Michael Reusch

The patient benefit index: a novel approach in patient-defined outcomes measurement for skin diseases

Evaluation of therapeutic benefits from the patient’s perspective is important in medical decision-making and reimbursement. This study aimed at developing and validating an instrument on patient-defined needs and benefits in dermatology. The questionnaire was developed according to international guidelines. The benefit assessment consists of two steps: before treatment, every patient defines his treatment needs according to a standardized list. After treatment, the patient rates the degree of benefits achieved. A “patient benefit index” (PBI) is calculated by averaging the preference-weighed results of all items. The PBI questionnaire was validated in a sample of 500 patients with ten skin diseases and in a treatment study on 906 patients with acne. The patients defined a broad spectrum of needs and treatment benefits, indicating disease-specific patterns. The PBI showed good feasibility, reliability (Cronbach’s alpha >0.91) and construct validity, high responsiveness, and discrimination between subgroups. The PBI permits valid evaluation of patient-relevant benefits in dermatological treatment.

German psoriasis registry PsoBest: objectives, methodology and baseline data.

The German psoriasis registry PsoBest records the long‐term efficacy, safety, patient benefit and treatment regimens of psoriasis.

Skin cancer screening in Germany – perception by the public

Background: In 2008, community skin cancer screening (cSCS) was introduced into routine care of the German statutory health insurances (SHI). In the meantime, more than 13 million individuals have been screened. To date, no data are available on the perception of cSCS by the general public.

Histopathological diagnostics of malignant melanoma in accordance with the recent AJCC classification 2009: Review of the literature and recommendations for general practice

Background: TNM classifications are the basis for diagnostic and therapeutic procedures in oncology. Histopathological reports have to enable a proper indexing of tumor specific findings into recent classifications.

Health Services Research in Psoriasis – The German Approach

insurance funds and other parties involved in the health care sector have realized the need to obtain specific data on health services provision. The task of health services research is to investigate the reality of health services provision under everyday conditions (German Medical Association 2005). Health services research has established itself as the third pillar of health research – along with biomedical basic research and clinical research. In order to provide a picture of the state of health services provision in Germany, it is necessary to obtain sufficient upto-date national data on the German health care system. Though the development of effective health services research is now regarded as essential, our knowledge of the state of health services provision in Germany is, in some cases, still only rudimentary, even in the case of some of the most common diseases. This is especially true for skin diseases.

Topical long‐term therapy of psoriasis with vitamin D3 analogues, corticosteroids and their two compound formulations: position paper on evidence and use in daily practice

Current data from daily practice show that vitamin D3 analogues, corticosteroids and their fixed combination products are used heterogeneously for topical long‐term treatment of psoriasis.

Routine skin cancer screening in Germany: First data on the impact on health care in dermatology.

Background: On July 1st 2008, community skin cancer screening (cSCS) was established in routine care of the German statutory health insurances (SHI). This study aimed at gathering preliminary data on the impact of community SCS on health care provision in German dermatology practices.

Health care characteristics of basal cell carcinoma in Germany: the role of insurance status and socio-demographic factors

In Germany population‐based data on health care of basal cell carcinoma (BCC) are rare.

Allergies in Germany – prevalence and perception by the public

During the recent decades allergies have become more frequent all over the world. However, it is unclear how important the topic of allergies is for the general German population and how appropriately patients with allergies are treated.

The German National Program on Psoriasis Health Care 2005–2015: results and experiences

In 2005, the first national psoriasis survey in Germany revealed large deficits in health care particularly in patients with moderate to severe disease. The consecutive goal was to improve health care for psoriasis countrywide. For this, a large-scale national program was initiated starting with a comprehensive analysis of structures and processes of care for psoriasis. Patient burden, economic impact and barriers to care were systematically analyzed. In order to optimize routine care, a S3 guideline, a set of outcomes measures and treatment goals, were developed. Implementation was enforced by the German Psoriasis Networks (PsoNet) connecting the most dedicated dermatologists. The annual National Conference on Health Care in Psoriasis established in 2009 consented National Health Care Goals in Psoriasis 2010–2015 and defined a set of quality indicators, which are monitored on a regular basis. Currently 28 regional networks including more than 800 dermatologists are active. Between 2005 and 2014 7 out of 8 quality indicators have markedly improved, and regional disparities were resolved. e.g., mean PASI (Psoriasis Area Severity Index) dropped from 11.4 to 8.1 and DLQI (Dermatology Life Quality Index) from 8.6 to 5.9. A decade of experience indicates that a coordinated nationwide psoriasis program based on goal orientation can contribute to better quality of care and optimized outcomes.