital intensive care (AKI) is a growing sector and is gaining increasing attention in research. In addition, the GKV-Intensive Care and Rehabilitation Strengthening Act (GKV-IPReG) influences the organization of care for people with AKI as well as the implementation and obligations of service providers. The aim is to promote decannulation and weaning from mechanical ventilation through surveys of potential. However, there is still a lack of scientifically sound evidence on care structures and care processes in AKI and the effects of the GKV-IPReG. These care structures were analyzed in the innovation fund project ATME (“Needs, requirements and cross-sectoral care pathways of out-of-hospital ventilated intensive care patients”).</div></div><div><h3>Methods</h3><div>As part of a mixed-methods approach, a quantitative online survey was conducted as part of the ATME project using a literature-based and interview-based questionnaire. Nurses in the AKI were surveyed from August to November 2023 on the care and care processes of patients in the AKI. Data was analyzed descriptively using SPSS. Critical care points and challenges of AKI were derived.</div></div><div><h3>Results</h3><div>There is a lack of both supply and personal capacities in the out-of-hospital intensive care setting. Hospital care is seen as critical and can lead to discontinuity of care. 308 nurses perceive themselves to be playing a central role in the coordination of care and everyday life, but at the same time they deplore the lack of recognition and want more room for autonomous care decisions. The primary therapeutic goal is not to wean patients from ventilation or decannulation, but to maintain their current health status. There is concern that the new legislation (GKV-IPReG) will lead to increased disruptions in care and additional bureaucracy.</div></div><div><h3>Conclusion</h3><div>The findings serve as a basis for further research and the optimization of interfaces and the solution to care issues. New care concepts need to be developed, in particular regarding the lack of personal and structural capacities. Greater cooperation across settings can prevent discontinuities in care and improve the perception of the care experienced. Also, there is a need for further monitoring of the effects of the GKV-IPReG and the implementation of the necessary conditions in patient care.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 60-67"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The aftermath of the COVID-19 pandemic in general practices compared to pre-pandemic times: Longitudinal questionnaire survey among general practitioners and medical practice assistants in Germany on how the pandemic shaped everyday care","authors":"Lisa Kümpel ,&nbsp;Doreen Kuschick ,&nbsp;Kahina Toutaoui ,&nbsp;Marius Dierks ,&nbsp;Florian Wolf ,&nbsp;Liliana Rost ,&nbsp;Christoph Heintze ,&nbsp;Susanne Döpfmer","doi":"10.1016/j.zefq.2025.02.002","DOIUrl":"10.1016/j.zefq.2025.02.002","url":null,"abstract":"<div><h3>Introduction</h3><div>During the COVID-19 pandemic, general practice teams faced numerous challenges. The aim of the VeCo practice project was to explore changes in the provision and utilisation of health care services in general practices as well as professional challenges and needs during and after the COVID-19 pandemic from the perspective of general practitioners (GPs) and medical practice assistants (MPAs). This article focusses on the follow-up survey of the two groups, administered shortly after the pandemic, to explore whether and which of the perceived changes persisted post-pandemic.</div></div><div><h3>Methods</h3><div>We administered a longitudinal, self-developed, paper-based survey to GPs and MPAs in three German federal states during the pandemic in April 2022 (baseline) and shortly after the pandemic in May 2023 (follow-up). The results were analysed descriptively.</div></div><div><h3>Results</h3><div>A total of 657 GPs and 762 MPAs participated in the baseline survey, and some 327 GPs and 369 MPAs took part in the follow-up survey. The results indicate that GPs and MPAs have perceived an increased frequency of scheduled visits and routine examinations since 2023. In contrast, during the pandemic, these services were offered at a considerably lower rate compared to pre-pandemic times. Compared to the data obtained from the baseline survey, the follow-up data indicates that both GPs and MPAs felt more satisfied with their work again, but still felt overburdened. Both professional groups continue to regard better remuneration, appreciation and more involvement in health policy decisions as the most important requirements. Additionally, our findings suggest that telephone sick notes, a separate service of infectious diseases consultation and mandatory face mask use for infectious patients should be maintained post-pandemic.</div></div><div><h3>Discussion</h3><div>The COVID-19 pandemic has led to numerous changes in GP care, some of which may have an impact beyond the pandemic. Shortly after the end of the pandemic, the changes in the supply and utilisation of GP services had not yet returned to pre-pandemic levels. This applied, for example, to aspects of the organisation of consultation hours, where sustainable changes and improvements have been made. Even after the end of the pandemic, GPs and MPAs are still calling for appropriate remuneration, better appreciation and less bureaucracy.</div></div><div><h3>Conclusion</h3><div>Reflecting on the changes in GP practices during and after the pandemic could provide important information about lessons learned, potentially useful adjustments and opportunities for improvements to daily practice as well as highlighting the importance of work satisfaction of GPs and MPAs.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 51-59"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abschlusseditorial","authors":"Angelina Müller,&nbsp;Olga A. Amberger,&nbsp;Kateryna Karimova","doi":"10.1016/j.zefq.2025.03.008","DOIUrl":"10.1016/j.zefq.2025.03.008","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 101-102"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wie können stationär tätige Ärzt*innen in Weiterbildung und Quereinsteiger*innen in die Allgemeinmedizin in der Phase des Übergangs aus der Klinik in die Praxis unterstützt werden? Eine qualitative Interviewstudie","authors":"Maria Farquharson ,&nbsp;Ida Lotter ,&nbsp;Martin Fink,&nbsp;Armin Wunder","doi":"10.1016/j.zefq.2025.02.001","DOIUrl":"10.1016/j.zefq.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>In the context of specialist training and lateral entry into general practice (GP), the transition from inpatient to outpatient work can be associated with challenges and uncertainty. In view of the GP shortages, it is particularly important to promote both the entry into primary care and the quality of postgraduate training.</div></div><div><h3>Methods</h3><div>In a qualitative interview study, 15 lateral entrants into GP and resident doctors (“residents”) were asked about challenges and needs, and the results were analyzed using content analysis.</div></div><div><h3>Results</h3><div>Lateral entrants and residents are characterized by their hospital-oriented approach. In addition, lateral entrants have to (re-)familiarize themselves with being a doctor in training. The heavy workload is a key challenge for residents. Different structures and requirements of the inpatient and outpatient setting are challenging for both groups. Both groups see a need for support in areas such as adapted specialist knowledge, GP vocabulary and outpatient work processes, and they benefit from educational programs in heterogeneous groups including both lateral entrants and doctors in training in the outpatient setting, e.g., through networking.</div></div><div><h3>Discussion</h3><div>The common needs identified provide information for educational program planning. Irrespective of heterogeneous life circumstances, joint support programs can be both useful and resource-sparing, as existing programs are often suitable for covering the identified needs. The qualitative findings of this study provide insight into the (professional) biographical context of the interviewees and should be quantitatively verified in further research.</div></div><div><h3>Conclusion</h3><div>In order to facilitate the transition from inpatient to outpatient care for both lateral entrants and residents, existing seminar and mentoring programs of the Competence Centers for Postgraduate Education can meet, with a few minor adjustments, the needs of both groups. However, it is important to find unique ways to address these groups and to identify and remove barriers to participation at an organizational level.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 93-100"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wie gehen Menschen mit Long COVID mit ihren Symptomen und Alltagseinschränkungen um? Eine qualitative Studie mit vier Fokusgruppen","authors":"Katharina Vieth ,&nbsp;Eva Hummers ,&nbsp;Sascha Roder ,&nbsp;Frank Müller ,&nbsp;Greta S. Wegener ,&nbsp;Christina Müllenmeister ,&nbsp;Iman El-Sayed ,&nbsp;Gloria Königs ,&nbsp;Dominik Schröder ,&nbsp;Tim Schmachtenberg","doi":"10.1016/j.zefq.2025.03.005","DOIUrl":"10.1016/j.zefq.2025.03.005","url":null,"abstract":"<div><h3>Background</h3><div>The heterogenous and fluctuating intensity of long COVID symptoms poses a challenge to both patients and healthcare providers due to a lack of causal treatment options. The aim of supportive therapies is to help individuals cope with symptoms in daily life and maintain functionality. This study aims to identify coping strategies employed by those affected by long COVID and their perceived benefits.</div></div><div><h3>Methods</h3><div>A qualitative study was conducted with four focus groups comprising 23 adult patients suffering from long COVID. The recorded and transcribed group discussions were analyzed using content-structuring content analysis according to Kuckartz. The results were then systematically analyzed, interpreted, and put in a theoretical context.</div></div><div><h3>Results</h3><div>Participants utilized healthcare resources but developed their own strategies for dealing with long COVID because of their dissatisfaction with medical care. These strategies included energy and resource management, physical activity, enhancing health literacy, changing mindset and lifestyle, infection prevention, using medical aids, and dietary changes.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that people with long COVID employ a variety of strategies to cope with impairments in everyday life. According to the interviewees, integrating these approaches into the treatment of long COVID can help to reduce the burden of symptoms on those affected, restore their everyday functionality, and improve their self-efficacy and quality of life. Established concepts like “pacing” or “shared-decision making” can serve as a starting point for developing individualized coping strategies and treatment concepts together with patients.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 68-77"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liste der Affiliierten Institute und Fachgesellschaften / List of Affiliations","authors":"","doi":"10.1016/S1865-9217(25)00142-4","DOIUrl":"10.1016/S1865-9217(25)00142-4","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Page OBC"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analyse der Implementierung und Nutzung von Fehlermeldesystemen in deutschen Universitätskliniken: Ergebnisse einer querschnittlichen Online-Befragung","authors":"Carlos Ramon Hölzing,&nbsp;Charlotte Meynhardt,&nbsp;Patrick Meybohm,&nbsp;Oliver Happel","doi":"10.1016/j.zefq.2025.03.010","DOIUrl":"10.1016/j.zefq.2025.03.010","url":null,"abstract":"<div><h3>Background</h3><div>Critical incident reporting systems (CIRS) are a central component for ensuring patient safety and an essential tool in risk management at German university hospitals. Despite their widespread use, there are still considerable challenges with regard to their practical application and effectiveness. The aim of this study is to analyze the dissemination and use of such systems and the associated barriers in order to identify potential for optimization.</div></div><div><h3>Methods</h3><div>A cross-sectional online survey was conducted among all German university hospitals (n = 38) between August and September 2024. Both structural and process-related variables were recorded, supplemented by selected aspects of the WHO CIRS self-assessment. The data was analyzed descriptively using SPSS® Statistics Version 29, supported by graphical representation using GrapPad Prism 9®.</div></div><div><h3>Results</h3><div>Of the 38 university hospitals contacted, 14 participated (36.8%). All participating university hospitals use internal critical incident reporting systems. 92.9% forward reports to cross-institutional systems, with 92.3% of the university hospitals forwarding less than 10% of the reports. Most university hospitals (11) evaluate ≥ 90% of incoming reports, ten hospitals do not use standardized analysis specifications. Feedback to reporting persons is provided in eight out of 14 university hospitals. The WHO self-assessment showed deficits in the implementation of personalized feedback and clear criteria.</div></div><div><h3>Conclusion</h3><div>Despite the widespread use of critical incident reporting systems, the results reveal a clear optimization potential in the standardization of analysis processes, the prompt processing of reports and feedback mechanisms. The low transfer of reports to cross-institutional systems indicates structural and organizational barriers that need to be addressed. These findings provide important insights to support the further development of incident reporting systems and thus improve both patient safety and risk management.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"195 ","pages":"Pages 28-35"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Outpatient forms of palliative care as predictors of outcome quality and costs of regional end-of-life care: a claims data-based cost-consequence analysis].","authors":"Antje Freytag, Markus Krause, Andreas Schmid, Bianka Ditscheid, Ursula Marschall, Ulrich Wedding, Franziska Meissner","doi":"10.1016/j.zefq.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.zefq.2025.04.001","url":null,"abstract":"<p><strong>Background: </strong>The quality of outcomes and cost-effectiveness of regional hospice and palliative care (PC) services vary greatly. This study examines the relationship between the different regional outpatient forms of PC and these two dimensions.</p><p><strong>Methods: </strong>The retrospective analysis is based on the study population of 145,372 persons who were insured with the BARMER health insurance fund, who died between 2016 and 2019 and received PC in the last year of their life. The association of primary palliative care (AAPV), specially qualified and coordinated PC (BQKPmV), and specialist palliative homecare (SAPV) with quality- and cost-related outcomes was determined through multiple regression analyses, taking into account regional variability of these associations and controlling for other forms of PC as well as patient and residential district characteristics.</p><p><strong>Results: </strong>AAPV in Rhineland-Palatinate, BQKPmV in Thuringia, and SAPV in Saxony-Anhalt and Berlin achieve an above-average impact on the quality of outcomes compared to the national average. The total costs of care in the last three months of life (except for the costs of ambulatory palliative care) are significantly reduced by AAPV. For SAPV, costs usually exceed potential savings, especially in North Rhine-Westphalia, with Berlin and Westphalia-Lippe being counter-examples. Whilst Westphalia-Lippe relies on a solidly effective, integrated, low-cost AAPV-SAPV model that benefits many people, Berlin represents a highly effective, low-cost SAPV model which, however, reaches fewer people.</p><p><strong>Conclusion: </strong>New evidence of good practice regions offers starting points for tackling the challenge of quality-of-life-oriented, resource-efficient palliative care for a demographically growing number of people in need. Approaches that result in fewer people receiving care and higher costs and at best increase the quality of care for a few, should be critically scrutinized.</p>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liste der Affiliierten Institute und Fachgesellschaften / List of Affiliations","authors":"","doi":"10.1016/S1865-9217(25)00108-4","DOIUrl":"10.1016/S1865-9217(25)00108-4","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"194 ","pages":"Page OBC"},"PeriodicalIF":1.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}