TY  - JOUR
A1  - Grabenhenrich, Linus B.
A1  - Reich, Andreas
A1  - Fischer, Felix
A1  - Zepp, Fred
A1  - Forster, Johannes
A1  - Schuster, Antje
A1  - Bauer, Carl-Peter
A1  - Bergmann, Renate L.
A1  - Bergmann, Karl E.
A1  - Wahn, Ulrich
A1  - Keil, Thomas
A1  - Lau, Susanne
T1  - The Novel 10-Item Asthma Prediction Tool: External Validation in the German MAS Birth Cohort
JF  - PLOS ONE
N2  - Background: A novel non-invasive asthma prediction tool from the Leicester Cohort, UK, forecasts asthma at age 8 years based on 10 predictors assessed in early childhood, including current respiratory symptoms, eczema, and parental history of asthma. 
Objective: We aimed to externally validate the proposed asthma prediction method in a German birth cohort. 
Methods: The MAS-90 study (Multicentre Allergy Study) recorded details on allergic diseases prospectively in about yearly follow-up assessments up to age 20 years in a cohort of 1,314 children born 1990. We replicated the scoring method from the Leicester cohort and assessed prediction, performance and discrimination. The primary outcome was defined as the combination of parent-reported wheeze and asthma drugs (both in last 12 months) at age 8. Sensitivity analyses assessed model performance for outcomes related to asthma up to age 20 years. Results: For 140 children parents reported current wheeze or cough at age 3 years. Score distribution and frequencies of later asthma resembled the Leicester cohort: 9% vs. 16% (MAS-90 vs. Leicester) of children at low risk at 3 years had asthma at 8 years, at medium risk 45% vs. 48%. Performance of the asthma prediction tool in the MAS-90 cohort was similar (Brier score 0.22 vs. 0.23) and discrimination slightly better than in the original cohort (area under the curve, AUC 0.83 vs. 0.78). Prediction and discrimination were robust against changes of inclusion criteria, scoring and outcome definitions. The secondary outcome 'physicians' diagnosed asthma at 20 years' showed the highest discrimination (AUC 0.89). 
Conclusion: The novel asthma prediction tool from the Leicester cohort, UK, performed well in another population, a German birth cohort, supporting its use and further development as a simple aid to predict asthma risk in clinical settings.
KW  - disease
KW  - models
KW  - symptoms
KW  - risk
KW  - early-life
KW  - young children
KW  - preschool children
KW  - sample
KW  - wheeze
KW  - age
Y1  - 2014
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-114202
SN  - 1932-6203
VL  - 9
IS  - 12
ER  - 
TY  - JOUR
A1  - Steinmann, Diana
A1  - Paelecke-Habermann, Yvonne
A1  - Geinitz, Hans
A1  - Aschoff, Raimund
A1  - Bayerl, Anja
A1  - Bölling, Tobias
A1  - Bosch, Elisabeth
A1  - Bruns, Frank
A1  - Eichenseder-Seiss, Ute
A1  - Gerstein, Johanna
A1  - Gharbi, Nadine
A1  - Hagg, Juliane
A1  - Hipp, Matthias
A1  - Kleff, Irmgard
A1  - Müller, Axel
A1  - Schäfer, Christof
A1  - Schleicher, Ursula
A1  - Sehlen, Susanne
A1  - Theodorou, Marilena
A1  - Wypior, Hans-Joachim
A1  - Zehentmayr, Franz
A1  - van Oorschot, Birgitt
A1  - Vordermark, Dirk
T1  - Prospective evaluation of quality of life effects in patients undergoing palliative radiotherapy for brain metastases
JF  - BMC Cancer
N2  - Background: Recently published results of quality of life (QoL) studies indicated different outcomes of palliative radiotherapy for brain metastases. This prospective multi-center QoL study of patients with brain metastases was designed to investigate which QoL domains improve or worsen after palliative radiotherapy and which might provide prognostic information. 
Methods: From 01/2007-01/2009, n=151 patients with previously untreated brain metastases were recruited at 14 centers in Germany and Austria. Most patients (82 %) received whole-brain radiotherapy. QoL was measured with the EORTC-QLQ-C15-PAL and brain module BN20 before the start of radiotherapy and after 3 months. 
Results: At 3 months, 88/142 (62 %) survived. Nine patients were not able to be followed up. 62 patients (70.5 % of 3-month survivors) completed the second set of questionnaires. Three months after the start of radiotherapy QoL deteriorated significantly in the areas of global QoL, physical function, fatigue, nausea, pain, appetite loss, hair loss, drowsiness, motor dysfunction, communication deficit and weakness of legs. Although the use of corticosteroid at 3 months could be reduced compared to pre-treatment (63 % vs. 37 %), the score for headaches remained stable. Initial QoL at the start of treatment was better in those alive than in those deceased at 3 months, significantly for physical function, motor dysfunction and the symptom scales fatigue, pain, appetite loss and weakness of legs. In a multivariate model, lower Karnofsky performance score, higher age and higher pain ratings before radiotherapy were prognostic of 3-month survival. 
Conclusions: Moderate deterioration in several QoL domains was predominantly observed three months after start of palliative radiotherapy for brain metastases. Future studies will need to address the individual subjective benefit or burden from such treatment. Baseline QoL scores before palliative radiotherapy for brain metastases may contain prognostic information.
KW  - breast cancer
KW  - brain tumours
KW  - survival
KW  - validation
KW  - symptoms
KW  - EORTC-QLQ-C15-PAL
KW  - EORTC-BN20
KW  - whole-brain radiotherapy
KW  - partitioning analysis RPA
KW  - cancer patients
KW  - lung cancer
KW  - prognostic index
KW  - radiation oncology
KW  - clinical trials
Y1  - 2012
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-135254
VL  - 12
IS  - 283
ER  -