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Abstract Background Fragmented and complex healthcare systems make it difficult to provide continuity of care for patients with advanced cancer near the end of life. Nurse‐based cross‐sectoral navigation support has the potential to increase patients' quality of life. The objective of this paper was to evaluate associations between navigation support and health care utilization, and the associated costs of care. Methods The evaluation is based on claims data from 37 statutory health insurance funds. Non‐randomized recruitment of the intervention group (IG) took place between 2018 and 2019 in four German hospitals. The comparison group (CG) was defined ex post. It comprises nonparticipating clients of the involved health insurance funds matched on age, gender, and diagnosis in a 1:4 ratio to the IG. Healthcare resource utilization was compared using incident rate ratios (IRRs) based on negative binomial regression models. Linear mixed models were performed to compare differences in lengths of hospital stays and costs between groups. Results A total of 717 patients were included (IG: 149, CG: 568). IG patients showed shorter average lengths of hospital stays (IG: 11 days [95% CI: 10, 13] vs. CG: 15 days [95% CI: 14, 16], p

Abstract Purpose Given the psychosocial burdens patients in advanced stages of cancer face, innovative care concepts are needed. At the same time, such vulnerable patient groups are difficult to reach for participation in intervention studies and randomized patient inclusion may not be feasible. This article aims to identify systematic biases respectively selection effects occurring during the recruitment phase and to discuss their potential causes based on a non-randomized, multicenter intervention study with patients in advanced stages of cancer. Methods Patients diagnosed with at least one of 16 predefined cancers were recruited at four hospitals in three German cities. The effect of social care nurses’ continuous involvement in acute oncology wards was measured by health-related quality of life (EORTC QLQ-C30), information and participation preferences, decisional conflicts, doctor-patient communication, health literacy and symptom perception. Absolute standardized mean difference was calculated as a standardized effect size to test baseline characteristics balance between the intervention and control groups. Results The study enrolled 362 patients, 150 in the intervention and 212 in the control group. Except for gender, both groups differed in relevant socio-demographic characteristics, e.g. regarding age and educational background. With respect to the distribution of diagnoses, the intervention group showed a higher symptom burden than the control group. Moreover, the control group reported better quality of life at baseline compared to the intervention group (52.6 points (SD 21.7); 47.8 points (SD 22.0), ASMD = 0.218, p = 0.044). Conclusion Overall, the intervention group showed more social and health vulnerability than the control group. Among other factors, the wide range of diagnoses included and structural variation between the recruiting clinics increased the risk for bias. We recommend a close, continuous monitoring of relevant social and health-related characteristics during the recruitment phase as well as the use of appropriate statistical analysis strategies for adjustment, such as propensity score methods. Trial registration: German Clinical Trials Register (DRKS-ID: DRKS00013640 ); registered on 29th December 2017.

Ceutorhynchinae Gistel are a diverse weevil subfamily of almost worldwide distribution and considerable economic importance. Nevertheless, the classification of Ceutorhynchinae and their phylogenetic relationships are not yet fully resolved. Here, we sequenced the mitogenomes of 54 ceutorhynchine species. Phylogenetic analyses by maximum likelihood and Bayesian inference were performed on a dataset of 13 protein‐coding and two ribosomal genes. All analyses recovered three well supported clades A–C. A principal component analysis shows that codon usage differs considerably between these clades, indicating a compositional asymmetry in ceutorhynchine mitogenomes. This increased the challenge of resolving the early relationships among the three clades. The resolution of the later diversification was more robust, and the resulting topologies were largely compatible with each other and with the current taxonomic classification. Exceptions are the genera Micrelus Thomson, which is transferred from the tribe Ceutorhynchini to Egriini Pajni and Kohli (new position) and Amalus Schoenherr, which is transferred to Phytobiini Gistel (new position). Amalini Wagner 1936 is a junior synonym of Phytobiini Gistel 1848 (syn. n.). Coeliodini Lacordaire (new status), a tribe previously regarded as junior synonym of Ceutorhynchini, is re‐established. Our analyses also clarified the difficult assignments of taxa to the tribes Scleropterini Schultze and Phytobiini. All taxa with the ability to jump as adult beetles belong to clade B, which comprises the tribes Cnemogonini Colonnelli, Hypurini Schultze, Mecysmoderini Wagner and Phytobiini. With dense taxon sampling and appropriate analytical methods, mitogenome data provide a phylogeny well suited to improve the traditional classification of this neglected and species‐rich taxon. [ABSTRACT FROM AUTHOR]