1
|
Veldman MHJ, van der Aa HPA, Knoop H, Bode C, Hulshof CTJ, van der Ham L, van Rens GHMB, Heymans MW, van Nispen RMA. Usability and feasibility of E-nergEYEze: a blended vision-specific E-health based cognitive behavioral therapy and self-management intervention to reduce fatigue in adults with visual impairment. BMC Health Serv Res 2023; 23:1271. [PMID: 37974261 PMCID: PMC10655361 DOI: 10.1186/s12913-023-10193-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 10/21/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Over 50% of adults with visual impairment experience severe fatigue. Therefore, we developed a guided E-health intervention based on cognitive behavioral therapy and self-management to reduce fatigue in this population. This pilot study evaluated the usability, feasibility, fidelity and potential effectiveness of E-nergEYEze. METHODS E-nergEYEze was developed by a design team and customized by conducting a pilot study using an iterative development strategy. The intervention was first tested in a usability study among adults with visual impairment (n = 5). Participants were asked to think-aloud while exploring the intervention features and a semi-structured interview was performed afterwards. Subsequently, the enhanced intervention was tested in a feasibility study. Adults with visual impairment and severe fatigue (n = 10) followed the intervention partially with guidance from a social worker and one-time computer trainer support. Fatigue severity (Checklist Individual Strength), fatigue impact (Modified Fatigue Impact Scale) and cognitive behavioral therapy skills (Competencies of Cognitive Therapy Scale-Self Report) were measured at baseline and at three months follow-up and analyzed with the Wilcoxon signed-rank test. The intervention was evaluated through evaluation forms. RESULTS The usability study resulted in adjustments to content and lay-out with regard to optically shortened text sentences, separate pages for information and assignments with one read-aloud audio and an additional descriptive explanation of page content. Digital challenges were overcome with mandatory computer training and e-platform modifications. The feasibility study showed a positive trend in reducing fatigue severity (Z -6.108; P < .001; SD 8.4), impact of fatigue (Z - 4.451; P < .001; SD 11.4) and cognitive behavioral therapy skills (Z -2.278; P = .023; SD 19.3). Participants gave useful feedback regarding accessibility, content and guidance, with an overall positive experience. The intervention was rated with a median score of 8 (range 7-10). CONCLUSION We developed, evaluated and optimized E-nergEYEze by applying a user-centered and iterative approach. E-nergEYEze showed a promising trend to reduce fatigue severity and impact of fatigue and to increase cognitive behavioral therapy skills. The study methods were feasible and the fidelity of the intervention protocol was suitable. Performing a randomized controlled trial is warranted to give insight into whether E-nergEYEze is cost-effective in reducing severe fatigue in adults with visual impairment. TRIAL REGISTRATION International Clinical Trial Registry Platform: NL7764. Date registered: 28-05-2019.
Collapse
Affiliation(s)
- M H J Veldman
- Ophthalmology, Amsterdam UMC, location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Amsterdam Public Health, Quality of Care, Mental Health, Aging and Later Life, Amsterdam, The Netherlands.
| | - H P A van der Aa
- Ophthalmology, Amsterdam UMC, location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Mental Health, Aging and Later Life, Amsterdam, The Netherlands
| | - H Knoop
- Departments of Medical Psychology, Amsterdam Public Health research institute, Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - C Bode
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - C T J Hulshof
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - L van der Ham
- Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - G H M B van Rens
- Ophthalmology, Amsterdam UMC, location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - M W Heymans
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers Boelelaan, Amsterdam, The Netherlands
| | - R M A van Nispen
- Ophthalmology, Amsterdam UMC, location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Mental Health, Aging and Later Life, Amsterdam, The Netherlands
| |
Collapse
|
2
|
Eertink JJ, Zwezerijnen GJC, Heymans MW, Pieplenbosch S, Wiegers SE, Dührsen U, Hüttmann A, Kurch L, Hanoun C, Lugtenburg PJ, Barrington SF, Mikhaeel NG, Ceriani L, Zucca E, Czibor S, Györke T, Chamuleau MED, Hoekstra OS, de Vet HCW, Boellaard R, Zijlstra JM. Baseline PET radiomics outperforms the IPI risk score for prediction of outcome in diffuse large B-cell lymphoma. Blood 2023; 141:3055-3064. [PMID: 37001036 PMCID: PMC10646814 DOI: 10.1182/blood.2022018558] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/31/2023] [Accepted: 02/27/2023] [Indexed: 04/03/2023] Open
Abstract
The objective of this study is to externally validate the clinical positron emission tomography (PET) model developed in the HOVON-84 trial and to compare the model performance of our clinical PET model using the international prognostic index (IPI). In total, 1195 patients with diffuse large B-cell lymphoma (DLBCL) were included in the study. Data of 887 patients from 6 studies were used as external validation data sets. The primary outcomes were 2-year progression-free survival (PFS) and 2-year time to progression (TTP). The metabolic tumor volume (MTV), maximum distance between the largest lesion and another lesion (Dmaxbulk), and peak standardized uptake value (SUVpeak) were extracted. The predictive values of the IPI and clinical PET model (MTV, Dmaxbulk, SUVpeak, performance status, and age) were tested. Model performance was assessed using the area under the curve (AUC), and diagnostic performance, using the positive predictive value (PPV). The IPI yielded an AUC of 0.62. The clinical PET model yielded a significantly higher AUC of 0.71 (P < .001). Patients with high-risk IPI had a 2-year PFS of 61.4% vs 51.9% for those with high-risk clinical PET, with an increase in PPV from 35.5% to 49.1%, respectively. A total of 66.4% of patients with high-risk IPI were free from progression or relapse vs 55.5% of patients with high-risk clinical PET scores, with an increased PPV from 33.7% to 44.6%, respectively. The clinical PET model remained predictive of outcome in 6 independent first-line DLBCL studies, and had higher model performance than the currently used IPI in all studies.
Collapse
Affiliation(s)
- J. J. Eertink
- Hematology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - G. J. C. Zwezerijnen
- Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Radiology and Nuclear Medicine, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M. W. Heymans
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Methodology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - S. Pieplenbosch
- Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Radiology and Nuclear Medicine, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - S. E. Wiegers
- Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Radiology and Nuclear Medicine, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - U. Dührsen
- Department of Hematology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - A. Hüttmann
- Department of Hematology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - L. Kurch
- Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Leipzig, Leipzig, Germany
| | - C. Hanoun
- Department of Hematology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - P. J. Lugtenburg
- Department of Hematology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - S. F. Barrington
- King’s College London and Guy’s and St Thomas’ PET Centre, School of Biomedical Engineering and Imaging Sciences, King’s Health Partners, King’s College London, London, United Kingdom
| | - N. G. Mikhaeel
- Department of Clinical Oncology, Guy’s Cancer Centre and School of Cancer and Pharmaceutical Sciences, King’s College London University, London, United Kingdom
| | - L. Ceriani
- Department of Nuclear Medicine and PET/CT Centre, Imaging Institute of Southern Switzerland, Università della Svizzera Italiana, Bellinzona, Switzerland
- SAKK Swiss Group for Clinical Cancer Research, Bern, Switzerland
| | - E. Zucca
- SAKK Swiss Group for Clinical Cancer Research, Bern, Switzerland
- Department of Oncology, IOSI - Oncology Institute of Southern Switzerland, Università della Svizzera Italiana, Bellinzona, Switzerland
| | - S. Czibor
- Department of Nuclear Medicine, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - T. Györke
- Department of Nuclear Medicine, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - M. E. D. Chamuleau
- Hematology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - O. S. Hoekstra
- Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Radiology and Nuclear Medicine, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - H. C. W. de Vet
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Methodology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - R. Boellaard
- Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Radiology and Nuclear Medicine, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - J. M. Zijlstra
- Hematology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - PETRA Consortium
- Hematology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Radiology and Nuclear Medicine, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Methodology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Hematology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Leipzig, Leipzig, Germany
- Department of Hematology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
- King’s College London and Guy’s and St Thomas’ PET Centre, School of Biomedical Engineering and Imaging Sciences, King’s Health Partners, King’s College London, London, United Kingdom
- Department of Clinical Oncology, Guy’s Cancer Centre and School of Cancer and Pharmaceutical Sciences, King’s College London University, London, United Kingdom
- Department of Nuclear Medicine and PET/CT Centre, Imaging Institute of Southern Switzerland, Università della Svizzera Italiana, Bellinzona, Switzerland
- SAKK Swiss Group for Clinical Cancer Research, Bern, Switzerland
- Department of Oncology, IOSI - Oncology Institute of Southern Switzerland, Università della Svizzera Italiana, Bellinzona, Switzerland
- Department of Nuclear Medicine, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| |
Collapse
|
3
|
Knoop J, van Lankveld W, Beijer L, Geerdink FJB, Heymans MW, Hoogeboom TJ, Hoppenbrouwers S, van Overmeeren E, Soer R, Veenhof C, Vissers KCP, van der Wees PJ, Sappelli M, Staal JB. Development and internal validation of a machine learning prediction model for low back pain non-recovery in patients with an acute episode consulting a physiotherapist in primary care. BMC Musculoskelet Disord 2022; 23:834. [PMID: 36057717 PMCID: PMC9440317 DOI: 10.1186/s12891-022-05718-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/21/2022] [Indexed: 11/17/2022] Open
Abstract
Background While low back pain occurs in nearly everybody and is the leading cause of disability worldwide, we lack instruments to accurately predict persistence of acute low back pain. We aimed to develop and internally validate a machine learning model predicting non-recovery in acute low back pain and to compare this with current practice and ‘traditional’ prediction modeling. Methods Prognostic cohort-study in primary care physiotherapy. Patients (n = 247) with acute low back pain (≤ one month) consulting physiotherapists were included. Candidate predictors were assessed by questionnaire at baseline and (to capture early recovery) after one and two weeks. Primary outcome was non-recovery after three months, defined as at least mild pain (Numeric Rating Scale > 2/10). Machine learning models to predict non-recovery were developed and internally validated, and compared with two current practices in physiotherapy (STarT Back tool and physiotherapists’ expectation) and ‘traditional’ logistic regression analysis. Results Forty-seven percent of the participants did not recover at three months. The best performing machine learning model showed acceptable predictive performance (area under the curve: 0.66). Although this was no better than a’traditional’ logistic regression model, it outperformed current practice. Conclusions We developed two prognostic models containing partially different predictors, with acceptable performance for predicting (non-)recovery in patients with acute LBP, which was better than current practice. Our prognostic models have the potential of integration in a clinical decision support system to facilitate data-driven, personalized treatment of acute low back pain, but needs external validation first. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05718-7.
Collapse
Affiliation(s)
- J Knoop
- Musculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, Netherlands.
| | - W van Lankveld
- Musculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, Netherlands
| | - L Beijer
- Musculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, Netherlands.,Research and Innovation Department, Sint Maartenskliniek, Nijmegen, Netherlands
| | - F J B Geerdink
- Research Group Smart Health, Saxion University of Applied Sciences, Enschede, Netherlands
| | - M W Heymans
- Department of Epidemiology and Data Science, Amsterdam UMC, Amsterdam, Netherlands
| | - T J Hoogeboom
- Radboud Institute for Health Sciences, Radboud University Medical Centre, IQ Healthcare, Nijmegen, Netherlands
| | - S Hoppenbrouwers
- Academy of IT and Mediadesign, Data and Knowledge Engineering Research Group, HAN University of Applied Sciences, Nijmegen, Netherlands.,Institute for Computing and Information Sciences, Radboud University, Nijmegen, Netherlands
| | - E van Overmeeren
- Royal Dutch Society for Physical Therapy, Amersfoort, Netherlands
| | - R Soer
- Research Group Smart Health, Saxion University of Applied Sciences, Enschede, Netherlands.,University of Groningen, University Medical Center Groningen, Groningen Pain Center, Groningen, Netherlands
| | - C Veenhof
- Department of Rehabilitation, Physiotherapy Science and Sport, University Medical Center Utrecht, Utrecht, Netherlands
| | - K C P Vissers
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - P J van der Wees
- Radboud Institute for Health Sciences, Radboud University Medical Centre, IQ Healthcare, Nijmegen, Netherlands
| | - M Sappelli
- Academy of IT and Mediadesign, Data and Knowledge Engineering Research Group, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - J B Staal
- Musculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, Netherlands.,Radboud Institute for Health Sciences, Radboud University Medical Centre, IQ Healthcare, Nijmegen, Netherlands
| |
Collapse
|
4
|
Panken AM, Heymans MW. A simple pooling method for variable selection in multiply imputed datasets outperformed complex methods. BMC Med Res Methodol 2022; 22:214. [PMID: 35927610 PMCID: PMC9351113 DOI: 10.1186/s12874-022-01693-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 07/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND For the development of prognostic models, after multiple imputation, variable selection is advised to be applied from the pooled model. The aim of this study is to evaluate by using a simulation study and practical data example the performance of four different pooling methods for variable selection in multiple imputed datasets. These methods are the D1, D2, D3 and recently extended Median-P-Rule (MPR) for categorical, dichotomous, and continuous variables in logistic regression models. METHODS Four datasets (n = 200 and n = 500), with 9 variables and correlations of respectively 0.2 and 0.6 between these variables, were simulated. These datasets included 2 categorical and 2 continuous variables with 20% missing at random data. Multiple Imputation (m = 5) was applied, and the four methods were compared with selection from the full model (without missing data). The same analyzes were repeated in five multiply imputed real-world datasets (NHANES) (m = 5, p = 0.05, N = 250/300/400/500/1000). RESULTS In the simulated datasets, the differences between the pooling methods were most evident in the smaller datasets. The MPR performed equal to all other pooling methods for the selection frequency, as well as for the P-values of the continuous and dichotomous variables, however the MPR performed consistently better for pooling and selecting categorical variables in multiply imputed datasets and also regarding the stability of the selected prognostic models. Analyzes in the NHANES-dataset showed that all methods mostly selected the same models. Compared to each other however, the D2-method seemed to be the least sensitive and the MPR the most sensitive, most simple, and easy method to apply. CONCLUSIONS Considering that MPR is the most simple and easy pooling method to use for epidemiologists and applied researchers, we carefully recommend using the MPR-method to pool categorical variables with more than two levels after Multiple Imputation in combination with Backward Selection-procedures (BWS). Because MPR never performed worse than the other methods in continuous and dichotomous variables we also advice to use MPR in these types of variables.
Collapse
Affiliation(s)
- A M Panken
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands. .,Physical Therapy Practice Panken, Roermond, The Netherlands.
| | - M W Heymans
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| |
Collapse
|
5
|
Balvert SCE, Milders MV, Bosmans JE, Heymans MW, van Bommel S, Dröes RM, Scherder EJA. The MOMANT study, a caregiver support programme with activities at home for people with dementia: a study protocol of a randomised controlled trial. BMC Geriatr 2022; 22:295. [PMID: 35392818 PMCID: PMC8991890 DOI: 10.1186/s12877-022-02930-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/11/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Because of the expected increase in the number of people with dementia, and the associated social and economic costs, there is an urgent need to develop effective and cost-effective care for people with dementia and their caregivers. The intervention proposed here combines two approaches to caregiver support that have shown to be effective in empowering caregivers, i.e., multiple components for caregiver support and actively engaging caregivers to involve the person with dementia in activities at home. The aim is to investigate whether the intervention is effective in improving quality of life in the caregiver and the person with dementia. A further aim will be to investigate whether this intervention can improve caregivers' feeling of competence, experience of caregiving, and mood. METHODS The study design is a pragmatic, cluster randomised controlled trial with cost-effectiveness analysis. The study participants are informal caregivers and home-living persons with dementia for whom they care, recruited in various regions in the Netherlands. The trial will compare outcomes in two groups of participants: 85 dyads who receive the intervention, and 85 dyads who receive care as usual. The intervention is a caregiver support training that is manual based and consists of 6 group sessions over 2 months. Training takes place in small groups of caregivers led by a health care professional presented at dementia day care centres. Randomisation occurs at the level of the day care centre. Participants are assessed on the outcome measures at baseline, prior to the intervention, and at 3 and 6 months after baseline. DISCUSSION The study will provide insight into effectiveness and cost-effectiveness of an intervention that has not previously been evaluated or implemented in the Netherlands. The intervention potentially adds to the effective support options for informal caregivers of people with dementia without greatly increasing the workload for health- or social care professionals. TRIAL REGISTRATION The trial is registered at the Dutch Trial Register at NTR6643 ; August 22nd, 2017.
Collapse
Affiliation(s)
- S C E Balvert
- Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - M V Milders
- Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands
| | - J E Bosmans
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - M W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, the Netherlands
| | - S van Bommel
- Management & Support, Stadionweg 53HS, 1077 RZ, Amsterdam, the Netherlands
| | - R-M Dröes
- Department of Psychiatry, Department of Research and Innovation, Amsterdam University Medical Centers, Location VU University Medical Center, GGZ inGeest, Amsterdam, the Netherlands
| | - E J A Scherder
- Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands
| |
Collapse
|
6
|
Noorduyn JCA, Teuwen MMH, van de Graaf VA, Willigenburg NW, Schavemaker M, van Dijk R, Scholten-Peeters GGM, Heymans MW, Coppieters MW, Poolman RW. In patients eligible for meniscal surgery who first receive physical therapy, multivariable prognostic models cannot predict who will eventually undergo surgery. Knee Surg Sports Traumatol Arthrosc 2022; 30:231-238. [PMID: 33550450 PMCID: PMC8800906 DOI: 10.1007/s00167-021-06468-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/20/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Although physical therapy is the recommended treatment in patients over 45 years old with a degenerative meniscal tear, 24% still opt for meniscal surgery. The aim was to identify those patients with a degenerative meniscal tear who will undergo surgery following physical therapy. METHODS The data for this study were generated in the physical therapy arm of the ESCAPE trial, a randomized clinical trial investigating the effectiveness of surgery versus physical therapy in patients of 45-70 years old, with a degenerative meniscal tear. At 6 and 24 months patients were divided into two groups: those who did not undergo surgery, and those who did undergo surgery. Two multivariable prognostic models were developed using candidate predictors that were selected from the list of the patients' baseline variables. A multivariable logistic regression analysis was performed with backward Wald selection and a cut-off of p < 0.157. For both models the performance was assessed and corrected for the models' optimism through an internal validation using bootstrapping technique with 500 repetitions. RESULTS At 6 months, 32/153 patients (20.9%) underwent meniscal surgery following physical therapy. Based on the multivariable regression analysis, patients were more likely to opt for meniscal surgery within 6 months when they had worse knee function, lower education level and a better general physical health status at baseline. At 24 months, 43/153 patients (28.1%) underwent meniscal surgery following physical therapy. Patients were more likely to opt for meniscal surgery within 24 months when they had worse knee function and a lower level of education at baseline at baseline. Both models had a low explained variance (16 and 11%, respectively) and an insufficient predictive accuracy. CONCLUSION Not all patients with degenerative meniscal tears experience beneficial results following physical therapy. The non-responders to physical therapy could not accurately be predicted by our prognostic models. LEVEL OF EVIDENCE III.
Collapse
Affiliation(s)
- Julia C A Noorduyn
- Department of Orthopaedic Surgery, Joint Research, OLVG Amsterdam, Oosterpark 9, 1091 AC, Amsterdam, The Netherlands.
| | - M M H Teuwen
- Department of Orthopaedic Surgery, Joint Research, OLVG Amsterdam, Oosterpark 9, 1091 AC, Amsterdam, The Netherlands
- Department of Orthopaedics, Leiden University Medical Centre, Leiden, The Netherlands
| | - V A van de Graaf
- Department of Orthopaedic Surgery, Joint Research, OLVG Amsterdam, Oosterpark 9, 1091 AC, Amsterdam, The Netherlands
- Department of Orthopeadic surgery, Antonius ziekenhuis, Nieuwegein, The Netherlands
| | - N W Willigenburg
- Department of Orthopaedic Surgery, Joint Research, OLVG Amsterdam, Oosterpark 9, 1091 AC, Amsterdam, The Netherlands
| | - M Schavemaker
- Department of Radiology, Dijklander Ziekenhuis, Hoorn, The Netherlands
| | - R van Dijk
- Department of Radiology, Isala, Zwolle, The Netherlands
| | - G G M Scholten-Peeters
- Faculty of Behavioural and Movement Sciences, Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M W Heymans
- Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands
| | - M W Coppieters
- Faculty of Behavioural and Movement Sciences, Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia
| | - R W Poolman
- Department of Orthopaedic Surgery, Joint Research, OLVG Amsterdam, Oosterpark 9, 1091 AC, Amsterdam, The Netherlands
- Department of Orthopaedics, Leiden University Medical Centre, Leiden, The Netherlands
| |
Collapse
|
7
|
van Oostendorp SE, Smits LJH, Vroom Y, Detering R, Heymans MW, Moons LMG, Tanis PJ, de Graaf EJR, Cunningham C, Denost Q, Kusters M, Tuynman JB. Local recurrence after local excision of early rectal cancer: a meta-analysis of completion TME, adjuvant (chemo)radiation, or no additional treatment. Br J Surg 2020; 107:1719-1730. [PMID: 32936943 PMCID: PMC7692925 DOI: 10.1002/bjs.12040] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/13/2020] [Accepted: 08/10/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The risks of local recurrence and treatment-related morbidity need to be balanced after local excision of early rectal cancer. The aim of this meta-analysis was to determine oncological outcomes after local excision of pT1-2 rectal cancer followed by no additional treatment (NAT), completion total mesorectal excision (cTME) or adjuvant (chemo)radiotherapy (aCRT). METHODS A systematic search was conducted in PubMed, Embase and the Cochrane Library. The primary outcome was local recurrence. Statistical analysis included calculation of the weighted average of proportions. RESULTS Some 73 studies comprising 4674 patients were included in the analysis. Sixty-two evaluated NAT, 13 cTME and 28 aCRT. The local recurrence rate for NAT among low-risk pT1 tumours was 6·7 (95 per cent c.i. 4·8 to 9·3) per cent. There were no local recurrences of low-risk pT1 tumours after cTME or aCRT. The local recurrence rate for high-risk pT1 tumours was 13·6 (8·0 to 22·0) per cent for local excision only, 4·1 (1·7 to 9·4) per cent for cTME and 3·9 (2·0 to 7·5) per cent for aCRT. Local recurrence rates for pT2 tumours were 28·9 (22·3 to 36·4) per cent with NAT, 4 (1 to 13) per cent after cTME and 14·7 (11·2 to 19·0) per cent after aCRT. CONCLUSION There is a substantial risk of local recurrence in patients who receive no additional treatment after local excision, especially those with high-risk pT1 and pT2 rectal cancer. The lowest recurrence risk is provided by cTME; aCRT has outcomes comparable to those of cTME for high-risk pT1 tumours, but shows a higher risk for pT2 tumours.
Collapse
Affiliation(s)
- S E van Oostendorp
- Department of Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Centre Amsterdam, Amsterdam, the Netherlands
| | - L J H Smits
- Department of Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Centre Amsterdam, Amsterdam, the Netherlands
| | - Y Vroom
- Department of Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Centre Amsterdam, Amsterdam, the Netherlands
| | - R Detering
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam, the Netherlands
| | - M W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - L M G Moons
- Department of Gastroenterology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - P J Tanis
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam, the Netherlands
| | - E J R de Graaf
- Department of Surgery, IJsselland Ziekenhuis, Capelle aan den Ijssel, the Netherlands
| | - C Cunningham
- Department of Surgery, Oxford University Hospitals, Oxford, UK
| | - Q Denost
- Department of Surgery, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - M Kusters
- Department of Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Centre Amsterdam, Amsterdam, the Netherlands
| | - J B Tuynman
- Department of Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Centre Amsterdam, Amsterdam, the Netherlands
| |
Collapse
|
8
|
Vollgraff Heidweiller-Schreurs CA, van Osch IR, Heymans MW, Ganzevoort W, Schoonmade LJ, Bax CJ, Mol B, de Groot C, Bossuyt P, de Boer MA. Cerebroplacental ratio in predicting adverse perinatal outcome: a meta-analysis of individual participant data. BJOG 2020; 128:226-235. [PMID: 32363701 PMCID: PMC7818434 DOI: 10.1111/1471-0528.16287] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2020] [Indexed: 12/17/2022]
Abstract
Objective To investigate if cerebroplacental ratio (CPR) adds to the predictive value of umbilical artery pulsatility index (UA PI) alone – standard of practice – for adverse perinatal outcome in singleton pregnancies. Design and setting Meta‐analysis based on individual participant data (IPD). Population or sample Ten centres provided 17 data sets for 21 661 participants, 18 731 of which could be included. Sample sizes per data set ranged from 207 to 9215 individuals. Patient populations varied from uncomplicated to complicated pregnancies. Methods In a collaborative, pooled analysis, we compared the prognostic value of combining CPR with UA PI, versus UA PI only and CPR only, with a one‐stage IPD approach. After multiple imputation of missing values, we used multilevel multivariable logistic regression to develop prediction models. We evaluated the classification performance of all models with receiver operating characteristics analysis. We performed subgroup analyses according to gestational age, birthweight centile and estimated fetal weight centile. Main outcome measures Composite adverse perinatal outcome, defined as perinatal death, caesarean section for fetal distress or neonatal unit admission. Results Adverse outcomes occurred in 3423 (18%) participants. The model with UA PI alone resulted in an area under the curve (AUC) of 0.775 (95% CI 0.709–0.828) and with CPR alone in an AUC of 0.778 (95% CI 0.715–0.831). Addition of CPR to the UA PI model resulted in an increase in the AUC of 0.003 points (0.778, 95% CI 0.714–0.831). These results were consistent across all subgroups. Conclusions Cerebroplacental ratio added no predictive value for adverse perinatal outcome beyond UA PI, when assessing singleton pregnancies, irrespective of gestational age or fetal size. Tweetable abstract Doppler measurement of cerebroplacental ratio in clinical practice has limited added predictive value to umbilical artery alone. Doppler measurement of cerebroplacental ratio in clinical practice has limited added predictive value to umbilical artery alone.
Collapse
Affiliation(s)
- C A Vollgraff Heidweiller-Schreurs
- Department of Obstetrics and Gynaecology, Reproduction and Development, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - I R van Osch
- Department of Obstetrics and Gynaecology, Reproduction and Development, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - W Ganzevoort
- Department of Obstetrics and Gynaecology, Reproduction and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - L J Schoonmade
- Department of Medical Library, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - C J Bax
- Department of Obstetrics and Gynaecology, Reproduction and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Bwj Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Vic., Australia
| | - Cjm de Groot
- Department of Obstetrics and Gynaecology, Reproduction and Development, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pmm Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - M A de Boer
- Department of Obstetrics and Gynaecology, Reproduction and Development, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | |
Collapse
|
9
|
Gorter R, Fox JP, Eekhout I, Heymans MW, Twisk J. Missing item responses in latent growth analysis: Item response theory versus classical test theory. Stat Methods Med Res 2020; 29:996-1014. [PMID: 32338179 DOI: 10.1177/0962280219897706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In medical research, repeated questionnaire data is often used to measure and model latent variables across time. Through a novel imputation method, a direct comparison is made between latent growth analysis under classical test theory and item response theory, while also including effects of missing item responses. For classical test theory and item response theory, by means of a simulation study the effects of item missingness on latent growth parameter estimates are examined given longitudinal item response data. Several missing data mechanisms and conditions are evaluated in the simulation study. The additional effects of missingness on differences in classical test theory- and item response theory-based latent growth analysis are directly assessed by rescaling the multiple imputations. The multiple imputation method is used to generate latent variable and item scores from the posterior predictive distributions to account for missing item responses in observed multilevel binary response data. It is shown that a multivariate probit model, as a novel imputation model, improves the latent growth analysis, when dealing with missing at random (MAR) in classical test theory. The study also shows that the parameter estimates for the latent growth model using item response theory show less bias and have smaller MSE’s compared to the estimates using classical test theory.
Collapse
Affiliation(s)
- R Gorter
- Brain research & Innovation Centre, Ministry of Defence, Utrecht, The Netherlands
| | - J-P Fox
- Department of Research Methodology, Measurement, and Data Analysis, Faculty of Behavioural, Management & Social Sciences, University of Twente, Enschede, The Netherlands
| | - I Eekhout
- TNO Child Health, Netherlands Organization for Applied Scientific Research, Leiden, The Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - M W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Jwr Twisk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| |
Collapse
|
10
|
Panken AM, Staal JB, Heymans MW. Kinesiophobia is not required to predict chronic low back pain in workers: a decision curve analysis. BMC Musculoskelet Disord 2020; 21:163. [PMID: 32164653 PMCID: PMC7068992 DOI: 10.1186/s12891-020-3186-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 03/03/2020] [Indexed: 12/23/2022] Open
Abstract
Background Currently used performance measures for discrimination were not informative to determine the clinical benefit of predictor variables. The purpose was to evaluate if a former relevant predictor, kinesiophobia, remained clinically relevant to predict chronic occupational low back pain (LBP) in the light of a novel discriminative performance measure, Decision Curve Analysis (DCA), using the Net Benefit (NB). Methods Prospective cohort data (n = 170) of two merged randomized trials with workers with LBP on sickleave, treated with Usual Care (UC) were used for the analyses. An existing prediction model for chronic LBP with the variables ‘a clinically relevant change in pain intensity and disability status in the first 3 months’, ‘baseline measured pain intensity’ and ‘kinesiophobia’ was compared with the same model without the variable ‘kinesiophobia’ using the NB and DCA. Results Both prediction models showed an equal performance according to the DCA and NB. Between 10 and 95% probability thresholds of chronic LBP risk, both models were of clinically benefit. There were virtually no differences between both models in the improved classification of true positive (TP) patients. Conclusions This study showed that the variable kinesiophobia, which was originally included in a prediction model for chronic LBP, was not informative to predict chronic LBP by using DCA. DCA and NB have to be used more often to develop clinically beneficial prediction models in workers because they are more sensitive to evaluate the discriminate ability of prediction models.
Collapse
Affiliation(s)
- A M Panken
- Department of Epidemiology and Biostatistics, Amsterdam Public health research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. .,Physical Therapy Practice Panken, Roermond, The Netherlands.
| | - J B Staal
- Han University of applied sciences, Nijmegen, The Netherlands
| | - M W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public health research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
11
|
Abstract
Latent growth models are often used to measure individual trajectories representing change over time. The characteristics of the individual trajectories depend on the variability in the longitudinal outcomes. In many medical and epidemiological studies, the individual health outcomes cannot be observed directly and are indirectly observed through indicators (i.e. items of a questionnaire). An item response theory or a classical test theory measurement model is required, but the choice can influence the latent growth estimates. In this study, under various conditions, this influence is directly assessed by estimating latent growth parameters on a common scale for item response theory and classical test theory using a novel plausible value method in combination with Markov chain Monte Carlo. The latent outcomes are considered missing data and plausible values are generated from the corresponding posterior distribution, separately for item response theory and classical test theory. These plausible values are linearly transformed to a common scale. A Markov chain Monte Carlo method was developed to simultaneously estimate the latent growth and measurement model parameters using this plausible value technique. It is shown that estimated individual trajectories using item response theory, compared to classical test theory to measure outcomes, provide a more detailed description of individual change over time, since item response patterns (item response theory) are more informative about the health measurements than sum scores (classical test theory).
Collapse
Affiliation(s)
- R Gorter
- Brain research & Innovation Centre, Ministry of Defence, Utrecht, The Netherlands
| | - J-P Fox
- Faculty of Behavioural, Management & Social Sciences, Department of Research Methodology, Measurement, and Data Analysis, University of Twente, Enschede, The Netherlands
| | - G Ter Riet
- Department of General Practice, Amsterdam University medical centre, Amsterdam, The Netherlands
| | - M W Heymans
- Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Jwr Twisk
- Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| |
Collapse
|
12
|
Maarsingh OR, Heymans MW, Verhaak PF, Penninx BWJH, Comijs HC. Development and external validation of a prediction rule for an unfavorable course of late-life depression: A multicenter cohort study. J Affect Disord 2018; 235:105-113. [PMID: 29655070 DOI: 10.1016/j.jad.2018.04.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 02/25/2018] [Accepted: 04/02/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Given the poor prognosis of late-life depression, it is crucial to identify those at risk. Our objective was to construct and validate a prediction rule for an unfavourable course of late-life depression. METHODS For development and internal validation of the model, we used The Netherlands Study of Depression in Older Persons (NESDO) data. We included participants with a major depressive disorder (MDD) at baseline (n = 270; 60-90 years), assessed with the Composite International Diagnostic Interview (CIDI). For external validation of the model, we used The Netherlands Study of Depression and Anxiety (NESDA) data (n = 197; 50-66 years). The outcome was MDD after 2 years of follow-up, assessed with the CIDI. Candidate predictors concerned sociodemographics, psychopathology, physical symptoms, medication, psychological determinants, and healthcare setting. Model performance was assessed by calculating calibration and discrimination. RESULTS 111 subjects (41.1%) had MDD after 2 years of follow-up. Independent predictors of MDD after 2 years were (older) age, (early) onset of depression, severity of depression, anxiety symptoms, comorbid anxiety disorder, fatigue, and loneliness. The final model showed good calibration and reasonable discrimination (AUC of 0.75; 0.70 after external validation). The strongest individual predictor was severity of depression (AUC of 0.69; 0.68 after external validation). LIMITATIONS The model was developed and validated in The Netherlands, which could affect the cross-country generalizability. CONCLUSIONS Based on rather simple clinical indicators, it is possible to predict the 2-year course of MDD. The prediction rule can be used for monitoring MDD patients and identifying those at risk of an unfavourable outcome.
Collapse
Affiliation(s)
- O R Maarsingh
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
| | - M W Heymans
- Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - P F Verhaak
- University of Groningen, University Medical Center Groningen, Department of General Practice, Groningen, The Netherlands; NIVEL, Netherlands Institute of Health Services Research, The Netherlands
| | - B W J H Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - H C Comijs
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
13
|
Merlijn T, Swart KMA, Lips P, Heymans MW, Sohl E, Van Schoor NM, Netelenbos CJ, Elders PJM. Prediction of insufficient serum vitamin D status in older women: a validated model. Osteoporos Int 2018; 29:1539-1547. [PMID: 29808229 PMCID: PMC6061708 DOI: 10.1007/s00198-018-4410-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 01/24/2018] [Indexed: 12/20/2022]
Abstract
UNLABELLED We developed an externally validated simple prediction model to predict serum 25(OH)D levels < 30, < 40, < 50 and 60 nmol/L in older women with risk factors for fractures. The benefit of the model reduces when a higher 25(OH)D threshold is chosen. INTRODUCTION Vitamin D deficiency is associated with increased fracture risk in older persons. General supplementation of all older women with vitamin D could cause medicalization and costs. We developed a clinical model to identify insufficient serum 25-hydroxyvitamin D (25(OH)D) status in older women at risk for fractures. METHODS In a sample of 2689 women ≥ 65 years selected from general practices, with at least one risk factor for fractures, a questionnaire was administered and serum 25(OH)D was measured. Multivariable logistic regression models with backward selection were developed to select predictors for insufficient serum 25(OH)D status, using separate thresholds 30, 40, 50 and 60 nmol/L. Internal and external model validations were performed. RESULTS Predictors in the models were as follows: age, BMI, vitamin D supplementation, multivitamin supplementation, calcium supplementation, daily use of margarine, fatty fish ≥ 2×/week, ≥ 1 hours/day outdoors in summer, season of blood sampling, the use of a walking aid and smoking. The AUC was 0.77 for the model using a 30 nmol/L threshold and decreased in the models with higher thresholds to 0.72 for 60 nmol/L. We demonstrate that the model can help to distinguish patients with or without insufficient serum 25(OH)D levels at thresholds of 30 and 40 nmol/L, but not when a threshold of 50 nmol/L is demanded. CONCLUSIONS This externally validated model can predict the presence of vitamin D insufficiency in women at risk for fractures. The potential clinical benefit of this tool is highly dependent of the chosen 25(OH)D threshold and decreases when a higher threshold is used.
Collapse
Affiliation(s)
- T Merlijn
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
- Stichting ArtsenLaboratorium en Trombosedienst, Koog aan de Zaan, The Netherlands.
| | - K M A Swart
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
- Stichting ArtsenLaboratorium en Trombosedienst, Koog aan de Zaan, The Netherlands
| | - P Lips
- Department of Internal Medicine and Endocrinology, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - M W Heymans
- Department of Health Sciences, Faculty of Earth and Life Sciences, Amsterdam Public Health Research Institute, VU University Amsterdam, Amsterdam, the Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - E Sohl
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - N M Van Schoor
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - C J Netelenbos
- Department of Internal Medicine and Endocrinology, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - P J M Elders
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
14
|
Van Schoor NM, Heymans MW, Lips P. Vitamin D status in relation to physical performance, falls and fractures in the Longitudinal Aging Study Amsterdam: A reanalysis of previous findings using standardized serum 25-hydroxyvitamin D values. J Steroid Biochem Mol Biol 2018; 177:255-260. [PMID: 28935550 DOI: 10.1016/j.jsbmb.2017.09.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 09/14/2017] [Accepted: 09/17/2017] [Indexed: 01/07/2023]
Abstract
The Longitudinal Aging Study Amsterdam (LASA) is an ongoing prospective cohort study in a representative sample of Dutch older persons. In previous LASA studies, lower serum 25-hydroxyvitamin D (25(OH)D) values, as assessed by a competitive protein binding assay or radioimmunoassay, have been associated with decreased physical functioning, falls and fractures. Recently, serum 25(OHD) values in LASA were standardized using the Vitamin D Standardization Program (VDSP) protocol as part of the European ODIN project. In the current manuscript, the influence of standardizing serum 25(OH)D values will be discussed using the associations with physical functioning, falls and fractures as examples.
Collapse
Affiliation(s)
- N M Van Schoor
- Amsterdam Public Health Research Institute, Department of Epidemiology and Biostatistics, VU University Medical Center (VUMC), Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands.
| | - M W Heymans
- Amsterdam Public Health Research Institute, Department of Epidemiology and Biostatistics, VU University Medical Center (VUMC), Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands
| | - P Lips
- Department of Internal Medicine, Endocrine section, VUMC, Amsterdam, Netherlands
| |
Collapse
|
15
|
Vollgraff Heidweiller‐Schreurs CA, De Boer MA, Heymans MW, Schoonmade LJ, Bossuyt PMM, Mol BWJ, De Groot CJM, Bax CJ. Prognostic accuracy of cerebroplacental ratio and middle cerebral artery Doppler for adverse perinatal outcome: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2018; 51:313-322. [PMID: 28708272 PMCID: PMC5873403 DOI: 10.1002/uog.18809] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/30/2017] [Accepted: 07/07/2017] [Indexed: 05/15/2023]
Abstract
OBJECTIVE Doppler ultrasonographic assessment of the cerebroplacental ratio (CPR) and middle cerebral artery (MCA) is widely used as an adjunct to umbilical artery (UA) Doppler to identify fetuses at risk of adverse perinatal outcome. However, reported estimates of its accuracy vary considerably. The aim of this study was to review systematically the prognostic accuracies of CPR and MCA Doppler in predicting adverse perinatal outcome, and to compare these with UA Doppler, in order to identify whether CPR and MCA Doppler evaluation are of added value to UA Doppler. METHODS PubMed, EMBASE, the Cochrane Library and ClinicalTrials.gov were searched, from inception to June 2016, for studies on the prognostic accuracy of UA Doppler compared with CPR and/or MCA Doppler in the prediction of adverse perinatal outcome in women with a singleton pregnancy of any risk profile. Risk of bias and concerns about applicability were assessed using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies-2) tool. Meta-analysis was performed for multiple adverse perinatal outcomes. Using hierarchal summary receiver-operating characteristics meta-regression models, the prognostic accuracy of CPR vs MCA Doppler was compared indirectly, and CPR and MCA Doppler vs UA Doppler compared directly. RESULTS The search identified 4693 articles, of which 128 studies (involving 47 748 women) were included. Risk of bias or suboptimal reporting was detected in 120/128 studies (94%) and substantial heterogeneity was found, which limited subgroup analyses for fetal growth and gestational age. A large variation was observed in reported sensitivities and specificities, and in thresholds used. CPR outperformed UA Doppler in the prediction of composite adverse outcome (as defined in the included studies) (P < 0.001) and emergency delivery for fetal distress (P = 0.003), but was comparable to UA Doppler for the other outcomes. MCA Doppler performed significantly worse than did UA Doppler in the prediction of low Apgar score (P = 0.017) and emergency delivery for fetal distress (P = 0.034). CPR outperformed MCA Doppler in the prediction of composite adverse outcome (P < 0.001) and emergency delivery for fetal distress (P = 0.013). CONCLUSION Calculating the CPR with MCA Doppler can add value to UA Doppler assessment in the prediction of adverse perinatal outcome in women with a singleton pregnancy. However, it is unclear to which subgroup of pregnant women this applies. The effectiveness of the CPR in guiding clinical management needs to be evaluated in clinical trials. © 2017 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
Collapse
Affiliation(s)
| | - M. A. De Boer
- Department of Obstetrics and GynecologyVU University Medical CenterAmsterdamThe Netherlands
| | - M. W. Heymans
- Department of Epidemiology and BiostatisticsVU University Medical CenterAmsterdamThe Netherlands
| | - L. J. Schoonmade
- Department of Medical LibraryVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - P. M. M. Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical CenterUniversity of AmsterdamAmsterdam, The Netherlands
| | - B. W. J. Mol
- Department of Obstetrics and Gynecology, The Robinson Institute, School of MedicineUniversity of AdelaideAdelaideAustralia
- The South Australian Health and Medical Research InstituteAdelaideAustralia
| | - C. J. M. De Groot
- Department of Obstetrics and GynecologyVU University Medical CenterAmsterdamThe Netherlands
| | - C. J. Bax
- Department of Obstetrics and Gynecology, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
| |
Collapse
|
16
|
Elders PJM, Merlijn T, Swart KMA, van Hout W, van der Zwaard BC, Niemeijer C, Heymans MW, van der Heijden AA, Rutters F, van der Horst HE, Lips P, Netelenbos JC, van Schoor NM. Design of the SALT Osteoporosis Study: a randomised pragmatic trial, to study a primary care screening and treatment program for the prevention of fractures in women aged 65 years or older. BMC Musculoskelet Disord 2017; 18:424. [PMID: 29078762 PMCID: PMC5658954 DOI: 10.1186/s12891-017-1783-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 10/15/2017] [Indexed: 01/07/2023] Open
Abstract
Background Several drugs have become available for the treatment of osteoporosis. However, screening and treatment of patients with a high fracture risk is currently not recommended in the Netherlands, because the effectiveness of bone sparing drugs has not been demonstrated in the general primary care population. Here we describe the design of the SALT Osteoporosis study, which aims to examine whether the screening and treatment of older, female patients in primary care can reduce fractures, in comparison to usual care. Methods A randomised pragmatic trial has been designed using a stepwise approach in general care practices in the Netherlands. Women aged ≥65 years, who are not prescribed bone sparing drugs or corticosteroids are eligible for the study. First, women with at least one clinical risk factor for fractures, as determined by questionnaires, are randomly assigned to the intervention or control group. Second, women in the intervention group having a high fracture risk according to our screening program, including an adapted fracture risk assessment (FRAX) tool, combined with dual-energy x-ray absorptiometry (DXA), and instant vertebral assessment (IVA), are offered a structured treatment program. The women in the control group receive care as usual and will undergo the same screening as the intervention group at the end of the trial. The follow-up duration will be three years and the primary outcome is time to first incident fracture and the total number of fractures. Discussion The results of the current study will be very important for underpinnings of the prevention strategy of the osteoporosis guidelines. Trial registration ID NTR2430. Registered 26 July 2010.
Collapse
Affiliation(s)
- P J M Elders
- Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam Public Health research institute, Amsterdam, The Netherlands.
| | - T Merlijn
- Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - K M A Swart
- Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam Public Health research institute, Amsterdam, The Netherlands.,Stichting ArtsenLaboratorium en Trombosedienst, Koog aan de Zaan, The Netherlands
| | - W van Hout
- Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - B C van der Zwaard
- Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - C Niemeijer
- Stichting ArtsenLaboratorium en Trombosedienst, Koog aan de Zaan, The Netherlands
| | - M W Heymans
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - A A van der Heijden
- Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - F Rutters
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - H E van der Horst
- Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - P Lips
- Department of Internal Medicine, Endocrine Section, VU University Medical Center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - J C Netelenbos
- Department of Internal Medicine, Endocrine Section, VU University Medical Center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - N M van Schoor
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| |
Collapse
|
17
|
van Helden EJ, Menke-van der Houven van Oordt CW, Heymans MW, Ket JCF, van den Oord R, Verheul HMW. Optimal use of anti-EGFR monoclonal antibodies for patients with advanced colorectal cancer: a meta-analysis. Cancer Metastasis Rev 2017; 36:395-406. [PMID: 28695301 PMCID: PMC5557867 DOI: 10.1007/s10555-017-9668-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This meta-analysis was performed to determine the optimal use of anti-EGFR mAb in the treatment of metastasized colorectal cancer (mCRC). Seventeen randomized clinical trials were included, all evaluating the added value of anti-EGFR mAb to standard treatment line in patients with KRAS wild-type mCRC. Hazard and odds ratios were pooled using a random effect model, weighted according to cohort size. Pooled data of six first- and two second-line studies demonstrated a significantly improved ORR (OR 1.62, CI 1.27-2.04; OR 4.78, CI 3.39-6.75, respectively) and PFS (HR 0.79, CI 0.67-0.94; HR 0.80, CI 0.71-0.91, respectively) with the addition of anti-EGFR mAb to chemotherapy, while OS remained similar. Two third-line anti-EGFR mAb monotherapy studies revealed an improved PFS and OS (HR 0.44, CI 0.35-0.52; HR 0.55, CI 0.41-0.74). Addition of anti-EGFR versus anti-VEGF mAb to first-line chemotherapy was evaluated in three studies; ORR and PFS were comparable, while OS was improved (HR 0.8, CI 0.65-0.97). The influence of the chemotherapy backbone on anti-EGFR mAb efficacy, evaluated with meta-regression, indicated a higher ORR with irinotecan-based versus oxaliplatin-based regimens, but comparable PFS and OS. Reported toxicity (≥3 grade) increased ~20% in all treatment lines with the addition of anti-EGFR mAb. Anti-EGFR treatment significantly improves response and survival outcome of patients with (K)RAS wild-type mCRC, regardless of treatment line or chemotherapeutic backbone. Saving anti-EGFR mAb as third-line monotherapy is a valid and effective option to prevent high treatment burden caused by combination therapy. Combination treatment with anti-EGFR mAb to achieve radical resection of metastases needs further investigation.
Collapse
Affiliation(s)
- E J van Helden
- Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | | | - M W Heymans
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - J C F Ket
- VU University, Medical Library, De Boelelaan 1117 (ZH3A-46), Postbus 7057, Amsterdam, 1081 HV, The Netherlands
| | - R van den Oord
- Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - H M W Verheul
- Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
| |
Collapse
|
18
|
van Ekris E, Altenburg TM, Singh AS, Proper KI, Heymans MW, Chinapaw MJM. An evidence-update on the prospective relationship between childhood sedentary behaviour and biomedical health indicators: a systematic review and meta-analysis. Obes Rev 2017; 18:712-714. [PMID: 28474511 DOI: 10.1111/obr.12526] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
19
|
Nikolopoulou M, Byraki A, Ahlberg J, Heymans MW, Hamburger HL, De Lange J, Lobbezoo F, Aarab G. Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnoea syndrome: a randomised, placebo-controlled trial on self-reported symptoms of common sleep disorders and sleep-related problems. J Oral Rehabil 2017; 44:452-460. [PMID: 28294380 DOI: 10.1111/joor.12505] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2017] [Indexed: 11/30/2022]
Abstract
Obstructive sleep apnoea syndrome (OSAS) is associated with several sleep disorders and sleep-related problems. Therefore, the aim of this study was to compare the effects of a mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. In this randomised placebo-controlled trial, sixty-four OSAS patients (52·0 ± 9·6 years) were randomly assigned to an MAD, nCPAP or an intra-oral placebo appliance in a parallel design. All participants filled out the validated Dutch Sleep Disorders Questionnaire (SDQ) twice: one before treatment and one after six months of treatment. With 88 questions, thirteen scales were constructed, representing common sleep disorders and sleep-related problems. Linear mixed model analyses were performed to study differences between the groups for the different SDQ scales over time. The MAD group showed significant improvements over time in symptoms corresponding with 'insomnia', 'excessive daytime sleepiness', 'psychiatric sleep disorder', 'periodic limb movements', 'sleep apnoea', 'sleep paralysis', 'daytime dysfunction', 'hypnagogic hallucinations/dreaming', 'restless sleep', 'negative conditioning' and 'automatic behaviour' (range of P values: 0·000-0·014). These improvements in symptoms were, however, not significantly different from the improvements in symptoms observed in the nCPAP and placebo groups (range of P values: 0·090-0·897). It can be concluded that there is no significant difference between MAD and nCPAP in their positive effects on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. These beneficial effects may be a result of placebo effects.
Collapse
Affiliation(s)
- M Nikolopoulou
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - A Byraki
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - J Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - M W Heymans
- Department of Epidemiology and Biostatistics, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - H L Hamburger
- Amsterdam Sleep Centre, Boerhaave Medical Centre, Amsterdam, The Netherlands
| | - J De Lange
- Department of Oral and Maxillofacial Surgery, Academic Medical Centre of the University of Amsterdam and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - F Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - G Aarab
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
20
|
van Hoffen MFA, Heymans MW, Twisk JWR, van Rhenen W, Roelen CAM. Can psychosocial working conditions identify workers at risk of mental sickness absence? Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw164.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
21
|
van Ekris E, Altenburg TM, Singh AS, Proper KI, Heymans MW, Chinapaw MJM. An evidence-update on the prospective relationship between childhood sedentary behaviour and biomedical health indicators: a systematic review and meta-analysis. Obes Rev 2016; 17:833-49. [PMID: 27256486 DOI: 10.1111/obr.12426] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 04/06/2016] [Accepted: 04/18/2016] [Indexed: 12/01/2022]
Abstract
Evidence for adverse health effects of excessive sedentary behaviour in children is predominantly based on cross-sectional studies, measuring TV viewing as proxy for sedentary behaviour. This systematic review and meta-analysis summarizes the evidence on the prospective relationship between childhood sedentary behaviour and biomedical health indicators, overall and stratified by type of sedentary behaviour (TV viewing, computer use/games, screen time and objective sedentary time). PubMed, EMBASE, PsycINFO and Cochrane were systematically searched till January 2015. Methodological quality of all included studies was scored, and a best evidence synthesis was applied. We included 109 studies of which 19 were of high quality. We found moderate-to-strong evidence for a relationship of overall sedentary time with some anthropometrics (overweight/obesity, weight-for-height), one cardiometabolic biomarker (HDL-cholesterol) and some fitness indicators (fitness, being unfit). For other health indicators, we found no convincing evidence because of inconsistent or non-significant findings. The evidence varied by type of sedentary behaviour. The meta-analysis indicated that each additional baseline hour of TV viewing (β = 0.01, 95%CI = [-0.002; 0.02]) or computer use (β = 0.00, 95%CI = [-0.004; 0.01]) per day was not significantly related with BMI at follow-up. We conclude that the evidence for a prospective relationship between childhood sedentary behaviour and biomedical health is in general unconvincing.
Collapse
Affiliation(s)
- E van Ekris
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - T M Altenburg
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - A S Singh
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - K I Proper
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - M W Heymans
- Department of Epidemiology and Biostatistics, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - M J M Chinapaw
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| |
Collapse
|
22
|
Panken AM, Heymans MW, van Oort L, Verhagen AP. CLINICAL PROGNOSTIC FACTORS FOR PATIENTS WITH ANTERIOR KNEE PAIN IN PHYSICAL THERAPY; A SYSTEMATIC REVIEW. Int J Sports Phys Ther 2015; 10:929-45. [PMID: 26673528 PMCID: PMC4675194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Although many authors have studied the prognostic factors that may contribute to anterior knee pain, synthesis of the existing evidence has not been performed. PURPOSE The purpose of this systematic review is to summarize and examine existing prognostic models in patients with anterior knee pain that first present to physical therapists (primary care setting). DESIGN Systematic review. METHOD For this review Pubmed, Embase and Cinahl databases were searched and published papers that reported prognostic models for patients with anterior knee pain that first present to physical therapists (primary care setting) were selected. The authors extracted and summarized the univariate and multivariate predictors and evaluated which predictors consistently appeared to be relevant to pain, function, or recovery. RESULTS Nine studies were included. The quality scores of these studies ranged from 9 to 17 positive items out of 21 items included in the assessment for quality. None of the prognostic models were validated internally or externally. Four studies were considered to be of sufficient quality. The authors of these four studies found 14 different predictors significantly related to pain intensity of which seven with limited evidence. Fifteen different predictors were found that were related to function of which seven with limited evidence. Furthermore, strong evidence was found that baseline pain intensity, pain coping and kinesiophobia are of no predictive value for pain, and activity related pain, pain coping and kinesiophobia are of no predictive value for function at follow up. CONCLUSIONS Because of the low quality of a number of studies and the heterogeneity of the examined variables and outcome measures of most of the studies, only limited evidence for seven predictors related to pain and seven predictors related to function in patients with anterior knee pain in a primary care setting was found. LEVEL OF EVIDENCE 1b.
Collapse
Affiliation(s)
| | | | - L van Oort
- Department of Physical Therapy, AVANS University of Applied Sciences, Breda, The Netherlands
| | | |
Collapse
|
23
|
Norder G, Roelen CAM, Heymans MW, van der Klink JJL, Bültmann U. Sustained work status in five years following return to work after mental sickness absence. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv168.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
24
|
van Hoffen MFA, Joling CI, Heymans MW, Twisk JWR, Roelen CAM. Mental health symptoms as predictors of future mental sickness absence. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
25
|
Abstract
BACKGROUND A prediction model including age, self-rated health (SRH) and prior sickness absence (SA) has previously been found to predict frequent SA. AIMS To further validate the model and develop it for clinical use. METHODS A multicentre study of care of the elderly workers employed at one of 14 centres in Aarhus (Denmark). SA episodes recorded in the year prior to baseline and both age and SRH at baseline were included in a prediction model for frequent (three or more) SA episodes during a 1-year follow-up period. The prediction model was developed in the largest centre. Risk predictions and discrimination between high- and low-risk workers were investigated in the other centres. The prediction rule 'SRH-prior SA' was derived from the prediction model and prognostic properties of the prediction rule were investigated for each centre, using score <0 as cut-off. RESULTS Of 2562 workers, 1930 had complete data for analysis. Predictions were accurate in 4 of 13 centres; discrimination was good in five and fair in another five centres. Prediction rule scores <0 identified workers at risk of frequent SA with sensitivities of 0.17-0.54, specificities of 0.86-0.96 and positive predictive values of 0.54-0.87 across centres. CONCLUSIONS The prediction model discriminated between workers at high and low risk of frequent SA in the majority of centres. The prediction rule 'SRH-prior SA' can be used in clinical practice specifically to identify workers at high risk of frequent SA.
Collapse
Affiliation(s)
- C A M Roelen
- ArboNed Occupational Health Service, PO Box 85091, 3508 AB Utrecht, The Netherlands, Department of Health Sciences Section Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD Groningen, The Netherlands, Department of Epidemiology and Biostatistics, VU University Medical Center, VU University, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands,
| | - U Bultmann
- Department of Health Sciences Section Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD Groningen, The Netherlands
| | - C M Stapelfeldt
- Public Health and Quality Improvement, Central Denmark Region, MarselisborgCentret, P.P. Ørumsgade 11, 8000 Aarhus C, Denmark
| | - C Jensen
- National Centre for Occupational Rehabilitation, Haddlandsveien 20, 3864 Rauland, Norway, Department of Public Health and General Practice, Norwegian University of Science and Technology, PO Box 8905, 7491 Trondheim, Norway
| | - M W Heymans
- Department of Epidemiology and Biostatistics, VU University Medical Center, VU University, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
| |
Collapse
|
26
|
Adriaanse BME, Uittenbogaard LB, Tromp CHN, Schaefer SS, Heymans MW, van Vugt JMG, Haak MC. Prenatal examination of the area and morphology of the atrioventricular valves using four-dimensional ultrasound in normal and abnormal hearts. Prenat Diagn 2015; 35:741-7. [PMID: 26125132 DOI: 10.1002/pd.4569] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 01/23/2015] [Accepted: 01/25/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Our aim is to evaluate the feasibility to examine the morphology and area of the atrioventricular (AV) valves in normal fetuses and fetuses with cardiac defects using spatiotemporal image correlation (STIC). METHODS Atrioventricular valves were analyzed longitudinally in STIC volumes of 74 normal fetuses between the 15th and 36th week of pregnancy. The valve area was measured in a rendered view in diastole, the number of valve leaflets in systole. Longitudinal data analysis was performed using linear mixed models. Fifty fetuses with cardiac defects were examined. RESULTS Examination of 355 STIC volumes of normal fetuses showed in 82.5% sufficient quality. The tricuspid valve leaflets were seen in 200 (68.3%) volumes and the mitral valve leaflets in 219 (74.7%) volumes. The tricuspid valve showed in 61.1% a round, 29.0% rectangle, and 8.9% elliptical shape and the mitral valve in 60.1% round, 28.0% rectangle, and 10.9% elliptical. Regression analysis revealed a positive relationship of the valve area with gestational age (p < 0.0001). Most heart defects with stenosis showed an area below the 5th percentile. CONCLUSION Prenatal examination of the morphology and area of the AV valves using four-dimensional ultrasound is feasible. A rectangular valve opening is normal, which was visualized in about one third of the normal fetuses.
Collapse
Affiliation(s)
- B M E Adriaanse
- Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands
| | - L B Uittenbogaard
- Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands
| | - C H N Tromp
- Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands
| | - S S Schaefer
- Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands
| | - M W Heymans
- Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - J M G van Vugt
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M C Haak
- Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
27
|
Abstract
CONTEXT Vitamin D is essential for bone health. In addition, vitamin D has recently been proposed to play a role in the pathophysiology of many chronic diseases. Despite the large number of studies published on vitamin D, the threshold for a sufficient serum 25-hydroxyvitamin D [25(OH)D] concentration is still debated and may differ according to outcomes and subgroups. OBJECTIVE The objective of the study was to estimate the thresholds for serum 25(OH)D concentration with respect to the different outcomes and for different subgroups. DESIGN, SETTING, AND PARTICIPANTS Observational data from the Longitudinal Aging Study Amsterdam, an ongoing population-based Dutch cohort study [n = 1164, mean (SD) age 75.2 (6.5) y], were used. MAIN OUTCOME MEASURES Falling, fractures, hypertension, cardiovascular disease, blood pressure, PTH, grip strength, physical performance, functional limitations, body mass index (BMI), and mortality were measured. To determine thresholds, spline curves were used. Visual inspection and the statistical best fit of the spline regression models were used together to estimate the best estimate of the thresholds. RESULTS Thresholds for serum 25(OH)D concentrations in the whole sample ranged from 46 nmol/L (PTH) to 68 nmol/L (hypertension). On average, women, the oldest old (≥ 75 y), and individuals with a high BMI (>25 kg/m(2)) had lower thresholds compared with men, the youngest old (65-75 y), and individuals with a low to normal BMI (<25 kg/m(2)). CONCLUSION The results indicate that thresholds for serum 25(OH)D may vary according to different outcomes and subgroups. This study does not support the high thresholds (>75 nmol/L) as advised by some experts, and the higher requirements in women, older persons, and those with high BMI.
Collapse
Affiliation(s)
- E Sohl
- Department of Epidemiology and Biostatistics (E.S., M.W.H., N.M.S.), EMGO Institute for Health and Care Research, and Department of Internal Medicine (R.T.d.J., P.L.), Endocrine Section, VU University Medical Center, 1081 BT Amsterdam, The Netherlands
| | - R T de Jongh
- Department of Epidemiology and Biostatistics (E.S., M.W.H., N.M.S.), EMGO Institute for Health and Care Research, and Department of Internal Medicine (R.T.d.J., P.L.), Endocrine Section, VU University Medical Center, 1081 BT Amsterdam, The Netherlands
| | - M W Heymans
- Department of Epidemiology and Biostatistics (E.S., M.W.H., N.M.S.), EMGO Institute for Health and Care Research, and Department of Internal Medicine (R.T.d.J., P.L.), Endocrine Section, VU University Medical Center, 1081 BT Amsterdam, The Netherlands
| | - N M van Schoor
- Department of Epidemiology and Biostatistics (E.S., M.W.H., N.M.S.), EMGO Institute for Health and Care Research, and Department of Internal Medicine (R.T.d.J., P.L.), Endocrine Section, VU University Medical Center, 1081 BT Amsterdam, The Netherlands
| | - P Lips
- Department of Epidemiology and Biostatistics (E.S., M.W.H., N.M.S.), EMGO Institute for Health and Care Research, and Department of Internal Medicine (R.T.d.J., P.L.), Endocrine Section, VU University Medical Center, 1081 BT Amsterdam, The Netherlands
| |
Collapse
|
28
|
Lodders JN, Parmar S, Stienen NLM, Martin TJ, Karagozoglu KH, Heymans MW, Forouzanfar T. Incidence of symptomatic venous thromboembolism in oncological oral and maxillofacial operations: retrospective analysis. Br J Oral Maxillofac Surg 2015; 53:244-50. [PMID: 25640701 DOI: 10.1016/j.bjoms.2014.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 12/02/2014] [Indexed: 10/24/2022]
Abstract
We retrospectively analysed the incidence of symptomatic venous thromboembolism (VTE) and associated risk factors in operations under general anaesthesia for cancer of the oral cavity. To identify symptoms related to deep venous thrombosis (DVT) and pulmonary embolism (PE), together with associated risk factors, we reviewed medical records of patients operated on in the department of oral and maxillofacial surgery at the Queen Elizabeth Hospital, Birmingham, United Kingdom, between June 2007 and October 2012. All patients were categorised according to their level of risk of VTE. The incidence of VTE was calculated with univariate associations and odds ratios with related 95% confidence intervals, where possible. In total, 233 patients were included, comprising 244 operations (mean (SD) age at operation 60.9 (13) years). Almost all patients (97%) were classified as having the highest risk of VTE. Swelling of an extremity, expectoration of blood, and tightness of the chest were the most common symptoms for suspected cases. An incidence of 0.41% was found for symptomatic VTE; one man developed a PE 2 days after operation. Associations between the analysed factors and symptomatic VTE were not significant. The development of the complication in oncological oral and maxillofacial operations seems to be rare, even in patients with a high risk. We cannot recommend the use of routine thromboprophylaxis, but it could be advocated in patients with obvious serious risk factors.
Collapse
Affiliation(s)
- J N Lodders
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, De Boelelaan 1118, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - S Parmar
- Department of Oral and Maxillofacial Surgery, University Hospital Birmingham NHS Trust, Queen Elizabeth Hospital, Edgebaston, Birmingham B15 2TH, United Kingdom.
| | - N L M Stienen
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, De Boelelaan 1118, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - T J Martin
- Department of Oral and Maxillofacial Surgery, University Hospital Birmingham NHS Trust, Queen Elizabeth Hospital, Edgebaston, Birmingham B15 2TH, United Kingdom.
| | - K H Karagozoglu
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, De Boelelaan 1118, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - M W Heymans
- Department of Epidemiology and Biostatistics, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, De Boelelaan 1118, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - T Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, De Boelelaan 1118, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| |
Collapse
|
29
|
van Velzen CL, Clur SA, Rijlaarsdam MEB, Bax CJ, Pajkrt E, Heymans MW, Bekker MN, Hruda J, de Groot CJM, Blom NA, Haak MC. Prenatal detection of congenital heart disease--results of a national screening programme. BJOG 2015; 123:400-7. [PMID: 25625301 DOI: 10.1111/1471-0528.13274] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2014] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Congenital heart disease (CHD) is the most common congenital malformation and causes major morbidity and mortality. Prenatal detection improves the neonatal condition before surgery, resulting in less morbidity and mortality. In the Netherlands a national prenatal screening programme was introduced in 2007. This study evaluates the effects of this screening programme. DESIGN Geographical cohort study. SETTING Large referral region of three tertiary care centres. POPULATION Fetuses and infants diagnosed with severe CHD born between 1 January 2002 and 1 January 2012. METHODS Cases were divided into two groups: before and after the introduction of screening. MAIN OUTCOME MEASURES Detection rates were calculated. RESULTS The prenatal detection rate (n = 1912) increased with 23.9% (95% confidence interval [95% CI] 19.5-28.3) from 35.8 to 59.7% after the introduction of screening and of isolated CHD with 21.4% (95% CI 16.0-26.8) from 22.8 to 44.2%. The highest detection rates were found in the hypoplastic left heart syndrome, other univentricular defects and complex defects with atrial isomerism (>93%). Since the introduction of screening, the 'late' referrals (after 24 weeks of gestation) decreased by 24.3% (95% CI 19.3-29.3). CONCLUSIONS This is the largest cohort study to investigate the prenatal detection rate of severe CHD in an unselected population. A nationally organised screening has resulted in a remarkably high detection rate of CHD (59.7%) compared with earlier literature.
Collapse
Affiliation(s)
- C L van Velzen
- Department of Obstetrics and Gynaecology, VU University Medical Centre, Amsterdam, the Netherlands
| | - S A Clur
- Department of Pediatric Cardiology, Academic Medical Centre, Emma Children's Hospital, Amsterdam, the Netherlands
| | - M E B Rijlaarsdam
- Department of Paediatric Cardiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - C J Bax
- Department of Obstetrics and Gynaecology, VU University Medical Centre, Amsterdam, the Netherlands
| | - E Pajkrt
- Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, the Netherlands
| | - M W Heymans
- Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, the Netherlands
| | - M N Bekker
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - J Hruda
- Department of Paediatric Cardiology, VU University Medical Centre, Amsterdam, the Netherlands
| | - C J M de Groot
- Department of Obstetrics and Gynaecology, VU University Medical Centre, Amsterdam, the Netherlands
| | - N A Blom
- Department of Pediatric Cardiology, Academic Medical Centre, Emma Children's Hospital, Amsterdam, the Netherlands.,Department of Paediatric Cardiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - M C Haak
- Department of Obstetrics and Gynaecology, Leiden University Medical Centre, Leiden, the Netherlands
| |
Collapse
|
30
|
Verkerk K, Luijsterburg PAJ, Heymans MW, Ronchetti I, Pool-Goudzwaard AL, Miedema HS, Koes BW. Prognosis and course of pain in patients with chronic non-specific low back pain: A 1-year follow-up cohort study. Eur J Pain 2015; 19:1101-10. [PMID: 25565501 DOI: 10.1002/ejp.633] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND It remains unclear to what extent patients recover from chronic non-specific low back pain (NSLBP). The objective of this study was to determine (1) the course of chronic NSLBP in tertiary care and (2) which factors predicted 5- and 12-month outcomes. METHODS This prospective study includes 1760 chronic NSLBP patients from a rehabilitation clinic (mean age 40.1 years, SD 10.6). After baseline measurement, patients followed a 2-month multidisciplinary therapy programme; evaluation took place at 2, 5 and 12 months post baseline. Recovery was defined as (1) relative recovery [30% improvement on the pain, visual analogue scale (VAS) compared with baseline] and (2) absolute recovery (VAS pain ≤ 10 mm). The multivariate logistic regression analysis included 23 baseline characteristics. RESULTS Patient-reported intensity of back pain decreased from 55.5 (SD 23.0) at baseline to 37.0 (SD 23.8), 35.3 (SD 26.1) and 32.3 (SD 26.9) at 2-, 5- and 12-month follow-up, respectively. Younger age, back pain at baseline, no psychological/physical dysfunction (Symptom Check List-90, item 9), and higher baseline scores on the physical component scale and mental component scale of quality of life (Short Form-36) were positively associated with recovery at 5 and 12 months. At 5-month follow-up, higher work participation at baseline was also a prognostic factor for both definitions of recovery. At 12-month follow-up, having co-morbidity was predictive for both definitions. CONCLUSION The results of this study indicate that in chronic NSLBP patients, bio-psychosocial prognostic factors may be important for clinicians when predicting recovery in back pain intensity during a 1-year period.
Collapse
Affiliation(s)
- K Verkerk
- Rotterdam University of Applied Sciences, The Netherlands.,Spine & Joint Centre, Rotterdam, The Netherlands.,Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - P A J Luijsterburg
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M W Heymans
- EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.,Department of Methodology and Applied Biostatistics, Institute for Health Sciences, VU University, Amsterdam, The Netherlands.,Department of Clinical Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands
| | - I Ronchetti
- Spine & Joint Centre, Rotterdam, The Netherlands
| | - A L Pool-Goudzwaard
- Department of Neuroscience, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - H S Miedema
- Rotterdam University of Applied Sciences, The Netherlands
| | - B W Koes
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
31
|
Roelen CAM, Heymans MW, van der Klink JJL, Groothoff JW, van Rhenen W. Work ability and disability pension in Dutch construction workers. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku162.095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
32
|
Roelen CAM, Heymans MW, van Rhenen W, Groothoff JW, Twisk JWR, Bültmann U. Fatigue as prognostic risk marker of mental sickness absence in white collar employees. J Occup Rehabil 2014; 24:307-315. [PMID: 23821309 DOI: 10.1007/s10926-013-9458-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE To investigate fatigue as prognostic risk marker for identifying working employees at risk of long-term sickness absence (SA). METHODS At baseline, fatigue was measured in 633 white collar employees with the checklist individual strength (CIS) including scales for fatigue severity, reduced concentration, reduced motivation, and reduced physical activity. SA was medically certified by an occupational physician in the 3rd or 4th SA week with diagnostic codes according to the 10th version of the International Classification of Diseases. Medically certified SA was retrieved at the individual level from an occupational health register after 1-year follow-up. CIS scores were investigated as prognostic risk markers predicting medically certified SA and particularly SA certified as mental SA. RESULTS 614 employees (N = 378 men and N = 236 women) had complete data and were eligible for analysis; 63 (10 %) had medically certified SA of whom 39 (6 %) had mental SA. Fatigue severity and total CIS scores were associated with medically certified SA in men, but poorly discriminated between men with and without medically certified SA. Fatigue severity, reduced concentration, reduced motivation, and total CIS scores were also associated with mental SA in men. CIS and its reduced concentration scale were valid prognostic risk markers of mental SA. CONCLUSION Fatigue was a prognostic risk marker of mental SA in white collar men. The CIS should be further validated as a screening tool for the risk of mental SA in white collar working populations.
Collapse
Affiliation(s)
- C A M Roelen
- Department of Health Sciences, Methodology and Applied Biostatistics, VU University, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands,
| | | | | | | | | | | |
Collapse
|
33
|
Adriaanse BME, Schats J, Tromp CHN, Uittenbogaard LB, Heymans MW, van Vugt JMG, Haak MC. Differential insertion of the atrioventricular valves: measurement protocol to detect various congenital heart defects. Prenat Diagn 2014; 34:935-9. [PMID: 24760486 DOI: 10.1002/pd.4395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 01/30/2014] [Accepted: 04/20/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The objectives of this study were to develop reference values for the distance between the atrioventricular valves, called differential insertion of the atrioventricular valves (DIAVV), in normal fetuses using four-dimensional ultrasound with spatio-temporal image correlation and to explore if DIAVV measurement can differentiate between normal hearts and hearts with cardiac defects. METHODS The DIAVV was analysed longitudinally following a measurement protocol in 74 fetuses between 15 and 36 weeks gestational age. The DIAVV was measured in an apical four-chamber view of the heart in end-diastole. Furthermore, the DIAVV was measured in 70 fetuses with cardiac defects. RESULTS In total, 337 normal and 70 abnormal spatio-temporal image correlation volumes were examined. Longitudinal regression analysis revealed a positive relationship of the DIAVV with gestational age and fetal biometry (p < 0.0001). The DIAVV of fetuses with double outlet right ventricle, truncus arteriosus, atrioventricular septal defects, Ebstein and tetralogy of Fallot all differed from normal fetuses (p < 0.05). CONCLUSION Measurement of the DIAVV is a promising tool; however, a well-defined measurement protocol should be followed to accomplish the correct plane and exact moment in the cardiac cycle. This study presents new nomograms following this measurement protocol and reports an abnormal DIAVV in a wide spectrum of congenital heart disease.
Collapse
Affiliation(s)
- B M E Adriaanse
- Department of Obstetrics and Gynaecology, VU University Medical Centre, Amsterdam, The Netherlands
| | | | | | | | | | | | | |
Collapse
|
34
|
Clarsen B, Bahr R, Heymans MW, Engedahl M, Midtsundstad G, Rosenlund L, Thorsen G, Myklebust G. The prevalence and impact of overuse injuries in five Norwegian sports: Application of a new surveillance method. Scand J Med Sci Sports 2014; 25:323-30. [DOI: 10.1111/sms.12223] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2014] [Indexed: 11/30/2022]
Affiliation(s)
- B. Clarsen
- Oslo Sports Trauma Research Center; Norwegian School of Sport Sciences; Oslo Norway
| | - R. Bahr
- Oslo Sports Trauma Research Center; Norwegian School of Sport Sciences; Oslo Norway
| | - M. W. Heymans
- Department of Epidemiology and Biostatistics; VU University Medical Center; Amsterdam The Netherlands
| | - M. Engedahl
- Oslo Sports Trauma Research Center; Norwegian School of Sport Sciences; Oslo Norway
| | - G. Midtsundstad
- Oslo Sports Trauma Research Center; Norwegian School of Sport Sciences; Oslo Norway
| | - L. Rosenlund
- Oslo Sports Trauma Research Center; Norwegian School of Sport Sciences; Oslo Norway
| | - G. Thorsen
- Oslo Sports Trauma Research Center; Norwegian School of Sport Sciences; Oslo Norway
| | - G. Myklebust
- Oslo Sports Trauma Research Center; Norwegian School of Sport Sciences; Oslo Norway
| |
Collapse
|
35
|
Holla JF, van der Leeden M, Heymans MW, Roorda LD, Bierma-Zeinstra SM, Boers M, Lems WF, Steultjens MP, Dekker J. SAT0334 Three Trajectories of Activity Limitations in Early Symptomatic Knee Osteoarthritis: a 5-Year Follow-Up Study. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.2059] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
36
|
Vergouw CG, Heymans MW, Hardarson T, Sfontouris IA, Economou KA, Ahlström A, Rogberg L, Lainas TG, Sakkas D, Kieslinger DC, Kostelijk EH, Hompes PGA, Schats R, Lambalk CB. No evidence that embryo selection by near-infrared spectroscopy in addition to morphology is able to improve live birth rates: results from an individual patient data meta-analysis. Hum Reprod 2014; 29:455-61. [PMID: 24408316 DOI: 10.1093/humrep/det456] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
STUDY QUESTION What is the value of embryo selection by metabolomic profiling of culture medium with near-infrared (NIR) spectroscopy as an adjunct to morphology, compared with embryo selection by morphology alone, based on an individual patient data meta-analysis (IPD MA)? SUMMARY ANSWER The IPD MA indicates that the live birth rate after embryo selection by NIR spectroscopy and morphology is not significantly different compared with the live birth rate after embryo selection by morphology alone. WHAT IS KNOWN ALREADY Retrospective proof of principle studies has consistently shown that high NIR viability scores are correlated with a high implantation potential of embryos. However, randomized controlled trials (RCTs) have generally shown no benefit of the NIR technology over embryo morphology, although there have been some conflicting results between pregnancy outcomes on different days of embryo transfer. STUDY DESIGN, SIZE, DURATION This IPD MA included all existing RCTs (n = 4) in which embryo selection by morphology was compared with embryo selection by morphology and the use of NIR spectroscopy of spent embryo culture medium by the Viametrics-E(™). PARTICIPANTS/MATERIALS, SETTING, METHODS Searches of PubMed, the Cochrane Library and the WHO International Clinical Trials Registry were conducted and the sole manufacturer of the Viametrics-E(™) was consulted to identify clinics where an RCT comparing embryo selection by morphology to embryo selection by morphology and the use of the Viametrics-E(™) (NIR viability score) was performed. A total of 20 citations were potentially eligible for inclusion, two of which met the inclusion criteria. The manufacturer of the Viametrics-E(™) provided two additional clinical sites of use. In total, four RCTs were identified as eligible for inclusion. The IPD MA was based on a fixed effect model due to the lack of heterogeneity between included studies. Differences between study groups were tested and reported using logistic regression models adjusted for significant confounders. The pooled analysis of the primary outcome led to a total sample size of 924 patients: 484 patients in the control group (embryo selection by morphology alone) and 440 patients in the treatment group (embryo selection by morphology plus NIR spectroscopy). MAIN RESULTS AND THE ROLE OF CHANCE The live birth rates in the control group and the NIR group were 34.7% (168 of 484) and 33.2% (146 of 440), respectively. The pooled odds ratio (OR) was 0.98 [95% confidence interval (CI) 0.74-1.29], indicating no difference in live birth rates between the two study groups. The data of the four studies showed no significant heterogeneity (I(2) = 26.2% P = 0.26). The multivariate regression analysis including all confounders show that maternal age (OR 0.90, 95% CI 0.87-0.94) and the number of previous IVF cycles (OR 0.83, 95% CI 0.71-0.96) were significantly related to live birth. The study group (i.e. embryo selection by morphology or embryo selection by morphology plus NIR) was not related to live birth (OR 0.97, 95% CI 0.73-1.29). LIMITATIONS AND REASONS FOR CAUTION The availability of at least two similar best quality embryos as an inclusion criterion prior to transfer in the two largest RCTs might have caused a selection bias towards a better prognosis patient group. WIDER IMPLICATIONS OF THE FINDINGS There is at present no evidence that NIR spectroscopy of spent embryo culture media in its current form can be used in daily practice to improve live birth rates.
Collapse
Affiliation(s)
- C G Vergouw
- Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
de Jonge RCJ, Sanders MS, Terwee CB, Heymans MW, Gemke RJBJ, Koomen I, Spanjaard L, van Furth AM. Unsuccessful validation of 2004 model for predicting academic or behavioural limitations after childhood bacterial meningitis. Acta Paediatr 2013; 102:e553-9. [PMID: 24033640 DOI: 10.1111/apa.12407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 06/16/2013] [Accepted: 08/22/2013] [Indexed: 11/28/2022]
Abstract
AIM In 2004, a model identifying children at risk of academic or behavioural limitations after bacterial meningitis (BM) was presented. Risk factors were male gender, low birthweight, lower educational level of the father, Streptococcus pneumoniae, lower cerebrospinal fluid (CSF) leucocyte count, delay between admission and start of antibiotics, dexamethasone <2 days, seizures and prolonged fever. The aim of this study was to validate that prediction model in an independent cohort. METHODS Academic or behavioural limitations were determined in 93 Dutch school-age BM survivors. Risk factors for limitations were obtained from medical files. Validation was performed by applying the model in the cohort, then assessing discrimination and goodness of fit. Multiple imputation techniques were used to deal with missing values. RESULTS Although fit of the model appeared good when it came to similarity of expected and observed cases (p-value of the Hosmer-Lemeshow test 0.24-0.57), discrimination was poor. Area under the curve (AUC) of the receiver operated characteristics (ROC) curve of the model was 0.83 (95% CI: 0.77-0.89) in the development cohort and 0.53 (95% CI: 0.41-0.65) in the validation cohort. CONCLUSION External validation of the model was unsuccessful. It is not suitable for implementation in practice.
Collapse
Affiliation(s)
- RCJ de Jonge
- Department of Paediatric Infectious Diseases - Immunology and Rheumatology; VU University Medical Center; Amsterdam The Netherlands
- Department of Neonatology; Erasmus MC - Sophia Children's Hospital; Rotterdam The Netherlands
| | - MS Sanders
- Department of Paediatric Infectious Diseases - Immunology and Rheumatology; VU University Medical Center; Amsterdam The Netherlands
- Department of Medical Microbiology; Laboratory for Immunogenetics; VU University Medical Center; Amsterdam The Netherlands
- Department of General Medicine; Antonius Hospital; Nieuwegein The Netherlands
| | - CB Terwee
- Department of Epidemiology and Biostatistics; The EMGO Institute for Health and Care Research; VU University Medical Center; Amsterdam The Netherlands
| | - MW Heymans
- Department of Epidemiology and Biostatistics; The EMGO Institute for Health and Care Research; VU University Medical Center; Amsterdam The Netherlands
| | - RJBJ Gemke
- Department of General Pediatrics and Other Subspecialties; VU University Medical Center; Amsterdam The Netherlands
| | - I Koomen
- Department of Paediatrics; Westfriesgasthuis; Hoorn The Netherlands
| | - L Spanjaard
- Department of Medical Microbiology; Netherlands Reference Laboratory for Bacterial Meningitis; Academic Medical Center; Amsterdam The Netherlands
| | - AM van Furth
- Department of Paediatric Infectious Diseases - Immunology and Rheumatology; VU University Medical Center; Amsterdam The Netherlands
| |
Collapse
|
38
|
Vonk Noordegraaf A, Anema JR, Louwerse MD, Heymans MW, van Mechelen W, Brölmann HAM, Huirne JAF. Prediction of time to return to work after gynaecological surgery: a prospective cohort study in the Netherlands. BJOG 2013; 121:487-97. [PMID: 24245993 DOI: 10.1111/1471-0528.12494] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To measure the impact of the level of invasiveness of gynaecological procedures on time to full Return to Work (RTW) and to identify the most important preoperative sociodemographic, medical and work-related factors that predict the risk of prolonged sick leave. DESIGN Prospective cohort study. SETTING Dutch university hospital. POPULATION A total of 148 women aged 18-65 years scheduled for gynaecological surgery for benign indications. METHODS A questionnaire regarding the surgical procedure as well as perioperative and postoperative complications was completed by the attending resident at baseline and 6 weeks after surgery. All other outcome measures were assessed using self-reported patient questionnaires at baseline and 12 weeks post-surgery. The follow-up period was extended up to 1 year after surgery in women failing to return to work. Surgical procedures were categorised into diagnostic, minor, intermediate and major surgery. MAIN OUTCOME MEASURES Time to RTW and important predictors for prolonged sick leave after surgery. RESULTS Median time to RTW was 7 days (interquartile range [IQR] 5-14) for diagnostic surgery, 14 days (IQR 9-28) for minor surgery, 60 days (IQR 28-101) for intermediate surgery and 69 days (IQR 56-135) for major surgery. Multivariable analysis showed a strongest predictive value of RTW 1 year after surgery for level of invasiveness of surgery (minor surgery hazard ratio [HR] 0.51, 95% CI 0.32-0.81; intermediate surgery HR 0.20, 95% CI 0.12-0.34; major surgery HR 0.09, 95% CI 0.06-0.16), RTW expectations before surgery (HR 0.55, 95% CI 0.36-0.84), and preoperative functional status (HR 1.09, 95% CI 1.04-1.13). A prediction model regarding the probability of prolonged sick leave at 6 weeks was developed, with a sensitivity of 89% and a specificity of 86%. CONCLUSIONS RTW often takes a long time, especially after intermediate and major surgery. This study reveals important predictors for prolonged sick leave and provides a prediction model for the risk of sick leave extending 6 weeks after benign gynaecological surgery in the Netherlands.
Collapse
Affiliation(s)
- A Vonk Noordegraaf
- Department of Obstetrics and Gynaecology, VU University Medical Centre, Amsterdam, the Netherlands; EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
| | | | | | | | | | | | | |
Collapse
|
39
|
Danad I, Raijmakers PG, Harms HJ, Heymans MW, Van Royen N, Lammetsma AA, Lubberink M, Van Rossum AC, Knaapen P. Impact of anatomical and functional severity of coronary atherosclerotic plaques on the transmural perfusion gradient: a H215O PET study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
40
|
Oomens MAEM, Heymans MW, Forouzanfar T. Risk of bias in research in oral and maxillofacial surgery. Br J Oral Maxillofac Surg 2013; 51:913-9. [PMID: 23746677 DOI: 10.1016/j.bjoms.2013.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2012] [Accepted: 05/07/2013] [Indexed: 12/15/2022]
Abstract
The risk of bias is important in the interpretation of the results of research. The aim of this review was to evaluate the risk of bias in randomised controlled trials (RCTs) in oral and maxillofacial surgery (OMFS) over a 10-year period. We searched databases of publications for RCTs published between January 2000 and January 2010. Papers were assessed with 2 up-to-date logical quality lists, the Delphi list and the Jadad scale. Those papers with a low risk of bias were given a Jadad score ≥4 (range 0-5) and a Delphi score ≥6 (range 0-9). A total of 230 papers met the inclusion criteria, and only 41 (18%) were assessed as being at low risk. Most of those included did not correctly describe such important items for risk of bias as method of randomisation (n=124, 54%), concealment of allocation (n=143, 62%), blinding (n=175, 76%), and intention-to-treat analyses (n=182, 79%). In the fields of implantology, traumatology, obstructive sleep apnoea syndrome, and extractions, no paper had a low risk of bias. This systematic review has shown a shortage of research in OMFS with a low risk of bias published over a 10-year period. Further research should concentrate on better describing items at important risk of bias.
Collapse
Affiliation(s)
- M A E M Oomens
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
| | | | | |
Collapse
|
41
|
van Genugten RE, Serné EH, Heymans MW, van Raalte DH, Diamant M. Postprandial microvascular function deteriorates in parallel with gradual worsening of insulin sensitivity and glucose tolerance in men with the metabolic syndrome or type 2 diabetes. Diabetologia 2013. [PMID: 23178932 DOI: 10.1007/s00125-012-2783-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS/HYPOTHESIS Hyperinsulinaemia-induced whole-body glucose uptake during a euglycaemic-hyperinsulinaemic clamp is partly mediated by increased capillary density. We hypothesised that physiological insulinaemia in response to a mixed meal may also enhance microvascular function, and that this may be impaired in insulin-resistant individuals and patients with type 2 diabetes. METHODS Twelve men with uncomplicated type 2 diabetes, 13 with metabolic syndrome and 12 age-matched healthy normoglycaemic controls, mean age 57 ± 6 years, underwent skin capillary video microscopy before and 60 and 120 min following a standardised mixed meal to measure baseline capillary density (BCD) and capillary density during post-occlusive peak reactive hyperaemia (PRH), also termed capillary recruitment. Oral glucose insulin sensitivity (Matsuda index) and postprandial hyperglycaemia (2 h AUC(glucose)) were calculated. RESULTS Fasting BCD was similar among groups, but fasting PRH was lowest in diabetes (p < 0.05). Postprandially, both BCD and PRH increased in all groups (p < 0.001); however, the meal-related increase in BCD was significantly lower in diabetes and metabolic syndrome vs controls (both p < 0.05). At all time points, postprandial PRH was lower in both diabetes and metabolic syndrome vs controls (both p < 0.05). In pooled analysis, postprandial mean PRH correlated with Matsuda index (r = 0.386, p = 0.018) and inversely with 2 h AUC(glucose) (r = -0.336, p = 0.042). CONCLUSIONS/INTERPRETATION Gradual deterioration in meal-related capillary recruitment was paralleled by decreasing insulin sensitivity and postprandial hyperglycaemia, as assessed in healthy normoglycaemic men, men with the metabolic syndrome and those with type 2 diabetes. These findings suggest that in both impaired glucose tolerance and in overt diabetes microvascular dysfunction might contribute to postprandial dysglycaemia. TRIAL REGISTRATION ClinicalTrials.gov NCT00721552.
Collapse
Affiliation(s)
- R E van Genugten
- Diabetes Center, Department of Internal Medicine, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
| | | | | | | | | |
Collapse
|
42
|
Swart KMA, van Schoor NM, Heymans MW, Schaap LA, den Heijer M, Lips P. Elevated homocysteine levels are associated with low muscle strength and functional limitations in older persons. J Nutr Health Aging 2013; 17:578-84. [PMID: 23732556 DOI: 10.1007/s12603-013-0047-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The current study aimed to examine homocysteine in relation to different aspects of physical functioning. DESIGN, SETTING AND PARTICIPANTS Cross-sectional and longitudinal data (3-years follow-up) from the Longitudinal Aging Study Amsterdam (LASA) were used. The study was performed in persons aged ≥ 65 years (N= 1301 after imputation). MEASUREMENTS Different measures of physical functioning, including muscle mass, grip strength, functional limitations, and falling were regarded as outcomes. Gender and serum creatinine level were investigated as effect modifiers. RESULTS Results were stratified by gender. In men, higher homocysteine levels were associated with lower grip strength (Quartile 4: regression coefficient (B)= -3.07 (-4.91; -1.22)), and more functional limitations at baseline (Quartile 4: B= 1.15 (0.16-2.14)). In women, higher homocysteine levels were associated with more functional limitations after 3 years (Quartile 4: B= 1.19 (0.25; 2.13)). Higher homocysteine levels were not associated with low muscle mass or falling. CONCLUSIONS These data suggest an inverse association of homocysteine levels with functional limitations in older men and women, and with muscle strength in older men.
Collapse
Affiliation(s)
- K M A Swart
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands.
| | | | | | | | | | | |
Collapse
|
43
|
van der Werff SD, Junco Díaz R, Reyneveld R, Heymans MW, Ponce Campos M, Gorbea Bonet M, Polman K. Prediction of asthma by common risk factors: a follow-up study in Cuban schoolchildren. J Investig Allergol Clin Immunol 2013; 23:415-420. [PMID: 24459818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE To determine which common risk factors, including environmental factors, are predictors for the development of asthma in Cuban schoolchildren. METHODS A longitudinal study was conducted in 1042 schoolchildren without asthma at baseline in 2 Cuban municipalities. Asthma status in 2007, diagnosed using the International Study of Asthma and Allergies in Childhood questionnaire, was related to a set of common risk factors assessed in 2003/2004 in a multivariable logistic regression model. Multiple imputation was used for missing values. The final prediction model was obtained by backward selection (P<.15). The model's prognostic accuracy (R2) and discriminative ability (area under the receiver operating characteristic curve [AUC]) were assessed and internal validation by bootstrapping was performed. RESULTS A family history of atopic diseases (odds ratio [OR], 2.19; 95% CI, 1.19-4.04), allergic sensitization (OR, 1.83; 95% CI, 0.94-3.55), municipality (OR, 0.34; 95% CI, 0.15-0.74), and use of antibiotics in the child's first year of life (OR, 1.66; 95% CI, 0.89-3.11) were predictors for asthma development. The model had an R2 of 8.0% and a moderate discriminative ability (AUC, 0.69; 95% CI, 0.60-0.78). Internal validation hardly influenced the model's performance. CONCLUSIONS Antibiotics use, genetic predisposition, and allergic sensitization were predictors of asthma in Cuban schoolchildren. Although known as common risk factors they could only partly predict asthma development. Poverty-related factors, such as low income and education, and parasitic infections, did not have an effect. Other or additional environmental predictors need to be identified, as these are potential targets for prevention and control of childhood asthma in affluent as well as nonaffluent countries.
Collapse
Affiliation(s)
- S D van der Werff
- Department of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands.
| | - R Junco Díaz
- National Institute of Hygiene, Epidemiology and Microbiology, Havana, Cuba
| | - R Reyneveld
- Department of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - M W Heymans
- Department of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - M Ponce Campos
- Department of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - M Gorbea Bonet
- National Institute of Hygiene, Epidemiology and Microbiology, Havana, Cuba
| | - K Polman
- Department of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
44
|
Groeneveld E, Lambers MJ, Stakelbeek MEF, Mooij TM, van den Belt-Dusebout AW, Heymans MW, Schats R, Hompes PGA, Hoek A, Burger CW, van Leeuwen FE, Lambalk CB. Factors associated with dizygotic twinning after IVF treatment with double embryo transfer. Hum Reprod 2012; 27:2966-70. [PMID: 22786776 DOI: 10.1093/humrep/des258] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Dizygotic twin pregnancies after IVF treatment are the result of multiple embryos transferred into the uterine cavity, followed by successful double implantation. Factors that increase the chance of multiple implantation after IVF are relatively unknown. The present study aimed to investigate whether features of body composition, such as maternal height, weight and body mass index (BMI) are associated with an increased chance of dizygotic twinning after IVF with double embryo transfer (DET). METHODS This study was conducted using data from a large Dutch nationwide cohort that comprised 19 861 women who had IVF or ICSI treatment between 1983 and 1995 (OMEGA study). First 'fresh' IVF and ICSI cycles with DET resulting in a delivery of a singleton or twin (living as well as stillborn) were selected. A multivariable logistic regression analysis was performed, with the delivery of a singleton or twin as the dependent variable and height, weight, BMI, maternal age, number of retrieved oocytes, use of alcohol, smoking, highest level of education and parity as independent variables. RESULTS Of the 6598 women who completed their first IVF or ICSI cycle, 2375 had DET, resulting in 496 deliveries of 371 singletons and 125 twins. Multivariable regression analysis revealed that tall women (>1.74 cm) and women with a high number of retrieved oocytes (>8) had an increased chance of dizygotic twinning [OR: 1.8 (95% CI: 1.0-3.4) and OR: 2.2 (95% CI: 1.3-3.8), respectively]. CONCLUSIONS Our data demonstrate that tall stature and increased number of retrieved oocytes independently increase the chance of dizygotic twinning after IVF with DET.
Collapse
Affiliation(s)
- E Groeneveld
- Centre for Reproductive Medicine, Department of Obstetrics and Gynaecology, VU University Medical Centre, 1007 MB Amsterdam, The Netherlands.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
van Schoor NM, de Jongh RT, Daniels JMA, Heymans MW, Deeg DJH, Lips P. Peak expiratory flow rate shows a gender-specific association with vitamin D deficiency. J Clin Endocrinol Metab 2012; 97:2164-71. [PMID: 22472566 DOI: 10.1210/jc.2011-3199] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT To our knowledge, no previous studies examined the longitudinal relationship between vitamin D status and pulmonary function in a population-based sample of older persons. OBJECTIVE Our objective was to examine the cross-sectional as well as the longitudinal relationship between vitamin D status and peak expiratory flow rate (PEFR) in a representative sample of the Dutch older population. DESIGN, SETTING, AND PARTICIPANTS Participants included men and women in the Longitudinal Aging Study Amsterdam, an ongoing cohort study in older people. MAIN OUTCOME MEASURE PEFR was measured using the mini-Wright peak flow meter. RESULTS Men with serum 25-hydroxyvitamin D (25-OHD) levels below 10 ng/ml (25 nmol/liter) had a significantly lower PEFR in the cross-sectional analyses, and men with serum 25-OHD levels below 20 ng/ml (50 nmol/liter) had a significantly lower PEFR in the longitudinal analyses as compared with men with serum 25-OHD levels above 30 ng/ml (75 nmol/liter) (cross-sectional: β = -47.0, P = 0.01 for serum 25-OHD <10 ng/ml; longitudinal: β = -45.0, P < 0.01 for serum 25-OHD <10 ng/ml; and β = -20.2, P = 0.03 for serum 25-OHD = 10-20 ng/ml in the fully adjusted models). Physical performance (β = -32.5, P = 0.08 for serum 25-OHD <10 ng/ml) and grip strength (β = -40.0, P = 0.03 for serum 25-OHD <10 ng/ml) partly mediated the cross-sectional associations but not the longitudinal associations. In women, statistically significant associations between 25-OHD and PEFR were observed in the cross-sectional analyses after adjustment for age and season of blood collection but not in the fully adjusted models or in the longitudinal analyses. CONCLUSIONS A strong relationship between serum 25-OHD and PEFR was observed in older men, both in the cross-sectional as well as longitudinal analyses, but not in older women. The association in men could partly be explained by physical performance and muscle strength.
Collapse
Affiliation(s)
- N M van Schoor
- EMGO Institute for Health and Care Research, VU University Medical Center, 1081 BT Amsterdam, The Netherlands.
| | | | | | | | | | | |
Collapse
|
46
|
Pisters MF, Veenhof C, van Dijk GM, Heymans MW, Twisk JWR, Dekker J. The course of limitations in activities over 5 years in patients with knee and hip osteoarthritis with moderate functional limitations: risk factors for future functional decline. Osteoarthritis Cartilage 2012; 20:503-10. [PMID: 22330176 DOI: 10.1016/j.joca.2012.02.002] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 12/18/2011] [Accepted: 02/07/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the course of limitations in activities over 5 years follow-up and identify predictors of future limitations in activities in elderly patients with osteoarthritis (OA) of the hip or knee with moderate functional limitations. METHOD A longitudinal cohort study with 5 years follow-up was conducted. Patients (n=288) were recruited at rehabilitation centers and hospitals. The main outcome measures were self-reported and performance-based limitations in activities. Prognostic factors were demographic and clinical data, body functions, comorbidity, cognitive functioning, avoidance of activity and social support. Measurements were conducted at baseline, 1, 2, 3 and 5 years follow-up. RESULTS Both in patients with knee and hip OA, the course of limitations in activities remained fairly stable over a period of 5 years. Avoidance of activity, increased pain, more comorbidity, a higher age, a longer disease duration, a reduced muscle strength and range of joint motion at baseline predicted more future limitations in activities in patients with knee OA. In patients with hip OA, avoidance of activity, increased pain, more comorbidity, a higher age, a higher educational level and a reduced range of motion at baseline predicted more future limitations in activities. CONCLUSIONS The course of limitations in activities remains fairly stable over a period of 5 years in elderly patients with hip or knee OA. However, at individual level there is considerable variation. Predictors of more future limitations in activities include avoidance of activity, increased pain, higher morbidity count, reduced range of motion, and a higher age.
Collapse
Affiliation(s)
- M F Pisters
- Clinical Health Sciences, University Medical Center Utrecht, Utrecht, The Netherlands.
| | | | | | | | | | | |
Collapse
|
47
|
van der Weijden MAC, van der Horst-Bruinsma IE, van Denderen JC, Dijkmans BAC, Heymans MW, Lems WF. High frequency of vertebral fractures in early spondylarthropathies. Osteoporos Int 2012; 23:1683-90. [PMID: 21927925 DOI: 10.1007/s00198-011-1766-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Accepted: 08/18/2011] [Indexed: 12/14/2022]
Abstract
UNLABELLED We demonstrated that vertebral fractures (VF) are commonly found in early SpA. Patients with VF had lower lumbar BMD than patients without VF. VF remained frequently 'unrecognized' and untreated. VF have been associated with more back pain, reduced Qol, and increased risk of future fractures which stresses the importance of recognition also in early stage SpA. INTRODUCTION VF are a common complication of long-standing ankylosing spondylitis (AS). However, data of VF in early AS patients and in other spondylarthropathies (SpA) are scarce. Therefore we examined the prevalence of VF in early SpA patients and investigated the associations between VF and demographic and disease-related variables. METHODS SpA patients were included consecutively and radiographs of the spine were made. VF were assessed according to the method of Genant et al.: fractures were defined as reduction of ≥20% of the vertebrae. Descriptive statistics, t-tests and logistic regression analyses were used to study the relationship between VF and demographic and disease-related variables, radiographic damage and BMD. RESULTS A total of 113 early SpA patients were included with a disease duration of 7 months, a mean age of 37 years. Seventeen patients (15%) had at least one VF. Fourteen patients had one VF, three patients had two VF. Most VF were located at Th6-Th8. In patients with VF, bone mineral density (BMD) of lumbar spine was lower than BMD of patients without VF (t-test: p = 0.043). Axial Psoriatic Arthritis (PsA) was significantly associated with a higher risk for VF (odds ratio [OR]: 4.62, 95% confidence interval [CI] 1.15-18.58, p = 0.031). No significant associations were found with disease activity variables nor with radiographic severity. CONCLUSION In a group of 113 early, young SpA patients, 15% already had at least one VF. Most VF were asymptomatic, undetected by routine diagnostic procedures and located at the mid-thoracic spine. The VF were associated with low BMD of the lumbar spine and with axial PsA.
Collapse
Affiliation(s)
- M A C van der Weijden
- Department of Rheumatology, VU University Medical Center, Room 3A-64, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | | | | | | | | | | |
Collapse
|
48
|
Roelen CA, van Rhenen W, Groothoff JW, van der Klink JJ, Bultmann U, Heymans MW. The development and validation of two prediction models to identify employees at risk of high sickness absence. Eur J Public Health 2012; 23:128-33. [DOI: 10.1093/eurpub/cks036] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
49
|
Martin WJJM, Heymans MW, Skorpil NE, Forouzanfar T. Can a single pain rating replace a multiple pain rating in third molar surgery studies? Analysis of 220 patients. Int J Oral Maxillofac Surg 2012; 41:1010-3. [PMID: 22446069 DOI: 10.1016/j.ijom.2012.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Revised: 12/29/2011] [Accepted: 02/20/2012] [Indexed: 10/28/2022]
Abstract
This study describes the comparison of multiple and single pain ratings in patients after surgical removal of the third molar. Correlation and agreement analysis were performed between the average pain intensity measured three times a day over a period of 7 days and one single pain rating (designated the 'recalled average' pain, as assessed by the patient) after surgical removal of the lower third molar. The study population consisted of patients participating in three randomized trials. The results show that both measurement correlated good to excellent, but there was a large variation in agreement between the ratings. In conclusion, in patients with surgical third molar removal a single pain rating is not an accurate predictor of the average pain measured by a multiple pain-rating test. A single pain rating cannot replace a multiple pain assessment.
Collapse
Affiliation(s)
- W J J M Martin
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Vrije Universiteit Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | | | | | | |
Collapse
|
50
|
Danad I, Raijmakers PG, Kamali P, Harms HJ, de Haan S, Lubberink M, van Kuijk C, Hoekstra OS, Lammertsma AA, Smulders YM, Heymans MW, Tulevski II, van Rossum AC, Knaapen P. Carotid artery intima-media thickness, but not coronary artery calcium, predicts coronary vascular resistance in patients evaluated for coronary artery disease. Eur Heart J Cardiovasc Imaging 2012; 13:317-23. [DOI: 10.1093/ehjci/jes038] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|