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Nichting TJ, van Lier ZA, de Vet C, van der Ven M, van der Woude DAA, Clur SA, van Oostrum NHM, Oei SG, van Laar JOEH. Feasibility and reliability of fetal two dimensional speckle tracking echocardiography at 16 weeks gestational age: A pilot study. PLoS One 2024; 19:e0302123. [PMID: 38630708 PMCID: PMC11023584 DOI: 10.1371/journal.pone.0302123] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Fetal two-dimensional speckle tracking echocardiography (2D-STE) is an emerging technique for assessing fetal cardiac function by measuring global longitudinal strain. Alterations in global longitudinal strain may serve as early indicator of pregnancy complications, making 2D-STE a potentially valuable tool for early detection. Early detection can facilitate timely interventions to reduce fetal and maternal morbidity and mortality. Therefore, the aim of this study was to investigate the feasibility of performing 2D-STE at 16 weeks gestational age. METHODS This pilot study utilized 50 ultrasound clips of the fetal four-chamber view recorded between 15+5 and 16+2 weeks gestational age from a prospective cohort study. A strict protocol assessed three parameters essential for 2D-STE analysis: fetal four-chamber view ultrasound clip quality, region of interest, and frame rates. Two independent researchers measured global longitudinal strain in all adequate fetal four-chamber view ultrasound clips to determine inter- and intra-operator reliability. RESULTS Out of the 50 ultrasound clips, 37 (74%) were feasible for 2D-STE analysis. The inter-operator reliability for global longitudinal strain measurements of the left and right ventricles was moderate (ICC of 0.64 and 0.74, respectively), while the intra-operator reliability was good (ICC of 0.76 and 0.79, respectively). CONCLUSIONS Our findings demonstrate that fetal 2D-STE analysis at 16 weeks gestational age is feasible when adhering to a strict protocol. However, further improvements are necessary to enhance the inter- and intra-operator reliability of 2D-STE at this gestational age.
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Affiliation(s)
- Thomas J. Nichting
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - Zoé A. van Lier
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Chantelle de Vet
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - Myrthe van der Ven
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Daisy A. A. van der Woude
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - Sally A. Clur
- Department of Pediatric Cardiology, Emma Children’s Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Member of the European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart–ERN GUARD-Heart, Amsterdam, The Netherlands
| | | | - S. Guid Oei
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - Judith O. E. H. van Laar
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
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Wu Y, Hamelmann P, van der Ven M, Asvadi S, van der Hout-van der Jagt MB, Oei SG, Mischi M, Bergmans J, Long X. Early prediction of gestational diabetes mellitus using maternal demographic and clinical risk factors. BMC Res Notes 2024; 17:105. [PMID: 38622619 PMCID: PMC11021008 DOI: 10.1186/s13104-024-06758-z] [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: 10/17/2023] [Accepted: 03/27/2024] [Indexed: 04/17/2024] Open
Abstract
OBJECTIVE To build and validate an early risk prediction model for gestational diabetes mellitus (GDM) based on first-trimester electronic medical records including maternal demographic and clinical risk factors. METHODS To develop and validate a GDM prediction model, two datasets were used in this retrospective study. One included data of 14,015 pregnant women from Máxima Medical Center (MMC) in the Netherlands. The other was from an open-source database nuMoM2b including data of 10,038 nulliparous pregnant women, collected in the USA. Widely used maternal demographic and clinical risk factors were considered for modeling. A GDM prediction model based on elastic net logistic regression was trained from a subset of the MMC data. Internal validation was performed on the remaining MMC data to evaluate the model performance. For external validation, the prediction model was tested on an external test set from the nuMoM2b dataset. RESULTS An area under the receiver-operating-characteristic curve (AUC) of 0.81 was achieved for early prediction of GDM on the MMC test data, comparable to the performance reported in previous studies. While the performance markedly decreased to an AUC of 0.69 when testing the MMC-based model on the external nuMoM2b test data, close to the performance trained and tested on the nuMoM2b dataset only (AUC = 0.70).
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Affiliation(s)
- Yanqi Wu
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Philips Research, Eindhoven, The Netherlands
| | | | - Myrthe van der Ven
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Department of Obstetrics and Gynaecology, Máxima Medical Center, Veldhoven, The Netherlands
| | - Sima Asvadi
- Philips Research, Eindhoven, The Netherlands
| | - M Beatrijs van der Hout-van der Jagt
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Department of Obstetrics and Gynaecology, Máxima Medical Center, Veldhoven, The Netherlands
| | - S Guid Oei
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Department of Obstetrics and Gynaecology, Máxima Medical Center, Veldhoven, The Netherlands
| | - Massimo Mischi
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Jan Bergmans
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Xi Long
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
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Nichting TJ, Bester M, Joshi R, Mischi M, van der Ven M, van der Woude DAA, Oei SG, van Laar JOEH, Vullings R. Evidence and clinical relevance of maternal-fetal cardiac coupling: A scoping review. PLoS One 2023; 18:e0287245. [PMID: 37437012 DOI: 10.1371/journal.pone.0287245] [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: 12/27/2022] [Accepted: 06/01/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Researchers have long suspected a mutual interaction between maternal and fetal heart rhythms, referred to as maternal-fetal cardiac coupling (MFCC). While several studies have been published on this phenomenon, they vary in terms of methodologies, populations assessed, and definitions of coupling. Moreover, a clear discussion of the potential clinical implications is often lacking. Subsequently, we perform a scoping review to map the current state of the research in this field and, by doing so, form a foundation for future clinically oriented research on this topic. METHODS A literature search was performed in PubMed, Embase, and Cochrane. Filters were only set for language (English, Dutch, and German literature were included) and not for year of publication. After screening for the title and the abstract, a full-text evaluation of eligibility followed. All studies on MFCC were included which described coupling between heart rate measurements in both the mother and fetus, regardless of the coupling method used, gestational age, or the maternal or fetal health condition. RESULTS 23 studies remained after a systematic evaluation of 6,672 studies. Of these, 21 studies found at least occasional instances of MFCC. Methods used to capture MFCC are synchrograms and corresponding phase coherence indices, cross-correlation, joint symbolic dynamics, transfer entropy, bivariate phase rectified signal averaging, and deep coherence. Physiological pathways regulating MFCC are suggested to exist either via the autonomic nervous system or due to the vibroacoustic effect, though neither of these suggested pathways has been verified. The strength and direction of MFCC are found to change with gestational age and with the rate of maternal breathing, while also being further altered in fetuses with cardiac abnormalities and during labor. CONCLUSION From the synthesis of the available literature on MFCC presented in this scoping review, it seems evident that MFCC does indeed exist and may have clinical relevance in tracking fetal well-being and development during pregnancy.
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Affiliation(s)
- Thomas J Nichting
- Department of Gynaecology and Obstetrics, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - Maretha Bester
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
- Department of Patient Care and Monitoring, Philips Research, Eindhoven, The Netherlands
| | - Rohan Joshi
- Department of Patient Care and Monitoring, Philips Research, Eindhoven, The Netherlands
| | - Massimo Mischi
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - Myrthe van der Ven
- Department of Gynaecology and Obstetrics, Veldhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Daisy A A van der Woude
- Department of Gynaecology and Obstetrics, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - S Guid Oei
- Department of Gynaecology and Obstetrics, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - Judith O E H van Laar
- Department of Gynaecology and Obstetrics, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - Rik Vullings
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
- Nemo Healthcare, Veldhoven, The Netherlands
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Nichting TJ, de Vet CM, van der Ven M, van der Woude DAA, Regis M, van Sloun RJG, Oei SG, van Laar JOEH, van Oostrum NHM. The impact of angles of insonation on left and right ventricular global longitudinal strain estimation in fetal speckle tracking echocardiography. PLoS One 2023; 18:e0287003. [PMID: 37437044 DOI: 10.1371/journal.pone.0287003] [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: 02/14/2023] [Accepted: 05/28/2023] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVES Two-dimensional speckle tracking echocardiography has been considered an angle-independent modality. However, current literature is limited and inconclusive on the actual impact of angle of insonation on strain values. Therefore, the primary objective of this study was to assess the impact of angles of insonation on the estimation of fetal left ventricular and right ventricular global longitudinal strain. Secondarily, the impact of different definitions for angles of insonation was investigated in a sensitivity analysis. METHODS This is a retrospective analysis of a prospective longitudinal cohort study with 124 healthy subjects. The analyses were based on the four-chamber view ultrasound clips taken between 18+0 and 21+6 weeks of gestation. Angles of insonation were categorized into three groups: up/down, oblique and perpendicular. The mean fetal left and right ventricular and global longitudinal strain values corresponding to these three groups were compared by an ANOVA test corrected for heteroscedasticity. RESULTS Fetal left and right ventricular global longitudinal strain values were not statistically different between the three angles of insonation (p-value >0.062 and >0.149, respectively). When applying another definition for angles of insonation in the sensitivity analysis, the mean left ventricular global longitudinal strain value was significantly decreased for the oblique compared to the up/down angle of insonation (p-value 0.041). CONCLUSIONS There is no evidence of a difference in fetal left and right ventricular global longitudinal strain between the different angles of insonation in fetal two-dimensional speckle tracking echocardiography.
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Affiliation(s)
- Thomas J Nichting
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - Chantelle M de Vet
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - Myrthe van der Ven
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Daisy A A van der Woude
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - Marta Regis
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Ruud J G van Sloun
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - S Guid Oei
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
| | - Judith O E H van Laar
- Department of Gynaecology and Obstetrics, Máxima MC, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Centre, Eindhoven, The Netherlands
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Zhang Y, Xu L, van der Ven M, Ouzounov S, Meftah M, Mischi M, Cantatore E, Harpe P. Comparison and Integration of Voltage and Charge Amplifiers for Capacitive ECG Measurements. IEEE Trans Biomed Eng 2022; 70:501-510. [PMID: 35917570 DOI: 10.1109/tbme.2022.3195771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Sensing with capacitive electrodes is of interest for long-term, comfortable bio-potential measurements (e.g., ECG). However, due to the small body-to-electrode capacitance (Ce), the design of the associated front-end amplifier remains a challenge. Both voltage amplifiers (VA) and charge amplifiers (CA) can be employed. While basic comparisons of both typologies were done before, this paper extends the comparison to their responses to artifacts (caused by motion or interference). Further, a VA-CA-switchable amplifier is proposed, allowing to adapt the amplifier type to different situations, and enabling to estimate the body-to-electrode capacitance Ce in a passive way. METHODS A VA-CA switchable amplifier was implemented in a 180 nm CMOS process. The responses to artifacts for VA and CA were studied by modelling, simulations and experiments using the custom IC. The proposed Ce estimation method was validated by electrical tests and in-vivo tests. RESULTS VAs are less affected by Ce variation artifacts, while CAs recover faster from triboelectricity artifacts. In a VA, these two artifacts are multiplicative and get modulated if they occur simultaneously, but in a CA they remain independent. CONCLUSION The combined VA-CA amplifier has the potential for optimal amplifier selection according to the properties of the recorded signal, the value of Ce and the actual presence of artifacts. Moreover, it can estimate Ce without extra hardware. SIGNIFICANCE The proposed VA-CA switchable structure is superior to an individual VA or CA, thanks its adaptability to signal quality and artifacts, and it provides extra information on the body-to-electrode interface quality (Ce).
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Nichting TJ, de Vet CM, van der Ven M, van der Woude DAA, van Sloun RJG, Oei SG, van Oostrum NHM, van Laar JOEH. Angle Independency of Fetal Speckle Tracking Echocardiography: a commentary letter. J Am Soc Echocardiogr 2022; 35:783-785. [PMID: 35271991 DOI: 10.1016/j.echo.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Thomas J Nichting
- Department of gynaecology and obstetrics, Máxima Medical Centre, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands; Department of electrical engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands.
| | - Chantelle M de Vet
- Department of gynaecology and obstetrics, Máxima Medical Centre, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands; Department of electrical engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
| | - Myrthe van der Ven
- Department of gynaecology and obstetrics, Máxima Medical Centre, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands; Department of electrical engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
| | - Daisy A A van der Woude
- Department of gynaecology and obstetrics, Máxima Medical Centre, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands; Department of electrical engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
| | - Ruud J G van Sloun
- Department of electrical engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
| | - S Guid Oei
- Department of gynaecology and obstetrics, Máxima Medical Centre, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands; Department of electrical engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
| | - Noortje H M van Oostrum
- Department of electrical engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Department of gynaecology and obstetrics, University Hospital Gent, 9000 Gent, Belgium
| | - Judith O E H van Laar
- Department of gynaecology and obstetrics, Máxima Medical Centre, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands; Department of electrical engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands; Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
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van der Hout-van der Jagt MB, Verweij EJT, Andriessen P, de Boode WP, Bos AF, Delbressine FLM, Eggink AJ, Erwich JJHM, Feijs LMG, Groenendaal F, Kramer BWW, Lely AT, Loop RFAM, Neukamp F, Onland W, Oudijk MA, te Pas AB, Reiss IKM, Schoberer M, Scholten RR, Spaanderman MEA, van der Ven M, Vermeulen MJ, van de Vosse FN, Oei SG. Interprofessional Consensus Regarding Design Requirements for Liquid-Based Perinatal Life Support (PLS) Technology. Front Pediatr 2022; 9:793531. [PMID: 35127593 PMCID: PMC8809135 DOI: 10.3389/fped.2021.793531] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/14/2021] [Indexed: 12/23/2022] Open
Abstract
Liquid-based perinatal life support (PLS) technology will probably be applied in a first-in-human study within the next decade. Research and development of PLS technology should not only address technical issues, but also consider socio-ethical and legal aspects, its application area, and the corresponding design implications. This paper represents the consensus opinion of a group of healthcare professionals, designers, ethicists, researchers and patient representatives, who have expertise in tertiary obstetric and neonatal care, bio-ethics, experimental perinatal animal models for physiologic research, biomedical modeling, monitoring, and design. The aim of this paper is to provide a framework for research and development of PLS technology. These requirements are considering the possible respective user perspectives, with the aim to co-create a PLS system that facilitates physiological growth and development for extremely preterm born infants.
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Affiliation(s)
- M. Beatrijs van der Hout-van der Jagt
- Department of Obstetrics and Gynecology, Máxima Medical Centre, Veldhoven, Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - E. J. T. Verweij
- Department of Obstetrics and Gynecology, Division of Fetal Therapy, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Peter Andriessen
- Department of Neonatology, Máxima Medical Centre, Veldhoven, Netherlands
- Department of Applied Physics, School of Medical Physics and Engineering Eindhoven, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Willem P. de Boode
- Division of Neonatology, Department of Perinatology, Radboud University Medical Center, Radboud Institute for Health Sciences, Amalia Children's Hospital, Nijmegen, Netherlands
| | - Arend F. Bos
- Department of Neonatology, University Medical Center Groningen, University of Groningen, Beatrix Children's Hospital, Groningen, Netherlands
| | - Frank L. M. Delbressine
- Department of Industrial Design Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Alex J. Eggink
- Department of Obstetrics and Gynecology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Jan Jaap H. M. Erwich
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Loe M. G. Feijs
- Department of Industrial Design Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Floris Groenendaal
- Department of Neonatology, Utrecht University Medical Center, Utrecht, Netherlands
| | - Boris W. W. Kramer
- Department of Neonatology, Maastricht University Medical Center (MUMC), Maastricht, Netherlands
| | - A. Titia Lely
- Department of Obstetrics and Gynecology, Utrecht University Medical Center, Utrecht, Netherlands
| | - Rachel F. A. M. Loop
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
- Department of Industrial Design Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Franziska Neukamp
- Institute for Applied Medical Engineering and Clinic for Neonatology, University Hospital Aachen, Aachen, Germany
| | - Wes Onland
- Department of Neonatology, Amsterdam UMC, Amsterdam, Netherlands
| | - Martijn A. Oudijk
- Amsterdam Reproduction and Development Research Institute, Department of Obstetrics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Arjan B. te Pas
- Department of Neonatology, Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Irwin K. M. Reiss
- Department of Neonatology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Mark Schoberer
- Institute for Applied Medical Engineering and Clinic for Neonatology, University Hospital Aachen, Aachen, Germany
| | - Ralph R. Scholten
- Department of Obstetrics and Gynecology, Radboud Medical Centre, Nijmegen, Netherlands
| | - Marc E. A. Spaanderman
- Department of Obstetrics and Gynecology, Radboud Medical Centre, Nijmegen, Netherlands
- Department of Obstetrics and Gynecology, Maastricht University Medical Center (MUMC), Maastricht, Netherlands
| | - Myrthe van der Ven
- Department of Obstetrics and Gynecology, Máxima Medical Centre, Veldhoven, Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Marijn J. Vermeulen
- Department of Neonatology, Erasmus Medical Centre, Rotterdam, Netherlands
- Care4Neo Foundation, Rotterdam, Netherlands
| | - Frans N. van de Vosse
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - S. Guid Oei
- Department of Obstetrics and Gynecology, Máxima Medical Centre, Veldhoven, Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
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8
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Galli A, Peri E, Zhang Y, Vullings R, van der Ven M, Giorgi G, Ouzounov S, Harpe PJA, Mischi M. Dedicated Algorithm for Unobtrusive Fetal Heart Rate Monitoring Using Multiple Dry Electrodes. Sensors (Basel) 2021; 21:s21134298. [PMID: 34201834 PMCID: PMC8271482 DOI: 10.3390/s21134298] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/16/2021] [Accepted: 06/21/2021] [Indexed: 12/03/2022]
Abstract
Multi-channel measurements from the maternal abdomen acquired by means of dry electrodes can be employed to promote long-term monitoring of fetal heart rate (fHR). The signals acquired with this type of electrode have a lower signal-to-noise ratio and different artifacts compared to signals acquired with conventional wet electrodes. Therefore, starting from the benchmark algorithm with the best performance for fHR estimation proposed by Varanini et al., we propose a new method specifically designed to remove artifacts typical of dry-electrode recordings. To test the algorithm, experimental textile electrodes were employed that produce artifacts typical of dry and capacitive electrodes. The proposed solution is based on a hybrid (hardware and software) pre-processing step designed specifically to remove the disturbing component typical of signals acquired with these electrodes (triboelectricity artifacts and amplitude modulations). The following main processing steps consist of the removal of the maternal ECG by blind source separation, the enhancement of the fetal ECG and identification of the fetal QRS complexes. Main processing is designed to be robust to the high-amplitude motion artifacts that corrupt the acquisition. The obtained denoising system was compared with the benchmark algorithm both on semi-simulated and on real data. The performance, quantified by means of sensitivity, F1-score and root-mean-square error metrics, outperforms the performance obtained with the original method available in the literature. This result proves that the design of a dedicated processing system based on the signal characteristics is necessary for reliable and accurate estimation of the fHR using dry, textile electrodes.
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Affiliation(s)
- Alessandra Galli
- Department of Information Engineering, University of Padova, I-35131 Padova, Italy; (A.G.); (G.G.)
- Department of Electrical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (E.P.); (Y.Z.); (R.V.); (M.v.d.V.); (P.J.A.H.)
| | - Elisabetta Peri
- Department of Electrical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (E.P.); (Y.Z.); (R.V.); (M.v.d.V.); (P.J.A.H.)
| | - Yijing Zhang
- Department of Electrical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (E.P.); (Y.Z.); (R.V.); (M.v.d.V.); (P.J.A.H.)
| | - Rik Vullings
- Department of Electrical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (E.P.); (Y.Z.); (R.V.); (M.v.d.V.); (P.J.A.H.)
| | - Myrthe van der Ven
- Department of Electrical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (E.P.); (Y.Z.); (R.V.); (M.v.d.V.); (P.J.A.H.)
| | - Giada Giorgi
- Department of Information Engineering, University of Padova, I-35131 Padova, Italy; (A.G.); (G.G.)
| | | | - Pieter J. A. Harpe
- Department of Electrical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (E.P.); (Y.Z.); (R.V.); (M.v.d.V.); (P.J.A.H.)
| | - Massimo Mischi
- Department of Electrical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (E.P.); (Y.Z.); (R.V.); (M.v.d.V.); (P.J.A.H.)
- Correspondence:
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Rogier C, van der Ven M, van der Helm-van Mil AHM, de Jong PHP. Is shoulder involvement in clinically suspect arthralgia an early feature of rheumatoid arthritis? A longitudinal ultrasound study. Rheumatology (Oxford) 2020; 59:2640-2642. [PMID: 32118273 PMCID: PMC7571510 DOI: 10.1093/rheumatology/keaa052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 12/03/2022] Open
Affiliation(s)
- Cleo Rogier
- Department of Rheumatology, Erasmus University Medical Center (Erasmus MC), Rotterdam
| | - Myrthe van der Ven
- Department of Rheumatology, Erasmus University Medical Center (Erasmus MC), Rotterdam
| | - Annette H M van der Helm-van Mil
- Department of Rheumatology, Erasmus University Medical Center (Erasmus MC), Rotterdam.,Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Pascal H P de Jong
- Department of Rheumatology, Erasmus University Medical Center (Erasmus MC), Rotterdam
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10
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van Mulligen E, de Jong PHP, Kuijper TM, van der Ven M, Appels C, Bijkerk C, Harbers JB, de Man Y, Molenaar THE, Tchetverikov I, Goekoop-Ruiterman YPM, van Zeben J, Hazes JMW, Weel AEAM, Luime JJ. Gradual tapering TNF inhibitors versus conventional synthetic DMARDs after achieving controlled disease in patients with rheumatoid arthritis: first-year results of the randomised controlled TARA study. Ann Rheum Dis 2019; 78:746-753. [DOI: 10.1136/annrheumdis-2018-214970] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/14/2019] [Accepted: 03/16/2019] [Indexed: 11/04/2022]
Abstract
ObjectivesThe aim of this study is to evaluate the effectiveness of two tapering strategies after achieving controlled disease in patients with rheumatoid arthritis (RA), during 1 year of follow-up.MethodsIn this multicentre single-blinded (research nurses) randomised controlled trial, patients with RA were included who achieved controlled disease, defined as a Disease Activity Score (DAS) ≤ 2.4 and a Swollen Joint Count (SJC) ≤ 1, treated with both a conventional synthetic disease-modifying antirheumatic drugs (csDMARD) and a TNF inhibitor. Eligible patients were randomised into gradual tapering csDMARDs or TNF inhibitors. Medication was tapered if the RA was still under control, by cutting the dosage into half, a quarter and thereafter it was stopped. Primary outcome was proportion of patients with a disease flare, defined as DAS > 2.4 and/or SJC > 1. Secondary outcomes were DAS, European Quality of Life-5 Dimensions (EQ5D) and functional ability (Health Assessment Questionnaire Disability Index [HAQ-DI]) after 1 year and over time.ResultsA total of 189 patients were randomly assigned to tapering csDMARDs (n = 94) or tapering anti-TNF (n = 95). The cumulative flare rates in the csDMARD and anti-TNF tapering group were, respectively, 33 % (95% CI,24% to 43 %) and 43 % (95% CI, 33% to 53 % (p = 0.17). Mean DAS, HAQ-DI and EQ-5D did not differ between tapering groups after 1 year and over time.ConclusionUp to 9 months, flare rates of tapering csDMARDs or TNF inhibitors were similar. After 1 year, a non-significant difference was found of 10 % favouring csDMARD tapering. Tapering TNF inhibitors was, therefore, not superior to tapering csDMARDs. From a societal perspective, it would be sensible to taper the TNF inhibitor first, because of possible cost reductions and less long-term side effects.Trial registration numberNTR2754
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van der Ven M, Kuijper TM, Gerards AH, Tchetverikov I, Weel AE, van Zeben J, Hazes JM, Luime JJ. No clear association between ultrasound remission and health status in rheumatoid arthritis patients in clinical remission. Rheumatology (Oxford) 2017; 56:1276-1281. [PMID: 28407127 DOI: 10.1093/rheumatology/kex080] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Indexed: 01/04/2023] Open
Abstract
Objectives Although RA patients achieve clinical remission, risk of flare still exists. Given the association between US synovitis and increased risk of flare, it is of clinical interest whether these patients report a different health status. Therefore, our aim was to evaluate the frequency of US remission in RA patients in clinical remission and to compare the health status of RA patients in clinical remission with those who were also in US remission. Methods In a prospective study, we included 89 RA patients (aged >17 years) treated with a synthetic DMARD and a TNF inhibitor who were in remission (DAS in 44 joints ⩽2.4 and swollen joint count ⩽1). Demographic characteristics, swollen and tender joints, laboratory variables, US (MCP2-5, PIP2-5, wrists and MTP2-5) and patient-reported outcomes (general health, functional ability, fatigue, depression and anxiety, pain and morning stiffness) were recorded at two consecutive visits (3 months apart). US remission was defined as grey scale grade ⩽1 and power Doppler = 0. Results At visit 1, 39% of patients were in US remission. At visit 2, 32% of patients were in US remission. At visit 1, functional ability (HAQ) was scored lower by patients in US remission (P = 0.029). At visit 2, HAQ scores were similar (P = 0.928). At visit 2, Hospital Anxiety and Depression Scale anxiety score and visual analog scale pain were significantly higher in patients in US remission. Similar levels were found for the other patient-reported outcomes. Conclusion One-third of RA patients in clinical remission were in US remission. In our study population, we could not find a clear association between health status of RA patients and being in US remission.
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Affiliation(s)
- Myrthe van der Ven
- Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam
| | - T Martijn Kuijper
- Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam
| | | | | | - Angelique E Weel
- Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam.,Department of Rheumatology, Maasstad Hospital
| | - Jendé van Zeben
- Department of Rheumatology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Johanna M Hazes
- Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam
| | - Jolanda J Luime
- Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam
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12
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van der Ven M, van der Veer-Meerkerk M, Ten Cate DF, Rasappu N, Kok MR, Csakvari D, Hazes JMW, Gerards AH, Luime JJ. Absence of ultrasound inflammation in patients presenting with arthralgia rules out the development of arthritis. Arthritis Res Ther 2017; 19:202. [PMID: 28915847 PMCID: PMC5602837 DOI: 10.1186/s13075-017-1405-y] [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] [Received: 04/18/2017] [Accepted: 08/15/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND To decrease the burden of disease of rheumatoid arthritis (RA), patients at risk for RA need to be identified as early as possible, preferably when no clinically apparent synovitis can be detected. Up to now, it has been fairly difficult to identify those patients with arthralgia who develop inflammatory arthritis (IA), but recent studies using ultrasound (US) suggest that earlier detection is possible. We aimed to identify patients with arthralgia developing IA within 1 year using US to detect subclinical synovitis at first consultation. METHODS In a multi-centre cohort study, we followed patients with arthralgia with at least two painful joints of the hands, feet or shoulders without clinical synovitis over 1 year. Symptom duration was < 1 year, and symptoms were not explained by other conditions. At baseline and at 6 and 12 months, data were collected for physical examinations, laboratory values and diagnoses. At baseline, we examined 26 joints ultrasonographically (bilateral metacarpophalangeal joints 2-5, proximal interphalangeal joints 2-5, wrist and metatarsophalangeal joints 2-5). Scoring was done semi-quantitatively on greyscale (GS; 0-3) and power Doppler (PD; 0-3) images. US synovitis was defined as GS ≥ 2 and/or PD ≥ 1. IA was defined as clinical soft tissue swelling. Sensitivity and specificity were used to assess the diagnostic value of US for the development of IA. Univariate logistic regression was used to analyse the association between independent variables and the incidence of IA. For multivariate logistic regression, the strongest variables (p < 0.157) were selected. Missing values for independent variables were imputed. RESULTS A total of 196 patients were included, and 159 completed 12 months of follow-up. Thirty-one (16%) patients developed IA, of whom 59% showed US synovitis at baseline. The sensitivity and specificity of US synovitis were 59% and 68%, respectively. If no joints were positive on US, negative predictive value was 89%. In the multivariate logistic regression, age (OR 1.1), the presence of morning stiffness for > 30 minutes (OR 3.3) and PD signal (OR 3.4) were associated with incident IA. CONCLUSIONS The presence of PD signal, morning stiffness for > 30 minutes and age at baseline were independently associated with the development of IA. Regarding the value of US in the diagnostic workup of patients with early arthralgia at risk for IA, US did perform well in ruling out IA in patients who did not have US synovitis.
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Affiliation(s)
- Myrthe van der Ven
- Department of Rheumatology (Na609), Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - M van der Veer-Meerkerk
- Department of Rheumatology (Na609), Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Rheumatology, Zuyderland Medical Centre, Heerlen, The Netherlands
| | - D F Ten Cate
- Department of Rheumatology (Na609), Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - N Rasappu
- Department of Rheumatology (Na609), Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - M R Kok
- Department of Rheumatology, Maasstad Hospital, Rotterdam, The Netherlands
| | - D Csakvari
- Department of Rheumatology (Na609), Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - J M W Hazes
- Department of Rheumatology (Na609), Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - A H Gerards
- Department of Rheumatology, Vlietland Hospital, Schiedam, The Netherlands
| | - J J Luime
- Department of Rheumatology (Na609), Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
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Karreman MC, Weel AEAM, van der Ven M, Vis M, Tchetverikov I, Nijsten TEC, Wakkee M, Hazes JMW, Luime JJ. Performance of screening tools for psoriatic arthritis: a cross-sectional study in primary care. Rheumatology (Oxford) 2017; 56:597-602. [PMID: 28013202 DOI: 10.1093/rheumatology/kew410] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 04/22/2016] [Indexed: 11/14/2022] Open
Abstract
Objective . To compare the screening performance of the Psoriasis Epidemiology Screening Tool (PEST), Psoriatic Arthritis Screening and Evaluation (PASE) and Early Arthritis for Psoriatic Patients (EARP) questionnaires for detecting PsA among psoriasis patients in a primary care setting. Methods In a cross-sectional study, 473 primary care psoriasis patients at risk for PsA completed the PEST, PASE and EARP questionnaires and were clinically evaluated by a trained research nurse. A PsA case was defined by a rheumatologist according to the CASPAR criteria. Sensitivity and specificity were determined for the PEST and EARP cut-offs (⩾3) and the PASE cut-offs (⩾44 and ⩾47). Results PsA was diagnosed in 53 patients. The PEST had a sensitivity of 0.68 and a specificity of 0.71. The PASE was validated for two different cut-offs. The cut-off of 47 led to a sensitivity of 0.59 and a specificity of 0.66, whereas the lower cut-off of 44 led to a sensitivity of 0.66 and a specificity of 0.57. For the EARP we found a sensitivity of 0.87 with a specificity of 0.34. Conclusion The PEST questionnaire has the most favourable trade-off between sensitivity and specificity to screen for PsA. However, as the prevalence of psoriasis and PsA is fairly low in primary care, screening only psoriasis patients with musculoskeletal complaints may be a better allocation of resources.
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Affiliation(s)
| | - Angelique E A M Weel
- Department of Rheumatology, Erasmus University Medical Centre.,Department of Rheumatology, Maasstad Hospital, Rotterdam
| | | | - Marijn Vis
- Department of Rheumatology, Erasmus University Medical Centre
| | | | - Tamar E C Nijsten
- Department of Dermatology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Marlies Wakkee
- Department of Dermatology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | | | - Jolanda J Luime
- Department of Rheumatology, Erasmus University Medical Centre
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van der Ven M, Karreman MC, Weel AEAM, Tchetverikov I, Vis M, Nijsten TEC, Hazes JMW, Luime JJ. Adding ultrasound to clinical examination reduced frequency of enthesitis in primary care psoriasis patients with musculoskeletal complaints. Clin Exp Rheumatol 2016; 34:1020-1025. [PMID: 27749228] [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] [Received: 01/04/2016] [Accepted: 05/02/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Part of the psoriasis patients with musculoskeletal complaints will have inflammation of the entheses. Entheseal inflammation is difficult to assess by clinical examination only. Therefore, we aimed to determine the frequency of clinically relevant ultrasound inflammation at the most commonly assessed entheses (MASEI; Madrid Sonographic Enthesis Index) in primary care psoriasis patients with one or more tender entheses. METHODS Adult primary care psoriasis patients with musculoskeletal complaints (tender enthesis or arthritis at physical examination) had an ultrasound examination of seven entheses according to the MASEI. Clinically relevant ultrasound inflammation was defined as active inflammation on ultrasound in combination with at least one clinical feature at the same enthesis. Active ultrasound inflammation contained positive power Doppler signal or in case of the plantar aponeurosis increased thickness. Structural changes entailed calcifications, enthesophytes, increased thickness, hypoechogeneicity indicating irregular fibre structure and erosions. Clinically, an enthesis was scored positive by a tender enthesis at clinical examination, reported pain in the history or self-reported pain in the questionnaires. RESULTS Of 542 primary care psoriasis patient, 111 patients had tender entheses and/or arthritis. These patients were both clinically and ultrasonographically evaluated. Active ultrasound inflammation accompanied with pain or tenderness at the enthesis was found in 36% of the patients (n=40). Most common were inflammation at the knee (n=11) and at the plantar aponeurosis (n=10). Structural changes were observed in 95% of the psoriasis patients independent of their clinical manifestation. CONCLUSIONS We found concurrent presence of ultrasound inflammatory changes and clinical symptoms in 36% of the primary care psoriasis patients who had tenderness at one or more entheseal sites.
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Affiliation(s)
- Myrthe van der Ven
- Department of Rheumatology, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Maren C Karreman
- Department of Rheumatology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Angelique E A M Weel
- Department of Rheumatology, Erasmus University Medical Center, Rotterdam; and Department of Rheumatology, Maasstad Hospital, Rotterdam, the Netherlands
| | - Ilja Tchetverikov
- Department of Rheumatology, Albert Schweitzer Hospital, Dordrecht, the Netherlands
| | - Marijn Vis
- Department of Rheumatology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Tamar E C Nijsten
- Department of Dermatology Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Johanna M W Hazes
- Department of Rheumatology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jolanda J Luime
- Department of Rheumatology, Erasmus University Medical Center, Rotterdam, the Netherlands
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Karreman MC, Weel AEAM, van der Ven M, Vis M, Tchetverikov I, Nijsten TEC, Wakkee M, Hazes JMW, Luime JJ. Prevalence of Psoriatic Arthritis in Primary Care Patients With Psoriasis. Arthritis Rheumatol 2016; 68:924-31. [DOI: 10.1002/art.39530] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 11/24/2015] [Indexed: 11/07/2022]
Affiliation(s)
| | | | | | - Marijn Vis
- Erasmus University Medical Centre; Rotterdam The Netherlands
| | | | | | - Marlies Wakkee
- Erasmus University Medical Centre; Rotterdam The Netherlands
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van der Ven M, Alves C, Luime JJ, Gerards AH, Barendregt PJ, van Zeben D, van Schaeybroeck B, de Sonnaville PBJ, Grillet BA, Hazes JMW. Do we need to lower the cut point of the 2010 ACR/EULAR classification criteria for diagnosing rheumatoid arthritis? Rheumatology (Oxford) 2015; 55:636-9. [DOI: 10.1093/rheumatology/kev383] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Indexed: 11/12/2022] Open
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Ten Cate DF, Luime JJ, van der Ven M, Hazes JMW, Kooiman K, de Jong N, Bosch JG. Very different performance of the power Doppler modalities of several ultrasound machines ascertained by a microvessel flow phantom. Arthritis Res Ther 2013; 15:R162. [PMID: 24286540 PMCID: PMC3978434 DOI: 10.1186/ar4345] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 10/02/2013] [Indexed: 11/12/2022] Open
Abstract
Introduction In many patients with rheumatoid arthritis (RA) subclinical disease activity can be detected with ultrasound (US), especially using power Doppler US (PDUS). However, PDUS may be highly dependent on the type of machine. This could create problems both in clinical trials and in daily clinical practice. To clarify how the PDUS signal differs between machines we created a microvessel flow phantom. Methods The flow phantom contained three microvessels (150, 1000, 2000 microns). A syringe pump was used to generate flows. Five US machines were used. Settings were optimised to assess the lowest detectable flow for each US machine. Results The minimal detectable flow velocities showed very large differences between the machines. Only two of the machines may be able to detect the very low flows in the capillaries of inflamed joints. There was no clear relation with price. One of the lower-end machines actually performed best in all three vessel sizes. Conclusions We created a flow phantom to test the sensitivity of US machines to very low flows in small vessels. The sensitivity of the power Doppler modalities of 5 different machines was very different. The differences found between the machines are probably caused by fundamental differences in processing of the PD signal or internal settings inaccessible to users. Machines considered for PDUS assessment of RA patients should be tested using a flow phantom similar to ours. Within studies, only a single machine type should be used.
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