We conducted a meta-analysis of cohort and case-control studies to evaluate all-cause and cardiovascular (CV) mortality of patients with type 2 diabetes mellitus (T2DM) who received sulphonylurea (SU) treatment, when compared to any other diabetes treatment. Only studies reporting raw data on mortality during SU treatment were included. Data were combined using random-effects (RE) models. Unadjusted odds ratios (ORs) are presented. Of 4991 publication titles and abstracts reviewed, 20 studies (n = 551,912 patients) were included. For cohort studies (n = 276,050), patients receiving SU monotherapy or combination treatment had significantly higher all-cause and CV mortality risks compared to any non-SU treatment [all-cause, 13 studies: OR = 1.92, 95% confidence interval (CI) = 1.48-2.49; CV, 5 studies: OR = 2.72, 95% CI = 1.95-3.79]. Validity was limited by the high treatment group heterogeneity (I (2) > 90%) and study-inherent biases/design differences. In conclusion, patients receiving SU treatment had increased all-cause and CV mortality risks. However, the meta-analysis was limited by the high heterogeneity of non-randomized studies.
Usage of online social business networks like LinkedIn and XING have become commonplace in today's workplace. This research addresses the question of what factors drive the intention to use online social business networks. Theoretical frame of the study is the Technology Acceptance Model (TAM) and its extensions, most importantly the TAM2 model. Data has been collected via a Web Survey among users of LinkedIn and XING from January to April 2010. Of 541 initial responders 321 finished the questionnaire. Operationalization was tested using confirmatory factor analyses and causal hypotheses were evaluated by means of structural equation modeling. Core result is that the TAM2 model generally holds in the case of online social business network usage behavior, explaining 73% of the observed usage intention. This intention is most importantly driven by perceived usefulness, attitude towards usage and social norm, with the latter effecting both directly and indirectly over perceived usefulness. However, perceived ease of use has-contrary to hypothesis-no direct effect on the attitude towards usage of online social business networks. Social norm has a strong indirect influence via perceived usefulness on attitude and intention, creating a network effect for peer users. The results of this research provide implications for online social business network design and marketing. Customers seem to evaluate ease of use as an integral part of the usefulness of such a service which leads to a situation where it cannot be dealt with separately by a service provider. Furthermore, the strong direct impact of social norm implies application of viral and peerto-peer marketing techniques while it's also strong indirect effect implies the presence of a network effect which stabilizes the ecosystem of online social business service vendors.
Cloud computing services have been growing rapidly in recent years, with Dropbox, Apple iCloud and Google Drive being amongst the most established. The main purpose of this study was to investigate whether there were moderator effects for cloud usage. Data was conducted via a web survey amongst internet users in Germany during October 2014. A total of 2135 panelists started the questionnaire with 2040 finishing. Data basis for the analyses was the number of cloud computing users (n=1047). Operationalization was tested using confirmatory factor analyses and causal hypotheses were evaluated by means of structural equation modeling. In addition, the critical ratios approach was applied to investigate moderating effects.Firstly, the results show that extended UTAUT is a robust research model. In detail, Social Influence, Performance Expectancy Effort Expectancy, and Perceived Security Risks were shown to significantly impact Attitude towards Use cloud services. The combination of all constructs used accounted for 67.2% of the variances observed in users' attitude and 82.4% in users' intention to use cloud services. Secondly, we found the moderating effect for all factors investigated, particularly gender and IT experience were shown to significantly moderate attitude and behavioral intention to use cloud services.
ObjectiveTo estimate both the number of patients with hepatocellular carcinoma (HCC) eligible annually for second-line therapy following sorafenib in Germany and the healthcare costs accrued by patients meeting eligibility criteria.MethodsPatients with an HCC diagnosis and one or more sorafenib prescription were identified from samples of > 3 million insured persons in each of 2012, 2013 and 2014 using the anonymised Betriebskrankenkasse health insurance scheme database. Incidence rates from 2013 were extrapolated to the German population using data from the statutory health insurance system database and Robert Koch Institute. Resource use and cost data were collected for a subset of patients with follow-up data post-sorafenib.ResultsBetween 1032 and 1484 patients with HCC in Germany (893–1390 publicly insured patients) were estimated as likely to be eligible for second-line therapy after sorafenib annually. For post-sorafenib analyses, 117 patients were identified with HCC, one or more sorafenib prescription and considered potentially eligible for second-line treatment, 15 of whom were alive after 12 months’ follow-up. Total mean costs per patient accrued in the 12 months after sorafenib treatment ended were €11,152 (hospital care, €6483 [58.1%]; outpatient prescriptions, €3137 [28.1%]).ConclusionThe estimated number of publicly insured HCC patients annually eligible for second-line therapy in Germany was < 1400 and mean total costs accrued in the year after completion of sorafenib therapy were approximately €11,000 per patient for the German statutory healthcare system. These estimates can be used when evaluating the budgetary impact of new second-line therapies for advanced HCC in Germany.Electronic supplementary materialThe online version of this article (10.1186/s13561-018-0199-1) contains supplementary material, which is available to authorized users.
Aim: This retrospective observational study aimed to evaluate the epidemiology of advanced gastric cancer (GC) in Germany. Methods: Data were extracted from the Betriebskrankenkassen (BKK) database, which consists of different company health insurance funds throughout Germany and contains anonymized records of medical services. Patient data were retrospectively reviewed from January 2008 and followed prospectively until 31st of December 2011. The identification of GC patients (ICD-10 C16) was based on data from 2011 (main cohort). Two alternative approaches were used to detect patients with advanced GC who were treated with any first-line chemotherapy. Results: The database included 2?890?285 persons. In total, 3184 patients with a GC diagnosis were identified across all areas of medical care (main cohort). Of these, an estimated 585 patients (or 342, depending on the estimation approach) had advanced GC and received first-line chemotherapy. Age- and gender-adjusted extrapolation resulted in approximately 15?200 (8800) advanced GC patients in the entire German statutory health insurance system in 2011, equating to 22 (13) per 100?000 insured. It was estimated that 4119 (2416) advanced GC patients treated with first-line chemotherapy were newly diagnosed in 2011; an incidence rate of 6 (3) per 100?000 insured. Conclusion: This is the first retrospective observational study that provides plausible epidemiologic data of advanced GC in Germany. It gives a representative estimation of incidence and prevalence of patients with advanced GC who were treated with first-line chemotherapy in 2011 and could be potentially eligible for second-line therapy.
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