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[心脏病学的创新。我们在新方法上进展太快]

[Innovations in cardiology. We are too fast with new methods].

作者信息

Diegeler A

机构信息

Herz- und Gefäßklinik Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Deutschland.

出版信息

Herz. 2016 Mar;41(2):120-4. doi: 10.1007/s00059-016-4411-y.

DOI:10.1007/s00059-016-4411-y
PMID:26919989
Abstract

Cardiology is rapidly developing on many levels. New treatment methods are introduced at ever decreasing intervals. Against the background of economization of other areas in medicine, dangers are lurking here for patients if safety, usefulness and sustainability of the treatment methods cannot be sufficiently proven. The German Federal Ministry of Health (Bundesministerium für Gesundheit, BMG) aims to adjust the regulatory framework for the approval of new medical products to the legal requirements of the European Union. With the establishment of the Institute for Quality Assessment and Transparency in Health Care (Institut für Qualitätssicherung und Transparenz im Gesundheitswesen, IQTIG) more precise quality controls should be carried out. Implantation registers will be soon implemented and the routinely performed quality control of different interventions will be coordinated across different healthcare sectors in order to achieve a better understanding of long-term results. Medicine in general and the safety of patients in particular, ultimately benefit from more stringent controls, neutrality and transparency in the assessment of new methods.

摘要

心脏病学正在多个层面迅速发展。新的治疗方法推出的间隔时间越来越短。在医学其他领域节约成本的背景下,如果治疗方法的安全性、有效性和可持续性不能得到充分证明,患者就会面临危险。德国联邦卫生部旨在使新医疗产品审批的监管框架符合欧盟的法律要求。随着医疗保健质量评估与透明度研究所(Institut für Qualitätssicherung und Transparenz im Gesundheitswesen, IQTIG)的成立,应进行更精确的质量控制。植入登记即将实施,不同医疗部门将协调对不同干预措施进行常规质量控制,以便更好地了解长期效果。总体而言,医学尤其是患者的安全最终将受益于对新方法评估中更严格的控制、中立性和透明度。

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1
[Innovations in cardiology. We are too fast with new methods].[心脏病学的创新。我们在新方法上进展太快]
Herz. 2016 Mar;41(2):120-4. doi: 10.1007/s00059-016-4411-y.
2
[Propagation of innovative medical devices in clinical cardiology: Is Germany too quick or too slow?].[创新型医疗设备在临床心脏病学中的推广:德国是太快还是太慢?]
Herz. 2016 Mar;41(2):95-6. doi: 10.1007/s00059-016-4409-5.
3
Healthcare System Stakeholders医疗保健系统利益相关者
4
Clinical evaluation of cardiovascular devices: principles, problems, and proposals for European regulatory reform. Report of a policy conference of the European Society of Cardiology.心血管器械的临床评估:欧洲监管改革的原则、问题和建议。欧洲心脏病学会政策会议报告。
Eur Heart J. 2011 Jul;32(13):1673-86. doi: 10.1093/eurheartj/ehr171. Epub 2011 May 14.
5
[Experiences and recommendations of the German Federal Institute for Drugs and Medical Devices (BfArM) concerning clinical investigation of medical devices and the evaluation of serious adverse events (SAE)].德国药品和医疗器械联邦研究所(BfArM)关于医疗器械临床研究及严重不良事件(SAE)评估的经验与建议
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2014 Dec;57(12):1368-75. doi: 10.1007/s00103-014-2060-y.
6
[Medical devices. Regulatory framework and contribution of the German Federal Institute for Drugs and Medical Devices (BfArM) to the safe application].[医疗设备。监管框架以及德国联邦药品和医疗器械研究所(BfArM)对安全应用的贡献]
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2014 Dec;57(12):1355-61. doi: 10.1007/s00103-014-2058-5.
7
[Marketing approval and market surveillance of medical devices in Germany: Where does policy integration take place?].[德国医疗器械的市场批准与市场监管:政策整合发生在何处?]
Z Evid Fortbild Qual Gesundhwes. 2014;108(5-6):320-4. doi: 10.1016/j.zefq.2013.11.003. Epub 2013 Dec 13.
8
Regulation and safe adoption of new medical devices and procedures.医疗器械和程序的监管和安全采用。
Br Med Bull. 2013;107:5-18. doi: 10.1093/bmb/ldt022. Epub 2013 Jul 29.
9
[Safety of medical devices].[医疗器械的安全性]
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2014 Dec;57(12):1353-4. doi: 10.1007/s00103-014-2087-0.
10
Medical devices regulation needs to be overhauled, says cardiologist.心脏病专家表示,医疗设备监管需要彻底改革。
BMJ. 2011 Oct 14;343:d6671. doi: 10.1136/bmj.d6671.

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1
Frequency, Risk Factors, and Outcome of Coexistent Small Vessel Disease and Intracranial Arterial Stenosis: Results From the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) Trial.并存小血管疾病和颅内动脉狭窄的频率、危险因素及转归:颅内狭窄支架置入和积极药物治疗预防复发性卒中(SAMMPRIS)试验结果
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12-month blood pressure results of catheter-based renal artery denervation for resistant hypertension: the SYMPLICITY HTN-3 trial.SYMPLICITY HTN-3 试验:经导管肾动脉去神经术治疗耐药性高血压的 12 个月血压结果。
J Am Coll Cardiol. 2015 Apr 7;65(13):1314-1321. doi: 10.1016/j.jacc.2015.01.037.
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Effect of a balloon-expandable intracranial stent vs medical therapy on risk of stroke in patients with symptomatic intracranial stenosis: the VISSIT randomized clinical trial.
球囊扩张颅内支架与药物治疗对症状性颅内狭窄患者卒中风险的影响:VISSIT 随机临床试验。
JAMA. 2015;313(12):1240-8. doi: 10.1001/jama.2015.1693.
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Stent design lowers angiographic but not clinical adverse events in stenting of symptomatic intracranial stenosis - results of a single center study with 100 consecutive patients.支架设计降低了症状性颅内狭窄支架置入术的血管造影不良事件,但未降低临床不良事件发生率——一项单中心 100 例连续患者研究结果。
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Meta-analysis of randomized trials comparing carotid endarterectomy and endovascular treatment.比较颈动脉内膜切除术和血管内治疗的随机试验的荟萃分析。
Eur J Vasc Endovasc Surg. 2007 Oct;34(4):470-9. doi: 10.1016/j.ejvs.2007.06.001. Epub 2007 Aug 1.