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de Jong K, Douglas S, Wolpert M, Delgadillo J, Aas B, Bovendeerd B, Carlier I, Compare A, Edbrooke-Childs J, Janse P, Lutz W, Moltu C, Nordberg S, Poulsen S, Rubel JA, Schiepek G, Schilling VNLS, van Sonsbeek M, Barkham M. Using Progress Feedback to Enhance Treatment Outcomes: A Narrative Review. Adm Policy Ment Health 2024:10.1007/s10488-024-01381-3. [PMID: 38733413 DOI: 10.1007/s10488-024-01381-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 05/13/2024]
Abstract
We face increasing demand for greater access to effective routine mental health services, including telehealth. However, treatment outcomes in routine clinical practice are only about half the size of those reported in controlled trials. Progress feedback, defined as the ongoing monitoring of patients' treatment response with standardized measures, is an evidence-based practice that continues to be under-utilized in routine care. The aim of the current review is to provide a summary of the current evidence base for the use of progress feedback, its mechanisms of action and considerations for successful implementation. We reviewed ten available meta-analyses, which report small to medium overall effect sizes. The results suggest that adding feedback to a wide range of psychological and psychiatric interventions (ranging from primary care to hospitalization and crisis care) tends to enhance the effectiveness of these interventions. The strongest evidence is for patients with common mental health problems compared to those with very severe disorders. Effect sizes for not-on-track cases, a subgroup of cases that are not progressing well, are found to be somewhat stronger, especially when clinical support tools are added to the feedback. Systematic reviews and recent studies suggest potential mechanisms of action for progress feedback include focusing the clinician's attention, altering clinician expectations, providing new information, and enhancing patient-centered communication. Promising approaches to strengthen progress feedback interventions include advanced systems with signaling technology, clinical problem-solving tools, and a broader spectrum of outcome and progress measures. An overview of methodological and implementation challenges is provided, as well as suggestions for addressing these issues in future studies. We conclude that while feedback has modest effects, it is a small and affordable intervention that can potentially improve outcomes in psychological interventions. Further research into mechanisms of action and effective implementation strategies is needed.
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Affiliation(s)
- Kim de Jong
- Clinical Psychology Unit, Institute of Psychology, Leiden University, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands.
| | - Susan Douglas
- Department of Leadership, Policy and Organizations, Vanderbilt University, Nashville, TN, USA
| | - Miranda Wolpert
- Division of Psychology and Language Sciences, Department of Clinical, Education and Health Psychology, University College London, United Kingdom, UK
| | - Jaime Delgadillo
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Benjamin Aas
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Faculty of Psychology and Educational Sciences, LMU Munich, Munich, Germany
| | - Bram Bovendeerd
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
- Dimence, Center for mental health care, Deventer, The Netherlands
| | - Ingrid Carlier
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
| | - Angelo Compare
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Julian Edbrooke-Childs
- Evidence Based Practice Unit, Anna Freud National Centre for Children and Families, University College London, London, UK
| | | | - Wolfgang Lutz
- Department of Psychology, University of Trier, Trier, Germany
| | - Christian Moltu
- District General Hospital of Førde, Førde, Norway
- Department of Health and Caring Science, Western Norway University of Applied Science, Førde, Norway
| | - Samuel Nordberg
- Department of Behavioral Health, Reliant Medical Group, Worcester, MA, USA
| | - Stig Poulsen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Julian A Rubel
- Institute of Psychology, University of Osnabrück, Salzburg, Austria
| | - Günter Schiepek
- Institute of Synergetics and Psychotherapy Research, Paracelsus Medical University, Salzburg, Austria
| | | | | | - Michael Barkham
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
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Castonguay LG, Atzil-Slonim D, de Jong K, Youn SJ. Practice-Oriented Research: An Introduction to New Developments and Future Directions. Adm Policy Ment Health 2024; 51:287-290. [PMID: 38568433 DOI: 10.1007/s10488-024-01369-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 05/08/2024]
Abstract
Aimed at understanding and improving psychological therapies as they are conducted in clinical routine, practice-oriented research (POR) is now a well-established approach to the scientific foundations of mental health care services. Resting on the accumulation of a wide range of practice-based evidence related to treatment outcome and process, as well as factors associated with the participants of psychotherapy and its context, POR is ripe for new developments - regarding what to investigate and how to investigate it. This paper is the introduction of a series devoted to recent advances and future directions of POR as their pertained to routine outcome monitoring, technologies and artificial intelligence, the integration of constructs and methods from program evaluation and implementation science, and the investigation of populations with limited financial resources across various regions of the world. The series also includes commentaries from two leaders of POR.
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Affiliation(s)
- Louis G Castonguay
- Department of Psychology, Penn State University, University Park, PA, 16802, USA.
| | | | - Kim de Jong
- Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, The Netherlands
| | - Soo Jeong Youn
- Reliant Medical Group, OptumCare, Worcester, MA, USA
- Harvard Medical School, Boston, MA, USA
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McAleavey AA, de Jong K, Nissen-Lie HA, Boswell JF, Moltu C, Lutz W. Routine Outcome Monitoring and Clinical Feedback in Psychotherapy: Recent Advances and Future Directions. Adm Policy Ment Health 2024; 51:291-305. [PMID: 38329643 PMCID: PMC11076375 DOI: 10.1007/s10488-024-01351-9] [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] [Accepted: 01/24/2024] [Indexed: 02/09/2024]
Abstract
In the past decade, there has been an increase in research related to the routine collection and active use of standardized patient data in psychotherapy. Research has increasingly focused on personalization of care to patients, clinical skills and interventions that modulate treatment outcomes, and implementation strategies, all of which appear to enhance the beneficial effects of ROM and feedback. In this article, we summarize trends and recent advances in the research on this topic and identify several essential directions for the field in the short to medium term. We anticipate a broadening of research from the focus on average effects to greater specificity around what kinds of feedback, provided at what time, to which individuals, in what settings, are most beneficial. We also propose that the field needs to focus on issues of health equity, ensuring that ROM can be a vehicle for increased wellbeing for those who need it most. The complexity of mental healthcare systems means that there may be multiple viable measurement solutions with varying costs and benefits to diverse stakeholders in different treatment contexts, and research is needed to identify the most influential components in each of these contexts.
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Affiliation(s)
- Andrew A McAleavey
- Helse Førde Hospital Trust, Svanehaugvegen 2, Førde, 6812, Norway.
- Department of Health and Caring Science, Western Norway University of Applied Science, Førde, Norway.
- Department of Psychiatry, Weill Cornell Medical Center, New York, NY, USA.
| | - Kim de Jong
- Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, The Netherlands
| | | | - James F Boswell
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Christian Moltu
- Helse Førde Hospital Trust, Svanehaugvegen 2, Førde, 6812, Norway
- Department of Health and Caring Science, Western Norway University of Applied Science, Førde, Norway
| | - Wolfgang Lutz
- Department of Psychology, University of Trier, Trier, Germany
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van Thiel SJ, de Jong K, Misset KS, Joosen MCW, van der Klink JJL, Vermunt JK, van Dam A. Determining differences between therapists using an extended version of the facilitative interpersonal skills performance test. J Clin Psychol 2024. [PMID: 38588045 DOI: 10.1002/jclp.23687] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 12/05/2023] [Accepted: 03/20/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVES The therapist-facilitative interpersonal skills (FIS) has shown to predict therapy outcomes, demonstrating that high FIS therapists are more effective than low FIS therapists. There is a need for more insight into the variability in strengths and weaknesses in therapist skills. This study investigates whether a revised and extended FIS-scoring leads to more differentiation in measuring therapists' interpersonal skills. Furthermore, we explorative examine whether subgroups of therapists can be distinguished in terms of differences in their interpersonal responses. METHOD Using secondary data analysis, 93 therapists were exposed to seven FIS-clips. Responses of therapists using the original and the extended FIS scoring were rated. RESULTS Three factors were found on the extended FIS scoring distinguishing supportive, expressive, and persuasive interpersonal responses of therapists. A latent profile analysis enlightened the presence of six subgroups of therapists. CONCLUSION Using the revised and extended FIS-scoring contributes to our understanding of the role of interpersonal skills in the therapeutic setting by unraveling the question what works for whom.
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Affiliation(s)
- Sabine J van Thiel
- Tilburg School of Social and Behavioral Sciences, Tranzo-Academic Collaborative Center Work & Health, Tilburg University, Tilburg, The Netherlands
- Mental Health Institute GGZ WNB, Bergen op Zoom, The Netherlands
| | - Kim de Jong
- Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Kirsten S Misset
- Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Margot C W Joosen
- Tilburg School of Social and Behavioral Sciences, Tranzo-Academic Collaborative Center Work & Health, Tilburg University, Tilburg, The Netherlands
| | - Jac J L van der Klink
- Tilburg School of Social and Behavioral Sciences, Tranzo-Academic Collaborative Center Work & Health, Tilburg University, Tilburg, The Netherlands
- Optentia, North West University of South Africa, Potchefstroom, South Africa
| | - Jeroen K Vermunt
- Tilburg School of Social and Behavioral Sciences, Tranzo-Academic Collaborative Center Work & Health, Tilburg University, Tilburg, The Netherlands
| | - Arno van Dam
- Tilburg School of Social and Behavioral Sciences, Tranzo-Academic Collaborative Center Work & Health, Tilburg University, Tilburg, The Netherlands
- Mental Health Institute GGZ WNB, Bergen op Zoom, The Netherlands
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Rijnhart-de Jong HG, Haenen J, Porta F, Timmermans M, Boerma EC, de Jong K. Hospital infections and health-related quality of life after cardiac surgery: a multicenter survey. J Cardiothorac Surg 2024; 19:84. [PMID: 38336817 PMCID: PMC10858541 DOI: 10.1186/s13019-024-02559-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Recent research suggested that hospital infections are a predictive marker for physical non-recovery one year after cardiothoracic surgery. The purpose of this study was to explore whether this risk factor is etiologic. Additional, the influence of a potential effect modifying factor, diabetes mellitus, was investigated. METHODS In this multicenter study, patients underwent elective or urgent cardiothoracic surgery between 01-01-2015 and 31-12-2019, and completed pre- and one year post-operative Short Form Health Survey 36/12 quality of life questionnaires. A binary logistic regression model, in which the inverse of the propensity score for infection risk was included as a weight variable, was used. Second, this analysis was stratified for diabetes mellitus status. RESULTS 8577 patients were included. After weighing for the propensity score, the standardized mean differences of all variables decreased and indicated sufficient balance between the infection and non-infection groups. Hospital infections were found to be a risk factor for non-recovery after cardiothoracic surgery in the original and imputed dataset before weighting. However, after propensity score weighing, hospital infections did not remain significantly associated with recovery (OR for recovery = 0.79; 95% CI [0.60-1.03]; p = 0.077). No significant interaction between diabetes mellitus and hospital infections on recovery was found (p = 0.845). CONCLUSIONS This study could not convincingly establish hospital infections as an etiologic risk factor for non-improvement of physical recovery in patients who underwent cardiothoracic surgery. In addition, there was no differential effect of hospital infections on non-improvement of physical recovery for patients with and without diabetes mellitus. Trial registration International Clinical Trials Registry Platform ID NL9818; date of registration, 22-10-2021 ( https://trialsearch.who.int/ ).
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Affiliation(s)
- Hilda G Rijnhart-de Jong
- Department of Cardiothoracic Surgery, Medisch Centrum Leeuwarden, Henri Dunantweg 2, Leeuwarden, 8934 AD, The Netherlands.
- Department of Intensive Care, Leeuwarden Medical Centre, Leeuwarden, The Netherlands.
| | - Jo Haenen
- Department of Cardiothoracic Surgery, Medisch Centrum Leeuwarden, Henri Dunantweg 2, Leeuwarden, 8934 AD, The Netherlands
| | - Fabiano Porta
- Department of Cardiothoracic Surgery, Medisch Centrum Leeuwarden, Henri Dunantweg 2, Leeuwarden, 8934 AD, The Netherlands
| | | | - E Christiaan Boerma
- Department of Intensive Care, Leeuwarden Medical Centre, Leeuwarden, The Netherlands
- Department of Sustainable Health, Rijksuniversiteit Groningen, Campus Fryslân Leeuwarden, Leeuwarden, The Netherlands
| | - Kim de Jong
- Department of Epidemiology, Leeuwarden Medical Centre, Leeuwarden, The Netherlands
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Ten Have L, de Jong K, Ten Brinke A. Reply to "Impact of oral corticosteroid on long-term weight following initiation of anti-IL-5/5Ra biologics in severe asthma". J Allergy Clin Immunol Pract 2024; 12:534-535. [PMID: 38336400 DOI: 10.1016/j.jaip.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 02/12/2024]
Affiliation(s)
- Lianne Ten Have
- Department of Epidemiology, Medical Center Leeuwarden, Leeuwarden, the Netherlands; Department of Biomedical Data Science, Medical Decision Making, Leiden University Medical Center, Leiden, the Netherlands.
| | - Kim de Jong
- Department of Epidemiology, Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Anneke Ten Brinke
- Department of Pulmonary Medicine, Medical Center Leeuwarden, Leeuwarden, the Netherlands
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Deisenhofer AK, Barkham M, Beierl ET, Schwartz B, Aafjes-van Doorn K, Beevers CG, Berwian IM, Blackwell SE, Bockting CL, Brakemeier EL, Brown G, Buckman JEJ, Castonguay LG, Cusack CE, Dalgleish T, de Jong K, Delgadillo J, DeRubeis RJ, Driessen E, Ehrenreich-May J, Fisher AJ, Fried EI, Fritz J, Furukawa TA, Gillan CM, Gómez Penedo JM, Hitchcock PF, Hofmann SG, Hollon SD, Jacobson NC, Karlin DR, Lee CT, Levinson CA, Lorenzo-Luaces L, McDanal R, Moggia D, Ng MY, Norris LA, Patel V, Piccirillo ML, Pilling S, Rubel JA, Salazar-de-Pablo G, Schleider JL, Schnurr PP, Schueller SM, Siegle GJ, Uher R, Watkins E, Webb CA, Wiltsey Stirman S, Wynants L, Youn SJ, Zilcha-Mano S, Lutz W, Cohen ZD. Implementing precision methods in personalizing psychological therapies: Barriers and possible ways forward. Behav Res Ther 2024; 172:104443. [PMID: 38086157 DOI: 10.1016/j.brat.2023.104443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/21/2023] [Accepted: 11/27/2023] [Indexed: 12/26/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | - Claudi L Bockting
- AmsterdamUMC, Department of Psychiatry, Research Program Amsterdam Public Health and Centre for Urban Mental Health, University of Amsterdam, the Netherlands
| | | | | | | | | | | | | | - Kim de Jong
- Leiden University, Institute of Psychology, USA
| | | | | | | | | | | | | | - Jessica Fritz
- University of Cambridge, UK; Philipps University of Marburg, Germany
| | | | - Claire M Gillan
- School of Psychology, Trinity College Institute for Neuroscience, And Global Brain Health Institute, Trinity College Dublin, USA
| | | | | | | | | | | | | | | | | | | | | | | | - Mei Yi Ng
- Florida International University, USA
| | | | | | | | | | | | | | - Jessica L Schleider
- Stony Brook University and Feinberg School of Medicine Northwestern University, USA
| | - Paula P Schnurr
- National Center for PTSD and Geisel School of Medicine at Dartmouth, USA
| | | | | | | | | | | | | | | | - Soo Jeong Youn
- Reliant Medical Group, OptumCare and Harvard Medical School, USA
| | | | | | - Zachary D Cohen
- University of California, Los Angeles and University of Arizona, USA.
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Visser E, Ten Brinke A, Sizoo D, Pepels JJS, Ten Have L, van der Wiel E, van Zutphen T, Kerstjens HAM, de Jong K. Effect of dietary interventions on markers of type 2 inflammation in asthma: A systematic review. Respir Med 2024; 221:107504. [PMID: 38141862 DOI: 10.1016/j.rmed.2023.107504] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/29/2023] [Accepted: 12/17/2023] [Indexed: 12/25/2023]
Abstract
INTRODUCTION Type 2 (T2) inflammation is a key mechanism in the pathophysiology of asthma. Diet may have immunomodulatory effects, and a role for diet in T2 inflammation has been suggested in the literature. Indeed, diet and food allergies play a role in children with atopic asthma, but less is known about diet in relation to adult asthma, which is often non-atopic. OBJECTIVE To review the effect of dietary interventions on markers of T2 inflammation in adults with asthma. METHODS The databases PubMed, Embase, Cochrane Library, and CINAHL were searched for eligible studies until December 2022. We included studies of all types of foods, nutrients, diets or supplements, either as an exposure or as an intervention, in adults and adolescents with asthma. Outcomes of interest included the T2 biomarkers FeNO, eosinophils, IL-4, IL-5, IL-13, eosinophil cationic protein and eosinophil peroxidase. The methodological quality of eligible studies was systematically evaluated, and the results were summarised according to dietary clusters. RESULTS The systematic search identified studies on the dietary clusters antioxidants (n = 14), fatty acids, (n = 14), Mediterranean-style diets (n = 5), phytotherapy (n = 7), prebiotics & probiotics (n = 8), vitamin D (n = 7), and other dietary factors (n = 5). Studies within the phytotherapy and omega-3 poly-unsaturated fatty acids (PUFA) clusters showed possible improvements in T2 inflammation. Furthermore, we found little evidence for an effect of antioxidants, prebiotics & probiotics, and Mediterranean-style diets on T2 inflammation. However, heterogeneity in study protocols, methodological shortcomings and limited power of almost all studies make it difficult to fully determine the impact of different dietary approaches on T2 inflammation in asthma. CONCLUSIONS Overall, the current evidence does not support a specific dietary intervention to improve T2 inflammation in asthma. Interventions involving phytotherapy and omega-3 PUFA currently have the best evidence and warrant further evaluation in well-designed and adequately powered studies, while taking into account T2-high phenotypes of asthma.
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Affiliation(s)
- Edith Visser
- Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, the Netherlands; Department of Sustainable Health, Faculty Campus Fryslân, University of Groningen, Leeuwarden, the Netherlands.
| | - Anneke Ten Brinke
- Department of Pulmonary Medicine, Medical Centre Leeuwarden, Leeuwarden, the Netherlands.
| | - Dionne Sizoo
- Department of Sustainable Health, Faculty Campus Fryslân, University of Groningen, Leeuwarden, the Netherlands; Centre Obesity Northern Netherlands (CON), Department of Surgery, Medical Centre Leeuwarden, Leeuwarden, the Netherlands.
| | - Janneke J S Pepels
- Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, the Netherlands.
| | - Lianne Ten Have
- Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, the Netherlands.
| | - Erica van der Wiel
- Department of Pulmonary Medicine, Martini Hospital, Groningen, the Netherlands.
| | - Tim van Zutphen
- Department of Sustainable Health, Faculty Campus Fryslân, University of Groningen, Leeuwarden, the Netherlands.
| | - Huib A M Kerstjens
- Department of Pulmonary Medicine, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands; Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands.
| | - Kim de Jong
- Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, the Netherlands.
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9
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Visser E, de Jong K, van Zutphen T, Kerstjens HAM, Ten Brinke A. Dietary Inflammatory Index and Clinical Outcome Measures in Adults With Moderate-to-Severe Asthma. J Allergy Clin Immunol Pract 2023; 11:3680-3689.e7. [PMID: 37652347 DOI: 10.1016/j.jaip.2023.08.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Diet is increasingly recognized as a modifiable factor in lung health, predominantly due to the immunomodulatory effects of nutrients. The Dietary Inflammatory Index (DII) is a score developed to express the inflammatory potential of a diet. OBJECTIVE We aimed to assess the association of the DII and food groups, with clinical, functional, and inflammatory asthma outcomes in adults with asthma. METHODS Patients with moderate-to-severe asthma were included in this cross-sectional study between June 2019 and October 2021, and completed a 3-day food diary, to calculate the DII and intake of food groups (ie, fruits, whole grains, processed meats, and sugar-sweetened beverages). Functional outcomes included pulmonary function tests and the 6-minute walking distance, whereas clinical outcomes were assessed using questionnaires on asthma control, quality of life, and health care utilization. Inflammatory markers were exhaled nitric oxide and blood leukocytes, eosinophils, and IL-6. Multivariable regression analyses were used to examine the association of DII and food groups with asthma outcomes. RESULTS A total of 109 patients participated (35% male, mean ± standard deviation age 51.8 ± 14.2 years, body mass index 27.4 ± 5.3 kg/m2). Overall, 62% had a DII score >0, indicating a proinflammatory diet, which was not related to asthma severity. A more proinflammatory diet was consistently associated with lower forced vital capacity (%pred), but inconsistent results were observed with respect to airway obstruction. Neither the DII nor food groups were associated with clinical outcomes. Except for higher levels of exhaled nitric oxide in relation to an anti-inflammatory diet, we found no associations between inflammatory markers and the DII. CONCLUSION Results from this cross-sectional study among patients with moderate-to-severe asthma do not support the hypothesis that a proinflammatory diet is associated with worse asthma outcomes, although limitations in study design and dietary intake estimation should be considered. Future well-designed experimental studies are needed to assess whether targeting the inflammatory potential of diet could lead to better outcomes in adults with asthma.
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Affiliation(s)
- Edith Visser
- Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, the Netherlands; Department of Sustainable Health, Faculty Campus Fryslân, University of Groningen, Leeuwarden, the Netherlands.
| | - Kim de Jong
- Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, the Netherlands
| | - Tim van Zutphen
- Department of Sustainable Health, Faculty Campus Fryslân, University of Groningen, Leeuwarden, the Netherlands
| | - Huib A M Kerstjens
- Department of Pulmonary Medicine, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands; Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands
| | - Anneke Ten Brinke
- Department of Pulmonary Medicine, Medical Centre Leeuwarden, Leeuwarden, the Netherlands
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10
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Visser E, Ten Have L, Ten Brinke A, de Jong K. Effect of Biologic Therapy on Total Body Composition in Severe Asthma. Ann Am Thorac Soc 2023; 20:1825-1828. [PMID: 37703386 DOI: 10.1513/annalsats.202304-321rl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 09/13/2023] [Indexed: 09/15/2023] Open
Affiliation(s)
- Edith Visser
- Medical Center Leeuwarden Leeuwarden, the Netherlands
- University of Groningen Leeuwarden, the Netherlands
| | | | | | - Kim de Jong
- Medical Center Leeuwarden Leeuwarden, the Netherlands
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Douglas S, Bovendeerd B, van Sonsbeek M, Manns M, Milling XP, Tyler K, Bala N, Satterthwaite T, Hovland RT, Amble I, Atzil-Slonim D, Barkham M, de Jong K, Kendrick T, Nordberg SS, Lutz W, Rubel JA, Skjulsvik T, Moltu C. A Clinical Leadership Lens on Implementing Progress Feedback in Three Countries: Development of a Multidimensional Qualitative Coding Scheme. Adm Policy Ment Health 2023:10.1007/s10488-023-01314-6. [PMID: 37917313 DOI: 10.1007/s10488-023-01314-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Progress feedback, also known as measurement-based care (MBC), is the routine collection of patient-reported measures to monitor treatment progress and inform clinical decision-making. Although a key ingredient to improving mental health care, sustained use of progress feedback is poor. Integration into everyday workflow is challenging, impacted by a complex interrelated set of factors across patient, clinician, organizational, and health system levels. This study describes the development of a qualitative coding scheme for progress feedback implementation that accounts for the dynamic nature of barriers and facilitators across multiple levels of use in mental health settings. Such a coding scheme may help promote a common language for researchers and implementers to better identify barriers that need to be addressed, as well as facilitators that could be supported in different settings and contexts. METHODS Clinical staff, managers, and leaders from two Dutch, three Norwegian, and four mental health organizations in the USA participated in semi-structured interviews on how intra- and extra-organizational characteristics interact to influence the use of progress feedback in clinical practice, supervision, and program improvement. Interviews were conducted in the local language, then translated to English prior to qualitative coding. RESULTS A team-based consensus coding approach was used to refine an a priori expert-informed and literature-based qualitative scheme to incorporate new understandings and constructs as they emerged. First, this hermeneutic approach resulted in a multi-level coding scheme with nine superordinate categories and 30 subcategories. Second-order axial coding established contextually sensitive categories for barriers and facilitators. CONCLUSIONS The primary outcome is an empirically derived multi-level qualitative coding scheme that can be used in progress feedback implementation research and development. It can be applied across contexts and settings, with expectations for ongoing refinement. Suggestions for future research and application in practice settings are provided. Supplementary materials include the coding scheme and a detailed playbook.
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Affiliation(s)
- Susan Douglas
- Department of Leadership, Policy and Organizations, Vanderbilt University, Peabody College, 230 Appleton Place PMB #414, Nashville, TN, 37203-5721, USA.
| | - Bram Bovendeerd
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
- Dimence, Center for Mental Health Care, Deventer, the Netherlands
| | | | - Mya Manns
- Department of Leadership, Policy and Organizations, Vanderbilt University, Peabody College, 230 Appleton Place PMB #414, Nashville, TN, 37203-5721, USA
| | - Xavier Patrick Milling
- Department of Leadership, Policy and Organizations, Vanderbilt University, Peabody College, 230 Appleton Place PMB #414, Nashville, TN, 37203-5721, USA
| | - Ke'Sean Tyler
- Department of Leadership, Policy and Organizations, Vanderbilt University, Peabody College, 230 Appleton Place PMB #414, Nashville, TN, 37203-5721, USA
| | | | - Tim Satterthwaite
- Department of Leadership, Policy and Organizations, Vanderbilt University, Peabody College, 230 Appleton Place PMB #414, Nashville, TN, 37203-5721, USA
| | - Runar Tengel Hovland
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway
- Department of Research and Innovation, Førde Hospital Trust, Førde, Norway
| | - Ingunn Amble
- Villa Sana - Centre for Work Health, Modum Bad, Norway
| | | | - Michael Barkham
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Kim de Jong
- Clinical Psychology Unit, Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - Tony Kendrick
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Samuel S Nordberg
- Department of Behavioral Health, Reliant Medical Group, Worcester, MA, USA
| | - Wolfgang Lutz
- Department of Psychology, University of Trier, Trier, Germany
| | - Julian A Rubel
- Department of Psychology, Psychotherapy Research Lab, Justus Liebig University Giessen, Giessen, Germany
| | | | - Christian Moltu
- District General Hospital of Førde, Førde, Norway
- Department of Health and Caring Science, Western Norway University of Applied Science, Førde, Norway
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12
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Bovendeerd B, de Jong K, de Groot E, Moerbeek M, Hafkenscheid A, de Keijser J. The effect of therapist characteristics on the use and outcome of systematic client feedback in outpatient mental healthcare. Clin Psychol Psychother 2023; 30:1146-1157. [PMID: 37278224 DOI: 10.1002/cpp.2873] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 08/26/2022] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Therapist characteristics are known to affect treatment outcome in general and could also influence the use of systematic client feedback (SCF). The current study explores the effect of feedback orientation, regulatory focus, self-efficacy, attitude towards feedback resources and perceived feedback validity on the use and outcome of SCF in outpatient mental healthcare. METHOD The data of therapists (n = 12) and patients (n = 504) of two outpatient centres offering brief psychological treatment were analysed when SCF, based on the Partners for Change Outcome Management System (PCOMS), was added to treatment as usual. The data of therapists were obtained through a therapist questionnaire composed of relevant characteristics from feedback studies in social and organizational psychology. The effect on the use of SCF was analysed using logistic regression; whereas, the effect on outcome was assessed using a two-level multilevel analysis. Regular use of SCF and the Outcome Questionnaire (OQ-45) were used as outcome variables. DSM-classification, sex and age of each patient were included as covariates. RESULTS High perceived feedback validity significantly increased the use of SCF. No significant therapist characteristics effects were found on outcome, but high promotion focus was associated with treating more complex patients. CONCLUSIONS The perceived feedback validity of SCF is likely to have an influence on its use and is probably affected by the changes in the organizational climate.
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Affiliation(s)
- Bram Bovendeerd
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
- GGZ Center for Mental Health Care, Dimence, Deventer, The Netherlands
| | - Kim de Jong
- Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Erik de Groot
- GGZ Center for Mental Health Care, Dimence, Deventer, The Netherlands
| | - Mirjam Moerbeek
- Department of Methodology and Statistics, Utrecht University, Utrecht, The Netherlands
| | - Anton Hafkenscheid
- Arkin/Sinaï Centre, Jewish Mental Health Services, Amersfoort/Amstelveen, The Netherlands
| | - Jos de Keijser
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
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Ten Have L, Visser E, Meulmeester FL, Bendien SA, Braunstahl GJ, Broeders MEAC, Fieten KB, Hashimoto S, van Huisstede A, Langeveld B, Oud KTM, Patberg KW, Smeenk FWJM, van Veen A, van Veen IH, van de Ven MJT, Weersink EJM, de Jong K, Sont JK, Kroes JA, Ten Brinke A. Long-Term Weight Changes After Starting Anti-IL-5/5Ra Biologics in Severe Asthma: The Role of Oral Corticosteroids. J Allergy Clin Immunol Pract 2023; 11:2748-2756.e3. [PMID: 37399945 DOI: 10.1016/j.jaip.2023.06.054] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/16/2023] [Accepted: 06/23/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Many patients with severe asthma are overweight or obese, often attributed to unintentional weight gain as a side effect of oral corticosteroids (OCSs). Anti-IL-5/5Ra biologics significantly reduce OCS use, but their long-term effects on weight are unknown. OBJECTIVES To examine (1) weight change up to 2 years after anti-IL-5/5Ra initiation in subgroups on the basis of maintenance OCS use at start of treatment and (2) whether cumulative OCS exposure before or changes in OCS exposure during treatment are related to weight change. METHODS Real-world data on weight and cumulative OCS dose from adults included in the Dutch Registry of Adult Patients with Severe asthma for Optimal DIsease management before and at least 2 years after starting anti-IL-5/5Ra were analyzed using linear mixed models and linear regression analyses. RESULTS For the included 389 patients (55% female; mean body mass index, 28 ± 5 kg/m2; 58% maintenance OCS), mean weight decreased -0.27 kg/y (95% CI, -0.51 to -0.03; P = .03), with more weight loss in patients with maintenance OCS use than in those without maintenance OCS use (-0.87 kg/y [95% CI, -1.21 to -0.52; P < .001] vs +0.54 kg/y [0.26 to 0.82; P < .001]). Greater weight loss at 2 years was associated with higher cumulative OCS dose in the 2 years before anti-IL-5/5Ra initiation (β = -0.24 kg/g; 95% CI, -0.38 to -0.10; P < .001) and, independently, greater reduction in cumulative OCS dose during follow-up (β = 0.27 kg/g; 95% CI, 0.11 to 0.43; P < .001). CONCLUSIONS Anti-IL-5/5Ra therapy is associated with long-term weight reduction, especially in patients with higher OCS exposure before treatment and those able to reduce OCS use during treatment. However, the effect is small and does not apply to all patients, and so additional interventions seem necessary if weight change is desired.
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Affiliation(s)
- Lianne Ten Have
- Department of Epidemiology, Medical Center Leeuwarden, Leeuwarden, The Netherlands; Department of Biomedical Data Science, Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands.
| | - Edith Visser
- Department of Epidemiology, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Fleur L Meulmeester
- Department of Biomedical Data Science, Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
| | - Sarah A Bendien
- Department of Respiratory Medicine, HAGA Teaching Hospital, Den Haag, The Netherlands
| | - Gert-Jan Braunstahl
- Department of Respiratory Medicine, St Franciscus Gasthuis en Vlietland, Rotterdam, The Netherlands
| | - Marielle E A C Broeders
- Department of Respiratory Medicine, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands
| | - Karin B Fieten
- Nederlands Astmacentrum Davos, Davos, Switzerland; Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Zurich, Switzerland
| | - Simone Hashimoto
- Department of Pulmonary Medicine, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
| | | | - Bas Langeveld
- Department of Respiratory Medicine, Deventer Ziekenhuis, Deventer, The Netherlands
| | - Karen T M Oud
- Department of Respiratory Medicine, Ziekenhuis Gelderse Vallei, Ede, The Netherlands
| | - Kornelis W Patberg
- Department of Respiratory Medicine, ISALA Clinics, Zwolle, The Netherlands
| | - Frank W J M Smeenk
- Department of Respiratory Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | - Anneke van Veen
- Department of Respiratory Medicine, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands
| | - Ilonka H van Veen
- Department of Respiratory Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | | | - Els J M Weersink
- Department of Pulmonary Medicine, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
| | - Kim de Jong
- Department of Epidemiology, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Jacob K Sont
- Department of Biomedical Data Science, Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
| | - Johannes A Kroes
- Department of Clinical Pharmacy and Pharmacology, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Anneke Ten Brinke
- Department of Pulmonary Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands
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Gijtenbeek RG, de Jong K, Venmans BJ, van Vollenhoven FH, Ten Brinke A, Van der Wekken AJ, van Geffen WH. Best first-line therapy for people with advanced non-small cell lung cancer, performance status 2 without a targetable mutation or with an unknown mutation status. Cochrane Database Syst Rev 2023; 7:CD013382. [PMID: 37419867 PMCID: PMC10327404 DOI: 10.1002/14651858.cd013382.pub2] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
BACKGROUND Most people who are newly diagnosed with non-small cell lung cancer (NSCLC) have advanced disease. For these people, survival is determined by various patient- and tumor-related factors, of which the performance status (PS) is the most important prognostic factor. People with PS 0 or 1 are usually treated with systemic therapies, whereas people with PS 3 or 4 most often receive supportive care. However, treatment for people with PS 2 without a targetable mutation remains unclear. Historically, people with a PS 2 cancer are frequently excluded from (important) clinical trials because of poorer outcomes and increased toxicity. We aim to address this knowledge gap, as this group of people represents a significant proportion (20% to 30%) of the total population with newly diagnosed lung cancer. OBJECTIVES To identify the best first-line therapy for advanced lung cancer in people with performance status 2 without a targetable mutation or with an unknown mutation status. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was 17 June 2022. SELECTION CRITERIA We included randomized controlled trials (RCTs) that compared different chemotherapy (with or without angiogenesis inhibitor) or immunotherapy regimens, specifically designed for people with PS 2 only or studies including a subgroup of these people. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were 1. overall survival (OS), 2. health-related quality of life (HRQoL), and 3. toxicity/adverse events. Our secondary outcomes were 4. tumor response rate, 5. progression-free survival, and 6. survival rates at six and 12 months' treatment. We used GRADE to assess certainty of evidence for each outcome. MAIN RESULTS We included 22 trials in this review and identified one ongoing trial. Twenty studies compared chemotherapy with different regimens, of which 11 compared non-platinum therapy (monotherapy or doublet) versus platinum doublet. We found no studies comparing best supportive care with chemotherapy and only two abstracts analyzing chemotherapy versus immunotherapy. We found that platinum doublet therapy showed superior OS compared to non-platinum therapy (hazard ratio [HR] 0.67, 95% confidence interval [CI] 0.57 to 0.78; 7 trials, 697 participants; moderate-certainty evidence). There were no differences in six-month survival rates (risk ratio [RR] 1.00, 95% CI 0.72 to 1.41; 6 trials, 632 participants; moderate-certainty evidence), whereas 12-month survival rates were improved for treatment with platinum doublet therapy (RR 0.92, 95% CI 0.87 to 0.97; 11 trials, 1567 participants; moderate-certainty evidence). PFS and tumor response rate were also better for people treated with platinum doublet therapy, with moderate-certainty evidence (PFS: HR 0.57, 95% CI 0.42 to 0.77; 5 trials, 487 participants; tumor response rate: RR 2.25, 95% CI 1.67 to 3.05; 9 trials, 964 participants). When analyzing toxicity rates, we found that platinum doublet therapy increased grade 3 to 5 hematologic toxicities, all with low-certainty evidence (anemia: RR 1.98, 95% CI 1.00 to 3.92; neutropenia: RR 2.75, 95% CI 1.30 to 5.82; thrombocytopenia: RR 3.96, 95% CI 1.73 to 9.06; all 8 trials, 935 participants). Only four trials reported HRQoL data; however, the methodology was different per trial and we were unable to perform a meta-analysis. Although evidence is limited, there were no differences in 12-month survival rates or tumor response rates between carboplatin and cisplatin regimens. With an indirect comparison, carboplatin seemed to have better 12-month survival rates than cisplatin compared to non-platinum therapy. The assessment of the efficacy of immunotherapy in people with PS 2 was limited. There might be a place for single-agent immunotherapy, but the data provided by the included studies did not encourage the use of double-agent immunotherapy. AUTHORS' CONCLUSIONS This review showed that as a first-line treatment for people with PS 2 with advanced NSCLC, platinum doublet therapy seems to be preferred over non-platinum therapy, with a higher response rate, PFS, and OS. Although the risk for grade 3 to 5 hematologic toxicity is higher, these events are often relatively mild and easy to treat. Since trials using checkpoint inhibitors in people with PS 2 are scarce, we identified an important knowledge gap regarding their role in people with advanced NSCLC and PS 2.
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Affiliation(s)
- Rolof Gp Gijtenbeek
- Department of Pulmonary Diseases, Medical Center Leeuwarden, Leeuwarden, Netherlands
| | - Kim de Jong
- Department of Epidemiology, Medical Center Leeuwarden, Leeuwarden, Netherlands
| | - Ben Jw Venmans
- Department of Pulmonary Diseases, Medical Center Leeuwarden, Leeuwarden, Netherlands
| | | | - Anneke Ten Brinke
- Department of Pulmonary Diseases, Medical Center Leeuwarden, Leeuwarden, Netherlands
| | - Anthonie J Van der Wekken
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Wouter H van Geffen
- Department of Pulmonary Diseases, Medical Center Leeuwarden, Leeuwarden, Netherlands
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Carlier IVE, van der Elst LV, de Jong K, van Vliet IM. Treatment Course Comparison Between Anxiety-Related Disorders in Adult Outpatients: A Leiden Routine Outcome Monitoring Study. J Nerv Ment Dis 2023:00005053-990000000-00100. [PMID: 37166241 DOI: 10.1097/nmd.0000000000001667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
ABSTRACT Anxiety-related disorders constitute the leading prevalent mental disorders, with major burden on patients, their relatives, and society. Moreover, there is considerable treatment nonadherence/nonresponse. We used routine outcome monitoring (ROM) data from outpatients covering four anxiety-related disorders (DSM-IV-R, N = 470) to examine their 6-month treatment course and its predictors: generalized anxiety disorder, panic disorder with agoraphobia, obsessive-compulsive disorder, and posttraumatic stress disorder. Measures included Mini-International Neuropsychiatric Interview Plus, Brief Symptom Inventory (BSI), Montgomery-Åsberg Depression Rating Scale (MADRS), Brief Anxiety Scale (BAS), and Short Form Health Survey 36 (SF-36). On the clinician-rated instruments (MADRS/BAS), all anxiety-related disorder groups showed a significant albeit modest improvement after treatment. On the BSI self-rating, only generalized anxiety disorder and posttraumatic stress disorder showed a significant modest improvement. No anxiety-related disorder groups improved significantly regarding SF-36 physical functioning. For BSI symptom course, significant predictors were comorbid somatoform/total disorders, SF-36 physical functioning/general health, and MADRS score. Clinical implications and future research recommendations are discussed.
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Affiliation(s)
| | - Lotte V van der Elst
- Clinical Psychology Unit, Leiden University, Institute of Psychology, Leiden, the Netherlands
| | - Kim de Jong
- Clinical Psychology Unit, Leiden University, Institute of Psychology, Leiden, the Netherlands
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Visser E, de Jong K, Pepels JJS, Kerstjens HAM, Ten Brinke A, van Zutphen T. Diet quality, food intake and incident adult-onset asthma: a Lifelines Cohort Study. Eur J Nutr 2023; 62:1635-1645. [PMID: 36739315 DOI: 10.1007/s00394-023-03091-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 01/12/2023] [Indexed: 02/05/2023]
Abstract
PURPOSE Dietary factors have been suggested as drivers of the rising prevalence of adult-onset asthma, but evidence is inconclusive, possibly due to the complex interrelation with obesity. We aim to explore the relation of diet quality and food intake with incident adult-onset asthma in normal weight and overweight adults of the prospective population-based Lifelines Cohort Study. METHODS Incident adult-onset asthma was defined as self-reported asthma at ± 4-year follow-up, in adults free of airway disease at baseline. Diet quality scores and food group intake were assessed at baseline. Log-binomial regression analyses were used to estimate adjusted relative risks (RR) between dietary intake (per portion) and incident adult-onset asthma, in categories of BMI (cutoff: 25 kg/m2). RESULTS 477 incident asthma cases (75% female, 62% overweight) and 34,698 controls (60% female, 53% overweight) were identified. Diet quality-assessed by the Lifelines Diet Score and Mediterranean Diet Score-was not associated with incident adult-onset asthma in the two BMI groups. Although the dietary intake of several food groups differed between cases and controls, after adjustment for confounders only few remained associated with adult-onset asthma, including red and processed meat (RR: 0.93 per 15 g intake; 95% CI 0.86-0.99) in the normal weight group and intake of cheese (RR 1.09 per 20 g intake; 95% CI 1.00-1.17) and vegetables (RR 1.10 per 50 g intake; 95% CI 1.00-1.21) in the overweight group. CONCLUSION The results of this study question the role of food as a 'simple' predictor of adult-onset asthma and call for an integrative approach, including a range of modifiable lifestyle factors and further asthma phenotyping.
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Affiliation(s)
- Edith Visser
- Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
- Department of Sustainable Health, Faculty Campus Fryslân, University of Groningen, Leeuwarden, The Netherlands.
| | - Kim de Jong
- Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Janneke J S Pepels
- Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Huib A M Kerstjens
- Department of Pulmonary Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Anneke Ten Brinke
- Department of Pulmonary Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Tim van Zutphen
- Department of Sustainable Health, Faculty Campus Fryslân, University of Groningen, Leeuwarden, The Netherlands
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Kroes JA, de Jong K, Hashimoto S, Zielhuis SW, van Roon EN, Sont JK, ten Brinke A. Clinical response to benralizumab can be predicted by combining clinical outcomes at 3 months with baseline characteristics. ERJ Open Res 2023; 9:00559-2022. [PMID: 37057095 PMCID: PMC10086738 DOI: 10.1183/23120541.00559-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 01/15/2023] [Indexed: 01/27/2023] Open
Abstract
BackgroundBenralizumab is highly effective in many, but not all, patients with severe asthma. Baseline characteristics alone are insufficient to predict an individual's probability of long-term benralizumab response.ObjectivesTo (1) study whether parameters at 3 months –in addition to baseline characteristics– contribute to the prediction of benralizumab response at 1 year and to (2) develop an easy-to-use prediction tool to assess an individual's probability of long-term response.MethodsWe assessed the effect of benralizumab treatment in 192 patients from the Dutch severe asthma registry (RAPSODI). To investigate predictors of long-term benralizumab response (≥50% reduction in maintenance oral corticosteroid (OCS) dose or annual exacerbation frequency) we used logistic regression, including baseline characteristics and 3-month Asthma Control Questionnaire (ACQ-6) score and maintenance OCS dose.ResultsBenralizumab treatment significantly improved several clinical outcomes and 144 (75%) patients were classified as long-term responders. Response prediction improved significantly when 3-month outcomes were added to a predictive model with baseline characteristics only (AUROC 0.85versus0.72, p=0.001). Based on this model, a prediction tool using gender, prior biologic use, baseline blood eosinophils, FEV1and at 3 months OCS dose and ACQ-6 was developed which classified patients into 3 categories with increasing probability of long-term response (95%CI): 25%(3–65), 67%(57–77) and 97%(91–99) respectively.ConclusionIn addition to baseline characteristics, treatment outcomes at 3 months contribute to the prediction of benralizumab response at 1 year in patients with severe eosinophilic asthma. Prediction tools as proposed in this study may help physicians optimize the use of costly biologics.
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Janse PD, Veerkamp C, de Jong K, van Dijk MK, Hutschemaekers GJM, Verbraak MJPM. Exploring therapist characteristics as potential moderators of the effects of client feedback on treatment outcome. Clin Psychol Psychother 2023. [PMID: 36639951 DOI: 10.1002/cpp.2828] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 12/11/2022] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
Although studies have shown that client feedback can improve treatment outcome, little is known about which factors might possibly moderate the effects of such feedback. The present study investigated potential therapist variables that might influence whether frequent client feedback is effective, including the Big Five personality traits, internal/external feedback propensity and self-efficacy. Data from two previous studies, a quasi-experimental study and a randomized controlled trial, were combined. The sample consisted of 38 therapists and 843 clients (55.4% females, mean age = 42.05 years, SD = 11.75) from an outpatient mental health institution. The control condition consisted of cognitive-behavioural therapies combined with low frequency monitoring of clients' symptoms. In the experimental condition, high-intensity (i.e., frequent) client feedback as an add-on to treatment as usual was provided. Outcomes were measured as adjusted post-treatment symptom severity on the Symptom Checklist-90 and drop out from treatment. The final model of the multilevel analyses showed that therapists with higher levels of self-efficacy had poorer treatment outcomes, but when high-intensity client feedback was provided, their effectiveness improved. Furthermore, higher self-efficacy was associated with a higher estimation of therapists' own effectiveness, but therapists' self-assessment of effectiveness was not correlated with their actual effectiveness. The results of this study might indicate that therapists with high levels of self-efficacy benefit from client feedback because it can correct their biases. However, for therapists with low self-efficacy, client feedback might be less beneficial, possibly because it can make them more insecure. These hypotheses need to be investigated in future research.
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Affiliation(s)
| | | | - Kim de Jong
- Institute of Psychology, Leiden University, Leiden, The Netherlands
| | | | - Giel J M Hutschemaekers
- Pro Persona Research, Wolfheze, The Netherlands.,Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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Aafjes-van Doorn K, de Jong K. Erratum: Correction of Reference in the Commentary Article “How to make the most of routine outcome monitoring (ROM): A multitude of clinical decisions and nuances to consider.
J Clin Psychol
. 2022;78: 2054‐2065. J Clin Psychol 2022; 79:1509. [PMID: 36404621 DOI: 10.1002/jclp.23455] [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: 11/22/2022]
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Koementas-de Vos MMW, Colleye LC, Tiemens B, Engelsbel F, de Jong K, Witteman CLM, Nugter MA. The feasibility, acceptability and effectiveness of a feedback-informed group treatment (FIGT) tool for patients with anxiety or depressive disorders. Res Psychother 2022; 25:647. [PMID: 36121108 PMCID: PMC9893042 DOI: 10.4081/ripppo.2022.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 09/07/2022] [Indexed: 02/05/2023]
Abstract
Monitoring treatment progress by the use of standardized measures in individual therapy, also called feedback-informed treatment (FIT), has a small but significant effect on improving outcomes. Results of FIT in group therapy settings are mixed, possibly due to contextual factors. The goals of this study were to investigate the feasibility, acceptability and effectiveness of a feedback-informed group treatment (FIGT) tool, based on the principles of the Contextual Feedback Theory and earlier FIGT research. Patients with anxiety or depressive disorders following interpersonal or cognitive behavioural group psychotherapy (IPT-G or CBT-G) were randomized to either feedback (n=104) or Treatment As Usual (TAU; n=93). In the feedback condition, patients filled out the Outcome-Questionnaire 45 (OQ-45) weekly in a FIGT tool and therapists were instructed to discuss the results in each session. Dropout, attendance and outcomes were measured. Additionally, in the feedback condition, OQ-45 response, feedback discussions and acceptability by patients and therapists were assessed. Results showed no differences on dropout, but lower attendance rates in the feedback condition. Although therapists reported high rates of feedback use and helpfulness, patients experienced that results were discussed with them only half of the time and they were also less optimistic about its usefulness. The findings indicate that the FIGT instrument was partially feasible, more acceptable to therapists than patients, and was not effective as intended. Future research is needed to discover how feedback can be beneficial for both therapists and patients in group therapy.
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Affiliation(s)
- Marjolein M. W. Koementas-de Vos
- Radboud University, Nijmegen, The Netherlands,GGZ Noord-Holland-Noord, Heerhugowaard, The Netherlands,GZZNoord- Holland-Noord, Antwoordnummer 1506, 1850 VB Heiloo, The Netherlands.
| | | | - Bea Tiemens
- Radboud University, Nijmegen, The Netherlands
| | | | - Kim de Jong
- Leiden University, Institute of Psychology, Clinical Psychology Unit, Leiden, The Netherlands
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Aafjes-van Doorn K, de Jong K. How to make the most of routine outcome monitoring (ROM): A multitude of clinical decisions and nuances to consider. J Clin Psychol 2022; 78:2054-2065. [PMID: 36041193 DOI: 10.1002/jclp.23438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 11/07/2022]
Abstract
Routine outcome monitoring (ROM) involves the use of patient-reported standardized outcome measures to monitor progress throughout the course of treatment, followed by feedback of the patient's scores to the therapist. The potential benefits of ROM have been established, however, from our own experiences, we know that the implementation in clinical practice can be challenging. We therefore wanted to explore in more detail exactly how we might be able to apply ROM in difficult clinical contexts. The inspiring case illustrations in this issue of Journal of Clinical Psychology: In Session highlight the heterogeneity in ROM systems, and the way in which ROM can be used in treatment. Just as there are many ways of interpreting a survey data-point, there are also many ways in which ROM may be used to complement the treatment and supervision. Whether or not ROM is implemented may partly be determined by clinic policies and routines, but there remain a multitude of clinical decisions that require careful consideration by the individual therapist. To complement the evidence supporting the benefits of using ROM, further empirical support and clinical guidance is needed on how exactly therapists are to use ROM in their work and how ROM may be used in evidence-based practice. We make suggestions for additional uses of ROM for deliberate practice, and teletherapy practice, and look toward novel ways of assessing progress in the near future.
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Affiliation(s)
| | - Kim de Jong
- Institute of Psychology, Leiden University, Leiden, the Netherlands
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van der Meer AN, de Jong K, Ferns M, Widrich C, Ten Brinke A. Overuse of Oral Corticosteroids in Asthma Is Often Underdiagnosed and Inadequately Addressed. J Allergy Clin Immunol Pract 2022; 10:2093-2098. [PMID: 35405380 DOI: 10.1016/j.jaip.2022.03.024] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/16/2022] [Accepted: 03/20/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Overuse of oral corticosteroids (OCS) is associated with serious adverse effects. It is currently unknown what proportion of patients with asthma regularly use these drugs, or whether they are optimally treated by specialists to minimize the use of these drugs. OBJECTIVE To investigate (1) the prevalence of patients requiring ≥2 courses or maintenance use of OCS (ie, frequent users), (2) their use of inhaled corticosteroids, and (3) who prescribed their asthma medications. METHODS We analyzed OCS prescription data (Dutch IQVIA Prescription Database) focusing on adult patients receiving asthma medication between March 2017 and March 2018 (focus year). An OCS course was defined as ≥20 mg prednisolone equivalent for 3 to 28 days; maintenance OCS as 2.5 to 17.5 mg/day for >28 days. Prescribers were classified as specialist or general practitioners. RESULTS Of 182,849 adults taking asthma medications, 77.8% had not received a prescription for OCS and 7.2% of patients were frequent OCS users: 2.6% received ≥2 OCS courses and 4.6% were on maintenance OCS. Of the frequent OCS users, 45.8% received only low or medium doses (<500 μg/day) of inhaled corticosteroids. Within the preceding 3 years (2014-2017), 51.1% and 34.3% of patients prescribed ≥2 OCS courses or maintenance OCS, respectively, had received prescriptions from a general practitioner without medication adjustments by a specialist. CONCLUSION This prescription-fill study shows that 7.2% of Dutch patients with asthma were overexposed to OCS, of whom only about half used adequate doses of inhaled corticosteroids, and 40.3% had not received specialist intervention within the previous 3 years. This suggests that OCS overuse is often underdiagnosed and inadequately addressed.
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Affiliation(s)
| | - Kim de Jong
- Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, the Netherlands
| | - Michiel Ferns
- Department of Respiratory Medicine, AstraZeneca, Den Haag, the Netherlands
| | - Christine Widrich
- Deparment of Real World Evidence Solutions, IQVIA, Amsterdam, the Netherlands
| | - Anneke Ten Brinke
- Department of Respiratory Medicine, Medical Centre Leeuwarden, Leeuwarden, the Netherlands
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23
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Koementas-de Vos MMW, van Dijk M, Tiemens B, de Jong K, Witteman CLM, Nugter MA. Feedback-informed Group Treatment: A Qualitative Study of the Experiences and Needs of Patients and Therapists. Int J Group Psychother 2022; 72:193-227. [PMID: 38446562 DOI: 10.1080/00207284.2022.2086557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Therapists, including group therapists, can systematically gather feedback from patients about how their group members are responding to treatment. However, results of research on using feedback-informed group treatment (FIGT) are mixed, and the underlying mechanisms responsible for positive patient changes remain unclear. Therefore, the present qualitative study examined the perceptions and experiences of both (a) group therapists and (b) group members regarding using feedback in their therapy groups to gauge treatment progress, across five different therapy groups. Specifically, three interpersonal psychotherapy groups and two cognitive-behavioral therapy groups used a FIGT tool in which treatment progress updates were provided to patients and therapists. Observational data were collected in the form of feedback discussions in these therapy groups, as well as during interviews conducted with patients and therapists. Data were analyzed using thematic analysis and a grounded theory approach. Overall, patients were mostly positive about their experiences with FIGT, but therapists also expressed concerns about FIGT. Results indicated that FIGT is useful for gaining insight and strengthening the working alliance. In addition, specific group processes were also found to be important, especially interpersonal learning, cohesion, and social comparison. Practical implications are discussed.
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24
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Bovendeerd B, de Jong K, de Groot E, Moerbeek M, de Keijser J. Enhancing the effect of psychotherapy through systematic client feedback in outpatient mental healthcare: A cluster randomized trial. Psychother Res 2021; 32:710-722. [PMID: 34949156 DOI: 10.1080/10503307.2021.2015637] [Citation(s) in RCA: 11] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Objective: Systematic client feedback (SCF), the regular monitoring and informing of patients' progress during therapy to patient and therapist, has been found to have effects on treatment outcomes varying from very positive to slightly negative. Several prior studies have been biased by researcher allegiance or lack of an independent outcome measure. The current study has taken this into account and aims to clarify the effects of SCF in outpatient psychological treatment. Method: Outpatients (n = 1733) of four centers offering brief psychological treatments were cluster randomized to either treatment as usual (TAU) or TAU with SCF based on the Partners for Change Outcome Management System (PCOMS). Primary outcome measure was the Outcome Questionnaire (OQ-45). Effects of the two treatment conditions on treatment outcome, patient satisfaction, dropout rate, costs, and treatment duration were assessed using a three-level multilevel analysis. DSM-classification, sex, and age of each patient were included as covariates. Results: In both analyses, SCF significantly improved treatment outcome, particularly in the first three months. No significant effects were found on the other outcome variables. Conclusions: Addition of systematic client feedback to treatment as usual, is likely to have a beneficial impact in outpatient psychological treatment. Implementation requires a careful plan of action. Clinical or methodological significance of this article: This study, with large sample size and several independent outcome measures, provides strong evidence that addition of systematic client feedback to outpatient psychological treatment can have a beneficial effect on treatment outcome (symptoms and wellbeing), particularly in the first three months. However, implementation requires a careful plan of action.
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Affiliation(s)
- Bram Bovendeerd
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands.,GGZ center for mental health care, Dimence, The Netherlands
| | - Kim de Jong
- Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Erik de Groot
- GGZ center for mental health care, Dimence, The Netherlands
| | - Mirjam Moerbeek
- Department of Methodology and Statistics, Utrecht University, Utrecht, The Netherlands
| | - Jos de Keijser
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
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van Zwieten TH, Okkema S, Kramp KH, de Jong K, Van Det MJ, Pierie JPEN. Procedure-based assessment for laparoscopic cholecystectomy can replace global rating scales. MINIM INVASIV THER 2021; 31:865-871. [PMID: 34699305 DOI: 10.1080/13645706.2021.1995000] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Global rating scales (GRSs) such as the Objective Structured Assessment of Technical Skills (OSATS) and Global Operative Assessment of Laparoscopic Surgery (GOALS) are assessment methods for surgical procedures. The aim of this study was to establish construct validity of Procedure-Based Assessment (PBA) and to compare PBA with GRSs for laparoscopic cholecystectomy. MATERIAL AND METHODS OSATS and GOALS GRSs were compared with PBA in their ability to discriminate between levels of performance between trainees who can perform the procedure independently and those who cannot. Three groups were formed based on the number of procedures performed by the trainee: novice (1-10), intermediate (11-20) and experienced (>20). Differences between groups were assessed using the Kruskal-Wallis and Mann-Whitney U tests. RESULTS Increasing experience correlated significantly with higher GRSs and PBA scores (all p < .001). Scores of novice and intermediate groups overlapped substantially on the OSATS (p = .1) and GOALS (p = .1), while the PBA discriminated between these groups (p = .03). The median score in the experienced group was higher with less dispersion for PBA (97.2[85.3-100]) compared to OSATS (82.1[60.7-100]) and GOALS (80[60-100]). CONCLUSION For assessing skill level or the capability of performing a laparoscopic cholecystectomy independently, PBA has a higher discriminative ability compared to the GRSs.
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Affiliation(s)
- Tom H van Zwieten
- Department of Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.,Postgraduate School of Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Sietske Okkema
- Department of Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Kelvin H Kramp
- Department of Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Kim de Jong
- Department of Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Marc J Van Det
- Department of Surgery, Hospital Group Twente, Almelo/ Hengelo, The Netherlands
| | - Jean-Pierre E N Pierie
- Department of Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.,Postgraduate School of Medicine, University Medical Centre Groningen, Groningen, The Netherlands
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26
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van der Meer AN, de Jong K, Hoekstra-Kuik A, Bel EH, Ten Brinke A. Targeting dynamic hyperinflation in moderate-to-severe asthma: a randomised controlled trial. ERJ Open Res 2021; 7:00738-2020. [PMID: 34409093 PMCID: PMC8365142 DOI: 10.1183/23120541.00738-2020] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 05/23/2021] [Indexed: 12/02/2022] Open
Abstract
Background Dynamic hyperinflation is highly prevalent in moderate-to-severe asthma, which may significantly impede activities of daily life. We hypothesised that dynamic hyperinflation in asthma is due to inflammation of large and small airways and can be reduced by systemic anti-inflammatory treatment. Therefore, we investigated the effect of systemic glucocorticoids on dynamic hyperinflation in moderate-to-severe asthma patients and explored the relationships between inflammatory markers and changes in dynamic hyperinflation. Methods In this randomised placebo-controlled trial we included 32 asthma patients on inhaled glucocorticoid therapy showing dynamic hyperinflation, defined by a ≥10% reduction in inspiratory capacity measured by standardised metronome-paced tachypnea test. Patients received either triamcinolone (80 mg) or placebo intramuscularly. Before and 2 weeks after treatment, patients completed respiratory health questionnaires, had blood eosinophils and exhaled nitric oxide levels measured, and underwent lung function and dynamic hyperinflation testing. Results After adjustment for potential confounders, dynamic hyperinflation was significantly reduced by 28.1% in the triamcinolone group and increased by 9.4% in the placebo group (p=0.027). In the triamcinolone-treated patients, the reduction in dynamic hyperinflation was greater in patients with higher blood eosinophils at baseline (r=−0.592, p=0.020) and tended to be associated with a reduction in blood eosinophils (r=0.412, p=0.127) and exhaled nitric oxide (r=0.442, p=0.099). Conclusions This exploratory study suggests that dynamic hyperinflation in asthma can be reduced by systemic anti-inflammatory treatment, particularly in patients with elevated blood eosinophils. This supports the hypothesis that dynamic hyperinflation in asthma is due to airway inflammation and should be considered an important target for treatment. Dynamic hyperinflation: a target for treatment in asthma, which can be reduced by systemic anti-inflammatory treatmenthttps://bit.ly/3gfyxYv
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Affiliation(s)
| | - Kim de Jong
- Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | | | - Elisabeth H Bel
- Amsterdam University Medical Centres, Amsterdam, The Netherlands
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27
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de Boer WJ, Visser C, van Kuijk SMJ, de Jong K. A prognostic model for the preoperative identification of patients at risk for receiving transfusion of packed red blood cells in cardiac surgery. Transfusion 2021; 61:2336-2346. [PMID: 34292607 DOI: 10.1111/trf.16438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 02/02/2021] [Accepted: 04/01/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Patients undergoing cardiothoracic surgery are at substantial risk for blood transfusion. Increased awareness and patient blood management have resulted in a significant reduction over the past years. The next step is preoperative treatment of patients at high risk for packed red blood cells (RBC) transfusion, with the ultimate goal to eventually prevent RBC transfusion. A prediction model was developed to select patients at high risk for RBC transfusion. MATERIALS AND METHODS Data of all patients that underwent cardiac surgery in our center between 2008 and 2013 (n = 2951) were used for model development, and between 2014 and 2016 for validation (n = 1136). Only preoperative characteristics were included in a multinomial regression model with three outcome categories (no, RBC, other transfusion). The accuracy of the estimated risks and discriminative ability of the model were assessed. Clinical usefulness was explored. RESULTS Risk factors included are sex, type of surgery, redo surgery, age, height, body mass index, preoperative hemoglobin level, and preoperative platelet count. The model has excellent discriminative ability for predicting RBC transfusion versus no transfusion (area under the curve [AUC] = 94%) and good discriminative ability for RBC transfusion versus other transfusion (AUC = 84%). With a cut-off value of RBC risk of 16.8% and higher, the model is well able to identify a high proportion of patients at risk for RBC transfusion (sensitivity = 87.1%, specificity = 82.3%). CONCLUSION In the current study, a prediction tool was developed to be used for risk stratification of patients undergoing elective cardiac surgery at risk for blood transfusions.
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Affiliation(s)
- Wiebe J de Boer
- Heart Center, Department Extra Corporeal Circulation, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Cornelis Visser
- Heart Center, Department Extra Corporeal Circulation, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Sander M J van Kuijk
- Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht UMC+, Maastricht, The Netherlands
| | - Kim de Jong
- Department of Epidemiology, MCL Academy, Medical Center Leeuwarden, Leeuwarden, The Netherlands
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28
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Delgadillo J, McMillan D, Gilbody S, de Jong K, Lucock M, Lutz W, Rubel J, Aguirre E, Ali S. Cost-effectiveness of feedback-informed psychological treatment: Evidence from the IAPT-FIT trial. Behav Res Ther 2021; 142:103873. [PMID: 33945983 DOI: 10.1016/j.brat.2021.103873] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 02/08/2021] [Accepted: 04/19/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Feedback-informed treatment (FIT) involves using computerized routine outcome monitoring technology to alert therapists to cases that are not responding well to psychotherapy, prompting them to identify and resolve obstacles to improvement. In this study, we present the first health economic evaluation of FIT, compared to usual care, to enable decision makers to judge whether this approach represents a good investment for health systems. METHODS This randomised controlled trial included 2233 patients clustered within 77 therapists who were randomly assigned to a FIT group (n = 1176) or a usual care control group (n = 1057). Treatment response was monitored using patient-reported depression (PHQ-9) and anxiety (GAD-7) measures. Therapists in the FIT group had access to a computerized algorithm that alerted them to cases that were "not on track", compared to normative clinical data. Health service costs included the cost of training therapists to use FIT and the cost of therapy sessions in each arm. The incremental cost-effectiveness of FIT was assessed relative to usual care, using multilevel modelling. RESULTS FIT was associated with an increased probability of reliable symptomatic improvement by 8.09 percentage points (95% CI: 4.16%-12.03%) which was statistically significant. The incremental cost of FIT was £15.17 (95% CI: £6.95 to £37.29) per patient and was not statistically significant. The incremental cost-effectiveness ratio (ICER) per additional case of reliable improvement was £187.4 (95% CI: £126.7 to £501.5); this confidence interval shows that the relative cost-effectiveness is between FIT being a dominant strategy (i.e. more effective and also cost-saving) to FIT being more effective at a modest incremental cost to the health system. CONCLUSIONS The FIT strategy increases the probability of reliable improvement in routine clinical practice and may be associated with a small (but uncertain) incremental cost. FIT is likely to be a cost-effective strategy for mental health services.
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Affiliation(s)
- Jaime Delgadillo
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, United Kingdom.
| | - Dean McMillan
- Department of Health Sciences and Hull York Medical School, University of York, United Kingdom
| | - Simon Gilbody
- Department of Health Sciences and Hull York Medical School, University of York, United Kingdom
| | - Kim de Jong
- Institute of Psychology, Leiden University, Netherlands
| | - Mike Lucock
- Centre for Applied Research in Health, University of Huddersfield, UK
| | - Wolfgang Lutz
- Department of Psychology, University of Trier, Germany
| | - Julian Rubel
- Department of Psychology, Justus-Liebig-University Giessen, Germany
| | - Elisa Aguirre
- North East London National Health Service (NHS) Foundation Trust, UK
| | - Shehzad Ali
- Department of Health Sciences and Hull York Medical School, University of York, United Kingdom; Department of Epidemiology and Biostatistics, Western University, Canada
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29
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van Thiel SJ, Joosen MCW, Joki AL, van Dam A, van der Klink JJL, de Jong K. Psychometric analysis of the Dutch language Facilitative Interpersonal Skills (FIS) video clips. ACTA ACUST UNITED AC 2021; 24:513. [PMID: 33937114 PMCID: PMC8082538 DOI: 10.4081/ripppo.2021.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/13/2021] [Indexed: 12/03/2022]
Abstract
With the motivation of investigating the replicability and transferability of the findings employing the Facilitative Interpersonal Skills (FIS) performance task beyond Anglophone countries, a set of Dutch FIS clips have been scripted and recorded. In this study the psychometric properties of the Dutch clips was tested. Furthermore, an additional set of FIS clips portraying a non-challenging client-therapist interaction was tested. 369 psychology students rated the interpersonal impact (IMI-C) and the affect (positive and negative affect schedule) displayed by the hypothetical client. Thirteen out of sixteen FIS clips were located in the same IMI-C quadrant as the US clips, indicating good content validity for all sets of FIS clips. Inter-rater reliability was reasonable for one set of Dutch language FIS clips (k=0.416). Visual inspection of quadrants showed the different character of the non-challenging set of FIS clips. The Dutch FIS clips are directly applicable for educational and research purposes.
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Affiliation(s)
- Sabine J van Thiel
- Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo - Academic collaborative center Work & Health, Tilburg, The Netherlands.,Mental Health Institute GGZ WNB, Bergen op Zoom, The Netherlands
| | - Margot C W Joosen
- Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo - Academic collaborative center Work & Health, Tilburg, The Netherlands.,Department Human Resource Studies, Tilburg University, Tilburg School of Social and Behavioral Sciences, Tilburg, The Netherlands
| | - Anne-Linde Joki
- Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Arno van Dam
- Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo - Academic collaborative center Work & Health, Tilburg, The Netherlands.,Mental Health Institute GGZ WNB, Bergen op Zoom, The Netherlands
| | - Jac J L van der Klink
- Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo - Academic collaborative center Work & Health, Tilburg, The Netherlands.,Optentia, North West University of South Africa, Vanderbijlpark, South Africa
| | - Kim de Jong
- Institute of Psychology, Leiden University, Leiden, The Netherlands
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30
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de Jong K, Conijn JM, Gallagher RAV, Reshetnikova AS, Heij M, Lutz MC. Using progress feedback to improve outcomes and reduce drop-out, treatment duration, and deterioration: A multilevel meta-analysis. Clin Psychol Rev 2021; 85:102002. [PMID: 33721605 DOI: 10.1016/j.cpr.2021.102002] [Citation(s) in RCA: 101] [Impact Index Per Article: 33.7] [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: 12/20/2019] [Revised: 02/04/2021] [Accepted: 02/23/2021] [Indexed: 01/08/2023]
Abstract
Progress feedback is an intervention aimed at enhancing patient outcomes in routine clinical practice. This study reports a comprehensive multilevel meta-analysis on the effectiveness of progress feedback in psychological treatments in curative care. The short- and long-term effects of feedback on symptom reduction were investigated using 58 (randomized and non-randomized) studies, analyzing 110 effect sizes in a total of 21,699 patients. Effects of feedback on dropout rate, percentage of deteriorated cases, and treatment duration were also examined. Moderation analyses were conducted for study and feedback characteristics. A small significant effect of progress feedback on symptom reduction (d = 0.15, 95% CI: [0.10, 0.20]) was found, compared to control groups. This was also true for not-on-track cases (d = 0.17, 95% CI: [0.11, 0.22]). In addition, feedback had a small favorable effect on dropout rates (OR = 1.19, 95% CI: [1.03, 1.38]). The moderation analyses identified several potentially interesting variables for further research, including feedback instrument, outcome instrument, type of feedback, feedback frequency, treatment intensity, and country in which the study was conducted. Future studies should report on these variables more consistently so that we can obtain a better understanding of when and why feedback improves outcomes.
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Affiliation(s)
- Kim de Jong
- Institute of Psychology, Leiden University, Leiden, the Netherlands.
| | - Judith M Conijn
- Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands
| | | | | | - Marya Heij
- Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - Miranda C Lutz
- Institute of Psychology, Leiden University, Leiden, the Netherlands; Department of Psychology, Education & Child Studies, Erasmus University, Rotterdam, the Netherlands
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31
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van der Lek LM, Pool SMW, de Jong K, Vermeij-Keers C, Mouës-Vink CM. Seasonal Influence on the Numbers of Gender-Related Orofacial Cleft Conceptions in the Netherlands. Cleft Palate Craniofac J 2021; 58:1422-1429. [PMID: 33467910 DOI: 10.1177/1055665620987693] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In the multifactorial etiology of orofacial clefts (OFCs), environmental factors play an important role. To trace the influence of these factors, the timing of the cell biological mechanisms that occur during embryological development of the primary and secondary palates must be taken into account. That is, the fusion process of the facial and palatal processes, respectively, followed by their differentiation into bone and musculature, which take place during the first trimester of pregnancy. During this period, harmful seasonal influences such as viral infections and vitamin deficiencies could induce OFC in the embryo. AIMS The aim of this study is to find out whether a seasonal conception period with an increased risk of OFC development exists, particularly gender related. METHODS This was a retrospective cross-sectional study on children with OFC born in the Netherlands from 2006 to 2016. Total conception rates of live births in the Netherlands were used as a control group. χ2 tests were performed to analyze monthly and seasonal differences. Males and females, positive and negative family history and subphenotype groups based on fusion and/or differentiation (F- and/or D-) defects, and their timing in embryogenesis were analyzed separately. RESULTS In total, 1653 children with OFC, 1041 males and 612 females, were analyzed. Only males with FD-defects showed a significant seasonal variation with an increase in conceptions during spring, most often in May. CONCLUSIONS Males with FD-defects showed a significant seasonal variation with an increase in conceptions during spring. No other seasonal trends could be demonstrated.
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Affiliation(s)
- Lisanne M van der Lek
- Department of Ear, Nose and Throat, 4480Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Shariselle M W Pool
- Department of Plastic Surgery, 10173University Medical Center Utrecht, the Netherlands
| | - Kim de Jong
- Department of Epidemiology, 4480Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Christl Vermeij-Keers
- Department of Plastic and Reconstructive Surgery, Erasmus MC, 10173University Medical Center Rotterdam, the Netherlands; Dutch Association for Cleft Palate and Craniofacial Anomalies the Netherlands
| | - Chantal M Mouës-Vink
- Department of Plastic Surgery, 4480Medical Center Leeuwarden, Leeuwarden, the Netherlands
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Kroes JA, Zielhuis SW, van der Meer AN, de Jong K, van Roon EN, Ten Brinke A. Optimizing omalizumab dosing in severe asthma-the exploration of therapeutic drug monitoring. J Allergy Clin Immunol Pract 2020; 9:1408-1410.e1. [PMID: 33338686 DOI: 10.1016/j.jaip.2020.12.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/20/2020] [Accepted: 12/02/2020] [Indexed: 02/08/2023]
Affiliation(s)
- Johannes Anthon Kroes
- Department of Clinical Pharmacy and Pharmacology, Medical Centre Leeuwarden, Leeuwarden, the Netherlands.
| | - Sander Wilhelm Zielhuis
- Department of Clinical Pharmacy and Pharmacology, Medical Centre Leeuwarden, Leeuwarden, the Netherlands
| | | | - Kim de Jong
- Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, the Netherlands
| | - Eric Nico van Roon
- Department of Clinical Pharmacy and Pharmacology, Medical Centre Leeuwarden, Leeuwarden, the Netherlands; Groningen Research Institute of Pharmacy, Unit of Pharmacotherapy, Epidemiology and Economics, Department of Pharmacy, University of Groningen, Groningen, the Netherlands
| | - Anneke Ten Brinke
- Department of Pulmonary Diseases, Medical Centre Leeuwarden, Leeuwarden, the Netherlands
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Janse PD, de Jong K, Veerkamp C, van Dijk MK, Hutschemaekers GJM, Verbraak MJPM. The effect of feedback-informed cognitive behavioral therapy on treatment outcome: A randomized controlled trial. J Consult Clin Psychol 2020; 88:818-828. [DOI: 10.1037/ccp0000549] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Ter Laak S, Lucas I, Oude Nijeweeme J, van Ravenstein L, de Jong K, Rollema C, de Vries T. An age-adjusted instruction video enhances the correct use of nasal corticosteroid sprays in children. Allergol Immunopathol (Madr) 2020; 48:465-468. [PMID: 32295726 DOI: 10.1016/j.aller.2019.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 11/04/2019] [Accepted: 11/12/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION AND OBJECTIVES Allergic rhinitis is a common disorder. Intranasal corticosteroid sprays are used to control symptoms. However, incorrect use of these sprays can decrease efficacy and lead to side effects such as nose bleeding. We studied if watching an age-adjusted instruction video is effective to improve administration technique. MATERIALS AND METHODS We invited children who used intranasal corticosteroid sprays. We examined their administration technique before, directly after, and one month after showing them an age-adjusted instruction video. We compared their administration technique with the instructions in the patient information leaflet. We assessed whether the children performed the seventeen maneuvers mentioned in the patient information leaflet and the eight we considered essential. RESULTS Of the 99 eligible children, 23 (15 boys, median age nine years) participated. Before watching the instruction video none of them administered according to all maneuvers in the patient information leaflet or showed all essential maneuvers. One month after seeing the instruction video, three children demonstrated correct inhalation as per the patient information leaflet. Three performed the essential maneuvers. When a 75% threshold level for carrying out all 17 maneuvers was used, still none showed 75% of all or of the essential maneuvers before watching the video. Yet, after one month 12 children showed sufficient administration technique (52%, 95% confidence interval (CI) 31%-73%, p = 0.004). Nine showed all essential manoeuvres (47%, 95%CI 24%-71%, p = 0.004). CONCLUSIONS An age-adjusted instruction video is a useful and easy method to teach children to administer nasal intranasal corticosteroid sprays correctly.
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Affiliation(s)
- Susanne Ter Laak
- Department of Pediatrics, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Iris Lucas
- Department of Pediatrics, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | | | - Lara van Ravenstein
- Department of Pediatrics, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Kim de Jong
- Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Corine Rollema
- Department of Pediatrics, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Tjalling de Vries
- Department of Pediatrics, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
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Pool SMW, der Lek LMV, de Jong K, Vermeij-Keers C, Mouës-Vink CM. Embryologically Based Classification Specifies Gender Differences in the Prevalence of Orofacial Cleft Subphenotypes. Cleft Palate Craniofac J 2020; 58:54-60. [PMID: 32602363 PMCID: PMC7739112 DOI: 10.1177/1055665620935363] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 12/01/2022] Open
Abstract
Background: A recently published validated classification system divides all orofacial cleft (OFC) subphenotypes into groups based on underlying developmental mechanisms, that is, fusion and differentiation, and their timing, that is, early and late periods, in embryogenesis of the primary and secondary palates. Aims: The aim of our study was to define gender differences in prevalence for all subphenotypes in newborns with OFC in the Netherlands. Methods: This was a retrospective cross-sectional study on children with OFC born from 2006 to 2016. Clefts were classified in early (E-), late (L-), and early/late (EL-) embryonic periods, in primary (P-), secondary (S-), and primary/secondary (PS-) palates, and further divided into fusion (F-), differentiation (D-), and fusion/differentiation (FD-) defects, respectively. Results: A total of 2089 OFC children were analyzed (1311 males and 778 females). Orofacial cleft subphenotypes in females occurred significantly more frequent in the L-period compared to males (66% vs 55%, P = .000), whereas clefts in males occurred significantly more in the EL-periods (40% vs 27%, P = .000). Females had significantly more S-palatal clefts (42% vs 23%, P = .000), while males had significantly more PS-palatal clefts (44% vs 30%, P = .000). Furthermore, the clefts in females were significantly more frequent the result of an F-defect (60% vs 52%, P = .000). Conclusions: Orofacial cleft in females mainly occur in the L-period are mostly S-palatal clefts, and are usually the result of an F-defect. Orofacial cleft in males more commonly occur in the EL-periods, are therefore more often combined PS-palatal clefts, and are more frequent D- and FD-defects.
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Affiliation(s)
- Shariselle M W Pool
- Department of Plastic Surgery, 10173University Medical Center Groningen, Groningen, the Netherlands
| | - Lisanne M van der Lek
- Department of Ear, Nose and Throat, 4480Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Kim de Jong
- Department of Epidemiology, 4480Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Christl Vermeij-Keers
- Department of Plastic and Reconstructive Surgery, 6993Erasmus University Medical Center, Rotterdam, the Netherlands.,Dutch Association for Cleft Palate and Craniofacial Anomalies, Mijdrecht, the Netherlands
| | - Chantal M Mouës-Vink
- Department of Plastic Surgery, 4480Medical Center Leeuwarden, Leeuwarden, the Netherlands
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36
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Brugnera A, Zarbo C, Compare A, Talia A, Tasca GA, de Jong K, Greco A, Greco F, Pievani L, Auteri A, Lo Coco G. Self-reported reflective functioning mediates the association between attachment insecurity and well-being among psychotherapists. Psychother Res 2020; 31:247-257. [PMID: 32429777 DOI: 10.1080/10503307.2020.1762946] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Objective: Subjective well-being is a crucial variable for mental health practitioners. This study examines the influence of therapists' attachment dimensions and self-reported reflective functioning on their perceived well-being. Further, it examines if reflective functioning mediates the association between attachment insecurity and well-being. Method: A total of 416 experienced psychotherapists were enrolled in this cross-sectional study, and completed self-report measures of attachment insecurity, reflective functioning, and well-being. We tested the hypothesized mediation model with path analysis that examined indirect effects. Results: Both attachment anxiety and avoidance dimensions had a significant negative association with perceived well-being with small to medium effects. "Certainty" in reflective functioning had a small positive effect on therapist well-being. Reflective functioning mediated the association between insecure attachment dimensions and well-being, suggesting that therapist's lower ability to mentalize may partially account for the effects of higher attachment insecurity on lower well-being. Conclusion: The well-being of psychotherapists with greater insecure attachment may deserve special attention, and therapists' mentalizing capacities may be targeted by researchers and trainers as a core ability to be cultivated in order to preserve therapists' professional and personal resources.
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Affiliation(s)
- Agostino Brugnera
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Cristina Zarbo
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy.,Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Angelo Compare
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Alessandro Talia
- Institute for Psychosocial Prevention, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | | | - Kim de Jong
- Institute of Psychology, Leiden University, Leiden, Netherlands
| | - Andrea Greco
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | | | - Luca Pievani
- Scuola di Psicoterapia Integrata, Bergamo, Italy
| | - Adalberto Auteri
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Gianluca Lo Coco
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
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Carlier IVE, van Eeden WA, de Jong K, Giltay EJ, van Noorden MS, van der Feltz-Cornelis C, Zitman FG, Kelderman H, van Hemert AM. Testing for response shift in treatment evaluation of change in self-reported psychopathology amongst secondary psychiatric care outpatients. Int J Methods Psychiatr Res 2019; 28:e1785. [PMID: 31206911 PMCID: PMC6852603 DOI: 10.1002/mpr.1785] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 03/18/2019] [Accepted: 04/01/2019] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES If patients change their perspective due to treatment, this may alter the way they conceptualize, prioritize, or calibrate questionnaire items. These psychological changes, also called "response shifts," may pose a threat to the measurement of therapeutic change in patients. Therefore, it is important to test the occurrence of response shift in patients across their treatment. METHODS This study focused on self-reported psychological distress/psychopathology in a naturalistic sample of 206 psychiatric outpatients. Longitudinal measurement invariance tests were computed across treatment in order to detect response shifts. RESULTS Compared with before treatment, post-treatment psychopathology scores showed an increase in model fit and factor loading, suggesting that symptoms became more coherently interrelated within their psychopathology domains. Reconceptualization (depression/mood) and reprioritization (somatic and cognitive problems) response shift types were found in several items. We found no recalibration response shift. CONCLUSION This study provides further evidence that response shift can occur in adult psychiatric patients across their mental health treatment. Future research is needed to determine whether response shift implies an unwanted potential bias in treatment evaluation or a desired cognitive change intended by treatment.
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Affiliation(s)
- Ingrid V E Carlier
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
| | - Wessel A van Eeden
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
| | - Kim de Jong
- Clinical Psychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
| | | | | | - Frans G Zitman
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
| | - Henk Kelderman
- Department of Methodology and Statistics, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Albert M van Hemert
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
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38
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Gijtenbeek RGP, de Jong K, Venmans BJW, van Vollenhoven FHM, Ten Brinke A, Van der Wekken AJ, van Geffen WH. Best first-line therapy for patients with advanced non-small cell lung cancer, performance status 2 without a targetable mutation or with an unknown mutation status. Hippokratia 2019. [DOI: 10.1002/14651858.cd013382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Rolof GP Gijtenbeek
- Medical Center Leeuwarden; Department of Pulmonary Diseases; Henri Dunantweg 2 Leeuwarden Netherlands
| | - Kim de Jong
- Medical Center Leeuwarden; Department of Epidemiology; Henri Dunantweg 2 Leeuwarden Friesland Netherlands
| | - Ben JW Venmans
- Medical Center Leeuwarden; Department of Pulmonary Diseases; Henri Dunantweg 2 Leeuwarden Netherlands
| | - Femke HM van Vollenhoven
- Medical Center Leeuwarden; Department of Pulmonary Diseases; Henri Dunantweg 2 Leeuwarden Netherlands
| | - Anneke Ten Brinke
- Medical Center Leeuwarden; Department of Pulmonary Diseases; Henri Dunantweg 2 Leeuwarden Netherlands
| | - Anthonie J Van der Wekken
- University of Groningen, University Medical Center Groningen; Department of Pulmonary Diseases; Hanzeplein 1 Groningen Netherlands
| | - Wouter H van Geffen
- Medical Center Leeuwarden; Department of Pulmonary Diseases; Henri Dunantweg 2 Leeuwarden Netherlands
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Imboden M, Wielscher M, Rezwan FI, Amaral A, Schaffner E, Jeong A, Beckmeyer-Borowko A, Harris SE, Starr JM, Deary I, Flexeder C, Waldenberger M, Peters A, Schulz H, Chen S, Sunny SK, Karmaus WJ, Jiang Y, Erhart G, Kronenberg F, Arathimos R, Sharp GC, Henderson AJ, Fu Y, Piirilä P, Pietiläinen KH, Ollikainen M, Johansson A, Gyllensten U, de Vries M, van der Plaat DA, de Jong K, Boezen HM, Hall I, Tobin MD, Jarvelin MR, Holloway J, Jarvis D, Probst-Hensch NM. Epigenome-wide association study of lung function level and its change. Eur Respir J 2019; 54:13993003.00457-2019. [PMID: 31073081 PMCID: PMC6610463 DOI: 10.1183/13993003.00457-2019] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 03/27/2019] [Indexed: 12/19/2022]
Abstract
Previous reports link differential DNA methylation (DNAme) to environmental exposures that are associated with lung function. Direct evidence on lung function DNAme is, however, limited. We undertook an agnostic epigenome-wide association study (EWAS) on pre-bronchodilation lung function and its change in adults.In a discovery-replication EWAS design, DNAme in blood and spirometry were measured twice, 6-15 years apart, in the same participants of three adult population-based discovery cohorts (n=2043). Associated DNAme markers (p<5×10-7) were tested in seven replication cohorts (adult: n=3327; childhood: n=420). Technical bias-adjusted residuals of a regression of the normalised absolute β-values on control probe-derived principle components were regressed on level and change of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and their ratio (FEV1/FVC) in the covariate-adjusted discovery EWAS. Inverse-variance-weighted meta-analyses were performed on results from discovery and replication samples in all participants and never-smokers.EWAS signals were enriched for smoking-related DNAme. We replicated 57 lung function DNAme markers in adult, but not childhood samples, all previously associated with smoking. Markers not previously associated with smoking failed replication. cg05575921 (AHRR (aryl hydrocarbon receptor repressor)) showed the statistically most significant association with cross-sectional lung function (FEV1/FVC: pdiscovery=3.96×10-21 and pcombined=7.22×10-50). A score combining 10 DNAme markers previously reported to mediate the effect of smoking on lung function was associated with lung function (FEV1/FVC: p=2.65×10-20).Our results reveal that lung function-associated methylation signals in adults are predominantly smoking related, and possibly of clinical utility in identifying poor lung function and accelerated decline. Larger studies with more repeat time-points are needed to identify lung function DNAme in never-smokers and in children.
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Affiliation(s)
- Medea Imboden
- Chronic Disease Epidemiology Unit, Dept of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland,University of Basel, Basel, Switzerland,These authors contributed equally to this work
| | - Matthias Wielscher
- MRC-PHE Centre for Environment and Health, Imperial College London, London, UK,Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK,These authors contributed equally to this work
| | - Faisal I. Rezwan
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK,These authors contributed equally to this work
| | - André F.S. Amaral
- MRC-PHE Centre for Environment and Health, Imperial College London, London, UK,Population Health and Occupational Disease, NHLI, Imperial College London, London, UK,These authors contributed equally to this work
| | - Emmanuel Schaffner
- Chronic Disease Epidemiology Unit, Dept of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland,University of Basel, Basel, Switzerland
| | - Ayoung Jeong
- Chronic Disease Epidemiology Unit, Dept of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland,University of Basel, Basel, Switzerland
| | - Anna Beckmeyer-Borowko
- Chronic Disease Epidemiology Unit, Dept of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland,University of Basel, Basel, Switzerland
| | - Sarah E. Harris
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK,Medical Genetics Section, University of Edinburgh Centre for Genomic and Experimental Medicine and MRC Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, UK
| | - John M. Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK,Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
| | - Ian J. Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK,Dept of Psychology, University of Edinburgh, Edinburgh, UK
| | - Claudia Flexeder
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Melanie Waldenberger
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany,Research Unit Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany,Research Unit Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Holger Schulz
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany,Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Su Chen
- Dept of Mathematical Sciences, University of Memphis, Memphis, TN, USA
| | - Shadia Khan Sunny
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Wilfried J.J. Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Yu Jiang
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Gertraud Erhart
- Division of Genetic Epidemiology, Dept of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Florian Kronenberg
- Division of Genetic Epidemiology, Dept of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ryan Arathimos
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK,Dept of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Gemma C. Sharp
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK,Dept of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK,Bristol Dental School, University of Bristol, Bristol, UK
| | | | - Yu Fu
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Päivi Piirilä
- Unit of Clinical Physiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Kirsi H. Pietiläinen
- Obesity Research Unit, Research Programs Unit, University of Helsinki, Helsinki, Finland,Abdominal Center, Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Miina Ollikainen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Asa Johansson
- Dept of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Ulf Gyllensten
- Dept of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Maaike de Vries
- University of Groningen, University Medical Center Groningen, Dept of Epidemiology, Groningen, The Netherlands,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Diana A. van der Plaat
- University of Groningen, University Medical Center Groningen, Dept of Epidemiology, Groningen, The Netherlands,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Kim de Jong
- University of Groningen, University Medical Center Groningen, Dept of Epidemiology, Groningen, The Netherlands,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - H. Marike Boezen
- University of Groningen, University Medical Center Groningen, Dept of Epidemiology, Groningen, The Netherlands,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ian P. Hall
- Division of Respiratory Medicine, University of Nottingham, Nottingham, UK,National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham University Hospitals, Nottingham, UK
| | - Martin D. Tobin
- Dept of Health Sciences, University of Leicester, Leicester, UK,National Institute of Health Research Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Marjo-Riitta Jarvelin
- Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland,Biocenter Oulu, University of Oulu, Oulu, Finland,Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland,Dept of Life Sciences, College of Health and Life Sciences, Brunel University London, London, UK,These authors contributed equally to this work
| | - John W. Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK,These authors contributed equally to this work
| | - Deborah Jarvis
- MRC-PHE Centre for Environment and Health, Imperial College London, London, UK,Population Health and Occupational Disease, NHLI, Imperial College London, London, UK,These authors contributed equally to this work
| | - Nicole M. Probst-Hensch
- Chronic Disease Epidemiology Unit, Dept of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland,University of Basel, Basel, Switzerland,These authors contributed equally to this work
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Bovendeerd B, de Jong K, Colijn S, de Groot E, Hafkenscheid A, Moerbeek M, de Keijser J. Systematic client feedback to brief therapy in basic mental healthcare: study protocol for a four-centre clinical trial. BMJ Open 2019; 9:e025701. [PMID: 31092647 PMCID: PMC6530302 DOI: 10.1136/bmjopen-2018-025701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The Partners for Change Outcome Management System (PCOMS) is a client feedback-system built on two brief visual analogue self-report scales. Prior studies of PCOMS have found effects varying from significant positive to negative. Aims of present study are; to test the predicted beneficial impact of PCOMS, while accounting for methodological flaws in prior studies and to clarify under which circumstances the addition of PCOMS to therapy has a beneficial effect. METHODS AND ANALYSIS This study focuses on patients applying for brief, time-limited treatments. Four centres will be randomised to either treatment as usual (TAU) or TAU with PCOMS. All participating patients will be assessed four times. The full staff in the experimental condition will be trained in PCOMS. In the second part of this study, all therapists in the PCOMS condition will fill in a questionnaire concerning the influence of regulatory focus, self-efficacy, external or internal feedback orientation and perceived feedback validity of PCOMS. Finally, patients in the PCOMS condition will be asked to give feedback through a structured interview.The primary outcome measure is the Outcome Questionnaire over the period from beginning to end of therapy. The Mental Health Continuum-Short Form and Consumer Quality Index are also completed. In the primary analysis, outcomes of the two treatment conditions on treatment outcome, patient satisfaction, costs, drop-out and duration will be examined with a three-level (within patient, between patients and between therapists) multilevel analysis. The DSM-classification, sex, education level, age of each patient and therapist factors will be included as covariates. ETHICS AND DISSEMINATION The Medical Ethics Committee of the University of Twente approved this study (K15-11, METC Twente). Data will be included from 1 January 2016 to 1 July 2019. Study results will be disseminated through peer-reviewed journals and conferences. TRIAL REGISTRATION NUMBER NTR5466; Pre-results.
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Affiliation(s)
- Bram Bovendeerd
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
- GGZ center for mental health care, Dimence, Deventer, The Netherlands
| | - Kim de Jong
- Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Sjoerd Colijn
- GGZ Center for Mental Health Care, GGZ Delfland, Delft, The Netherlands
| | - Erik de Groot
- GGZ center for mental health care, Dimence, Deventer, The Netherlands
| | - Anton Hafkenscheid
- Outpatient Clinic, Arkin/Sinaï Centre Jewish Mental Health Services, Amersfoort/Amstelveen, The Netherlands
| | - Mirjam Moerbeek
- Department of Methodology and Statistics, University of Utrecht, Utrecht, The Netherlands
| | - Jos de Keijser
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
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Prins DJ, van Vendeloo SN, Brand PLP, Van der Velpen I, de Jong K, van den Heijkant F, Van der Heijden FMMA, Prins JT. The relationship between burnout, personality traits, and medical specialty. A national study among Dutch residents. Med Teach 2019; 41:584-590. [PMID: 30394166 DOI: 10.1080/0142159x.2018.1514459] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Purpose: To examine the associations between residents' personality traits, type of specialty, and symptoms of burnout. Method: A cross-sectional online survey among Dutch residents was conducted (see Supplementary Material ). The 20-item Dutch translation of the Maslach Burnout Inventory was used to ascertain burnout. Personality traits were assessed with the 44-item Dutch Big Five Inventory. Logistic regression analyses, including all five personality traits, were used to assess associations with burnout. Analyses were stratified by specialties. Results: One thousand two hundred thirty one residents participated, 185 (15.0%) of whom met the criteria for burnout. Neuroticism was significantly associated with resident burnout in all specialties, more strongly in supportive (odds ratio (OR) 6.19, 95% CI 2.12-18.12) and surgical (OR 4.37, 95% CI 1.76-10.86) than in medical residents (OR 1.99, 95% CI 1.22-3.24). Extraversion was significantly associated with less burnout in surgical residents (OR 0.26, 95% CI 0.13-0.58). These findings remained highly significant after controlling for gender, overtime, autonomy at work, satisfaction between work and private life, and the perceived quality of the learning environment. Conclusions: Burnout risk was associated with personality traits in residents. Consistently, residents scoring high on neuroticism reported more burnout. Extraverted surgical residents were less susceptible to burnout. Residents scoring high on neuroticism may require more intense monitoring during their training years.
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Affiliation(s)
- David J Prins
- a Department of Pulmonology , Medical Center Leeuwarden , Leeuwarden , The Netherlands
| | - Stefan N van Vendeloo
- b Department of Orthopedic Surgery and Traumatology , Isala Hospital , Zwolle , The Netherlands
| | - Paul L P Brand
- c Postgraduate School of Medicine , University Medical Center Groningen , Groningen , The Netherlands
| | - Inge Van der Velpen
- d Department of Obstetrics and Gynaecology , Martini Hospital , Groningen , The Netherlands
| | - Kim de Jong
- e Department of Epidemiology, MCL academy , Medical Center Leeuwarden , Leeuwarden , The Netherlands
| | | | | | - Jelle T Prins
- h MCL Academy , Medical Center Leeuwarden , Leeuwarden , The Netherlands
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van der Meer AN, de Jong K, Hoekstra-Kuik A, Bel EH, Ten Brinke A. Dynamic hyperinflation impairs daily life activity in asthma. Eur Respir J 2019; 53:13993003.01500-2018. [PMID: 30679190 DOI: 10.1183/13993003.01500-2018] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 01/13/2019] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Dynamic hyperinflation has been documented in asthma, yet its impact on overall health and daily life activities is unclear. We assessed the prevalence of dynamic hyperinflation in moderate to severe asthma and its relationship with the scores of a set of specific and general respiratory health questionnaires. METHODS 77 nonsmoking asthma patients (Global Initiative for Asthma steps 4-5) were recruited consecutively and completed five questionnaires: Asthma Control Questionnaire, Clinical COPD (chronic obstructive pulmonary disease) Questionnaire, St George's Respiratory Questionnaire, London Chest Activity of Daily Living scale (LCADL) and Shortness of Breath with Daily Activities (SOBDA). Dynamic hyperinflation was defined as ≥10% reduction in inspiratory capacity induced by standardised metronome-paced tachypnoea. Associations between level of dynamic hyperinflation and questionnaire scores were assessed and adjusted for asthma severity. RESULTS 81% (95% CI 71.7-89.4%) of patients showed dynamic hyperinflation. Higher levels of dynamic hyperinflation were related to poorer scores on all questionnaires (r=0.228-0.385, p<0.05). After adjustment for asthma severity, dynamic hyperinflation remained associated with poorer scores on LCADL (p=0.027) and SOBDA (p=0.031). CONCLUSION Dynamic hyperinflation is associated with poorer overall health and impaired daily life activities, independent of asthma severity. Because of its major impact on everyday life activities, dynamic hyperinflation is an important target for treatment in asthma.
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Affiliation(s)
| | - Kim de Jong
- Medical Centre Leeuwarden, Leeuwarden, The Netherlands
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van der Plaat DA, Vonk JM, Terzikhan N, de Jong K, de Vries M, La Bastide-van Gemert S, van Diemen CC, Lahousse L, Brusselle GG, Nedeljkovic I, Amin N, Kromhout H, Vermeulen RCH, Postma DS, van Duijn CM, Boezen HM. Occupational exposure to gases/fumes and mineral dust affect DNA methylation levels of genes regulating expression. Hum Mol Genet 2019; 28:2477-2485. [PMID: 31152171 PMCID: PMC6643643 DOI: 10.1093/hmg/ddz067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 03/13/2019] [Accepted: 03/23/2019] [Indexed: 12/21/2022] Open
Abstract
Many workers are daily exposed to occupational agents like gases/fumes, mineral dust or biological dust, which could induce adverse health effects. Epigenetic mechanisms, such as DNA methylation, have been suggested to play a role. We therefore aimed to identify differentially methylated regions (DMRs) upon occupational exposures in never-smokers and investigated if these DMRs associated with gene expression levels. To determine the effects of occupational exposures independent of smoking, 903 never-smokers of the LifeLines cohort study were included. We performed three genome-wide methylation analyses (Illumina 450 K), one per occupational exposure being gases/fumes, mineral dust and biological dust, using robust linear regression adjusted for appropriate confounders. DMRs were identified using comb-p in Python. Results were validated in the Rotterdam Study (233 never-smokers) and methylation-expression associations were assessed using Biobank-based Integrative Omics Study data (n = 2802). Of the total 21 significant DMRs, 14 DMRs were associated with gases/fumes and 7 with mineral dust. Three of these DMRs were associated with both exposures (RPLP1 and LINC02169 (2×)) and 11 DMRs were located within transcript start sites of gene expression regulating genes. We replicated two DMRs with gases/fumes (VTRNA2-1 and GNAS) and one with mineral dust (CCDC144NL). In addition, nine gases/fumes DMRs and six mineral dust DMRs significantly associated with gene expression levels. Our data suggest that occupational exposures may induce differential methylation of gene expression regulating genes and thereby may induce adverse health effects. Given the millions of workers that are exposed daily to occupational exposures, further studies on this epigenetic mechanism and health outcomes are warranted.
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Affiliation(s)
- Diana A van der Plaat
- Department of Epidemiology.,Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Judith M Vonk
- Department of Epidemiology.,Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Natalie Terzikhan
- Department of Epidemiology.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Kim de Jong
- Department of Epidemiology.,Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Maaike de Vries
- Department of Epidemiology.,Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Cleo C van Diemen
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lies Lahousse
- Department of Epidemiology.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.,Department of Respiratory Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Guy G Brusselle
- Department of Epidemiology.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.,Department of Respiratory Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Ivana Nedeljkovic
- Department of Respiratory Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | | | - Hans Kromhout
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Roel C H Vermeulen
- Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Dirkje S Postma
- Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - H Marike Boezen
- Department of Epidemiology.,Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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44
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van der Plaat DA, Vonk JM, Lahousse L, de Jong K, Faiz A, Nedeljkovic I, Amin N, van Diemen CC, Brusselle GG, Bossé Y, Brandsma CA, Hao K, Paré PD, van Duijn CM, Postma DS, Boezen HM. Limited overlap in significant hits between genome-wide association studies on two airflow obstruction definitions in the same population. BMC Pulm Med 2019; 19:58. [PMID: 30845926 PMCID: PMC6407273 DOI: 10.1186/s12890-019-0811-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 02/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Airflow obstruction is a hallmark of chronic obstructive pulmonary disease (COPD), and is defined as either the ratio between forced expiratory volume in one second and forced vital capacity (FEV1/FVC) < 70% or < lower limit of normal (LLN). This study aimed to assess the overlap between genome-wide association studies (GWAS) on airflow obstruction using these two definitions in the same population stratified by smoking. METHODS GWASes were performed in the LifeLines Cohort Study for both airflow obstruction definitions in never-smokers (NS = 5071) and ever-smokers (ES = 4855). The FEV1/FVC < 70% models were adjusted for sex, age, and height; FEV1/FVC < LLN models were not adjusted. Ever-smokers models were additionally adjusted for pack-years and current-smoking. The overlap in significantly associated SNPs between the two definitions and never/ever-smokers was assessed using several p-value thresholds. To quantify the agreement, the Pearson correlation coefficient was calculated between the p-values and ORs. Replication was performed in the Vlagtwedde-Vlaardingen study (NS = 432, ES = 823). The overlapping SNPs with p < 10- 4 were validated in the Vlagtwedde-Vlaardingen and Rotterdam Study cohorts (NS = 1966, ES = 3134) and analysed for expression quantitative trait loci (eQTL) in lung tissue (n = 1087). RESULTS In the LifeLines cohort, 96% and 93% of the never- and ever-smokers were classified concordantly based on the two definitions. 26 and 29% of the investigated SNPs were overlapping at p < 0.05 in never- and ever-smokers, respectively. At p < 10- 4 the overlap was 4% and 6% respectively, which could be change findings as shown by simulation studies. The effect estimates of the SNPs of the two definitions correlated strongly, but the p-values showed more variation and correlated only moderately. Similar observations were made in the Vlagtwedde-Vlaardingen study. Two overlapping SNPs in never-smokers (NFYC and FABP7) had the same direction of effect in the validation cohorts and the NFYC SNP was an eQTL for NFYC-AS1. NFYC is a transcription factor that binds to several known COPD genes, and FABP7 may be involved in abnormal pulmonary development. CONCLUSIONS The definition of airflow obstruction and the population under study may be important determinants of which SNPs are associated with airflow obstruction. The genes FABP7 and NFYC(-AS1) could play a role in airflow obstruction in never-smokers specifically.
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Affiliation(s)
- Diana A van der Plaat
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700, RB, Groningen, The Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Judith M Vonk
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700, RB, Groningen, The Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lies Lahousse
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Kim de Jong
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700, RB, Groningen, The Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Alen Faiz
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ivana Nedeljkovic
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Najaf Amin
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Cleo C van Diemen
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Guy G Brusselle
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.,Department of Respiratory Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Yohan Bossé
- Department of Molecular Medicine, Institut universitaire de cardiologie et de pneumologie de Québec, Laval University, Québec, Canada
| | - Corry-Anke Brandsma
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ke Hao
- Merck Research Laboratories, Boston, MA, USA
| | - Peter D Paré
- Department of Medicine, Center for Heart Lung Innovation and Institute for Heart and Lung Health, University of British Columbia, St. Paul's Hospital, Vancouver, Canada
| | | | - Dirkje S Postma
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - H Marike Boezen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700, RB, Groningen, The Netherlands. .,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
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45
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Sakornsakolpat P, Prokopenko D, Lamontagne M, Reeve NF, Guyatt AL, Jackson VE, Shrine N, Qiao D, Bartz TM, Kim DK, Lee MK, Latourelle JC, Li X, Morrow JD, Obeidat M, Wyss AB, Bakke P, Barr RG, Beaty TH, Belinsky SA, Brusselle GG, Crapo JD, de Jong K, DeMeo DL, Fingerlin TE, Gharib SA, Gulsvik A, Hall IP, Hokanson JE, Kim WJ, Lomas DA, London SJ, Meyers DA, O'Connor GT, Rennard SI, Schwartz DA, Sliwinski P, Sparrow D, Strachan DP, Tal-Singer R, Tesfaigzi Y, Vestbo J, Vonk JM, Yim JJ, Zhou X, Bossé Y, Manichaikul A, Lahousse L, Silverman EK, Boezen HM, Wain LV, Tobin MD, Hobbs BD, Cho MH. Genetic landscape of chronic obstructive pulmonary disease identifies heterogeneous cell-type and phenotype associations. Nat Genet 2019; 51:494-505. [PMID: 30804561 PMCID: PMC6546635 DOI: 10.1038/s41588-018-0342-2] [Citation(s) in RCA: 194] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 12/20/2018] [Indexed: 11/09/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is the leading cause of respiratory mortality worldwide. Genetic risk loci provide new insights into disease pathogenesis. We performed a genome-wide association study in 35,735 cases and 222,076 controls from the UK Biobank and additional studies from the International COPD Genetics Consortium. We identified 82 loci associated with P < 5 × 10-8; 47 of these were previously described in association with either COPD or population-based measures of lung function. Of the remaining 35 new loci, 13 were associated with lung function in 79,055 individuals from the SpiroMeta consortium. Using gene expression and regulation data, we identified functional enrichment of COPD risk loci in lung tissue, smooth muscle, and several lung cell types. We found 14 COPD loci shared with either asthma or pulmonary fibrosis. COPD genetic risk loci clustered into groups based on associations with quantitative imaging features and comorbidities. Our analyses provide further support for the genetic susceptibility and heterogeneity of COPD.
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Affiliation(s)
- Phuwanat Sakornsakolpat
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Dmitry Prokopenko
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Genetics and Aging Research Unit, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Maxime Lamontagne
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Quebec, Canada
| | - Nicola F Reeve
- Genetic Epidemiology Group, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Anna L Guyatt
- Genetic Epidemiology Group, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Victoria E Jackson
- Genetic Epidemiology Group, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Nick Shrine
- Genetic Epidemiology Group, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Dandi Qiao
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Traci M Bartz
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Deog Kyeom Kim
- Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Mi Kyeong Lee
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Raleigh, NC, USA
| | - Jeanne C Latourelle
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Xingnan Li
- Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Jarrett D Morrow
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Ma'en Obeidat
- University of British Columbia Center for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Annah B Wyss
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Raleigh, NC, USA
| | - Per Bakke
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - R Graham Barr
- Department of Medicine, College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Terri H Beaty
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Guy G Brusselle
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
- Department of Respiratory Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - James D Crapo
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, National Jewish Health, Denver, CO, USA
| | - Kim de Jong
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands
| | - Dawn L DeMeo
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Tasha E Fingerlin
- Center for Genes, Environment and Health, National Jewish Health, Denver, CO, USA
- Department of Biostatistics and Informatics, University of Colorado Denver, Aurora, CO, USA
| | - Sina A Gharib
- Computational Medicine Core, Center for Lung Biology, UW Medicine Sleep Center, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Amund Gulsvik
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Ian P Hall
- Division of Respiratory Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK
- National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, UK
| | - John E Hokanson
- Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, School of Medicine, Kangwon National University, Chuncheon, South Korea
| | - David A Lomas
- UCL Respiratory, University College London, London, UK
| | - Stephanie J London
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Raleigh, NC, USA
| | | | - George T O'Connor
- National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, USA
- Pulmonary Center, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Stephen I Rennard
- Pulmonary, Critical Care, Sleep and Allergy Division, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
- Clinical Discovery Unit, AstraZeneca, Cambridge, UK
| | - David A Schwartz
- Department of Medicine, School of Medicine, University of Colorado Denver, Aurora, CO, USA
- Department of Immunology, School of Medicine, University of Colorado Denver, Aurora, CO, USA
| | - Pawel Sliwinski
- 2nd Department of Respiratory Medicine, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
| | - David Sparrow
- VA Boston Healthcare System and Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - David P Strachan
- Population Health Research Institute, St. George's University of London, London, UK
| | | | | | - Jørgen Vestbo
- School of Biological Sciences, University of Manchester, Manchester, UK
| | - Judith M Vonk
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands
| | - Jae-Joon Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Xiaobo Zhou
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Yohan Bossé
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Quebec, Canada
- Department of Molecular Medicine, Laval University, Québec, Québec, Canada
| | - Ani Manichaikul
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Lies Lahousse
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Bioanalysis, Ghent University, Ghent, Belgium
| | - Edwin K Silverman
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - H Marike Boezen
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands
| | - Louise V Wain
- Genetic Epidemiology Group, Department of Health Sciences, University of Leicester, Leicester, UK
- National Institute for Health Research Leicester Respiratory Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Martin D Tobin
- Genetic Epidemiology Group, Department of Health Sciences, University of Leicester, Leicester, UK
- National Institute for Health Research Leicester Respiratory Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Brian D Hobbs
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Michael H Cho
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, USA.
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46
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Lamontagne M, Bérubé JC, Obeidat M, Cho MH, Hobbs BD, Sakornsakolpat P, de Jong K, Boezen HM, Nickle D, Hao K, Timens W, van den Berge M, Joubert P, Laviolette M, Sin DD, Paré PD, Bossé Y. Leveraging lung tissue transcriptome to uncover candidate causal genes in COPD genetic associations. Hum Mol Genet 2019; 27:1819-1829. [PMID: 29547942 DOI: 10.1093/hmg/ddy091] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 03/09/2018] [Indexed: 12/20/2022] Open
Abstract
Causal genes of chronic obstructive pulmonary disease (COPD) remain elusive. The current study aims at integrating genome-wide association studies (GWAS) and lung expression quantitative trait loci (eQTL) data to map COPD candidate causal genes and gain biological insights into the recently discovered COPD susceptibility loci. Two complementary genomic datasets on COPD were studied. First, the lung eQTL dataset which included whole-genome gene expression and genotyping data from 1038 individuals. Second, the largest COPD GWAS to date from the International COPD Genetics Consortium (ICGC) with 13 710 cases and 38 062 controls. Methods that integrated GWAS with eQTL signals including transcriptome-wide association study (TWAS), colocalization and Mendelian randomization-based (SMR) approaches were used to map causality genes, i.e. genes with the strongest evidence of being the functional effector at specific loci. These methods were applied at the genome-wide level and at COPD risk loci derived from the GWAS literature. Replication was performed using lung data from GTEx. We collated 129 non-overlapping risk loci for COPD from the GWAS literature. At the genome-wide scale, 12 new COPD candidate genes/loci were revealed and six replicated in GTEx including CAMK2A, DMPK, MYO15A, TNFRSF10A, BTN3A2 and TRBV30. In addition, we mapped candidate causal genes for 60 out of the 129 GWAS-nominated loci and 23 of them were replicated in GTEx. Mapping candidate causal genes in lung tissue represents an important contribution to the genetics of COPD, enriches our biological interpretation of GWAS findings, and brings us closer to clinical translation of genetic associations.
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Affiliation(s)
- Maxime Lamontagne
- Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université Laval, Quebec City, QC, Canada
| | - Jean-Christophe Bérubé
- Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université Laval, Quebec City, QC, Canada
| | - Ma'en Obeidat
- The University of British Columbia Centre for Heart Lung Innovation, St Paul's Hospital, Vancouver, BC, Canada
| | - Michael H Cho
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Brian D Hobbs
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Phuwanat Sakornsakolpat
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Kim de Jong
- Department of Epidemiology, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands.,University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands
| | - H Marike Boezen
- Department of Epidemiology, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands.,University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands
| | | | - David Nickle
- Merck Research Laboratories (MRL), Seattle, WA, USA
| | - Ke Hao
- Icahn Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Wim Timens
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, The Netherlands
| | - Maarten van den Berge
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, The Netherlands
| | - Philippe Joubert
- Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université Laval, Quebec City, QC, Canada.,Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University, Quebec City, QC, Canada
| | - Michel Laviolette
- Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université Laval, Quebec City, QC, Canada
| | - Don D Sin
- The University of British Columbia Centre for Heart Lung Innovation, St Paul's Hospital, Vancouver, BC, Canada.,Respiratory Division, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Peter D Paré
- The University of British Columbia Centre for Heart Lung Innovation, St Paul's Hospital, Vancouver, BC, Canada.,Respiratory Division, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Yohan Bossé
- Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université Laval, Quebec City, QC, Canada.,Department of Molecular Medicine, Laval University, Quebec City, QC, Canada
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47
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Scholten LA, Kedilioglu MA, Huizinga PM, Kibbelaar RE, de Jong K, Mouës CM. Long-term recurrence rates of whole specimen intraoperative frozen section analysis in basal cell carcinomas of the face with WIFSA. J Surg Oncol 2019; 119:903-908. [PMID: 30737791 DOI: 10.1002/jso.25396] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 01/11/2019] [Accepted: 01/09/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVES Recent studies show that whole specimen intraoperative frozen section analysis (WIFSA) is a reliable method for margin analysis in basal cell carcinoma (BCC) and has low recurrence rates after five-years follow-up. There are no studies with longer follow-up. Our aim is to present long-term recurrence rates after WIFSA. MATERIALS AND METHODS All patients with a facial BCC receiving excision with WIFSA between 1992 and 2007 were evaluated. Recurrence rates were examined for primary BCC (pBCC), recurrent BCCs (rBCC), and the different histological subtypes. The accuracy of WIFSA was assessed by comparing with formalin-fixed paraffin-embedded section analysis. RESULTS A total of 1140 patients with 1265 BCCs underwent excision with WIFSA, with a median and maximum follow-up of 10 and 25.3 years, respectively. Of all tumors, 90.0% were primary. Excisions were radical after an average of 1.4 excision rounds;5, 10, and 15-year recurrence rates for pBCCs are 3.3%, 5.1%, and 7.3%, respectively. An aggressive growth pattern and rBCCs are associated with more recurrences. The accuracy of WIFSA is 98.4%. CONCLUSIONS WIFSA provides a highly accurate analysis and has a low recurrence rate for primary BCCs. The increasing recurrence rates over time imply 5 years of follow-up may be insufficient.
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Affiliation(s)
- Laura A Scholten
- Department of Plastic Surgery and Hand Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Muhammed A Kedilioglu
- Department of Plastic Surgery and Hand Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Pauline M Huizinga
- Department of Plastic Surgery and Hand Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Robby E Kibbelaar
- Department of Pathology, Pathologie Friesland, Leeuwarden, The Netherlands
| | - Kim de Jong
- Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Chantal M Mouës
- Department of Plastic Surgery and Hand Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
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48
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Zeng X, Vonk JM, van der Plaat DA, Faiz A, Paré PD, Joubert P, Nickle D, Brandsma CA, Kromhout H, Vermeulen R, Xu X, Huo X, de Jong K, Boezen HM. Genome-wide interaction study of gene-by-occupational exposures on respiratory symptoms. Environ Int 2019; 122:263-269. [PMID: 30449631 DOI: 10.1016/j.envint.2018.11.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/05/2018] [Accepted: 11/08/2018] [Indexed: 02/05/2023]
Abstract
Respiratory symptoms are important indicators of respiratory diseases. Both genetic and environmental factors contribute to respiratory symptoms development but less is known about gene-environment interactions. We aimed to assess interactions between single nucleotide polymorphisms (SNPs) and occupational exposures on respiratory symptoms cough, dyspnea and phlegm. As identification cohort LifeLines I (n = 7976 subjects) was used. Job-specific exposure was estimated using the ALOHA + job exposure matrix. SNP-by-occupational exposure interactions on respiratory symptoms were tested using logistic regression adjusted for gender, age, and current smoking. SNP-by-exposure interactions with a p-value <10-4 were tested for replication in two independent cohorts: LifeLines II (n = 5260) and the Vlagtwedde-Vlaardingen cohort (n = 1529). The interaction estimates of the replication cohorts were meta-analyzed using PLINK. Replication was achieved when the meta-analysis p-value was <0.05 and the interaction effect had the same direction as in the identification cohort. Additionally, we assessed whether replicated SNPs associated with gene expression by analyzing if they were cis-acting expression quantitative trait loci (eQTL) in lung tissue. In the replication meta-analysis, sixteen out of 477 identified SNP-by-occupational exposure interactions had a p-value <0.05 and 9 of these interactions had the same direction as in the identification cohort. Several identified loci were plausible candidates for respiratory symptoms, such as TMPRSS9, SERPINH1, TOX3, and ARHGAP18. Three replicated SNPs were cis-eQTLs for FCER1A, CHN1, and TIMM13 in lung tissue. Taken together, this genome-wide SNP-by-occupational exposure interaction study in relation to cough, dyspnea, and phlegm identified several suggestive susceptibility genes. Further research should determine if these genes are true susceptibility loci for respiratory symptoms in relation to occupational exposures.
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Affiliation(s)
- Xiang Zeng
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands; Shantou University Medical College, Laboratory of Environmental Medicine and Developmental Toxicology, Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou, China; Xinxiang Medical University, School of Public Health, Department of Epidemiology and Health Statistics, Xinxiang, China
| | - Judith M Vonk
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands
| | - Diana A van der Plaat
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands
| | - Alen Faiz
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, the Netherlands
| | - Peter D Paré
- University of British Columbia, Department of Medicine, Center for Heart Lung Innovation and Institute for Heart and Lung Health, St. Paul's Hospital, Vancouver, BC, Canada
| | - Philippe Joubert
- Institut universitaire de cardiologie et de pneumologie de Québec, Laval University, Québec, QC, Canada
| | | | - Corry-Anke Brandsma
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, the Netherlands
| | - Hans Kromhout
- University of Utrecht, Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht, the Netherlands
| | - Roel Vermeulen
- University of Utrecht, Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht, the Netherlands
| | - Xijin Xu
- Shantou University Medical College, Laboratory of Environmental Medicine and Developmental Toxicology, Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou, China
| | - Xia Huo
- Jinan University, School of Environment, Guangdong Key Laboratory of Environmental Pollution and Health, Guangzhou Key Laboratory of Environmental Exposure and Health, Guangzhou, China
| | - Kim de Jong
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands
| | - H Marike Boezen
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands.
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49
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Bos B, Antonescu I, Osinga H, Veenje S, de Jong K, de Vries TW. Corticosteroid phobia (corticophobia) in parents of young children with atopic dermatitis and their health care providers. Pediatr Dermatol 2019; 36:100-104. [PMID: 30338542 DOI: 10.1111/pde.13698] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Adherence to topical corticosteroids is low among atopic dermatitis patients and their parents. This can lead to treatment failure and decreased quality of life. OBJECTIVE To assess and compare the worries and beliefs concerning topical corticosteroids among parents of children with atopic dermatitis, involved health care professionals, and between different professionals. Also, we identify factors associated with corticosteroid phobia (corticophobia) in professionals. METHODS Parents and health care professionals were invited to complete a questionnaire about corticophobia (Topicop). Higher questionnaire scores, expressed as a percentage, indicate more severe corticophobia. Professionals were asked to answer the questions as though they were using topical corticosteroids on their own child. RESULTS The scores for 29 parents and 31 public health care nurses were equal: 44%. The score for 51 general practitioners was 39%. The score for 33 public health care physicians and of 47 pediatricians was 31%. The differences between parents and these professionals were statistically significantly different (P = 0.001). Type of profession and having a child with atopic dermatitis were significantly associated factors for the score. CONCLUSION Corticophobia is present among parents of children with atopic dermatitis and among health care professionals involved in caring for children with atopic dermatitis. Health care nurses express the same level of corticophobia as parents. The presence of corticophobia among health care professionals may affect parental perspectives and topical corticosteroids adherence negatively.
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Affiliation(s)
- Bernies Bos
- Department of Paediatrics, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Ioana Antonescu
- Department of Paediatrics, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Hilda Osinga
- Department of Paediatrics, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Sietske Veenje
- Department of Paediatrics, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Kim de Jong
- Department of Epidemiology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Tjalling W de Vries
- Department of Paediatrics, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
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50
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Wyss AB, Sofer T, Lee MK, Terzikhan N, Nguyen JN, Lahousse L, Latourelle JC, Smith AV, Bartz TM, Feitosa MF, Gao W, Ahluwalia TS, Tang W, Oldmeadow C, Duan Q, de Jong K, Wojczynski MK, Wang XQ, Noordam R, Hartwig FP, Jackson VE, Wang T, Obeidat M, Hobbs BD, Huan T, Gui H, Parker MM, Hu D, Mogil LS, Kichaev G, Jin J, Graff M, Harris TB, Kalhan R, Heckbert SR, Paternoster L, Burkart KM, Liu Y, Holliday EG, Wilson JG, Vonk JM, Sanders JL, Barr RG, de Mutsert R, Menezes AMB, Adams HHH, van den Berge M, Joehanes R, Levin AM, Liberto J, Launer LJ, Morrison AC, Sitlani CM, Celedón JC, Kritchevsky SB, Scott RJ, Christensen K, Rotter JI, Bonten TN, Wehrmeister FC, Bossé Y, Xiao S, Oh S, Franceschini N, Brody JA, Kaplan RC, Lohman K, McEvoy M, Province MA, Rosendaal FR, Taylor KD, Nickle DC, Williams LK, Burchard EG, Wheeler HE, Sin DD, Gudnason V, North KE, Fornage M, Psaty BM, Myers RH, O'Connor G, Hansen T, Laurie CC, Cassano PA, Sung J, Kim WJ, Attia JR, Lange L, Boezen HM, Thyagarajan B, Rich SS, Mook-Kanamori DO, Horta BL, Uitterlinden AG, Im HK, Cho MH, Brusselle GG, Gharib SA, Dupuis J, Manichaikul A, London SJ. Multiethnic meta-analysis identifies ancestry-specific and cross-ancestry loci for pulmonary function. Nat Commun 2018; 9:2976. [PMID: 30061609 PMCID: PMC6065313 DOI: 10.1038/s41467-018-05369-0] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 06/21/2018] [Indexed: 02/07/2023] Open
Abstract
Nearly 100 loci have been identified for pulmonary function, almost exclusively in studies of European ancestry populations. We extend previous research by meta-analyzing genome-wide association studies of 1000 Genomes imputed variants in relation to pulmonary function in a multiethnic population of 90,715 individuals of European (N = 60,552), African (N = 8429), Asian (N = 9959), and Hispanic/Latino (N = 11,775) ethnicities. We identify over 50 additional loci at genome-wide significance in ancestry-specific or multiethnic meta-analyses. Using recent fine-mapping methods incorporating functional annotation, gene expression, and differences in linkage disequilibrium between ethnicities, we further shed light on potential causal variants and genes at known and newly identified loci. Several of the novel genes encode proteins with predicted or established drug targets, including KCNK2 and CDK12. Our study highlights the utility of multiethnic and integrative genomics approaches to extend existing knowledge of the genetics of lung function and clinical relevance of implicated loci.
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Affiliation(s)
- Annah B Wyss
- Epidemiology Branch National Institute of Environmental Health Sciences, National Institutes of Health, US Department of Health and Human Services, Research Triangle Park, NC, 27709, USA
| | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Department of Medicine, Harvard Medical School, Boston, MA, 02115, USA
| | - Mi Kyeong Lee
- Epidemiology Branch National Institute of Environmental Health Sciences, National Institutes of Health, US Department of Health and Human Services, Research Triangle Park, NC, 27709, USA
| | - Natalie Terzikhan
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, 9000, Belgium
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, 3000, CA, The Netherlands
| | - Jennifer N Nguyen
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, 22908, USA
| | - Lies Lahousse
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, 3000, CA, The Netherlands
- Department of Bioanalysis, FFW, Ghent University, Ghent, 9000, Belgium
| | - Jeanne C Latourelle
- Department of Neurology, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Albert Vernon Smith
- Icelandic Heart Association, Kopavogur, 201, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, 98101, USA
- Department of Biostatistics, University of Washington, Seattle, WA, 98195, USA
| | - Mary F Feitosa
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St Louis, MO, 63110, USA
| | - Wei Gao
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Tarunveer S Ahluwalia
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Metabolic Genetics Section, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark
- Steno Diabetes Center Copenhagen, Gentofte, 2820, Denmark
| | - Wenbo Tang
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14853, USA
| | - Christopher Oldmeadow
- Hunter Medical Research Institute and Faculty of Health, University of Newcastle, Callaghan, NSW, 2305, Australia
| | - Qing Duan
- Department of Genetics, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Kim de Jong
- Department of Epidemiologie, University of Groningen, University Medical Center Groningen, 9713 GZ, Groningen, Netherlands
| | - Mary K Wojczynski
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St Louis, MO, 63110, USA
| | - Xin-Qun Wang
- Division of Biostatistics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, 22908, USA
| | - Raymond Noordam
- Department of Internal Medicine, Section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, 2300 RC, The Netherlands
| | - Fernando Pires Hartwig
- Postgraduate Program in Epidemiology, Federal University of Pelotas, 96020-220, Pelotas, Brazil
- Medical Research Council Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, BS8 2BN, UK
| | - Victoria E Jackson
- Department of Health Sciences, University of Leicester, Leicester, LE1 7RH, UK
| | - Tianyuan Wang
- Integrative Bioinformatics Support Group National Institute of Environmental Health Sciences, National Institutes of Health, US Department of Health and Human Services, Research Triangle Park, NC, 27709, USA
| | - Ma'en Obeidat
- The University of British Columbia Center for Heart Lung Innovation, St Paul's Hospital, Vancouver, BC, V6Z 1Y6, Canada
| | - Brian D Hobbs
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Tianxiao Huan
- The Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, MD, 20892, USA
| | - Hongsheng Gui
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Margaret M Parker
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Donglei Hu
- School of Medicine, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Lauren S Mogil
- Department of Biology, Loyola University Chicago, Chicago, IL, 60660, USA
| | - Gleb Kichaev
- University of California Los Angeles, Los Angeles, CA, 90095, USA
| | | | - Mariaelisa Graff
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Tamara B Harris
- Department of Health and Human Services, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Ravi Kalhan
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Susan R Heckbert
- Department of Epidemiology, Cardiovascular Health Research Unit, University of Washington, Seattle, WA, 98101, USA
| | - Lavinia Paternoster
- Medical Research Council Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, BS8 2BN, UK
| | - Kristin M Burkart
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA
| | - Yongmei Liu
- Wake Forest School of Medicine, Winston-Salem, NC, 27101, USA
| | - Elizabeth G Holliday
- Hunter Medical Research Institute and Faculty of Health, University of Newcastle, Callaghan, NSW, 2305, Australia
| | - James G Wilson
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, 39216, USA
| | - Judith M Vonk
- Department of Epidemiologie, University of Groningen, University Medical Center Groningen, 9713 GZ, Groningen, Netherlands
| | - Jason L Sanders
- Department of Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - R Graham Barr
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, 2300 RC, The Netherlands
| | | | - Hieab H H Adams
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, 3000, CA, The Netherlands
- Department of Radiology, Erasmus University Medical Center, Rotterdam, 3015 GD, The Netherlands
| | - Maarten van den Berge
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, 9700 AB, The Netherlands
| | - Roby Joehanes
- Hebrew SeniorLife, Harvard University, Boston, MA, 02131, USA
| | - Albert M Levin
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Jennifer Liberto
- School of Medicine, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Lenore J Launer
- Department of Health and Human Services, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Alanna C Morrison
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Colleen M Sitlani
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, 98101, USA
| | - Juan C Celedón
- Division of Pulmonary Medicine, Allergy, and Immunology, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, PA, 15224, USA
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Rodney J Scott
- Hunter Medical Research Institute and Faculty of Health, University of Newcastle, Callaghan, NSW, 2305, Australia
- Division of Molecular Medicine, Pathology North, NSW Health Pathology, Newcastle, NSW, 2305, Australia
| | - Kaare Christensen
- Department of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Odense, 5000, Denmark
| | - Jerome I Rotter
- Department of Pediatrics, Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, 90502, USA
| | - Tobias N Bonten
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, 2300 RC, The Netherlands
- Department of Pulmonology, Leiden University Medical Center, Leiden, 2300 RC, The Netherlands
| | | | - Yohan Bossé
- Department of Molecular Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, G1V 4G5, Canada
| | - Shujie Xiao
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Sam Oh
- School of Medicine, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Nora Franceschini
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Jennifer A Brody
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, 98101, USA
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Kurt Lohman
- Wake Forest School of Medicine, Winston-Salem, NC, 27101, USA
| | - Mark McEvoy
- Hunter Medical Research Institute and Faculty of Health, University of Newcastle, Callaghan, NSW, 2305, Australia
| | - Michael A Province
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St Louis, MO, 63110, USA
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, 2300 RC, The Netherlands
| | - Kent D Taylor
- Department of Pediatrics, Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, 90502, USA
| | - David C Nickle
- Merck Research Laboratories, GpGx, Merck & Co., Inc., Kenilworth, NJ, 07033, USA
| | - L Keoki Williams
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, 48202, USA
- Department of Internal Medicine, Henry Ford Health System, Detroit, MI, 48202, USA
| | - Esteban G Burchard
- School of Medicine, University of California San Francisco, San Francisco, CA, 94143, USA
- School of Pharmacy, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Heather E Wheeler
- Department of Biology, Loyola University Chicago, Chicago, IL, 60660, USA
| | - Don D Sin
- The University of British Columbia Center for Heart Lung Innovation, St Paul's Hospital, Vancouver, BC, V6Z 1Y6, Canada
- Respiratory Division, Department of Medicine, University of British Columbia, Vancouver, BC, V5Z 1M9, Canada
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, 201, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
| | - Kari E North
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine and Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, 98101, USA
- Department of Epidemiology, Cardiovascular Health Research Unit, University of Washington, Seattle, WA, 98101, USA
- Cardiovascular Health Research Unit, Department of Health Services, University of Washington, Seattle, WA, 98101, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, 98101, USA
| | - Richard H Myers
- Department of Neurology, Boston University School of Medicine, Boston, MA, 02118, USA
| | - George O'Connor
- National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, 01702, USA
- Pulmonary Center, Department of Medicine, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Metabolic Genetics Section, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark
| | - Cathy C Laurie
- Department of Biostatistics, University of Washington, Seattle, WA, 98195, USA
| | - Patricia A Cassano
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14853, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, 10065, USA
| | - Joohon Sung
- Department of Health Science, School of Public Health, Seoul National University, Seoul, 08826, South Korea
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, Kangwon National University, Chuncheon, 24341, South Korea
| | - John R Attia
- Hunter Medical Research Institute and Faculty of Health, University of Newcastle, Callaghan, NSW, 2305, Australia
| | - Leslie Lange
- University of Colorado Denver, Denver, CO, 80204, USA
| | - H Marike Boezen
- Department of Epidemiologie, University of Groningen, University Medical Center Groningen, 9713 GZ, Groningen, Netherlands
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, 22908, USA
| | - Dennis O Mook-Kanamori
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, 2300 RC, The Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, 2300 RC, The Netherlands
| | - Bernardo Lessa Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, 96020-220, Pelotas, Brazil
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, 3015 CN, The Netherlands
| | - Hae Kyung Im
- Section of Genetic Medicine, The University of Chicago, Chicago, IL, 60637, USA
| | - Michael H Cho
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Guy G Brusselle
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, 9000, Belgium
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, 3000, CA, The Netherlands
- Department of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, 3000 CA, The Netherlands
| | - Sina A Gharib
- Department of Medicine, Computational Medicine Core, Center for Lung Biology, UW Medicine Sleep Center, University of Washington, Seattle, WA, 98109, USA
| | - Josée Dupuis
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA
- National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, 01702, USA
| | - Ani Manichaikul
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, 22908, USA
| | - Stephanie J London
- Epidemiology Branch National Institute of Environmental Health Sciences, National Institutes of Health, US Department of Health and Human Services, Research Triangle Park, NC, 27709, USA.
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