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Your search keyword '"Hapfelmeier, Alexander"' showing total 8 results
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8 results on '"Hapfelmeier, Alexander"'

3. Decision impact and feasibility of different ASCO-recommended biomarkers in early breast cancer: Prospective comparison of molecular marker EndoPredict and protein marker uPA/PAI-1

Author

Ettl, Johannes, Klein, Evelyn, Hapfelmeier, Alexander, Grosse Lackmann, Kirsten, Paepke, Stefan, Petry, Christoph, Specht, Katja, Wolff, Laura, Höfler, Heinz, and Kiechle, Marion

Subjects
Adult, Histology, Cancer Treatment, Gene Expression, lcsh:Medicine, Breast Neoplasms, Biochemistry, Risk Assessment, Diagnostic Medicine, Breast Tumors, Breast Cancer, Plasminogen Activator Inhibitor 1, Medicine and Health Sciences, Genetics, Humans, Prospective Studies, lcsh:Science, Aged, Aged, 80 and over, lcsh:R, Cancers and Neoplasms, Biology and Life Sciences, Endocrine Therapy, Middle Aged, Prognosis, Urokinase-Type Plasminogen Activator, Hormones, Oncology, Chemotherapy, Adjuvant, Practice Guidelines as Topic, Feasibility Studies, Female, lcsh:Q, Anatomy, Biomarkers, Research Article
Abstract

Background Adjuvant therapy decisions in early breast cancer are based on accurate risk assessment. Urokinase plasminogen activator (uPA) and plaminogen activator inhibitor-1 (PAI-1) have been the first biomarkers in hormone receptor (HR) positive breast cancer to reach highest level of evidence. The EndoPredict test (EPclin) combines gene expression information with nodal status and tumor size. The aim of this prospective study was to compare uPA/PAI-1 and EPclin as prognostic biomarkers with regard to feasibility, risk stratification and impact on adjuvant therapy recommendation. Materials and method 395 patients with HR positive, HER2 negative, intermediate risk breast cancer were enrolled. Relations and concordance of histologic grading as well as EPclin and uPA/PAI-1 values were assessed by Spearman’s rank correlation coefficient and Cohen’s Kappa. To compare decision impact of EPclin and uPA/PAI-1 three independent case discussions were held: One with known uPA/PAI-1 and EPclin results, one blinded to EPclin alone and another one blinded to both EPclin and uPA/PAI-1. Results EPclin could be determined in all 395 (100%), uPA/PAI-1 in 190 (48%) of the tumor samples. EPclin allocated 250 patients (63%) to the low-risk group and 145 patients (37%) to the high-risk group, whereas uPA/PAI-1 allocated 88 patients (46%) to the low-risk group and 102 patients (54%) to the high-risk group. In 59% of cases, both tests showed concordant results. EPclin resulted more frequently in a change of therapy recommendation than the uPA/PAI-1 test (46% vs 24%). Recommendation of adjuvant chemotherapy (CTX) was abandoned twice as often by EPclin (45%) compared to uPA/PAI-1 (22%). Conclusion In this first prospective comparison of EPclin and uPA/PAI-1 we found, that EPclin is superior to uPA/PAI-1 with respect to feasibility and decision impact. This leads to substantial avoidance of adjuvant CTX in endocrine-sensitive, HER2-negative breast cancer. Data collection for patients´ clinical outcome is ongoing.

Published
2017

5. Does Anticoagulant Medication Alter Fracture-Healing? A Morphological and Biomechanical Evaluation of the Possible Effects of Rivaroxaban and Enoxaparin Using a Rat Closed Fracture Model

Author

Prodinger, Peter Michael, primary, Burgkart, Rainer, additional, Kreutzer, Kilian, additional, Liska, Franz, additional, Pilge, Hakan, additional, Schmitt, Andreas, additional, Knödler, Martina, additional, Holzapfel, Boris Michael, additional, Hapfelmeier, Alexander, additional, Tischer, Thomas, additional, and Bissinger, Oliver, additional

Published
2016
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6. Biliary Endoprosthesis: A Prospective Analysis of Bacterial Colonization and Risk Factors for Sludge Formation

Author

Schneider, Jochen, primary, Hapfelmeier, Alexander, additional, Fremd, Julia, additional, Schenk, Philipp, additional, Obermeier, Andreas, additional, Burgkart, Rainer, additional, Forkl, Stefanie, additional, Feihl, Susanne, additional, Wantia, Nina, additional, Neu, Bruno, additional, Bajbouj, Monther, additional, von Delius, Stefan, additional, Schmid, Roland M., additional, Algül, Hana, additional, and Weber, Andreas, additional

Published
2014
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8. Combining the GP's assessment and the PHQ-9 questionnaire leads to more reliable and clinically relevant diagnoses in primary care.

Author

Teusen C, Hapfelmeier A, von Schrottenberg V, Gökce F, Pitschel-Walz G, Henningsen P, Gensichen J, and Schneider A

Subjects
Humans, Reproducibility of Results, Longitudinal Studies, Surveys and Questionnaires, Patient Health Questionnaire, Primary Health Care
Abstract

Background: Screening questionnaires are not sufficient to improve diagnostic quality of depression in primary care. The additional consideration of the general practitioner's (GP's) assessment could improve the accuracy of depression diagnosis. The aim of this study was to examine whether the GP rating supports a reliable depression diagnosis indicated by the PHQ-9 over a period of three months., Methods: We performed a secondary data analysis from a previous study. PHQ-9 scores of primary care patients were collected at the time of recruitment (t1) and during a follow-up 3 months later (t2). At t1 GPs independently made a subjective assessment whether they considered the patient depressive (yes/no). Two corresponding groups with concordant and discordant PHQ-9 and GP ratings at t1 were defined. Reliability of the PHQ-9 results at t1 and t2 was assessed within these groups and within the entire sample by Cohen's Kappa, Pearson's correlation coefficient and Bland-Altman plots., Results: 364 consecutive patients from 12 practices in the region of Upper Bavaria/Germany participated in this longitudinal study. 279 patients (76.6%) sent back the questionnaire at t2. Concordance of GP rating and PHQ-9 at t1 led to higher replicability of PHQ-9 results between t1 and t2. The reliability of PHQ-9 was higher in the concordant subgroup (κ = 0.507) compared to the discordant subgroup (κ = 0.211) (p = 0.064). The Bland-Altman Plot showed that the deviation of PHQ-9 scores at t1 and t2 decreased by about 15% in the concordant subgroup. Pearson's correlation coefficient between PHQ-9 scores at t1 and t2 increased significantly if the GP rating was concordant with the PHQ-9 at t1 (r = 0.671) compared to the discordant subgroup (r = 0.462) (p = 0.044)., Conclusions: The combination of PHQ-9 and GP rating might improve diagnostic decision making regarding depression in general practices. PHQ-9 positive results might be more reliable and accurate, when a concordant GP rating is considered., Competing Interests: The authors have declared that no competing interests exist.

Published
2022
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