@article{KollmannPretzschKunzetal.2020, author = {Kollmann, Cath{\´e}rine T. and Pretzsch, Elise B. and Kunz, Andreas and Isbert, Christoph and Krajinovic, Katica and Reibetanz, Joachim and Kim, Mia}, title = {Anorectal angle at rest predicting successful sacral nerve stimulation in idiopathic fecal incontinence—a cohort analysis}, series = {International Journal of Colorectal Disease}, volume = {35}, journal = {International Journal of Colorectal Disease}, issn = {0179-1958}, doi = {10.1007/s00384-020-03720-w}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232379}, pages = {2293-2299}, year = {2020}, abstract = {Purpose Sacral nerve stimulation is an effective treatment for patients suffering from fecal incontinence. However, less is knownabout predictors of success before stimulation. The purpose of this study was to identify predictors of successful sacral nervestimulation in patients with idiopathic fecal incontinence. Methods Consecutive female patients, receiving peripheral nerve evaluation and sacral nerve stimulation between September2008 and October 2014, suffering from idiopathic fecal incontinence were included in this study. Preoperative patient'scharac-teristics, anal manometry, and defecography results were collected prospectively and investigated by retrospective analysis. Mainoutcome measures were independent predictors of treatment success after sacral nerve stimulation. Results From, all in all, 54 patients suffering from idiopathic fecal incontinence receiving peripheral nerve evaluation, favorableoutcome was achieved in 23 of 30 patients after sacral nerve stimulation (per protocol 76.7\%; intention to treat 42.6\%). From allanalyzed characteristics, wide anorectal angle at rest in preoperative defecography was the only independent predictor offavorable outcome in multivariate analysis (favorable 134.1 ± 13.9° versus unfavorable 118.6 ± 17.1°). Conclusions Anorectal angle at rest in preoperative defecography might present a predictor of outcome after sacral nervestimulation in patients with idiopathic fecal incontinence.}, language = {en} } @article{KerwagenFuchsUllrichetal.2023, author = {Kerwagen, Fabian and Fuchs, Konrad F. and Ullrich, Melanie and Schulze, Andres and Straka, Samantha and Krop, Philipp and Latoschik, Marc E. and Gilbert, Fabian and Kunz, Andreas and Fette, Georg and St{\"o}rk, Stefan and Ertl, Maximilian}, title = {Usability of a mHealth solution using speech recognition for point-of-care diagnostic management}, series = {Journal of Medical Systems}, volume = {47}, journal = {Journal of Medical Systems}, number = {1}, doi = {10.1007/s10916-022-01896-y}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-324002}, year = {2023}, abstract = {The administrative burden for physicians in the hospital can affect the quality of patient care. The Service Center Medical Informatics (SMI) of the University Hospital W{\"u}rzburg developed and implemented the smartphone-based mobile application (MA) ukw.mobile1 that uses speech recognition for the point-of-care ordering of radiological examinations. The aim of this study was to examine the usability of the MA workflow for the point-of-care ordering of radiological examinations. All physicians at the Department of Trauma and Plastic Surgery at the University Hospital W{\"u}rzburg, Germany, were asked to participate in a survey including the short version of the User Experience Questionnaire (UEQ-S) and the Unified Theory of Acceptance and Use of Technology (UTAUT). For the analysis of the different domains of user experience (overall attractiveness, pragmatic quality and hedonic quality), we used a two-sided dependent sample t-test. For the determinants of the acceptance model, we employed regression analysis. Twenty-one of 30 physicians (mean age 34 ± 8 years, 62\% male) completed the questionnaire. Compared to the conventional desktop application (DA) workflow, the new MA workflow showed superior overall attractiveness (mean difference 2.15 ± 1.33), pragmatic quality (mean difference 1.90 ± 1.16), and hedonic quality (mean difference 2.41 ± 1.62; all p < .001). The user acceptance measured by the UTAUT (mean 4.49 ± 0.41; min. 1, max. 5) was also high. Performance expectancy (beta = 0.57, p = .02) and effort expectancy (beta = 0.36, p = .04) were identified as predictors of acceptance, the full predictive model explained 65.4\% of its variance. Point-of-care mHealth solutions using innovative technology such as speech-recognition seem to address the users' needs and to offer higher usability in comparison to conventional technology. Implementation of user-centered mHealth innovations might therefore help to facilitate physicians' daily work.}, language = {en} } @article{JordanJovicGilbertetal.2020, author = {Jordan, Martin C. and Jovic, Sebastian and Gilbert, Fabian and Kunz, Andreas and Ertl, Maximilian and Strobl, Ute and Jakubietz, Rafael G. and Jakubietz, Michael G. and Meffert, Rainer H. and Fuchs, Konrad F.}, title = {Qualit{\"a}tssteigerung der Abrechnungspr{\"u}fung durch Smartphone-basierte Fotodokumentation in der Unfall-, Hand-, und Plastischen Chirurgie}, series = {Der Unfallchirurg}, volume = {124}, journal = {Der Unfallchirurg}, issn = {0177-5537}, doi = {10.1007/s00113-020-00866-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232415}, pages = {366-372}, year = {2020}, abstract = {Hintergrund Die Fotodokumentation von offenen Frakturen, Wunden, Dekubitalulzera, Tumoren oder Infektionen ist ein wichtiger Bestandteil der digitalen Patientenakte. Bisher ist unklar, welchen Stellenwert diese Fotodokumentation bei der Abrechnungspr{\"u}fung durch den Medizinischen Dienst der Krankenkassen (MDK) hat. Fragestellung Kann eine Smartphone-basierte Fotodokumentation die Verteidigung von erl{\"o}srelevanten Diagnosen und Prozeduren sowie der Verweildauer verbessern? Material und Methoden Ausstattung der Mitarbeiter mit digitalen Endger{\"a}ten (Smartphone/Tablet) in den Bereichen Notaufnahme, Schockraum, OP, Sprechstunden sowie auf den Stationen. Retrospektive Auswertung der Abrechnungspr{\"u}fung im Jahr 2019 und Identifikation aller Fallbesprechungen, in denen die Fotodokumentation eine Erl{\"o}sver{\"a}nderung bewirkt hat. Ergebnisse Von insgesamt 372 Fallbesprechungen half die Fotodokumentation in 27 F{\"a}llen (7,2 \%) zur Best{\"a}tigung eines Operationen- und Prozedurenschl{\"u}ssels (OPS) (n = 5; 1,3 \%), einer Hauptdiagnose (n = 10; 2,7 \%), einer Nebendiagnose (n = 3; 0,8 \%) oder der Krankenhausverweildauer (n = 9; 2,4 \%). Pro oben genanntem Fall mit Fotodokumentation ergab sich eine durchschnittliche Erl{\"o}ssteigerung von 2119 €. Inklusive Aufwandpauschale f{\"u}r die Verhandlungen wurde somit ein Gesamtbetrag von 65.328 € verteidigt. Diskussion Der Einsatz einer Smartphone-basierten Fotodokumentation kann die Qualit{\"a}t der Dokumentation verbessern und Erl{\"o}seinbußen bei der Abrechnungspr{\"u}fung verhindern. Die Implementierung digitaler Endger{\"a}te mit entsprechender Software ist ein wichtiger Teil des digitalen Strukturwandels in Kliniken.}, language = {de} }