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Klug-entscheiden-Empfehlungen in der Angiologie

Choosing wisely recommendations in angiology

  • Schwerpunkt: Klug entscheiden
  • Published:
Der Internist Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Die Klug-entscheiden-Initiative bezieht sich auf Maßnahmen, die von besonderer medizinischer Bedeutung sind und nach Expertenmeinung häufig nicht fachgerecht erbracht werden.

Ziel der Arbeit

Steigerung der Indikationsqualität durch Hilfestellung zu diagnostischen und therapeutischen Maßnahmen im Bereich der Angiologie

Material und Methoden

Im Rahmen der Initiative Klug entscheiden wurden fünf Positivempfehlungen zu Aspekten der Unterversorgung und fünf Negativempfehlungen zu möglicher Überversorgung von den Gremien der Deutschen Gesellschaft für Angiologie erarbeitet und in einer Konsensuskonferenz der zwölf mit der Deutschen Gesellschaft für Innere Medizin verbundenen internistischen Fachgesellschaften validiert.

Ergebnisse und Diskussion

Die Empfehlungen umfassen ein breites Spektrum von Diagnostik- und Therapieverfahren, wie die Rolle von Ultraschalluntersuchungen bei Gefäßerkrankungen, Screeninguntersuchungen von Bauchaortenaneurysmen, Diagnostik und Therapie bei peripherer arterieller Verschlusskrankheit (PAVK), Abklärung chronischer Ulzera, die Therapie der Varikose sowie die Problematik des Einsatzes von Gerinnungshemmern bei PAVK oder Thrombose. Durch Diskussion der Evidenzlage möchten wir dafür sensibilisieren, dass nicht alles medizinisch Machbare auch in jeder Situation sinnvoll ist.

Abstract

Background

The Choosing wisely initiative addresses measures of high medical impact which are frequently not appropriately performed according to expert opinion.

Objective

To increase the quality of indications by providing supportive information on diagnostic and therapeutic measures in the field of angiology.

Materials and methods

As part of the Choosing wisely initiative, the German Society of Angiology has constructed five positive recommendations on underused measures and five negative recommendations concerning those possibly overused. The recommendations were validated by the twelve professional societies of the German Society of Internal Medicine in a consensus conference.

Results and discussion

The recommendations cover a broad spectrum of diagnostic and therapeutic modalities, such as the role of ultrasound examinations in vascular diseases, screening for abdominal aortic aneurysms, diagnosis and therapy of peripheral artery disease (PAD), investigation of chronic ulcers, therapy of varicosis, and finally, the problems associated with using anticoagulants in PAD or thrombosis. By discussing the evidence, we aim to demonstrate that not all medically possible measures are actually appropriate in every situation.

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Authors and Affiliations

  1. Innere Medizin III, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Deutschland

    O. J. Müller

  2. Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Heidelberg/Mannheim, Heidelberg, Deutschland

    O. J. Müller

  3. Praxisklinik Herz und Gefäße, Akademische Lehrpraxisklinik der TU Dresden, Forststr. 3, 01099, Dresden, Deutschland

    R. Sternitzky

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Correspondence to O. J. Müller.

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Interessenkonflikt

O.J. Müller hat von Aspen, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, und Daiichi Sankyo Vorträgshonorare erhalten und an Advisory boards von Bayer, Boehringer-Ingelheim und Daiichi-Sankyo mitgewirkt. R. Sternitzky gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Additional information

Redaktion

U.R. Fölsch, Kiel

M. Hallek, Köln

G. Hasenfuß, Göttingen

E. Märker-Hermann, Wiesbaden

C.C. Sieber, Nürnberg

O.J. Müller und R. Sternitzky für die Deutsche Gesellschaft für Angiologie – Gesellschaft für Gefäßmedizin (DGA) Teile dieses Beitrags wurden bereits veröffentlicht in Sternitzky et al. (2016) Klug entscheiden … in der Angiologie. Dtsch Arztebl 113(21): A‑1036/B-871/C-855

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Müller, O.J., Sternitzky, R. Klug-entscheiden-Empfehlungen in der Angiologie. Internist 58, 532–538 (2017). https://doi.org/10.1007/s00108-017-0252-x

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