Technology assessment and project evaluation

 

 

PD Dr. med. Michael Nagler, PhD, MSc

 “One question has pre-occuppied me since I started my professional career: How can we improve the medical care of patients? This problem is particularly pressing as health care is changing dramatically. It is recognized that several areas would benefit from significantly more scientific enquiry: diagnostic procedures, predictive measures, monitoring of treatment and effectiveness in clinical practice. To address these questions, the experience of practicing physicians and extensive laboratory expertise as well as profound methodological research knowledge is required. At TAPE, we provide all these skills hand in hand.”

Current healthcare challenges

The needs and requirements imposed on health care systems and health care delivery continue to change dramatically. Health care costs are rising sharply with new diagnostic and therapeutic approaches, and an aging population. The critical appraisal of health care innovations such as diagnostic tools, predictive measures, monitoring tools, as well as treatment schemes, is both essential and difficult. There is however a paucity of studies promoting the implementation of these health care innovations into clinical practice and a major “implementation gap” is acknowledged by health care authorities. The following challenges are apparent:

  • Significantly increasing health care costs 
  • Problems associated with overdiagnosis and overtreatment 
  • New biologicals claim to cure life-threatening diseases
  • Innovative new technologies are rapidly entering the market
  • Demands on medical devices and in-vitro diagnostics are increasing
  • Integration of digital health care in a way that aids healthcare professionals and benefits patient care patient care.

Vision

Delivery of comprehensive laboratory services and expertise, broad experience in clinical medicine as well as profound knowledge in methods of patient-oriented research, to provide all-round expertise including customized solutions to answer patient-oriented research questions. 

Aims and Scope/ What we do

In collaboration with our partners within and beyond the Center for Laboratory Medicine, we address a broad range of major scientific questions.

Unique opportunities at TAPE

The environment TAPE offers a number of unique opportunities:

  1. All-round expertise in laboratory medicine, epidemiology, as well as clinical medicine
  2. Access to a comprehensive spectrum of high-end laboratory technologies (incl. genomics, pharmacogenomics, cytomics, biobanking solutions)
  3. Extensive network of recognized experts in all areas of laboratory medicine and clinical medicine
  4. Large patient numbers at Inselspital including patients with severe and rare diseases
  5. Close collaboration with existing data repositories at Inselspital

Industry Partners

Current projects

Team

Michael Nagler, PhD, MSc
PD Dr. med. Michael Nagler, PhD, MSc
Group leader, Principle Investigator
Anja Stalder
Anja Stalder
Data management
Vincent Benites
Vincent Benites
BMA HF (Laboratory assistant)
Jonas Kaufmann
Jonas Kaufmann
Doctoral thesis (Dr. med.)
Michael Esteves  Pereira
Michael Esteves Pereira
Doctoral thesis (Dr. med.)
Luca Pellegrini
Luca Pellegrini
Doctoral thesis (Dr. med.)
Annika Burger
Annika Burger
Master’s thesis (MD)
Tamara Mertins
Tamara Mertins
Master’s thesis (MD)
Robin Boss
Robin Boss
Master’s thesis (MD)
Daria Eppenberger
Daria Eppenberger
Master’s thesis (MD)
Matthias Knuchel
Matthias Knuchel
Student assistant

Publications

Pubmed

2019

  • Roost E, Weber A, Alberio L, Englberger L, Reineke D, Keller D, Nagler M,Carrel T. “Rivaroxaban in patients with mechanical heart valves: A pilot study” Thromb Res. 2019 Dec 7;186:1-6. [Epub ahead of print]
  • Pollak, M., and M. Nagler (2019) “Thrombophilieabklärung im Hinblick auf östrogenhaltige Kontrazeptiva und Hormonersatztherapie" Gynäkologische Endokrinologie 17:139-147
  • Brodard J, Alberio L, Angelillo-Scherrer A, Nagler M “Accuracy of heparin-induced platelet aggregation test for the diagnosis of heparin-induced thrombocytopenia” Thromb Res 2019 (ahead of print)
  • Wolfensberger N, Georgiou G, Giabbani E, Reusser M, Njue LM, Fiedler M, Leichtle AB, Nagler M. Rapid Centrifugation in the Routine Hemostasis Laboratory. Thromb Haemost. 2019 Oct 10. doi: 10.1055/s-0039-1696712. [Epub ahead of print] PubMed PMID: 31600807.
  • Wieland Greguare-Sander, A., W. A. Wuillemin, and M. Nagler (2018) "Utility of thromboelastometry analysis as a diagnostic tool in patients with mild bleedings disorders: a prospective cohort study". European Journal of Anaesthesiology (accepted for publication)
  • Vuilleumier PH, Nagler M, Beldi G, Vogt A. Orthotopic Liver Transplant in a Patient Anticoagulated With Rivaroxaban: A Case Report. A A Pract. 2019 Feb 27.doi: 10.1213/XAA.0000000000000989. [Epub ahead of print]
  • Schnegg-Kaufmann A, Calzavarini S, Limacher A, Mean M, Righini M, Staub D, Beer JH, Frauchiger B, Osterwalder J, Kucher N, Matter CM, Husmann M, Banyai M, Aschwanden M, Mazzolai L, Hugli O, Nagler M, Daskalakis M, Rodondi N, Aujesky D, Angelillo-Scherrer A. A high Gas6 level in plasma predicts venous thromboembolism recurrence, major bleeding and mortality in the elderly: a prospective multicenter cohort study. J Thromb Haemost. 2019 Feb;17(2):306-318.
  • Adler, M., J. Kaufmann, L. Alberio, and M. Nagler (2019) "Diagnostic utility of the ISTH bleeding assessment tool in patients with suspected platelet function disorders”. Journal of Thrombosis and Haemostasis (epub ahead of print)
  • Engelberger, R., V. Schroeder, M. Nagler, R. Prince, D. Periard, D. Hayoz, N. Kucher (2019) “Enhanced thrombolysis by ultrasound-assisted catheter-directed thrombolysis and microbubbles in an in-vitro model of iliofemoral deep vein thrombosis”. Thrombosis and Haemostasis (epub ahead of print)
  • Müller, M., Eastline, J., Nagler, M., Exadaktylos, A.K., Sauter, T. (2019) “Application of prothrombin complex concentrate for reversal of direct oral anticoagulants in clinical practice: indications, patient characteristics and clinical outcomes compared to reversal of vitamin K antagonists” Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine (epub ahead of print)
  • Calzavarini, S., J. Brodard, C. Quarroz, L. Maire, R. Nützi, J. Jankovic, L.C. Rotondo, E. Giabbani, M. Fiedler, M. Nagler, A. Angelillo-Scherrer “Thrombin generation measurement using the ST Genesia Thrombin Generation System in a cohort of healthy adults: normal values and variability”. Research and Practice in Thrombosis and Haemostasis (accepted for publication)
  • Müller M, Bosshard F, Nagler M, Roth B, Exadaktylos AK, Sauter TC. Shorter Hospital Stay and Fewer Hospitalizations in Patients With Visible Hematuria on Direct Oral Anticoagulants Compared to on Vitamin K Antagonists. doi: 10.1016/j.urology.2019.06.004

2018

  • Erdoes G, Schloer H, Eberle B, and Nagler M. Next generation viscoelasticity assays in cardiothoracic surgery: Feasibility of the TEG6s system. PLoS One. 2018 Dec 20;13(12):e0209360
  • Müller M, Schlittler F, Schaller B, Nagler M, Exadaktylos AK, Sauter TC. Characteristics, treatment and outcome of bleeding after tooth extraction in patients on DOAC and phenprocoumon compared to non-anticoagulated patients-a retrospective study of emergency department consultations. Clin Oral Investig. 2018 Oct 5. doi: 10.1007/s00784-018-2676-7. [Epub ahead of print]
  • Bellwald S, Balasubramaniam R, Nagler M, Burri MS, Fischer SDA, Hakim A, Dobrocky T, Yu Y, Scalzo F, Heldner MR, Wiest R, Mono ML, Sarikya H, El-Koussy M, Mordasini P, Fischer U, Schroth G, Gralla J, Mattle HP, Arnold M, Liebeskind D, Jung S. Association of anemia and hemoglobin decrease during acute stroke treatment with infarct growth and clinical outcome. PLoS One. 2018 Se 26;13(9):e0203535
  • Erdoes G, Dietrich W, Stucki MP, Merz TM, Angelillo-Scherrer A, Nagler M, Carrel T, Eberle B. Short-term recovery pattern of plasma fibrinogen after cardiacsurgery: A prospective observational study. PLoS One. 2018 Aug 3;13(8):e0201647
  • Nagler M, Ten Cate H, Prins MH, Ten Cate-Hoek AJ. Risk factors for recurrence in deep vein thrombosis patients following a tailored anticoagulant treatment incorporating residual vein obstruction. Res Pract Thromb Haemost. 2018 Feb 3;2(2):299-309.
  • Bürki S, Brand B, Escher R, Wuillemin WA, and Nagler M. Accuracy, reproducibility and costs of different laboratory assays for the monitoring of unfractionated heparin in clinical practice: a prospective evaluation study and survey among Swiss institutions. BMJ Open. 2018 Jun 9;8(6):e022943
  • Sauter TC, Eberle B, Wuillemin WA, Thiele T, Angelillo-Scherrer A, Exadaktylos AK, Erdoes G, Cuker A, and Nagler M. How I manage patients with anticoagulation-associated bleeding or urgent surgery. Swiss Med Wkly. 2018 Mar 14;148:w14598

2017

  • Nagler M, Angelillo-Scherrer A, Méan M, Limacher A, Abbal C, Righini M, Beer JH, Osterwalder J, Frauchiger B, Aschwanden M, Matter CM, Kucher N, Cornuz J, Banyai M, Husmann M, Staub D, Mazzolai L, Hugli O, Rodondi N, Aujesky D. Long-term outcomes of elderly patients with CYP2C9 and VKORC1 variants treated with vitamin K antagonists. J Thromb Haemost. 2017 Nov;15(11):2165-2175
  • Bankova A, Andres Y, Horn MP, Alberio L, and Nagler M. Rapid immunoassays for diagnosis of heparin-induced thrombocytopenia: Comparison of diagnostic accuracy, reproducibility, and costs in clinical practice. PLoS One. 2017 Jun 8;12(6):e0178289
  • Studt JD, Alberio L, Angelillo-Scherrer A, Asmis LM, Fontana P, Korte W, Mendez A, Schmid P, Stricker H, Tsakiris DA, Wuillemin WA, and Nagler M. Accuracy and consistency of anti-Xa activity measurement for determination of rivaroxaban plasma levels. J Thromb Haemost. 2017 Aug;15(8):1576-1583
  • Bulla O, Poncet A, Alberio L, Asmis LM, Gähler A, Graf L, Nagler M, Studt JD, Tsakiris DA, Fontana P. Impact of a product-specific reference standard for the measurement of a PEGylated rFVIII activity: the Swiss Multicentre Field Study. Haemophilia. 2017 Jul;23(4):e335-e339
  • Sauter TC, Hegazy K, Hautz WE, Krummrey G, Ricklin ME, Nagler M, Borner U, Exadaktylos AK. Epistaxis in anticoagulated patients: Fewer hospital admissions and shorter hospital stays on rivaroxaban compared to phenprocoumon. Clin Otolaryngol. 2018 Feb;43(1):103-108
  • Adler M, Ivic S, Bodmer NS, Ten Cate H, Bachmann LM, Wuillemin WA, and Nagler M. Thromboelastometry and Thrombelastography Analysis under Normal Physiological Conditions - Systematic Review. Transfus Med Hemother. 2017 Apr;44(2):78-83
  • Fontana P, Alberio L, Angelillo-Scherrer A, Asmis LM, Korte W, Mendez A, Schmid P, Stricker H, Studt JD, Tsakiris DA, Wuillemin WA, and Nagler M. Impact of rivaroxaban on point-of-care assays. Thromb Res. 2017 May;153:65-70
  • Nagler M, Cuker A. Profile of Instrumentation Laboratory's HemosIL® AcuStar HIT-Ab(PF4-H) assay for diagnosis of heparin-induced thrombocytopenia. Expert Rev Mol Diagn. 2017 May;17(5):419-426

Publications before 2017

  • Angelillo-Scherrer A, and Nagler M. Thrombophilieabklärung. Ther Umsch. 2016;73(10):626-634
  • Nagler M, Angelillo-Scherrer A. Thromboembolien und Thrombophilie in der Schwangerschaft. Ther Umsch. 2016;73(7):377-383.
  • Nagler M, Bakchoul T. Clinical and laboratory tests for the diagnosis of heparin-induced thrombocytopenia. Thromb Haemost. 2016 Oct 28;116(5):823-834.
  • Sauter TC, Blum S, Nagler M, Schlittler FL, Ricklin ME, Exadaktylos AK. Reversal of Dabigatran Using Idarucizumab in a Septic Patient with Impaired Kidney Function in Real Life Practice. Case Rep Emerg Med. 2016;2016:1393057.
  • Schaefer C, Wuillemin WA, Kessels A, Jacobson A, and Nagler M. Predictors of anticoagulation quality in 15 834 patients performing patient self-management of oral anticoagulation with vitamin K antagonists in real-life practice: a survey of the International Self-Monitoring Association of Orally Anticoagulated Patients. Br J Haematol. 2016 Nov;175(4):677-685.
  • Nagler M, Kremer Hovinga JA, Alberio L, Peter-Salonen K, von Tengg-Kobligk H, Lottaz D, Neerman-Arbez M, Lämmle B. Thromboembolism in patients with congenital afibrinogenaemia. Long-term observational data and systematic review. Thromb Haemost. 2016 Sep 27;116(4):722-32.
  • Nagler M, Bachmann LM, ten Cate H, ten Cate-Hoek A. Diagnostic value of immunoassays for heparin-induced thrombocytopenia: a systematic review and meta-analysis. Blood. 2016 Feb 4;127(5):546-57.
  • Spronk HM, Cannegieter S, Morange P, Hackeng T, Huisman M, Nagler M, Posthuma J, Ninivaggi M, Zwaveling S, van der Hulle T, Scheres LJ, van Mens TE, Mackman N. Theme 2: Epidemiology, Biomarkers, and Imaging of Venous Thromboembolism (and postthrombotic syndrome). Thromb Res. 2015 Sep;136 Suppl 1:S8-S12.
  • Adler M, and Nagler M. Adherence to treatment with non-vitamin K antagonist anticoagulants: once- vs. twice-daily regimens. Europace. 2015 Aug;17(8):1316.
  • Nagler M, Wuillemin WA. Patient self-management of oral anticoagulation with vitamin K antagonists in everyday practice. Br J Haematol. 2015 May;169(4):600-1.
  • Nagler M, Ten Cate H. Thromboelastometry changes in myeloproliferative neoplasms-surrogate for a procoagulant haemostatic imbalance or a consequence of technical reasons? Ann Hematol (2013) 92:1633-1639
  • Nagler M, Angelillo-Scherrer A. Diagnostic value of the 4Ts score for heparin-induced thrombocytopenia in the critically ill. J Crit Care. 2014 Dec;29(6):1126-7
  • Nagler M, Keller P, Siegrist D, Alberio L. A case of EDTA-dependent pseudothrombocytopenia: simple recognition of an underdiagnosed and misleading phenomenon. BMC Clin Pathol. 2014 May 1;14:19
  • Nagler M, Bachmann LM, Schmid P, Raddatz Müller P, Wuillemin WA. Patient self-management of oral anticoagulation with vitamin K antagonists in everyday practice: efficacy and safety in a nationwide long-term prospective cohort study. PLoS One. 2014 Apr 18;9(4):e95761
  • Nagler M, ten Cate H, Kathriner S, Casutt M, Bachmann LM, Wuillemin WA. Consistency of thromboelastometry analysis under scrutiny: results of a systematic evaluation within and between analysers. Thromb Haemost. 2014 Jun;111(6):1161-6.
  • Simeon L, Nagler M, Wuillemin WA. [New oral anticoagulants - influence on coagulation tests]. Dtsch Med Wochenschr. 2014 Jan;139(3):94-9
  • Nagler M, Bachmann LM, Alberio L, Angelillo-Scherrer A, Asmis LM, Korte W, Mendez A, Reber G, Stricker H, Tsakiris DA, Wuillemin WA. Variability between laboratories performing coagulation tests with identical platforms: a nationwide evaluation study. Thromb J. 2013 Mar 7;11(1):6.
  • Nagler M, Kathriner S, Bachmann LM, Wuillemin WA. Impact of changes in haematocrit level and platelet count on thromboelastometry parameters. Thromb Res. 2013 Mar;131(3):249-53
  • Nagler M, Raddatz-Müller P, Schmid P, Bachmann LM, Wuillemin WA. Accuracy of the point-of-care coagulometer CoaguChek XS in the hands of patients. J Thromb Haemost. 2013 Jan;11(1):197-9.
  • Nagler M, Wuillemin W. [Laboratory diagnostic with regard to new anticoagulants - monitoring and influence on coagulation tests]. Ther Umsch. 2012 Nov;69(11):650-6.
  • Nagler M, Feller S, Beyeler C. Retrospective adjustment of self-assessed medical competencies - noteworthy in the evaluation of postgraduate practical training courses. GMS Z Med Ausbild. 2012;29(3):Doc45.
  • Nagler M, Haslauer M, Wuillemin WA. Fondaparinux - data on efficacy and safety in special situations. Thromb Res. 2012 Apr;129(4):407-17
  • Nagler M, Fabbro T, Wuillemin WA. Prospective evaluation of the interobserver reliability of the 4Ts score in patients with suspected heparin-induced
  • thrombocytopenia. J Thromb Haemost. 2012 Jan;10(1):151-2.
  • Nagler M, Gregor M, Wuillemin WA. Iron chelation with deferasirox in two patients
  • with HFE hemochromatosis and chronic anemia. Acta Haematol. 2011;126(2):119-21.
  • Nagler M, Wuillemin WA. Leeching as a substitute for phlebotomy. Br J Haematol. 2011 May;153(4):420
  • Nagler, M., P. Erne, R. Babst, W. Korte and W. A. Wuillemin (2011). "Periinterventionelles Manage¬ment der Antikoagulation und Antiaggregation." Schweizerisches Medizin Forum 11(23-24): 407-412.
  • Nagler M, Haslauer M, Wuillemin WA. Long-term anticoagulation with fondaparinux in a patient with a mechanical heart valve. Ann Hematol. 2011 Oct;90(10):1225-6.
  • Nagler M, Müller B, Briner V, Winterhalder R. Severe hyperkalemia and bilateral adrenal metastasis. J Oncol. 2009;2009:831979