In order to encourage outstanding doctoral dissertations, the Münchner Bank, the Verein der Freunde und Förderer (VdFF), and the Helmholtz Graduate School Environmental Health (HELENA) again awarded three Graduate Students Awards this autumn. Each is endowed with 1,500 euros. One award went to Michael Laxy. In an interview, we discussed his doctoral dissertation.
Mr. Laxy, please describe your project.
My work is in the field of healthcare research and health economics. Subject of these fields of research is the analysis of routine care and the cost-effectiveness of alternative treatment strategies in health care.
In my dissertation, I examined disease management strategies for people with type 2 diabetes at the level of the healthcare system, general practitioner care and patient self-management. Analyses were based on data of the population-based KORA studies and a randomized pragmatic trial from Great Britain. At the healthcare system level, I analysed whether the German Disease Management Programmes (DMPs) for type 2 diabetes, in which today more than four million diabetes patients are enrolled, have a positive effect on the quality of care, patient self-management, and patient mortality. I also examined the cost-effectiveness of intensive multifactorial general practitioner treatment in diabetes patients detected by screening and the association between patient self-management and mortality.
The analyses showed that the DMPs are associated with better quality of care, but not directly with reduced mortality. In addition, it was seen that intensive general practitioner treatment is cost-effective over the long-term and that a high quality of care and good patient self-management are associated with significantly reduced mortality.
The results suggest that comprehensive care in accordance with evidence-based guidelines, intensive treatment, and patient training for improved self-management are very important components for reducing the burden of type 2 diabetes. The difficulty in analysing these research questions, however, was that randomized studies in this context are often difficult to carry out and some of the analyses are based on observational data. In spite of adequate statistical methods in the analysis of these observational data, further research is needed to clarify the question of causality regarding the found relationships.
How did you hear about the Helmholtz Zentrum München?
As a part of the Public Health (Master) programme at the LMU Faculty of Medicine, I attended the "Health economic evaluation" teaching module that was offered by the IGM staff. I really enjoyed the lectures, and therefore decided to do my master’s thesis at the IGM. After I finished my thesis, I then applied for a PhD position.
How important was the supervision you received during your doctoral work?
The supervision is one of the most important components for a successful PhD project. My advisor, Prof. Dr. Rolf Holle, gave me a great deal of freedom so that I could allow my scientific curiosity free rein. But he was also always there when I needed feedback and for helping me make strategic decisions regarding the next step in my PhD research. This was the perfect combination for me. The Thesis Committee meetings held in the framework of HELENA were helpful because they "forced" me to summarize my work's status and progress and to reflect on my work. The Thesis Committee members also gave me helpful suggestions for my dissertation project.
How important were the HELENA graduate school offers for you?
The HELENA Graduate School offers were a major asset. In the courses and events, I met many colleagues from various institutes and research fields. In addition, the financial support from HELENA allowed me to enjoy a three-month research stay at the MRC Epidemiology Unit of the University of Cambridge, an opportunity from which I still greatly profit today.
What are your plans for the future?
I am currently a PostDoc in the research group for economic evaluation at the IGM and am attempting to establish my own scientific profile at the intersection of healthcare research/health economics and diabetes research. In the future, I would like to set up a small team in order to carry out my own research projects.
Thank you very much, Mr. Laxy.
Laxy, M.: „Disease Management and Outcomes in Patients with Type 2 Diabetes and Cardiovascular Comorbidities. The Burden of Disease and the Effectiveness and Cost-Effectiveness of Strategies on the Health Care System, Physician, and Patient Level“ Download...