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Epidemiologische Forschung und Behandlungsdatenanalyse zu chronisch-entzündlichen Darmerkrankungen

Verbesserung der Versorgung von Kindern und Jugendlichen
  • Jan de LaffolieEmail author
Leitthema

Zusammenfassung

Schätzungen zufolge nehmen Inzidenz und Prävalenz der chronisch-entzündlichen Darmerkrankungen (CED) im Kindes- und Jugendalter stark zu. Deutschland zählt zu den Ländern mit den höchsten geschätzten Inzidenzraten weltweit, in den Jahren 2009: 13,65/100.000 Kinder und Jugendliche * Jahr (95 %-Konfidenzintervall [95 %-KI] 15–20) und 2012: 17,41 (95 %-KI 15–20), sowie einer Prävalenz von 66,3/100.000 Kinder und Jugendliche im Jahr 2012.

Vor diesem Hintergrund ist die epidemiologische Erforschung von Umweltfaktoren, die bezüglich der Krankheitsentstehung bedeutsam und die veränderbar sind, dringend erforderlich. Da sich die CED im Kindes- und Jugendalter phänotypisch und in ihrer Bedeutung von der des Erwachsenen unterscheidet, ist die Behandlungsdatenanalyse besonders wichtig. Auch sind Beeinflussungsumfang und -dauer im Kindesalter im Vergleich zum Erwachsenen leichter zu überblicken

Vordringlich sind z. B. Einflussfaktoren aus den Bereichen Ernährung, Umwelteinflüsse, Lebensstil und intestinales Mikrobiom zu untersuchen, da sich präventive oder therapeutische Handlungsmöglichkeiten ableiten lassen könnten. Bisher ergibt sich ein sehr heterogenes Bild, sodass die gezielte Sammlung und Auswertung großer Datenbestände mithilfe moderner Methoden, z. B. in Patientenregistern, notwendig ist. Patientenregister der Fachgesellschaften, wie z. B. CEDATA-GPGE®, dienen darüber hinaus der Qualitätsverbesserung der beteiligten Zentren durch Rückmeldung der Behandlungsergebnisse, der Etablierung eines kontinuierlichen Qualitätsverbesserungsprozesses und dem gemeinsamen Lernen aus den gewonnenen Daten. Dies wird exemplarisch anhand der Entwicklung des ImproveCareNow Network in den USA seit 2004 dargestellt.

Schlüsselwörter

Qualitätsverbesserung Lernendes Gesundheitssystem Register Lebensstil Gastrointestinales Mikrobiom 

Epidemiological research and treatment data analysis for chronic inflammatory bowel diseases

Improvement in care of children and adolescents

Abstract

It is estimated that the incidence and prevalence of pediatric onset chronic inflammatory bowel disease (pIBD) are on the rise around the globe. Germany has one of the highest estimates of incidence worldwide, which in 2009 was 13.65/100,000 children and adolescents per year (95% confidence interval, CI 15–20) and in 2012 was 17.41 (95% CI 15–20). The prevalence was estimated to be 66.3/100,000 children and adolescents in 2012.

Against this background the epidemiological research of environmental factors, which are important with respect to disease emergence and can be influenced, is urgently needed. As pIBD is phenotypically and in importance different from that of adults, the analysis of treatment data is particularly important. The extent of the influence and the duration in childhood are easier to oversee in comparison to adults.

Of high priority are, for example, influencing factors from the areas of nutrition, environmental influences, lifestyle and investigation of the intestinal microbiome from which preventive and therapeutic options for action could be derived. So far, the picture is very heterogeneous so that the targeted collection and evaluation of large databases with the help of modern methods, such as patient registers, are necessary.

Furthermore, patient registers of specialist societies, such as the CEDATA-GPGE® register of the Society for Pediatric Gastroenterology and Nutrition (GPGE) also serve to improve the quality of care of participating centers by feedback on the treatment results, the establishment of a continuous quality improvement process and a mutual learning from the acquired data. This is exemplary illustrated by the development and concept of the ImproveCareNow network in the USA since 2004.

Keywords

Quality improvement Learning health system Registry Lifestyle Gastrointestinal microbiome 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

J. de Laffolie hat Honorare von Abbvie, Takeda und Dr. Falk Pharma erhalten.

Für diesen Beitrag wurden vom Autor keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2020

Authors and Affiliations

  1. 1.Abteilung Allgemeine Pädiatrie und NeonatologieUniversitätsklinikum Gießen und Marburg, Standort Gießen, Justus-Liebig-UniversitätGießenDeutschland

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