Yasemin Yüksel is in a white coat in front of a Cabinet at the entrance to your treatment room and fiddles in a flat cardboard box. "Laboratory tests that cost nothing, are popular," she says and shows in the box of test tubes, swabs, and forms for various proof tests of flu about whooping cough to Lyme disease. For the patients, the Tests are free of charge, nevertheless, it is not, of course, that you agree. In the case of Influenza, for example, needs a nasal swab, is not exactly pleasant. In addition, it will take at least two days, until the result is known. "Most of the patients are already on the mend," says Yüksel.
The 57-year-old Swiss woman is a doctor, a house, as you imagine, in the conversation in a pragmatic way, and somehow always on the go, to the next treatment appointment. Yüksel leads his own practice in Winterthur and has been for over 15 years, a member of the Sentinella reporting system. The network of 160 to 180 house and children's doctors covers the whole of Switzerland and collects data mainly to frequent infectious diseases. This is All coordinated by the Federal office for health (BAG).
During the influenza season, the Sentinel data are an important basis for the weekly management reports, documenting the Roll of the wave of Flu with about a week delay. Currently, the threshold value is exceeded for four weeks. How hard is the shaft to fail this year, it will show in the first place. In the last season, it was very long and infected an unusually high number of people. The year before it came out because of the flu, even to 1600 additional deaths.
Google, with its project
not failed, there Would be the Sentinella data, knew no one so exactly when and how severely influenza viruses to rage in us. The flu wave has finally seen no one. Nevertheless, one may wonder what the close-meshed data sammlerei be good. The viruses come from anyway each year, and, once infected, can at best alleviate the symptoms.
Daniel Koch, head of the Department for Communicable diseases at the Federal office for health (BAG), the influenza monitoring, of course, be "very useful". Actually makes it easier for the Doctors diagnosis, if you know that, currently, the influenza virus is circulating. In uncomplicated cases, you can reassure the patient, and certain tests, and medications omit.
Even outside of doctor's offices, the people can benefit. "If you get sick during flu season, you should not drag yourself into the office and infect others," says cook. "It can also be useful to move in this time, a visit to the Hospital." Persons, which are due to other diseases or age are particularly vulnerable, can remain in the home.
And finally, the pandemic plan of the Federal government, a flu surveillance. If, in fact, a dangerous influenza virus should occur, it is important that the resources in the right place. For cooking, the Sentinella reporting system is "a great success". It is not working stable and on a voluntary Basis. Also because the expense is compensated, and every day, around ten minutes in.
Other Trials of influenza surveillance have failed. In particular, the "Flu Trends" from Google. The company tried, the intensity of flu outbreaks based on online queries to capture in real-time. In 2015, the Experiment was discontinued. "The Problem with such systems is that they amplify," says cook. If the media reports about the flu, increasing the number of Google queries, even if the Virus is not active. Better than Sentinella, the systems in countries such as the UK, Sweden or the Netherlands, however, work. The digitalization in the health sector is more advanced, and medical data from the medical offices can almost be in real-time, centrally evaluated.
"a new analysis of The population sensibli"
Mumps, whooping cough and shingles are the names of the other infectious diseases, which are currently notified through Sentinella. In addition, the Doctors to collect a prescription of antibiotics. "It is all about, to monitor diseases that are relatively common," says cook. Rare infections, such as tetanus, tuberculosis, or Syphilis, however, are for all the Doctors to be reported.
The other regular reporting topic in the media, similar to a great deal of attention as the flu, are ticks. The Sentinella Doctors to report for over ten years, tick bites and infection with Lyme borreliosis, which you encounter in your practice. For some years, the FOPH published in the summer half-year monthly reports, combined with the cases of tick-borne encephalitis (TBE), the Sentinella-Not-have to be of all the Doctors reported. "With the Reports we want to sensitize the population to protect themselves by their behavior, and with a TBE vaccination," says cook.
insomnia, testimonials, binge drinking
At the founding of the Sentinella over 30 years ago, it was solely to infections. Later the activities were extended. In addition, the network of drinking followed again and again topics about only a few years of insomnia, for example, work incapacity certificates, or noise.
Meanwhile, the research projects coming from the house doctor, and institutes of the universities. "We have realized that the Sentinella network is ideal for studies is suitable", says Andreas Zeller, who, for several years, both as a doctor and as a Director of the centre for family medicine at the University of Basel. "In 2013, we launched the first-infectious study on Work-Life Balance of doctors," he recalls. Meanwhile, the number of publications is considerable. "Sentinella is for the doctor's research is very valuable," says Zeller.
not surprisingly, there is no shortage of ideas for new projects. "We must ensure that we don't take too much to clean," says Zeller. "If the effort is too great, the Doctors are less reliable." What are the reporting topics and what projects will be implemented and how is determined by the Sentinella programme Commission, which meets three times per year. It also the BAG as well as the in-house doctor institutions in addition to representatives of the Doctors of the six reporting regions. Andreas Zeller for the University of Basel and Yasemin Yüksel as a regional representative for the North-East Switzerland.
Every third person is chronically Ill, has more than two diseases
Although the Winterthur Doctor a long time ago, she thinks of quitting. "I'm looking for epidemiology and infectious diseases," said Yüksel, who has after training as a General practitioner, a Master's degree in Public Health. "As the Sentinella-member, I can take responsibility and move forward."
The Sentinella network, interested, increasingly, the supply of researchers to the doctor institutes of the Swiss universities. A first major study, which had infectious diseases on the subject, dealt with the reconciliation of professional and private life to the doctors and was released in 2013. The leader, Andreas Zeller, who is now in charge of the centre for family medicine at the University of Basel. According to the survey, the participating Sentinel Physicians, the majority were "quite satisfied", were, however, of the patients is often not appreciated.
another, not-yet-completed project, this time from the University of Bern is concerned with the early detection of bowel cancer. This can be done from 50, with two almost equivalent methods: either with a colonoscopy every ten years, or a stool test every two. "The study aims to clarify how the interview with the doctor influenced the decision of the patient," says Zeller.
diseases to occur, A further investigation captured using Sentinella, for the first time, how often several times in the Swiss house doctor's offices. Therefore, every second Patient has more than one chronic disease at the same time, each of the third parties more than two. Were widely used in hypertension and Depression. "It is important to know how often multi-morbidity occurs, and that is not a Specialist, but mainly in-house doctors to take care of these patients," says Zeller.
study of the core business of family physicians
Currently, a project of the Institute for family medicine Lucerne runs to visit the house, "one of the core business of General practitioners", as Zeller puts it. The Sentinella Physicians collect, how frequently, for how long, to visit at any time of the day and what is the reason for patients at home.
another way the Institute for family medicine of the University of Zurich has been beating for a couple of years ago with his project Fire ("Family Medicine ICPC Research Using Electronic Medical Records"). Almost 500 primary care providers taking part in the meantime. They provide anonymized medical routine data, such as diagnoses, lab values or prescription drugs and ask for research projects of the Institute. In return, you will receive feedback on the quality and quantity of their work in comparison to other participating Physicians. The Fire data collection was in Switzerland once, it means at the University of Zurich.
Created: 07.02.2019, 15:07 PM