One million cases LymeBorreliosis Germany 2012

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inmacdonald
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One million cases LymeBorreliosis Germany 2012

Post by inmacdonald » Wed 23 Jan 2013 18:26

Link:
http://www.ifl-leipzig.de - Medizingeographie: IfL-Karte zeigt Borreliose-Risiko im deutschlandweiten Vergleich
http://www.ifl-leipzig.de/de/aktuelles/ ... leich.html

Maps:
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Lyme in Germany One million Mpa and annotation.jpg
Lyme in Germany Map and Commentary
Lyme in Germany One million Mpa and annotation.jpg (135.57 KiB) Viewed 3875 times
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Lyme In germany Map.jpg
Lyme in Germany hot spots 2012
Lyme In germany Map.jpg (72.42 KiB) Viewed 3875 times

One Million Cases in one year of LB in one country - Germany

best,
Alan B. MacDonald MD
Jan 23,2013

Bagge
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Re: One million cases LymeBorreliosis Germany 2012

Post by Bagge » Wed 23 Jan 2013 18:58

.
The annual number of physicians' billing cases in Germany has now reached one million.
What exactly does the above statement mean? It seems presumptuous and incorrect to assume that each billing case equates to a unique patient new onset case of Lyme disease. Most patients seek medical attention across multiple visits, multiple billings.
immacdonald wrote:One Million Cases in one year of LB in one country - Germany

best,
Alan B. MacDonald MD
Jan 23,2013
One million billings does not necessarily equate to one million individual or newly onset cases of disease, nor does it assume they used proper diagnosis techniques.
.
Edited for clairity: added strickout and inserted blue-colored type.
Last edited by Bagge on Wed 23 Jan 2013 20:55, edited 1 time in total.

X-member
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Re: One million cases LymeBorreliosis Germany 2012

Post by X-member » Wed 23 Jan 2013 19:02

Bagge wrote:
..nor does it assume they used proper diagnosis techniques.
About 77% of the Swedish Lyme cases are diagnosed with Erythema migrans.

How is this diagnosed?

RitaA
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Re: One million cases LymeBorreliosis Germany 2012

Post by RitaA » Wed 23 Jan 2013 20:33

Bagge wrote:.
The annual number of physicians' billing cases in Germany has now reached one million.
What exactly does the above statement mean? It seems presumptuous and incorrect to assume that each billing case equates to a unique patient. Most patients seek medical attention across multiple visits, multiple billings.
immacdonald wrote:One Million Cases in one year of LB in one country - Germany

best,
Alan B. MacDonald MD
Jan 23,2013
One million billings does not necessarily equate to one million individual or new onset cases of disease, nor does it assume they used proper diagnosis techniques.
.
I was just about to bring up the same point. I'm not familiar with the German healthcare system, however I do know that in Canada one billing = one office visit or hospital consultation or a single test or a procedure (whether surgical or not). Depending on how the billing "reason" (i.e. provisional or confirmed diagnosis) is coded, this could just as easily apply to a single office visit for someone who suspects they may have Lyme disease as it does to one of multiple follow-up visits for a patient with EM and/or laboratory-confirmed Lyme disease.

This could help to explain the one million billings (as opposed to new cases) in Germany for the year 2012, but this is just speculation on my part.

Lorima
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Re: One million cases LymeBorreliosis Germany 2012

Post by Lorima » Wed 23 Jan 2013 21:33

Why would there be follow-up visits? Lyme disease is easily cured with a short course of antibiotics.
;)
Lorima
"I have to understand the world, you see."
Richard Feynman

RitaA
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Re: One million cases LymeBorreliosis Germany 2012

Post by RitaA » Wed 23 Jan 2013 21:40

Lorima wrote:Why would there be follow-up visits? Lyme disease is easily cured with a short course of antibiotics.
;)
Lorima
Good point, Lorima.

Then again, some of us supposedly "very rare" cases do fall through some of the cracks in the medical system (so we develop late-stage Lyme disease) and/or our bodies stubbornly refuse to comply with IDSA guidelines.

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Re: One million cases LymeBorreliosis Germany 2012

Post by X-member » Wed 23 Jan 2013 22:25

Bagge, I didn't missed what you wrote! :D

But if only 50% of the cases have an Erythema migrans, then the Swedish numbers must be wrong, and how many cases are míssed?

The highest incidence in Sweden is 160/100 000. And the population in Germany is over 81 000 000.

How many Lyme cases is that, and if we also add all those cases that most likely are missed with early Lyme in Sweden, how many cases can it be in Germany?

Lorima
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Re: One million cases LymeBorreliosis Germany 2012

Post by Lorima » Wed 23 Jan 2013 22:43

Good point, Carina. Did you see my post, here?
http://www.lymeneteurope.org/forum/view ... 056#p34056
The number doesn't seem too high, to me.

Dr. MacDonald, thanks for providing the details about this information. It's nice, some would say essential, to know the source of information, especially when it might seem surprising. We could probably avoid some wheel-spinning by avoiding bare assertions, when offering information that could be sourced. 

I wish, for example, that hv808ct had attached a source for his condensed history, and that Henry had given us a source for his many assertions, intended to be taken as facts. Otherwise, one has to risk embarrassing another person by asking them for a source, as if one didn't trust them. And sometimes they don't respond to sourcing requests, so we're left with a mystery. 

I looked up the source, Dr. Thomas Kistemann, for the map and 1,000,000 cases (or doctor visits; either way, it's an impressive number). 

http://userpages.umbc.edu/~earickso/Pro ... emann.html 

Thomas Kistemann grew up in Aachen, Germany. He holds an MD degree from Gottingen University, a Masters in geography and a PhD (hygiene & medical geography) from the University of Bonn. He is a medical specialist for hygiene & environmental medicine. Thomas’ interest in medical and health geography was stimulated by field experiences as young research assistant in the Bolivian Andes, together with his impression that German medical geography had traditionally been dominated by medicine and lacked adequate perceptions of modern geography. After some years of clinical work experience, Thomas returned to academia and has held various posts in the Hygiene & Public Health Institute at Bonn University. He leads the department of Medical Geography & Public health and heads the institute’s WHO Collaborating Centre for Health Promoting Water Management & Risk Communication. Additionally, he is professor at the University’s Department of Geography and senior fellow at the Department of Political & Cultural Change of the University’s Centre for Development Research. His research is funded by the German Federal Ministries of Health, Environment and Research, as well as by the European Union. Thomas has taught medical geography, hygiene and preventive medicine since 1993. He has co-published a German textbook on GIS applications in the health system (Wichmann, 2004), a monograph on synergies of nature and health protection (BfN, 2005), and made contributions to books including Infectious Disease Epidemiology (Springer, 2003), GIS in Public Health Practice (CRC Press, 2004), and Water as a Human Right (2007). Thomas organized the Twelfth International Medical Geography Symposium that convened at Bonn University in July, 2007.

Thomas may be contacted at thomas.kistemann@ukb.uni-bonn.de. See also http://www.ihph.de
http://www.ihph.de/english/Thomas-Kistemann.php 

That seems like a source that even the most conventional among us, can feel good about. 

Edited to add: note that image/reference to the one million figure, that Dr. M posted above, is from this institution, which also seems "legitimate" in the most conservative sense: http://www.ifl-leipzig.de/en/about-us/organisation.html
"I have to understand the world, you see."
Richard Feynman

RitaA
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Re: One million cases LymeBorreliosis Germany 2012

Post by RitaA » Wed 23 Jan 2013 23:20

Lorima wrote: I wish, for example, that hv808ct had attached a source for his condensed history ...
Lorima,

I just went back to hv808ct's post and used the first sentence to do a Google search. While it may not be identical, this looks pretty close (with the same 22 references listed at the bottom):

http://relative-risk.blogspot.com/2011/ ... -name.html
05 MAY 2011

By any other name

Lorima
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Re: One million cases LymeBorreliosis Germany 2012

Post by Lorima » Thu 24 Jan 2013 4:41

Rita, yes, that's it.
Thanks!
"I have to understand the world, you see."
Richard Feynman

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