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Broeders M, van Rooij J, Oussoren E, van Gestel T, Smith C, Kimber S, Verdijk R, Wagenmakers M, van den Hout J, van der Ploeg A, Narcisi R, Pijnappel W. Modeling cartilage pathology in mucopolysaccharidosis VI using iPSCs reveals early dysregulation of chondrogenic and metabolic gene expression. Front Bioeng Biotechnol 2022; 10:949063. [PMID: 36561048 PMCID: PMC9763729 DOI: 10.3389/fbioe.2022.949063] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022] Open
Abstract
Mucopolysaccharidosis type VI (MPS VI) is a metabolic disorder caused by disease-associated variants in the Arylsulfatase B (ARSB) gene, resulting in ARSB enzyme deficiency, lysosomal glycosaminoglycan accumulation, and cartilage and bone pathology. The molecular response to MPS VI that results in cartilage pathology in human patients is largely unknown. Here, we generated a disease model to study the early stages of cartilage pathology in MPS VI. We generated iPSCs from four patients and isogenic controls by inserting the ARSB cDNA in the AAVS1 safe harbor locus using CRISPR/Cas9. Using an optimized chondrogenic differentiation protocol, we found Periodic acid-Schiff positive inclusions in hiPSC-derived chondrogenic cells with MPS VI. Genome-wide mRNA expression analysis showed that hiPSC-derived chondrogenic cells with MPS VI downregulated expression of genes involved in TGF-β/BMP signalling, and upregulated expression of inhibitors of the Wnt/β-catenin signalling pathway. Expression of genes involved in apoptosis and growth was upregulated, while expression of genes involved in glycosaminoglycan metabolism was dysregulated in hiPSC-derived chondrogenic cells with MPS VI. These results suggest that human ARSB deficiency in MPS VI causes changes in the transcriptional program underlying the early stages of chondrogenic differentiation and metabolism.
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Affiliation(s)
- M. Broeders
- Department of Pediatrics, Erasmus MC University Medical Center, Rotterdam, Netherlands
- Department of Clinical Genetics, Erasmus MC University Medical Center, Rotterdam, Netherlands
- Center for Lysosomal and Metabolic Diseases, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Jgj van Rooij
- Department of Internal Medicine, Erasmus MC Medical Center, Rotterdam, Netherlands
| | - E. Oussoren
- Department of Pediatrics, Erasmus MC University Medical Center, Rotterdam, Netherlands
- Center for Lysosomal and Metabolic Diseases, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Tjm van Gestel
- Department of Pediatrics, Erasmus MC University Medical Center, Rotterdam, Netherlands
- Department of Clinical Genetics, Erasmus MC University Medical Center, Rotterdam, Netherlands
- Center for Lysosomal and Metabolic Diseases, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Ca Smith
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Sj Kimber
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Rm Verdijk
- Department of Pathology, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Maem Wagenmakers
- Center for Lysosomal and Metabolic Diseases, Erasmus MC University Medical Center, Rotterdam, Netherlands
- Department of Internal Medicine, Erasmus MC Medical Center, Rotterdam, Netherlands
| | - Jmp van den Hout
- Department of Pediatrics, Erasmus MC University Medical Center, Rotterdam, Netherlands
- Center for Lysosomal and Metabolic Diseases, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - At van der Ploeg
- Department of Pediatrics, Erasmus MC University Medical Center, Rotterdam, Netherlands
- Center for Lysosomal and Metabolic Diseases, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - R. Narcisi
- Department of Orthopaedics and Sports Medicine, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Wwmp Pijnappel
- Department of Pediatrics, Erasmus MC University Medical Center, Rotterdam, Netherlands
- Department of Clinical Genetics, Erasmus MC University Medical Center, Rotterdam, Netherlands
- Center for Lysosomal and Metabolic Diseases, Erasmus MC University Medical Center, Rotterdam, Netherlands
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de Munck L, Eijkelboom A, Otten H, Broeders M, Siesling S. Screen-detected breast cancers have an improved 5-year recurrence free interval compared to interval and non-screened breast cancers: a population-based study. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01431-9] [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: 11/19/2022]
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Siesling S, Voets M, Groothuis K, Veneklaas L, Manohar S, Brinkhuis M, Veltman J, de Munck L, de Geus-Oei L, Broeders M. Diagnostic work-up in women suspect for breast cancer in the Netherlands. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30767-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rossi P, Lebeau A, Canelo-Aybar C, Rivera MP, Comas D, Quinn C, Coello P, McGarrigle H, Warman S, Broeders M, Duffy S, Langendam M, Gräwingholt A, Follmann M, Saz-Parkinson Z, Schünemann H. Recommendations from the European Commission Initiative on Breast Cancer on multigene tests to guide the use of adjuvant chemotherapy in patients who have hormone receptor positive, HER-2 negative, lymph node negative or up to 3 lymph nodes positive invasive breast cancer. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30555-4] [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: 10/23/2022]
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Duenk RG, Verhagen C, Bronkhorst EM, van Mierlo P, Broeders M, Collard SM, Dekhuijzen P, Vissers K, Heijdra Y, Engels Y. Proactive palliative care for patients with COPD (PROLONG): a pragmatic cluster controlled trial. Int J Chron Obstruct Pulmon Dis 2017; 12:2795-2806. [PMID: 29033560 PMCID: PMC5628666 DOI: 10.2147/copd.s141974] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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] [Indexed: 12/25/2022] Open
Abstract
Background and aim Patients with advanced chronic obstructive pulmonary disease (COPD) have poor quality of life. The aim of this study was to assess the effects of proactive palliative care on the well-being of these patients. Trial registration This trial is registered with the Netherlands Trial Register, NTR4037. Patients and methods A pragmatic cluster controlled trial (quasi-experimental design) was performed with hospitals as cluster (three intervention and three control) and a pretrial assessment was performed. Hospitals were selected for the intervention group based on the presence of a specialized palliative care team (SPCT). To control for confounders, a pretrial assessment was performed in which hospitals were compared on baseline characteristics. Patients with COPD with poor prognosis were recruited during hospitalization for acute exacerbation. All patients received usual care while patients in the intervention group received additional proactive palliative care in monthly meetings with an SPCT. Our primary outcome was change in quality of life score after 3 months, which was measured using the St George Respiratory Questionnaire (SGRQ). Secondary outcomes were, among others, quality of life at 6, 9 and 12 months; readmissions: survival; and having made advance care planning (ACP) choices. All analyses were performed following the principle of intention to treat. Results During the year 2014, 228 patients (90 intervention and 138 control) were recruited and at 3 months, 163 patients (67 intervention and 96 control) completed the SGRQ. There was no significant difference in change scores of the SGRQ total at 3 months between groups (−0.79 [95% CI, −4.61 to 3.34], p=0.70). However, patients who received proactive palliative care experienced less impact of their COPD (SGRQ impact subscale) at 6 months (−6.22 [−11.73 to −0.71], p=0.04) and had more often made ACP choices (adjusted odds ratio 3.26 [1.49–7.14], p=0.003). Other secondary outcomes were not significantly different. Conclusion Proactive palliative care did not improve the overall quality of life of patients with COPD. However, patients more often made ACP choices which may lead to better quality of care toward the end of life.
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Affiliation(s)
- R G Duenk
- Department of Anesthesiology, Pain and Palliative Medicine
| | - C Verhagen
- Department of Anesthesiology, Pain and Palliative Medicine
| | - E M Bronkhorst
- Department of Health Evidence, Radboud University Medical Center, Nijmegen
| | - Pjwb van Mierlo
- Department of Supportive and Palliative Medicine.,Department of Geriatric Medicine, Rijnstate Hospital, Arnhem
| | - Meac Broeders
- Department of Pulmonary Diseases, Jeroen Bosch Hospital, 's-Hertogenbosch
| | - S M Collard
- Department of Pulmonary Diseases, Meander Medical Center, Amersfoort
| | - Pnr Dekhuijzen
- Department of Pulmonary Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Kcp Vissers
- Department of Anesthesiology, Pain and Palliative Medicine
| | - Y Heijdra
- Department of Pulmonary Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Y Engels
- Department of Anesthesiology, Pain and Palliative Medicine
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De Munck L, Fracheboud J, de Bock G, Siesling S, Broeders M. Advanced stage breast cancer is less often diagnosed in women who attend breast cancer screening. Breast 2017. [DOI: 10.1016/s0960-9776(17)30183-2] [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: 10/20/2022] Open
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Levy ML, Dekhuijzen P, Barnes PJ, Broeders M, Corrigan CJ, Chawes BL, Corbetta L, Dubus JC, Hausen T, Lavorini F, Roche N, Sanchis J, Usmani OS, Viejo J, Vincken W, Voshaar T, Crompton GK, Pedersen S. Erratum: Inhaler technique: facts and fantasies. A view from the Aerosol Drug Management Improvement Team (ADMIT). NPJ Prim Care Respir Med 2016; 26:16028. [PMID: 31265706 PMCID: PMC4881806 DOI: 10.1038/npjpcrm.2016.28] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
[This corrects the article DOI: 10.1038/npjpcrm.2016.17.].
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Levy ML, Dekhuijzen PNR, Barnes PJ, Broeders M, Corrigan CJ, Chawes BL, Corbetta L, Dubus JC, Hausen T, Lavorini F, Roche N, Sanchis J, Usmani OS, Viejo J, Vincken W, Voshaar T, Crompton GK, Pedersen S. Inhaler technique: facts and fantasies. A view from the Aerosol Drug Management Improvement Team (ADMIT). NPJ Prim Care Respir Med 2016; 26:16017. [PMID: 27098045 PMCID: PMC4839029 DOI: 10.1038/npjpcrm.2016.17] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/23/2016] [Accepted: 02/09/2016] [Indexed: 01/04/2023] Open
Abstract
Health professionals tasked with advising patients with asthma and chronic obstructive pulmonary disease (COPD) how to use inhaler devices properly and what to do about unwanted effects will be aware of a variety of commonly held precepts. The evidence for many of these is, however, lacking or old and therefore in need of re-examination. Few would disagree that facilitating and encouraging regular and proper use of inhaler devices for the treatment of asthma and COPD is critical for successful outcomes. It seems logical that the abandonment of unnecessary or ill-founded practices forms an integral part of this process: the use of inhalers is bewildering enough, particularly with regular introduction of new drugs, devices and ancillary equipment, without unnecessary and pointless adages. We review the evidence, or lack thereof, underlying ten items of inhaler ‘lore’ commonly passed on by health professionals to each other and thence to patients. The exercise is intended as a pragmatic, evidence-informed review by a group of clinicians with appropriate experience. It is not intended to be an exhaustive review of the literature; rather, we aim to stimulate debate, and to encourage researchers to challenge some of these ideas and to provide new, updated evidence on which to base relevant, meaningful advice in the future. The discussion on each item is followed by a formal, expert opinion by members of the ADMIT Working Group.
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Affiliation(s)
- Mark L Levy
- General Practitioner and Respiratory Lead, Harrow, London, UK
| | - P N R Dekhuijzen
- Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - P J Barnes
- National Heart and Lung Institute, Imperial College London, London, UK
| | - M Broeders
- University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | - C J Corrigan
- Department of Respiratory Medicine and Allergy, King's College London School of Medicine, London, UK
| | - B L Chawes
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - L Corbetta
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - J C Dubus
- Unité de Medicine Infantile, Marseille, France
| | | | - F Lavorini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - N Roche
- Service de Pneumologie et Soins Intensifs Respiratoires, Groupe Hospitalier Cochin, Université Paris-Descartes, Paris, France
| | - J Sanchis
- Departament de Pneumologia, Hospital de la Santa Creuide Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Omar S Usmani
- NIHR Career Development Fellow, National Heart and Lung Institute (NHLI), Imperial College London, UK.,Royal Brompton Hospital, London, UK
| | - J Viejo
- Hospital General Yagüe de Burgos, Spain
| | - W Vincken
- Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Dienst Pneumologie, Brussels, Belgium
| | | | | | - Soren Pedersen
- Pediatric Research Unit, University of Southern Denmark, Kolding Hospital, Kolding, Denmark
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Abstract
OBJECTIVE We examined the development of Parkinson disease (PD)-mild cognitive impairment (MCI) in patients with newly diagnosed PD over 5 years using recently proposed consensus criteria, and we assessed the reliability of the criteria. METHODS Patients with PD (n = 123) underwent extensive neuropsychological testing at baseline and after 3 (n = 93) and 5 years (n = 59). Two neuropsychologists independently applied the PD-MCI criteria to examine the interrater and intrarater reliability. RESULTS At baseline, 35% of patients had PD-MCI. Three years later, 53% of the patients had PD-MCI. At 5-year follow-up, 20 patients who had PD-MCI at an earlier assessment had converted to PD dementia and 50% of the remaining patients without dementia had MCI. The interrater reliability (kappa) was 0.91. The intrarater reliabilities were 0.85 and 0.96. CONCLUSION Approximately one-third of patients with newly diagnosed PD fulfill the consensus criteria for PD-MCI; after 5 years, this proportion is approximately 50% of patients without dementia. The criteria have good interrater and intrarater reliability.
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Affiliation(s)
- M Broeders
- Department of Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands.
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Moss S, Nyström L, Jonsson H, Paci E, Lynge E, Njor S, Broeders M. The Impact of Mammographic Screening on Breast Cancer Mortality in Europe: A Review of Trend Studies. J Med Screen 2012; 19 Suppl 1:26-32. [DOI: 10.1258/jms.2012.012079] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Sm Moss
- Professor of Cancer Epidemiology, Centre for Cancer Prevention, Wolfson Institute for Preventive Medicine, Queen Mary University of London, London, UK
| | - L Nyström
- Associate Professor of Epidemiology, Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - H Jonsson
- Associate Professor of Cancer Epidemiology, Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - E Paci
- Director, Clinical and Descriptive Epidemiology Unit, ISPO, Cancer Research and Prevention Institute, Florence, Italy
| | - E Lynge
- Professor of Epidemiology, Department of Public Health, University of Copenhagen, Denmark
| | - S Njor
- Post Doc, Centre for Epidemiology and Screening, University of Copenhagen, Denmark
| | - M Broeders
- Senior Epidemiologist, Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, and National Expert and Training Centre for Breast Cancer Screening, Nijmegen, The Netherlands
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11
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Leenders MWH, Broeders M, Croese C, Richir MC, Go HLS, Langenhorst BLAM, Meijer S, Schreurs WH. Ultrasound and fine needle aspiration cytology of axillary lymph nodes in breast cancer. To do or not to do? Breast 2012; 21:578-83. [PMID: 22717665 DOI: 10.1016/j.breast.2012.05.008] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 05/12/2012] [Accepted: 05/17/2012] [Indexed: 02/05/2023] Open
Abstract
AIM The purpose of our study was to evaluate the accuracy of axillary ultrasound and ultrasound-guided fine needle aspiration cytology (FNAC) in the preoperative diagnosis of axillary metastases. METHODS Between 2004 and 2009, 1132 female patients were evaluated and treated in our clinic for histologically proven breast carcinoma. Preoperative axillary ultrasound with subsequent FNAC in case of suspicious lymph nodes was performed in 1150 axillae (18 bilateral breast carcinomas). We analyzed the results of axillary ultrasound and FNAC retrospectively. Pathological node status was used as the reference standard (based on axillary dissection or sentinel node biopsy). RESULTS Axillary ultrasound showed suspicious lymph nodes in 327 axillae (28.4%). FNAC showed axillary metastases in 107 of these 327 axillae. Final histological analysis confirmed 106 metastases (one false positive). Histological analysis showed metastatic disease in 429 of 1150 axillae (37.3%). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of axillary ultrasound alone were 43.8% (188/429), 80.7% (582/721), 57.5% (188/327) and 70.7% (582/823), respectively. When combining axillary ultrasound with FNAC of suspicious lymph nodes, sensitivity was 24.7% (106/429), specificity was 99.9% (720/721), PPV was 99.1% (106/107) and NPV was 69.0% (720/1043). CONCLUSIONS 106/429 (24.7%) Node-positive axillae were identified by ultrasound-guided FNAC and spared unnecessary sentinel node biopsy. Unfortunately, the percentage of false negative results of ultrasound-guided FNAC (28.1%, 323/1150) was very high.
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Affiliation(s)
- M W H Leenders
- Department of Surgery, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands.
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Bouwman R, Young K, Lazzari B, Ravaglia V, Broeders M, van Engen R. An alternative method for noise analysis using pixel variance as part of quality control procedures on digital mammography systems. Phys Med Biol 2009; 54:6809-22. [PMID: 19847017 DOI: 10.1088/0031-9155/54/22/004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
According to the European Guidelines for quality assured breast cancer screening and diagnosis, noise analysis is one of the measurements that needs to be performed as part of quality control procedures on digital mammography systems. However, the method recommended in the European Guidelines does not discriminate sufficiently between systems with and without additional noise besides quantum noise. This paper attempts to give an alternative and relatively simple method for noise analysis which can divide noise into electronic noise, structured noise and quantum noise. Quantum noise needs to be the dominant noise source in clinical images for optimal performance of a digital mammography system, and therefore the amount of electronic and structured noise should be minimal. For several digital mammography systems, the noise was separated into components based on the measured pixel value, standard deviation (SD) of the image and the detector entrance dose. The results showed that differences between systems exist. Our findings confirm that the proposed method is able to discriminate systems based on their noise performance and is able to detect possible quality problems. Therefore, we suggest to replace the current method for noise analysis as described in the European Guidelines by the alternative method described in this paper.
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Affiliation(s)
- R Bouwman
- National Expert and Training Centre, Radboud University Nijmegen Medical Centre (LRCB), Weg door Jonkerbos 90, 6532 SZ Nijmegen, The Netherlands.
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Perry N, Broeders M, de Wolf C, Törnberg S, Holland R, von Karsa L. European guidelines for quality assurance in breast cancer screening and diagnosis. Fourth edition--summary document. Ann Oncol 2007; 19:614-22. [PMID: 18024988 DOI: 10.1093/annonc/mdm481] [Citation(s) in RCA: 470] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Breast cancer is a major cause of suffering and death and is of significant concern to many women. Early detection of breast cancer by systematic mammography screening can find lesions for which treatment is more effective and generally more favourable for quality of life. The potential harm caused by mammography includes the creation of unnecessary anxiety and morbidity, inappropriate economic cost and the use of ionising radiation. It is for this reason that the strongest possible emphasis on quality control and quality assurance is required. Development of the European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis has been an initiative within the Europe Against Cancer Programme. The fourth edition of the multidisciplinary guidelines was published in 2006 and comprises approximately 400 pages divided into 12 chapters prepared by >200 authors and contributors. The multidisciplinary editorial board has prepared a summary document to provide an overview of the fundamental points and principles that should support any quality screening or diagnostic service. This document includes a summary table of key performance indicators and is presented here in order to make these principles and standards known to a wider scientific community.
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Affiliation(s)
- N Perry
- London Region Breast Screening Programme, Quality Assurance Reference Centre, St Bartholomew's Hospital, London, UK
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Crompton GK, Barnes PJ, Broeders M, Corrigan C, Corbetta L, Dekhuijzen R, Dubus JC, Magnan A, Massone F, Sanchis J, Viejo JL, Voshaar T. The need to improve inhalation technique in Europe: a report from the Aerosol Drug Management Improvement Team. Respir Med 2006; 100:1479-94. [PMID: 16495040 DOI: 10.1016/j.rmed.2006.01.008] [Citation(s) in RCA: 174] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2005] [Revised: 12/21/2005] [Accepted: 01/09/2006] [Indexed: 11/27/2022]
Abstract
Although the principles of asthma management are well established in Europe, the available data indicate that asthma in patients is not well controlled. Many patients derive incomplete benefit from their inhaled medication because they do not use inhaler devices correctly and this may compromise asthma control. The Aerosol Drug Management Improvement Team (ADMIT), incorporating clinicians from the UK, Germany, France, Italy, Spain and The Netherlands, reviewed published evidence to examine ways to improve the treatment of reversible airways disease in Europe. Data indicate that there is a clear need for specific training of patients in correct inhalation technique for the various devices currently available, and this should be repeated frequently to maintain correct inhalation technique. Devices which provide reassurance to patients and their physicians that inhalation is performed correctly should help to improve patient compliance and asthma control. Educational efforts should also focus on primary prescribers of inhaler devices. ADMIT recommends dissemination of information on the correct inhalation technique for each model of device by the use of an accessible dedicated literature base or website which would enable to match the appropriate inhaler to the individual patient. There is also a need for standardisation of prescribing practices throughout Europe. Regular checking of inhalation technique by prescribers is crucial as correct inhalation is one of the keystones of successful asthma management.
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Affiliation(s)
- G K Crompton
- Respiratory Unit, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, Scotland, UK.
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Klabunde CN, Sancho-Garnier H, Broeders M, Thoresen S, Rodrigues VJ, Ballard-Barbash R. Quality assurance for screening mammography data collection systems in 22 countries. Int J Technol Assess Health Care 2002; 17:528-41. [PMID: 11758297] [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: 02/23/2023]
Abstract
OBJECTIVES To document the mammography data that are gathered by the organized screening programs participating in the International Breast Cancer Screening Network (IBSN), the nature of their procedures for data quality assurance, and the measures used to assess program performance and impact. METHODS A detailed questionnaire covering multiple aspects of quality assurance in screening mammography was mailed to IBSN representatives in 23 countries. RESULTS Countries collect a wealth of screening mammography data, much of it computerized. Most countries have designated staff for data quality assurance. All provide staff training, and most have documentation requirements for data collection. Nearly all have one or more procedures to maintain data confidentiality. Countries are heterogeneous in collecting and assessing data to monitor screening program performance and impact. CONCLUSIONS Demonstrating that population-based screening mammography reduces breast cancer mortality requires collection of high-quality data on key aspects of the multi-step screening process. Assuring the quality of data collection systems for screening mammography programs is an important and evolving area for IBSN countries.
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Ballard-Barbash R, Klabunde C, Paci E, Broeders M, Coleman EA, Fracheboud J, Bouchard F, Rennert G, Shapiro S. Breast cancer screening in 21 countries: delivery of services, notification of results and outcomes ascertainment. Eur J Cancer Prev 1999; 8:417-26. [PMID: 10548397 DOI: 10.1097/00008469-199910000-00007] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.2] [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: 11/26/2022]
Abstract
Following clinical trial evidence of mammography screening's efficacy and effectiveness, data are needed from organized population-based programmes to determine whether screening in these programmes results in breast cancer mortality reductions comparable to those demonstrated in controlled settings. The International Breast Cancer Screening Network (IBSN) conducted two international programme assessments: in 1990 among nine countries and in 1995 among 22 countries, obtaining information on the organization and process for screening within breast cancer screening programmes. This manuscript describes procedures for recruitment, service delivery, interpretation and communication of results, case ascertainment, and quality assurance. Practices in more established programmes are compared with pilot programmes. Each IBSN country defined a unique programme of population-based breast cancer screening. Some programmes were sub-national rather than national in scope, while others were in pilot stages of development. Screening took place in dedicated centres in established programmes and in both dedicated and general radiology centres in pilot programmes. Although most countries used personal invitation systems to recruit women to screening, other recruitment mechanisms were used. Most countries used two-view mammography in their screening programmes. About half had implemented independent double reading of mammograms, considering it a key component of high-quality mammography screening. In conclusion, diversity exists in the organization and delivery of screening mammography internationally. Quality assurance activities are a priority and are being evaluated in the IBSN.
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Shapiro S, Coleman EA, Broeders M, Codd M, de Koning H, Fracheboud J, Moss S, Paci E, Stachenko S, Ballard-Barbash R. Breast cancer screening programmes in 22 countries: current policies, administration and guidelines. International Breast Cancer Screening Network (IBSN) and the European Network of Pilot Projects for Breast Cancer Screening. Int J Epidemiol 1998; 27:735-42. [PMID: 9839727 DOI: 10.1093/ije/27.5.735] [Citation(s) in RCA: 158] [Impact Index Per Article: 6.1] [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: 11/13/2022] Open
Abstract
BACKGROUND Currently there are at least 22 countries worldwide where national, regional or pilot population-based breast cancer screening programmes have been established. A collaborative effort has been undertaken by the International Breast Cancer Screening Network (IBSN), an international voluntary collaborative effort administered from the National Cancer Institute in the US for the purposes of producing international data on the policies, funding and administration, and results of population-based breast cancer screening. METHODS Two surveys conducted by the IBSN in 1990 and 1995 describe the status of population-based breast cancer screening in countries which had or planned to establish breast cancer screening programmes in their countries. The 1990 survey was sent to ten countries in the IBSN and was completed by nine countries. The 1995 survey was sent to and completed by the 13 countries in the organization at that time and an additional nine countries in the European Network. RESULTS The programmes vary in how they have been organized and have changed from 1990 to 1995. The most notable change is the increase in the number of countries that have established or plan to establish organized breast cancer screening programmes. A second major change is in guidelines for the lower age limit for mammography screening and the use of the clinical breast examination and breast self-examination as additional detection methods. CONCLUSION As high quality population-based breast cancer screening programmes are implemented in more countries, they will offer an unprecedented opportunity to assess the level of coverage of the population for initial and repeat screening, evaluation of performance, and, in the longer term, outcome of screening in terms of reduction in the incidence of late-stage disease and in mortality.
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Affiliation(s)
- S Shapiro
- Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD, USA
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Taylor R, Chidley K, Goodwin J, Broeders M, Kirby B. Accutracker II (version 30/23) ambulatory blood pressure monitor: clinical validation using the British Hypertension Society and Association for the Advancement of Medical Instrumentation standards. J Hypertens 1993; 11:1275-82. [PMID: 8301110] [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: 01/29/2023]
Abstract
OBJECTIVE To assess the Accutracker II (version 30/23) ambulatory blood pressure monitor by nationally agreed protocols in order to resolve previous conflicting assessments, and to examine the feasibility of combining these protocols into one study. DESIGN The protocols of the Association for the Advancement of Medical Instrumentation (AAMI) and the British Hypertension Society (BHS) were used simultaneously. SUBJECTS Five normotensive subjects were used to assess interobserver variation; 30 subjects took part in the field evaluation and 85 in the laboratory evaluation. The latter subjects were selected to cover a wide range of blood pressures and differences in arm circumference. OUTCOME MEASUREMENTS Classification of device accuracy according to the criteria of the BHS and AAMI protocols. RESULTS Among 255 observations the mean +/- SD difference between blood pressure measurements by the Accutracker II and the observers was -2.2 +/- 0.8/-3.5 +/- 0.9 mmHg. There was a small but statistically significant difference between one device and the other two, but all three fulfilled the BHS criteria of 95% of measurements falling within 3 mmHg before and after use. In 30 24-h recordings > 80% of the programmed inflations produced valid recordings. Editing criteria accounted for the majority (55%) of invalid readings; weak Korotkoff sounds, imperfect electrocardiogram signals or movement artefact accounted for the remainder. CONCLUSIONS Version 30/23 of the Accutracker II fulfilled the AAMI criteria; using the BHS system, it was graded A for systolic and C for diastolic blood pressure. Although both protocols were readily combined into one study, they do not assess exactly the same aspects of blood pressure measurement. Previous conflicting evaluations could be due to differences in applying the protocols or may result from modifications in production models. Posture may affect the rating given by the BHS protocol. Until there is general international agreement on the method used to validate ambulatory blood pressure monitors, simultaneous use of both the BHS and AAMI protocols is recommended. In future assessments or investigational use of any similar instruments the model used should be described precisely.
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Affiliation(s)
- R Taylor
- St Loyes School of Occupational Therapy, Exeter, UK
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