Metabolic Syndrome Is Common Following Haematopoietic Cell Transplantation (HCT) and Is Associated with Increased Cardiovascular Disease and Second Cancers: An EBMT Cross-Sectional Non-Interventional Study

Abstract Metabolic syndrome (MetS) is defined as a clustering of five factors including (1) fasting hyperglycaemia (2) hypertriglyceridaemia (3) low HDL cholesterol (4) hypertension (5) obesity (high waist circumference). According to the International Diabetes Federation harmonised definition, a large waist circumference plus any other two features meet criteria for diagnosis of MetS. It is associated with raised risk of cardiovascular disease (CVD) by 3-fold and is increasingly recognised in patients after HCT. Recent guidelines for long-term HCT survivors recommend screening for MetS. We performed a large cross-sectional service evaluation of HCT survivors in centres working in accordance with international screening guidelines. We have previously presented interim results regarding the prevalence of MetS and associated risk factors and now present the final results. This was an EBMT approved cross-sectional, non-interventional study of consecutive HCT patients (allo and auto) aged 18+ years and a minimum of 2 year post-transplant attending routine follow-up HCT and/or late effects clinics in 9 centres. Centres completed proformas incorporating routine recording of the MetS parameters (given above) as well as performance status (ECOG); evidence of cardiovascular events; family history of premature CVD; and relevant drug history. Univariate comparison of patients and HCT characteristics between the 2 groups (MetS vs no MetS) was performed using non-parametric Mann-Witney U test for continuous variables and Chi-square test or Fisher test for categorical variables. All tests were two-sided. Multivariate logistic regression analyses were performed to predict MetS and cardiovascular events. Variables with a p-value <0.2 in univariate analysis were included. Table 1 gives the population demographic, age, primary disease and transplant details. The prevalence of MetS was 30.4% (allo 29%, auto 35.6% ns). There was a significant difference in prevalence by age at follow-up (p<0.001 with increasing age) with 39% having MetS in those aged 50+. ECOG status was not significantly different between those with or without MetS. No relationship between presence or degree of acute or chronic GvHD was observed and no difference in current use of immunosuppressant therapy. Notably, there was a significantly higher prevalence of cardiovascular events in those with MetS than those without (22.6.vs 10.7%, P=0.006). Logistic regression analysis confirmed that MetS is a predictor of cardiovascular events (OR 4.72, 95%CI 2.11-10.57). CVE were also associated with occurrence of a second malignancy (OR 7.93, 95%CI 2.91-21.61). There was an influence of increasing age both in the prevalence of metabolic syndrome (OR 7.3, 95% CI 3.2,16.8) and CVE (OR 3, 95%CI 0.8-11.32) for the over 50s compared with those aged 18-29. This large study in HCT survivors confirms high prevalence of metabolic syndrome following both allogeneic and autologous HCT of 30.4% overall rising to 39% in those aged over 50 years at follow-up. The data support MetS being an age-related late effect of HCT that is strongly associated with not only cardiovascular events but also the occurrence of second cancers. Further analysis examining the relationship between intensity of treatment and prevalence of MetS and CVE is needed. The data supports routine screening for MetS of both allo and auto HCT patients. Early intervention of reversible features of MetS with lifestyle and medical management may reduce the risk of cardiovascular events, but this needs be tested in a randomised controlled trial setting. Meanwhile, screening and management should be robustly integrated within routine HCT long-term follow-up care. Table 1. Table 1. Disclosures Cortelezzi: janssen: Consultancy; novartis: Consultancy; roche: Consultancy; abbvie: Consultancy. Mohty:Jazz Pharmaceuticals: Honoraria, Research Funding, Speakers Bureau; Servier: Consultancy; Sanofi: Consultancy, Honoraria, Research Funding, Speakers Bureau; MaaT Pharma: Consultancy, Membership on an entity's Board of Directors or advisory committees; Takeda: Honoraria, Speakers Bureau; Bristol Myers: Consultancy, Research Funding; Celgene: Consultancy, Honoraria; Amgen: Consultancy, Honoraria; Molmed: Consultancy; Janssen: Honoraria, Research Funding, Speakers Bureau. Kroeger:Novartis: Honoraria, Research Funding; Celgene: Honoraria, Research Funding; Riemser: Honoraria, Research Funding; JAZZ: Honoraria; Sanofi: Honoraria; Neovii: Honoraria, Research Funding. Snowden:Jazz & Sanofi: Other: Speaker fees at ASH; Jannssen/J&J: Other: Speaker fees.

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Metabolic syndrome and cardiovascular disease after haematopoietic cell transplantation (HCT) in adults: an EBMT cross-sectional non-interventional study

Bone Marrow Transplantation ◽

10.1038/s41409-021-01414-7 ◽

2021 ◽

Author(s):

D. M. Greenfield ◽

N. Salooja ◽

C. Peczynski ◽

S. van der Werf ◽

H. Schoemans ◽

...

Keyword(s):

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Cardiovascular Risk ◽

Cell Transplantation ◽

Interventional Study ◽

Cross Sectional ◽

Haematopoietic Cell ◽

Age Related ◽

Randomised Controlled

AbstractMetabolic syndrome (MetS) is associated with cardiovascular disease in the general population and is also a potential cardiovascular risk factor in survivors of haematopoietic cell transplantation (HCT). We report an EBMT cross-sectional, multi-centre, non-interventional study of 453 adult HCT patients surviving a minimum of 2 years post-transplant attending routine follow-up HCT and/or late effects clinics in 9 centres. The overall prevalence of MetS was 37.5% rising to 53% in patients >50 years of age at follow-up. There were no differences in rates of MetS between autologous and allogeneic HCT survivors, nor any association with graft-versus-host disease (GvHD) or current immunosuppressant therapy. Notably, there was a significantly higher occurrence of cardiovascular events (CVE, defined as cerebrovascular accident, coronary heart disease or peripheral vascular disease) in those with MetS than in those without MetS (26.7% versus 9%, p < 0.001, OR 3.69, 95% CI 2.09–6.54, p < 0.001), and, as expected, MetS and CVE were age-related. Unexpectedly, CVE were associated with occurrence of second malignancy. Screening for and management of MetS should be integrated within routine HCT long-term follow-up care for both allogeneic and autologous HCT survivors. Further research is warranted, including randomised controlled trials of interventional strategies and mechanistic studies of cardiovascular risk in HCT survivors.

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Does physical activity lower the risk for metabolic syndrome: a longitudinal study of physically active older women

BMC Geriatrics ◽

10.1186/s12877-020-01952-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Izabela Zając-Gawlak ◽

Jana Pelclová ◽

Dorota Groffik ◽

Miroslava Přidalová ◽

Agnieszka Nawrat-Szołtysik ◽

...

Keyword(s):

Physical Activity ◽

Metabolic Syndrome ◽

Longitudinal Study ◽

Older Women ◽

Repeated Measures ◽

Cross Sectional ◽

Physically Active ◽

High Density Cholesterol

Abstract Background The associations between physical activity and metabolic syndrome (MetS) have been mainly found in cross-sectional studies. The aim of this longitudinal study was to examine the relationship between meeting step-based guidelines and changes in the risk of metabolic syndrome. Methods This study included data from older women (baseline age 62.9 ± 4.3 years) from a 7-year longitudinal study in Central Europe. At baseline and follow-up, physical activity was measured by an accelerometer, and the risk for MetS was assessed according to the NCEP-ATP III criteria. In 59 women, multivariate repeated measures ANOVA was used to compare differences in changes in the risk of MetS in groups based on meeting step-based guidelines (10,000 steps/day and 9000 steps/day for women aged <65 and ≥ 65 years, respectively). Results Over 7 years, steps/day increased from 10,944 ± 3560 to 11,652 ± 4865, and the risk of MetS decreased from 41 to 12% in our sample. Women who longitudinally met step-based guidelines had a significantly higher mean concentration of high-density cholesterol (HDL-C) (64.5 and 80.3 mg/dL at baseline and follow-up, respectively) and a lower concentration of triglycerides (TGs) (158.3 and 123.8 mg/dL at baseline and follow-up, respectively) at follow-up compared to baseline. Moreover, women who increased their daily steps over 7 years to the recommended steps/day value significantly decreased the concentration of TGs (158.3 mg/dL and 123.8 mg/dL at baseline and follow-up, respectively). Conclusions Our study might suggest that the long-term meeting of step-based guidelines or an increase in daily steps/day to achieve the recommended value could be related to a lower risk of MetS, specifically in concentrations of HDL-C and TG. These findings may help in designing interventions aiming to decrease the risk of MetS in older women.

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The effectiveness of intensive and traditional cardiac rehabilitation programs for improving cardiometabolic outcomes in patients with cardiovascular disease

European Heart Journal ◽

10.1093/ehjci/ehaa946.3113 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

I Swiatkiewicz ◽

L De Fazio ◽

V Mazzilli ◽

S Di Somma ◽

P.R Taub

Keyword(s):

Cardiovascular Disease ◽

Waist Circumference ◽

Cardiac Rehabilitation ◽

Visceral Fat ◽

Hemodynamic Parameters ◽

Supervised Exercise ◽

Long Term Follow Up ◽

Metabolic Biomarkers

Abstract Background Cardiac rehabilitation (CR) is integral to the optimal medical management of patients with cardiovascular disease (CVD). Purpose This study aims at evaluating the effectiveness of traditional (TCR) and intensive (ICR) CR programs for improving cardiometabolic outcomes of patients with CVD. Methods The study is based on retro-prospective review of hospital medical data of patients enrolled in TCR or ICR programs. TCR involved 36 supervised exercise and educational sessions (1 hr) 3 days/week over 12 weeks. ICR included a structured class model (4 hrs) twice a week over 9 weeks (a total of 18 sessions, 72 hrs). The ICR sessions were provided by a multidisciplinary team and consisted of supervised exercise, plant-based diet, nutrition education, stress management, and social support. The comparative analyses of numerous biomarkers and hemodynamic parameters before and after CR program for both groups were performed. The occurrence of major cardiac adverse events (MACE) in the long-term follow-up was assessed. Results In total, 314 patients (213 in TCR and 101 in ICR) were enrolled. Mean treatment adherence was 78% (97% in ICR vs 68% in TCR, p=0.000). Mean follow-up for MACE was 12.6 months (13.2 in ICR vs 12 in TCR, p=0.038). No differences were observed between TCR and ICR in patient age (66 years on average) and gender (68–73% of males). Coronary heart disease, hypertension, and heart failure (HF) were the most frequent CVDs in both TCR and ICR groups (88% vs 95%, p=0.044, 75% vs 66%, p=0.104, 48% vs 25%, p=0.000, respectively). There was no significant difference in incidence of diabetes and chronic kidney disease, and pharmacotherapy between groups. TCR program resulted in significant improvements in body and visceral fat, waist circumference, and exercise capacity whereas no significant changes were observed in weight, body mass index (BMI), blood pressure (BP), heart rate (HR), and lipids levels. ICR resulted in significant improvements in most metabolic biomarkers (weight, BMI, body and visceral fat, waist circumference), hemodynamic parameters (exercise capacity, BP) and lipid biomarkers levels (total cholesterol, low-density and non-high-density-lipoprotein cholesterol). Compared with TCR, ICR resulted in more significant improvements of metabolic biomarkers such as weight (p<0.001), BMI (p<0.001), body fat (p<0.05) and waist circumference (p=0.002), and hemodynamic parameters such as diastolic BP (p<001) and HR (p=0.05). A trend towards lower incidence of MACE (all-cause death, non-fatal myocardial infarction, unstable angina, and revascularisation) with significantly lower rates of hospitalisation for HF (2 vs 24, p=0.005) in the long-term follow-up was observed in ICR compared with TCR group. Conclusion Intense and more comprehensive lifestyle modification provided by the ICR program had greater impact on improving cardiometabolic outcomes including long-term MACE compared to the TCR program. Funding Acknowledgement Type of funding source: None

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Risk factors for the presence and development of Familial Dysbetalipoproteinemia in subjects from the general population with an APOE2E2 genotype

European Heart Journal ◽

10.1093/ehjci/ehaa946.2982 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

B.E Heidemann ◽

F.J Wolters ◽

M Kavousi ◽

E.G Gruppen ◽

R.P.F Dullaart ◽

...

Keyword(s):

Insulin Resistance ◽

Cardiovascular Disease ◽

Waist Circumference ◽

Ldl Receptor ◽

Lipid Lowering ◽

Funding Source ◽

Cross Sectional ◽

Lipid Phenotype ◽

Familial Dysbetalipoproteinemia

Abstract Background Subjects who carry one or two ɛ2 alleles of the APOE gene are protected from cardiovascular disease due to low LDL-cholesterol levels. However, 10–18% of ɛ2 homozygotes (ɛ2ɛ2) develop Familial Dysbetalipoproteinemia (FD), which is characterized by extensive remnant lipoprotein accumulation, making it a good model to study the effect of remnants on atherosclerosis and cardiovascular disease. Important causal factors for FD, or an “FD like phenotype” in ɛ2 heterozygotes (ɛ2ɛ3), are thought to be adiposity and insulin resistance. However, to date this relation was only evaluated in cross-sectional studies. Purpose To evaluate the cross-sectional and longitudinal association of adiposity and insulin resistance on the presence and development of FD in ɛ2ɛ2 or an “FD-like” phenotype in ɛ2ɛ3 subjects. Methods For this study we included 18042 subjects with an APOE measurement from two Dutch population-based cohorts; the PREVEND cohort (follow-up 4.1 (interquartile range (IQR) 4.0–4.4) years) and the Rotterdam Study (follow-up 10.1 (IQR 5.6–10.8) years). Subjects with an ɛ3ɛ3 genotype (n=10391) and ɛ4 carriers were excluded (n=5265). FD and “FD like” phenotype were defined as triglyceride levels >3 mmol/l or use of lipid lowering medication. Logistic regression models were used to evaluate the effect of age, sex, BMI, waist circumference, type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS) on FD lipid phenotype. Changes in adiposity measures and insulin resistance between baseline and follow-up were compared in subjects with and without development of FD at follow-up. Results In total, 2386 subjects were included of whom 118 participants had ɛ2ɛ2 and 2268 had ɛ2ɛ3 of whom 68% completed a follow-up visit. Subjects mean age was 59±14 years and 44% were male. In ɛ2ɛ2 subjects, 19% (n=23) had FD at baseline and 16% (n=11) developed FD during follow-up. In ɛ2ɛ3 subjects 13% (n=305) had an “FD like” phenotype at baseline and 11% (n=146) at follow-up. Cross-sectional determinants for the presence of an FD or “FD like” phenotype at baseline were male sex, BMI, waist circumference and non-lipid MetS criteria. In ɛ2ɛ2 subjects who developed FD during follow-up, markers of adiposity and insulin resistance did not change compared to baseline. However, these FD patients more often had adiposity (BMI, weight and waist circumference) and T2DM at baseline, compared to those and who did not developed FD. Conclusions These results show for the first time that adiposity and insulin resistance are important risk markers for future development of FD or “FD like” phenotype in ɛ2ɛ2- and ɛ2ɛ3 subjects. The increased susceptibility of ɛ2 carriers for development of an FD lipid phenotype by adiposity and insulin resistance might be due to impaired remnant clearance consequent to decreased binding affinity of APOɛ2 to the LDL-receptor in combination with degradation of the heparan sulfate receptor by insulin resistance (mediated by sulfatase 2 activation). Odds Ratios for FD lipid phenotype Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): UMC Utrecht; Erasmus MC; UMC Groningen

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Predictors of Metabolic Syndrome in Participants of a Cardiac Rehabilitation Program

ISRN Cardiology ◽

10.5402/2012/736314 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Alejandra Farias Godoy ◽

Andrew Ignaszewski ◽

Jiri Frohlich ◽

Scott A. Lear

Keyword(s):

Metabolic Syndrome ◽

Waist Circumference ◽

Cardiac Rehabilitation ◽

Cardiovascular Events ◽

Rehabilitation Program ◽

Program Completion ◽

Cardiac Rehabilitation Program ◽

Logistic Regression Models

Metabolic syndrome increases the risk of all-cause mortality, cardiovascular mortality and cardiovascular events in patients with cardiovascular disease (CVD). This study assessed the predictors of metabolic syndrome, both its incidence and resolution in a cohort of cardiac rehabilitation program graduates. Methods. A total of 154 and 80 participants without and with metabolic syndrome respectively were followed for 48 months. Anthropometric measurements, metabolic risk factors, and quality of life were assessed at baseline and at 48 months. Logistic regression models were used to assess the predictors of metabolic syndrome onset and resolution. Results. Increasing waist circumference (OR 1.175, P≤0.001) was an independent predictor for incident metabolic syndrome (R2 for model = 0.46). Increasing waist circumference (OR 1.234, P≤0.001), decreasing HDL-C (OR 0.027, P=0.005), and increasing triglycerides (OR 3.005, P=0.003) were predictors of metabolic syndrome resolution. Conclusion. Patients with CVD that further develop metabolic syndrome are particularly susceptible for the cascade of cardiovascular events and mortality. Increasing waist circumference confers a higher risk for future onset of metabolic syndrome in this group of patients. They will require closer follow-up and should be targeted for further prevention strategies after cardiac rehabilitation program completion.

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NOAC Therapy Is Also Effective and Safe in Patients Older Than 80 Years — Results of the Prospective Dresden NOAC Registry (NCT01588119)

Blood ◽

10.1182/blood-2018-99-118081 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 422-422

Author(s):

Jan Beyer-Westendorf ◽

Luise Tittl ◽

Christiane Naue ◽

Sandra Marten

Keyword(s):

Cardiovascular Events ◽

Research Funding ◽

Composite Endpoint ◽

Systemic Embolism ◽

Old Patients ◽

Very Old ◽

Fatal Bleeding ◽

Very Old Patients

Abstract Background: Non-vitamin-K-antagonist oral anticoagulants (NOACs) have rapidly become a cornerstone in anticoagulant therapy. However, anticoagulated patients older than 80 years represent an especially challenging population, since their thromboembolic and bleeding risks are excessively high and chronic kidney disease is common, making treatment decisions even more complicated. As a consequence, long-term safety data for this specific population are needed. Patients and methods: Using data from DRESDEN NOAC, a prospective regional registry in Germany in which patients with oral anticoagulation undergo prospective follow-up (FU) by quarterly phone interviews, we assessed rates of thromboembolic and bleeding outcomes in patients older than 80 years, based on centrally adjudicated events using standard outcome definitions. Results: Until 30th November 2017, 3984 patients were enrolled into the registry (53% male, mean age 70.2 years), including 935 patients aged ≥ 80 years (487 [52.1%] received rivaroxaban, 198 [21.2%] apixaban, 165 [17.6%] edoxaban and 85 [9.1%] dabigatran, respectively). Indication for anticoagulant therapy was atrial fibrillation (AF) in 752 (80.4%) cases, venous thromboembolism (VTE) in 179 (19.1%), and other indications in 4 (0.4%) cases. This subset of patients had a mean age of 84.2 years (range 80-100y) and 406 (43.4%) patients were male (Table 1). During a mean follow-up of 970.7 ± 642.2 days (mean NOAC exposure 815.3 ± 644.5 days) an intention-to-treat (all events counted) analysis of all very old patients demonstrated an event rate for the composite endpoint of stroke, TIA, systemic embolism or VTE of 1.0/100 patient-years (95% CI 0.8 - 1.2). In AF patients, the rate for stroke, TIA, systemic embolism was 1.0/100 patient-years (95% CI 0.8 - 1.2) and in VTE patients, the rate for recurrent DVT or PE in VTE patients was 0.4/100 patient-years (95% CI 0.2 - 0.7). In the on-treatment analysis (only on-treatment events counted), the corresponding event rates were 0.7/100 patient-years (95% CI 0.5 - 0.9) for the composite endpoint, 0.7/100 patient-years (95% CI 0.5 - 0.9) for stroke, TIA, systemic embolism in AF patients, and 0.1/100 patient-years (95% CI 0.01 - 0.3) for recurrent VTE in VTE patients, respectively. The overall rate of ISTH major bleeding was 1.0/100 patient-years (95% CI 0.8 - 1.2), with numerically higher rates in SPAF patients (1.2/100 patient-years; 95% CI 0.9 - 1.5) compared to VTE patients (0.4/100 patient-years; 95% CI 0.2 - 0.7). 255 patients died during FU (2.2/100 patient-years; 95% CI 2.0 - 2.5), of which 120 deaths occurred during or within 3 days after last intake of NOAC (1.3/100 patient-years; 95% CI 1.1 - 1.6). Most common causes of death were fatal cardiovascular event (n= 86; consisting of 20 cases of acute coronary syndrome, 19 ischaemic strokes, 17 VTE, 2 systemic embolism and 123 cases of other cardiovascular deaths such as worsening of chronic heart failure, or unexplained deaths ruled as potentially related to cardiovascular events) and age related death (n= 79), followed by sepsis/infection (n= 40), terminal malignant disease (n= 26), fatal bleeding (n= 11) and other causes (n= 13). Overall, after 1800 days of FU, approximately 80% of this very old population were outcome-free survivors, as indicated by the Kaplan Meier curve (figure1). Conclusions: During long-term FU of more than 2.5 years, this very old population of NOAC recipients demonstrated low rates of cardiovascular or major bleeding complications during active NOAC therapy. Approximately one quarter of the study population died during follow-up, with cardiovascular events being the leading cause of death. Only 11 fatal bleeding events were observed; however, most of the 58 fatal thromboembolic events occurred after anticoagulation was discontinued. This indicates that continued anticoagulation with NOACs may result in a beneficial risk-benefit ratio also in very old patients. Disclosures Beyer-Westendorf: Bayer: Honoraria, Research Funding; Boehringer-Ingelheim: Honoraria, Research Funding; Pfizer: Honoraria, Research Funding; Daiichi Sankyo: Honoraria, Research Funding. Marten:Bayer: Honoraria; Daiichi Sankyo: Honoraria.

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Assessment of Long Term Metabolic Effects of Atypical Antipsychotics in Schizophrenia Patients

Romanian Journal of Diabetes Nutrition and Metabolic Diseases ◽

10.2478/rjdnmd-2019-0028 ◽

2019 ◽

Vol 26 (3) ◽

pp. 267-277 ◽

Cited By ~ 1

Author(s):

Nicolae-Marius Cason ◽

Petru Aurel Babeş ◽

Enikő Béres ◽

Katalin Babeş

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Logistic Regression ◽

Chronic Schizophrenia ◽

Metabolic Effects ◽

Base Line ◽

The Metabolic Syndrome ◽

Independent Risk Factors

Abstract Background and aims. Patients with schizophrenia have a shorter life expectancy than normal population partially due to the metabolic side effects of antipsychotic treatment. The aim of this study is to evaluate the long-term evolution of the metabolic syndrome in chronic schizophrenia patients on fixed second generation antipsychotics (SGA). Material and method. The components of metabolic syndrome were evaluated repeatedly in a minimum 6 months and maximum 2 years follow-up period. The presence of metabolic syndrome (MetS) and metabolic risk scores (cMetS) according to National Cholesterol Education Program Adult Treatment Panel III were calculated and compared in time. In the prevalence, incidence and normalization logistic regression studies included all the known risk factors together with the follow-up period. Finally, all these rates were compared depending on the type of SGA. Results. Only cMetS, waist circumference and diastolic blood pressure presented significant increase in the follow-up period which was in average 385.5 days. The prevalence of MetS at base-line was 39.4%, which increased to 48.5% after the follow-up period. The calculated incidence of 30% was associated with a 23.1% rate of normalization. Logistic regression studies revealed as independent risk factors the age and base-line cMetS/weight for incidence and for normalization. In the aripiprazole group the normalization rate exceeded the incidence rate (33.3% vs 20%). Conclusions. The results emphasize the highly dynamic character of the metabolic syndrome even in chronic schizophrenia patients with fixed SGA regimen. The normalization of MetS is a possibility that should not ignored. The age and weight continue to remain independent risk factors, thus close monitoring in elderly and strict weight control plan are necessary. Aripiprazole showed better safety profile, but more extensive studies are required for definitive conclusions.

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Theoretical and Methodological Problems of a 10-Year Follow-Up Program Evaluation Study

European Journal of Psychological Assessment ◽

10.1027//1015-5759.18.3.229 ◽

2002 ◽

Vol 18 (3) ◽

pp. 229-241 ◽

Cited By ~ 6

Author(s):

Kurt A. Heller ◽

Ralph Reimann

Keyword(s):

Program Evaluation ◽

Evaluation Studies ◽

Evaluation Study ◽

Control Groups ◽

Cross Sectional ◽

Long Term Study ◽

Partial Inclusion ◽

Methodological Problems

Summary In this paper, conceptual and methodological problems of school program evaluation are discussed. The data were collected in conjunction with a 10 year cross-sectional/longitudinal investigation with partial inclusion of control groups. The experiences and conclusions resulting from this long-term study are revealing not only from the vantage point of the scientific evaluation of new scholastic models, but are also valuable for program evaluation studies in general, particularly in the field of gifted education.

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