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2. Barriers and Facilitators for the Implementation of an Online Clinical Health Community in Addition to Usual Fertility Care: A Cross-Sectional Study

Author

Aarts, Johanna WM, Faber, Marjan J, den Boogert, Anne G, Cohlen, Ben J, van der Linden, Paul JQ, Kremer, Jan AM, and Nelen, Willianne LDM

Subjects
Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, RA1-1270
Abstract

BackgroundOnline health communities are becoming more popular in health care. Patients and professionals can communicate with one another online, patients can find peer support, and professionals can use it as an additional information channel to their patients. However, the implementation of online health communities into daily practice is challenging. These challenges relate to the fact that patients need to be activated to (1) become a member (ie, subscription) and (2) participate actively within the community before any effect can be expected. Therefore, we aimed at answering 2 research questions: (1) what factors are associated with subscription to an online health community, and (2) which are associated with becoming an active participant within an online health community. ObjectiveTo identify barriers and facilitators as perceived by patients for the implementation of an online health community. MethodsWe performed a cross-sectional study. Three Dutch fertility clinics (2 IVF-licensed) offered their patients a secure online clinical health community through which clinicians can provide online information and patients can ask questions to the medical team or share experiences and find support from peers. We randomly selected and invited 278 men and women suffering from infertility and attending 1 of the participating clinics. Participants filled out a questionnaire about their background characteristics and current use of the online community. Possible barriers and facilitators were divided into 2 parts: (1) those for subscription to the community, and (2) those for active participation in the community. We performed 2 multivariate logistic regression analyses to calculate determinants for both subscription and active participation. ResultsSubscription appeared to be associated with patients’ background characteristics (eg, gender, treatment phase), intervention-related facilitators (odds ratio [OR] 2.45, 95% CI 1.14-5.27), and patient-related barriers (OR 0.20, 95% CI 0.08-0.54), such as not feeling the need for such an online health community. After subscription, determinants for participation consisted of aspects related to participant’s age (OR 0.86, 95% CI 0.76-0.97), length of infertility (OR 1.48, 05% CI 1.09-2.02), and to intervention-related facilitators (OR 5.79, 95% CI 2.40-13.98), such as its reliable character and possibility to interact with the medical team and peers. ConclusionsImplementing an online health community in addition to usual fertility care should be performed stepwise. At least 2 strategies are needed to increase the proportion of patient subscribers and consequently make them active participants. First, the marketing strategy should contain information tailored to different subgroups of the patient population. Second, for a living online health community, incorporation of interactive elements, as well as frequent news and updates are needed. These results imply that involving patients and their needs into the promotion strategy, community’s design, and implementation are crucial.

Published
2013
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4. The 2021 Dutch Working Party on Antibiotic Policy (SWAB) guidelines for empirical antibacterial therapy of sepsis in adults

Author

Sieswerda, Elske, Bax, Hannelore I., Hoogerwerf, Jacobien J., de Boer, Mark G. J., Boermeester, Marja, Bonten, Marc J. M., Dekker, Douwe, van Wijk, Roy Gerth, Juffermans, Nicole P., Kuindersma, Marnix, van der Linden, Paul D., Melles, Damian C., Pickkers, Peter, Schouten, Jeroen A., Rebel, Jasper R., van Zanten, Arthur R. H., Prins, Jan M., and Wiersinga, W. Joost

Published
2022
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5. Global Daily Surface Air Temperatures from EUSTACE

Author

Rayner, Nick A., Auchmann, Renate, Bessembinder, Janette, Brönnimann, Stefan, Brugnara, Yuri, Capponi, Francesco, Carrea, Laura, Dodd, Emma M. A., Ghent, Darren, Good, Elizabeth, Høyer, Jacob L., Kennedy, John J., Kent, Elizabeth C., Killick, Rachel E., van der Linden, Paul, Lindgren, Finn, Madsen, Kristine S., Merchant, Christopher J., Mitchelson, Joel R., Morice, Colin P., Nielsen-Englyst, Pia, Ortiz, Patricio F., Remedios, John J., van der Schrier, Gerard, Squintu, Antonello A., Stephens, Ag, Thorne, Peter W., Tonboe, Rasmus T., Trent, Tim, Veal, Karen L., Waterfall, Alison M., Winfield, Kate, Winn, Jonathan, and Woolway, R. Iestyn

Published
2020

6. The EUSTACE Project : Delivering Global, Daily Information on Surface Air Temperature

Author

Rayner, Nick A., Auchmann, Renate, Bessembinder, Janette, Brönnimann, Stefan, Brugnara, Yuri, Capponi, Francesco, Carrea, Laura, Dodd, Emma M. A., Ghent, Darren, Good, Elizabeth, Høyer, Jacob L., Kennedy, John J., Kent, Elizabeth C., Killick, Rachel E., van der Linden, Paul, Lindgren, Finn, Madsen, Kristine S., Merchant, Christopher J., Mitchelson, Joel R., Morice, Colin P., Nielsen-Englyst, Pia, Ortiz, Patricio F., Remedios, John J., van der Schrier, Gerard, Squintu, Antonello A., Stephens, Ag, Thorne, Peter W., Tonboe, Rasmus T., Trent, Tim, Veal, Karen L., Waterfall, Alison M., Winfield, Kate, Winn, Jonathan, and Woolway, R. Iestyn

Published
2020

8. Diagnosis-linked antibiotic prescribing quality indicators: demonstrating feasibility using practice-based routine primary care data, reliability, validity and their potential in antimicrobial stewardship

Author

Infection & Immunity, Epi Infectieziekten Team 1, HAG Infectieziekten, JC onderzoeksprogramma Infectieziekten, van den Eijnde, Sharon E J D, van der Linden, Paul D, van der Velden, Alike W, Infection & Immunity, Epi Infectieziekten Team 1, HAG Infectieziekten, JC onderzoeksprogramma Infectieziekten, van den Eijnde, Sharon E J D, van der Linden, Paul D, and van der Velden, Alike W

Published
2024

9. Women on diuretics have a higher risk of hospital admission because of hyponatremia than men

Author

Hendriksen, Linda C., van der Linden, Paul D., Herings, Ron M.C., Stricker, Bruno H., Visser, Loes E., Hendriksen, Linda C., van der Linden, Paul D., Herings, Ron M.C., Stricker, Bruno H., and Visser, Loes E.

Abstract

Purpose: Recent studies suggest that women are more susceptible to diuretic-induced hyponatremia resulting in hospital admission than men. The aim of this study was to confirm whether these sex differences in hyponatremia-related hospital admissions in diuretic users remain after adjusting for several confounding variables such as age, dose, and concurrent medication. Methods: In a case–control design nested in diuretic users, cases of hyponatremia associated hospital admissions between 2005 and 2017 were identified from the PHARMO Data Network. Cases were 1:10 matched to diuretic users as controls. Odds ratios (OR) with 95%CIs were calculated for women versus men and adjusted for potential confounders (age, number of diuretics, other hyponatremia-inducing drugs, chronic disease score) using unconditional logistic regression analysis. A subgroup analysis was performed for specific diuretic groups (thiazides, loop diuretics and aldosterone antagonists). Results: Women had a statistically significantly higher risk of a hospital admission associated with hyponatremia than men while using diuretics (OR 1.86, 95%CI 1.64–2.11). Adjusting for the potential confounders resulted in an increased risk for women compared to men (ORadj 2.65, 95% CI 2.31–3.04). This higher risk in women was also seen in the three subgroup analyses after adjustment. Conclusion: Our findings show a higher risk of hyponatremia-related hospital admission in women than men while using diuretics. Further research is needed to understand the underlying mechanism of this sex difference to be able to provide sex-specific recommendations.

Published
2023

11. IS HOME-BASED MONITORING OF OVULATION TO TIME FROZEN EMBRYO TRANSFER AN EFFECTIVE ALTERNATIVE FOR HOSPITAL-BASED MONITORING OF OVULATION?

Author

Zaat, Tjitske, primary, De Bruin, Jan Peter P., additional, Groenewoud, Eva, additional, Baart, Esther B., additional, Van Baal, Wilhelmina, additional, Brandes, Monique, additional, Cantineau, Astrid E.P., additional, Broekmans, Frank, additional, Gielen, Susanne, additional, Goddijn, Mariette, additional, Van Disseldorp, Jeroen, additional, van Heusden, Arne M., additional, Kaaijk, Eugenie M., additional, Klijn, Nicole, additional, Koks, Carolien A.M., additional, De Koning, Cornelia, additional, Van Der Linden, Paul J.Q., additional, Manger, Petra, additional, Moolenaar, Lobke, additional, Van Oppenraaij, Robbert, additional, Pieterse, Quirine, additional, Smeenk, Jesper M.J., additional, Visser, Jantien, additional, Van Wely, Madelon, additional, and Mol, Femke, additional

Published
2022
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12. Medicamenteuze behandeling covid-19 in de tweede lijn: Een update

Author

Hensgens, Marjolein P M, Gieling, Emilie, de Lange, Dylan, Boersma, Wim G, van der Linden, Paul, Sinha, Bhanu N M, de Boer, Mark, Critical care, Anesthesiology, Peri-operative and Emergency medicine, and Microbes in Health and Disease

Subjects
Hospitalization, Inpatients, SARS-CoV-2, COVID-19, Humans
Abstract

In dit overzichtsartikel geven wij een update van de adviezen voor de medicamenteuze behandeling van covid-19 in de tweede lijn. Deze adviezen zijn opgesteld door de Stichting Werkgroep Antibioticabeleid (SWAB) in samenwerking met onder andere de Federatie Medisch Specialisten (FMS). Zowel opties voor behandeling in het ziekenhuis als opties voor behandeling in de ambulante setting worden besproken. De behandeling omvat zowel anti-inflammatoire als antivirale therapie.

Published
2022

13. The dynamics in applied COVID-19 pharmacotherapy and the influence of national guidance in The Netherlands: a quantitative and qualitative study

Author

Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, Uitvlugt, Elien B, Soeng, Danny Y F, van der Linden, Paul, van de Garde, Ewoudt M W, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, Uitvlugt, Elien B, Soeng, Danny Y F, van der Linden, Paul, and van de Garde, Ewoudt M W

Published
2022

14. Medicamenteuze behandeling covid-19 in de tweede lijn

Author

MS Interne Geneeskunde, Apotheek Klinische Farmacie, Medische Staf Intensive Care, NVIC bedrijfsvoering, Brain, Infection & Immunity, Hensgens, Marjolein P M, Gieling, Emilie, de Lange, Dylan, Boersma, Wim G, van der Linden, Paul, Sinha, Bhanu N M, de Boer, Mark, MS Interne Geneeskunde, Apotheek Klinische Farmacie, Medische Staf Intensive Care, NVIC bedrijfsvoering, Brain, Infection & Immunity, Hensgens, Marjolein P M, Gieling, Emilie, de Lange, Dylan, Boersma, Wim G, van der Linden, Paul, Sinha, Bhanu N M, and de Boer, Mark

Published
2022

15. The 2021 Dutch Working Party on Antibiotic Policy (SWAB) guidelines for empirical antibacterial therapy of sepsis in adults

Author

MMB Medische Staf, Epi Infectieziekten, Infection & Immunity, Epidemiology of Sepsis & Inflammation in Critically Ill Patients, JC onderzoeksprogramma Infectieziekten, Medische Staf Spoedeisende Hulp, Epi Infectieziekten Team 1, Sieswerda, Elske, Bax, Hannelore I, Hoogerwerf, Jacobien J, de Boer, Mark G J, Boermeester, Marja, Bonten, Marc J M, Dekker, Douwe, van Wijk, Roy Gerth, Juffermans, Nicole P, Kuindersma, Marnix, van der Linden, Paul D, Melles, Damian C, Pickkers, Peter, Schouten, Jeroen A, Rebel, Jasper R, van Zanten, Arthur R H, Prins, Jan M, Wiersinga, W Joost, MMB Medische Staf, Epi Infectieziekten, Infection & Immunity, Epidemiology of Sepsis & Inflammation in Critically Ill Patients, JC onderzoeksprogramma Infectieziekten, Medische Staf Spoedeisende Hulp, Epi Infectieziekten Team 1, Sieswerda, Elske, Bax, Hannelore I, Hoogerwerf, Jacobien J, de Boer, Mark G J, Boermeester, Marja, Bonten, Marc J M, Dekker, Douwe, van Wijk, Roy Gerth, Juffermans, Nicole P, Kuindersma, Marnix, van der Linden, Paul D, Melles, Damian C, Pickkers, Peter, Schouten, Jeroen A, Rebel, Jasper R, van Zanten, Arthur R H, Prins, Jan M, and Wiersinga, W Joost

Published
2022

16. Antibiotic stewardship in the real world - Authors' reply

Author

Epi Infectieziekten Team 1, Infection & Immunity, MMB opleiding Arts microbioloog, JC onderzoeksprogramma Infectieziekten, Epi Infectieziekten, van Heijl, Inger, Schweitzer, Valentijn A, van der Linden, Paul D, van Werkhoven, Cornelis H, Bonten, Marc J M, Epi Infectieziekten Team 1, Infection & Immunity, MMB opleiding Arts microbioloog, JC onderzoeksprogramma Infectieziekten, Epi Infectieziekten, van Heijl, Inger, Schweitzer, Valentijn A, van der Linden, Paul D, van Werkhoven, Cornelis H, and Bonten, Marc J M

Published
2022

17. Additional file 1 of The 2021 Dutch Working Party on Antibiotic Policy (SWAB) guidelines for empirical antibacterial therapy of sepsis in adults

Author

Sieswerda, Elske, Bax, Hannelore I., Hoogerwerf, Jacobien J., de Boer, Mark G. J., Boermeester, Marja, Bonten, Marc J. M., Dekker, Douwe, van Wijk, Roy Gerth, Juffermans, Nicole P., Kuindersma, Marnix, van der Linden, Paul D., Melles, Damian C., Pickkers, Peter, Schouten, Jeroen A., Rebel, Jasper R., van Zanten, Arthur R. H., Prins, Jan M., and Wiersinga, W. Joost

Abstract

Additional file 1. sTable 1. Alternative empirical treatment strategies in sepsis and low estimated risk of involvement of 3GCR-E. sTable 2. Alternative empirical treatment strategies in sepsis and increased or high estimated risk of involvement of 3GCR-E. sTable 3. Recommended iv doses of empirical antibacterial treatment for sepsis.

Published
2022
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18. The dynamics in applied COVID-19 pharmacotherapy and the influence of national guidance in The Netherlands: a quantitative and qualitative study

Author

Uitvlugt, Elien B, Soeng, Danny Y F, van der Linden, Paul, van de Garde, Ewoudt M W, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, Afd Pharmacoepi & Clinical Pharmacology, and Pharmacoepidemiology and Clinical Pharmacology

Subjects
Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Short Report, Scientific literature, Pharmacy, Prescription data, Drug treatment, Pharmacotherapy, Pandemic, medicine, Humans, organization and administration, General Pharmacology, Toxicology and Pharmaceutics, Pandemics, Aged, Netherlands, business.industry, SARS-CoV-2, practice guideline, COVID-19, Off-Label Use, virology, COVID-19 Drug Treatment, Family medicine, pulmonary medicine, Female, business, Cohort study, Qualitative research
Abstract

Objective At the beginning of the COVID-19 pandemic in the Netherlands, the Dutch Working Party on Antibiotic Policy constructed an advisory document about off-label drug treatment options that was regularly updated with new scientific findings. The aim of this study is to describe the dynamics in applied COVID-19 pharmacotherapy during the first 100 days of the pandemic and to assess how the national advisory document influenced local hospital policies. Methods A multicentre observational cohort study was conducted in six hospitals in the Netherlands. Patients with confirmed COVID-19 admitted between 27 February and 7 June 2020 were studied. Drug prescription data were collected and percentages of patients receiving a specific treatment were calculated. These percentages were plotted together with release dates of the national advisory document. Semi-structured in-depth interviews with hospital pharmacists and infectious diseases specialists were conducted to gain insight into the development and implementation of pharmacotherapy treatment protocols in hospitals. Results Data from 1511 patients (60% men, mean age 66 years) were analysed. From mid-March (hydroxy)chloroquine was being prescribed in all six hospitals to approximately 70% of patients at admission. Frequencies of other off-label treatments were below 2%. In the week of 6 April 2020, the first hospital discontinued prescribing (hydroxy)chloroquine and the last hospital discontinued in the week of 4 May 2020 (total range −19 to +10 days after the national advisory document advised against its use (1 May 2020)). All interviewees (n=6) stated that the hospitals based their policies mainly on the national advisory document but also assessed scientific literature themselves. Order panels were constructed to support prescribing. Conclusion Dutch hospitals opted en masse for (hydroxy)chloroquine as COVID-19 therapy at the start of the pandemic, although the time until the therapy was no longer prescribed differed by several weeks. The fact that hospitals defined pharmacotherapy regimens based on their own assessment of the scientific literature besides the national advisory document can explain this variation.

Published
2021

19. Discontinuation of Antihypertensive Medications on the Outcome of Hospitalized Patients With Severe Acute Respiratory Syndrome-Coronavirus 2

Author

Singh, Sandeep, primary, Offringa-Hup, Annette K., additional, Logtenberg, Susan J.J., additional, Van der Linden, Paul D., additional, Janssen, Wilbert M.T., additional, Klein, Hubertina, additional, Waanders, Femke, additional, Simsek, Suat, additional, de Jager, Cornelis P.C., additional, Smits, Paul, additional, van der Feltz, Machteld, additional, Jan Beumer, Gerrit, additional, Widrich, Christine, additional, Nap, Martijn, additional, and Pinto-Sietsma, Sara-Joan, additional

Published
2021
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20. Women are started on a lower daily dose of metoprolol than men irrespective of dose recommendations::A potential source of confounding by contraindication in pharmacoepidemiology

Author

Hendriksen, Linda C., Verhamme, Katia M. C., Van der Linden, Paul D., Stricker, Bruno H., Visser, Loes E., Hendriksen, Linda C., Verhamme, Katia M. C., Van der Linden, Paul D., Stricker, Bruno H., and Visser, Loes E.

Abstract

Purpose: Current guidelines have no sex-specific dosage advice for metoprolol. To evalu-ate whether women and men are prescribed the same dose a cohort analysis was per-formed in the population-based Rotterdam Study (RS). Results were replicated in theIntegrated Primary Care Information (IPCI) database of automated general practice data.Methods: The mean daily starting doses of metoprolol in both sexes were comparedwith independent-samples t-tests and a linear regression analysis was used to adjustin the RS for co-variables, notably, cardiovascular comorbidity, migraine, age, SBP,DBP, BMI, socioeconomic status, use of other antihypertensive drugs, smoking, andalcohol. In the IPCI-database, adjustment was for age only.Results: The mean daily starting dose was statistically significantly lower in womenthan in men in both the RS and IPCI database, with a mean difference of 4.8 mg (95%CI −7.8, −1.8) and 4.6 mg (95%CI −5.3,-4.0), respectively. Statistical significanceremained after adjustment in both databases.Conclusions: Women received lower starting doses of metoprolol than men in twoindependent data collections despite non-sex specific cardiovascular guideline rec-ommendations. This example of real-life pharmacotherapy can lead to a form of con-founding by contraindication in pharmacoepidemiology

Published
2021

21. Attributable mortality of antibiotic resistance in Gram-negative infections in the Netherlands: a parallel matched cohort study

Author

Epi Infectieziekten Team 1, Epidemiology & Health Economics, Epi Infectieziekten, MMB, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Rottier, Wouter C, Deelen, J W Timotëus, Caruana, Giorgia, Buiting, Anton G M, Dorigo-Zetsma, J Wendelien, Kluytmans, Jan A J W, van der Linden, Paul D, Thijsen, Steven F T, Vlaminckx, Bart J M, Weersink, Annemarie J L, Ammerlaan, Heidi S M, Bonten, Marc J M, Epi Infectieziekten Team 1, Epidemiology & Health Economics, Epi Infectieziekten, MMB, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Rottier, Wouter C, Deelen, J W Timotëus, Caruana, Giorgia, Buiting, Anton G M, Dorigo-Zetsma, J Wendelien, Kluytmans, Jan A J W, van der Linden, Paul D, Thijsen, Steven F T, Vlaminckx, Bart J M, Weersink, Annemarie J L, Ammerlaan, Heidi S M, and Bonten, Marc J M

Published
2021

22. Short-course aminoglycosides as adjunctive empirical therapy in patients with Gram-negative bloodstream infection, a cohort study

Author

JC onderzoeksprogramma Infectieziekten, Infection & Immunity, Epi Infectieziekten Team 1, MMB, Epidemiology & Health Economics, Epi Infectieziekten, Deelen, J W Timotëus, Rottier, Wouter C, Buiting, Anton G M, Dorigo-Zetsma, J Wendelien, Kluytmans, Jan A J W, van der Linden, Paul D, Thijsen, Steven F T, Vlaminckx, Bart J M, Weersink, Annemarie J L, Ammerlaan, Heidi S M, Bonten, Marc J M, van Werkhoven, Cornelis H, JC onderzoeksprogramma Infectieziekten, Infection & Immunity, Epi Infectieziekten Team 1, MMB, Epidemiology & Health Economics, Epi Infectieziekten, Deelen, J W Timotëus, Rottier, Wouter C, Buiting, Anton G M, Dorigo-Zetsma, J Wendelien, Kluytmans, Jan A J W, van der Linden, Paul D, Thijsen, Steven F T, Vlaminckx, Bart J M, Weersink, Annemarie J L, Ammerlaan, Heidi S M, Bonten, Marc J M, and van Werkhoven, Cornelis H

Published
2021

23. Medicamenteuze behandeling van covid-19: een beknopte update

Author

de Boer, Mark G J, Gieling, Emilie M, van der Linden, Paul D, Sinha, Bhanu N M, Vollaard, Albert M, Critical care, Anesthesiology, Peri-operative and Emergency medicine, and Microbes in Health and Disease

Abstract

Much has changed in the medical treatment of COVID-19 after the first patient with an infection with SARS-CoV-2 in the Netherlands was diagnosed in February 2020. On the basis of limited data, at first only off-label use of (hydroxy)chloroquine seemed to be a treatment option. However, now based on the findings of several randomized studies, other medicines have been included in the Dutch guidelines about the treatment of COVID-19. In this article, we will briefly discuss the current state of affairs with regard to the drugs (hydroxy) chloroquine, remdesivir and corticosteroids. Again, it appears that only well-executed randomized clinical trials can determine the status of various supposedly effective drugs.

Published
2020

25. The EUSTACE Project: Delivering Global, Daily Information on Surface Air Temperature

Author

Rayner, Nick, Auchmann, R., Bessembinder, Janette, Brönnimann, S., Brugnara, Yuri, Capponi, Francesco, Carrea, Laura, Dodd, Emma, Ghent, Darren, Good, Elizabeth, Høyer, Jacob, Kennedy, John J., Kent, Elizabeth, Killick, Rachel, van der Linden, Paul, Lindgren, Finn, Madsen, Kristine, Merchant, Chris, Mitchelson, Joel, Morice, Colin, Ortiz, Patricio, Nielsen-Englyst, Pia, Remedios, J.J., van der Schrie, Gerard, Squintu, A., Stephens, Ag, Thorne, Peter, Tonboe, Ramus, Trent, Tim, Veal, Karen, Waterfall, Alison, Winfield, Kate, Winn, Jonathan, Woolway, R. Iestyn, Rayner, Nick, Auchmann, R., Bessembinder, Janette, Brönnimann, S., Brugnara, Yuri, Capponi, Francesco, Carrea, Laura, Dodd, Emma, Ghent, Darren, Good, Elizabeth, Høyer, Jacob, Kennedy, John J., Kent, Elizabeth, Killick, Rachel, van der Linden, Paul, Lindgren, Finn, Madsen, Kristine, Merchant, Chris, Mitchelson, Joel, Morice, Colin, Ortiz, Patricio, Nielsen-Englyst, Pia, Remedios, J.J., van der Schrie, Gerard, Squintu, A., Stephens, Ag, Thorne, Peter, Tonboe, Ramus, Trent, Tim, Veal, Karen, Waterfall, Alison, Winfield, Kate, Winn, Jonathan, and Woolway, R. Iestyn

Abstract

Day-to-day variations in surface air temperature affect society in many ways, but daily surface air temperature measurements are not available everywhere. Therefore, a global daily picture cannot be achieved with measurements made in situ alone and needs to incorporate estimates from satellite retrievals. This article presents the science developed in the EU Horizon 2020-funded EUSTACE project (2015-19, www.eustaceproject.org ) to produce global and European multidecadal ensembles of daily analyses of surface air temperature complementary to those from dynamical reanalyses, integrating different ground-based and satellite-borne data types. Relationships between surface air temperature measurements and satellite-based estimates of surface skin temperature over all surfaces of Earth (land, ocean, ice, and lakes) are quantified. Information contained in the satellite retrievals then helps to estimate air temperature and create global fields in the past, using statistical models of how surface air temperature varies in a connected way from place to place; this needs efficient statistical analysis methods to cope with the considerable data volumes. Daily fields are presented as ensembles to enable propagation of uncertainties through applications. Estimated temperatures and their uncertainties are evaluated against independent measurements and other surface temperature datasets. Achievements in the EUSTACE project have also included fundamental preparatory work useful to others, for example, gathering user requirements, identifying inhomogeneities in daily surface air temperature measurement series from weather stations, carefully quantifying uncertainties in satellite skin and air temperature estimates, exploring the interaction between air temperature and lakes, developing statistical models relevant to non-Gaussian variables, and methods for efficient computation.

Published
2020

26. The burden of bacteremic and non-bacteremic Gram-negative infections: a prospective multicenter cohort study in a low-resistance country

Author

Epi Infectieziekten Team 1, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, MMB, MMB KAM, Epi Infectieziekten, Deelen, J W Timotëus, Rottier, Wouter C, van Werkhoven, Cornelis H, Woudt, Sjoukje H S, Buiting, Anton G M, Dorigo-Zetsma, J Wendelien, Kluytmans, Jan A J W, van der Linden, Paul D, Thijsen, Steven F T, Vlaminckx, Bart J M, Weersink, Annemarie J L, Ammerlaan, Heidi S M, Bonten, Marc J M, Epi Infectieziekten Team 1, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, MMB, MMB KAM, Epi Infectieziekten, Deelen, J W Timotëus, Rottier, Wouter C, van Werkhoven, Cornelis H, Woudt, Sjoukje H S, Buiting, Anton G M, Dorigo-Zetsma, J Wendelien, Kluytmans, Jan A J W, van der Linden, Paul D, Thijsen, Steven F T, Vlaminckx, Bart J M, Weersink, Annemarie J L, Ammerlaan, Heidi S M, and Bonten, Marc J M

Published
2020

27. Impact of antimicrobial de-escalation on mortality: a literature review of study methodology and recommendations for observational studies

Author

Epi Infectieziekten Team 1, Infection & Immunity, MMB opleiding Arts microbioloog, Epi Infectieziekten, MMB, JC onderzoeksprogramma Infectieziekten, Van Heijl, Inger, Schweitzer, Valentijn A., van der Linden, Paul D., Bonten, Marc J. M., Van Werkhoven, Cornelis H., Epi Infectieziekten Team 1, Infection & Immunity, MMB opleiding Arts microbioloog, Epi Infectieziekten, MMB, JC onderzoeksprogramma Infectieziekten, Van Heijl, Inger, Schweitzer, Valentijn A., van der Linden, Paul D., Bonten, Marc J. M., and Van Werkhoven, Cornelis H.

Published
2020

28. Diabetes and Glucose Dysregulation and Transition to Delirium in ICU Patients

Author

van Keulen, Kris, Knol, Wilma, Belitser, Svetlana V, van der Linden, Paul D, Heerdink, Eibert R, Egberts, Toine C G, Slooter, Arjen J C, Sub Pharmacotherapy, Theoretical, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, Sub Pharmacotherapy, Theoretical, Afd Pharmacoepi & Clinical Pharmacology, and Pharmacoepidemiology and Clinical Pharmacology

Subjects
Male, medicine.medical_specialty, Intensive care unit patients, endocrine system diseases, Hypoglycemia, Critical Care and Intensive Care Medicine, Diabetes Complications, 03 medical and health sciences, 0302 clinical medicine, Intensive care, Diabetes mellitus, Internal medicine, Taverne, mental disorders, Diabetes Mellitus, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Aged, business.industry, Diabetes, Confounding, Delirium, nutritional and metabolic diseases, 030208 emergency & critical care medicine, Odds ratio, Middle Aged, medicine.disease, Intensive Care Units, Hyperglycemia, Population study, Female, medicine.symptom, business
Abstract

Objectives To investigate whether diabetes and glucose dysregulation (hyperglycemia and/or hypoglycemia) are associated with ICU delirium. Design Prospective cohort study. Setting Thirty-two-bed mixed intensive care in a tertiary care center. Patients Critically ill patients admitted to the ICU with transitions of mental status from awake and nondelirious to delirious or remaining awake and nondelirious on the next day. Patients admitted because of a neurologic illness were excluded. Interventions None. Measurements and main results The study population consisted of 2,745 patients with 1,720 transitions from awake and nondelirious to delirious and 11,421 nontransitions remaining awake and nondelirious. Generalized mixed effects models with logit link function were performed to study the association between diabetes mellitus, glucose dysregulation, and delirium, adjusting for potential confounders. Diabetes was not associated with delirium (odds ratio adjusted, 0.93; 95% CI, 0.73-1.18). In all patients, the occurrence of hyperglycemia (odds ratio adjusted, 1.35; 95% CI, 1.15-1.59) and the occurrence of both hyperglycemia and hypoglycemia on the same day (odds ratio adjusted, 1.65; 95% CI, 1.12-2.28) compared with normoglycemia were associated with transition to delirium. Hypoglycemia was not associated with transition to delirium (odds ratio adjusted, 1.86; 95% CI, 0.73-3.71). In patients without diabetes, the occurrence of hyperglycemia (odds ratio adjusted, 1.41; 95% CI, 1.16-1.68) and the occurrence of both hyperglycemia and hypoglycemia on the same day (odds ratio adjusted, 1.87; 95% CI, 1.07-2.89) were associated with transition to delirium. In patients with diabetes, glucose dysregulation was not associated with ICU delirium. Conclusions Diabetes mellitus was not associated with the development of ICU delirium. For hypoglycemia, only a nonsignificant odds ratio for ICU delirium could be noted. Hyperglycemia and the occurrence of hyperglycemia and hypoglycemia on the same day were associated with ICU delirium but only in patients without diabetes. Our study supports the institution of measures to prevent glucose dysregulation in nondiabetic ICU patients and contributes to the understanding of the determinants of delirium.

Published
2018

30. Brief communication: Strengthening coherence between climate change adaptation and disaster risk reduction

Author

Mysiak Jaroslav, Castellari Sergio, Kurnik Blaz, Swart Rob, Pringle Patrick, Schwarze Reimur, Henk Wolters, Jeuken Ad, and Van der Linden Paul

Abstract

Reducing disaster risks and adapting to climate change are ever more important policy goals in Europe and worldwide. The commitment to the 2030 Agenda for Sustainable Development and complementary multilateral frameworks, including the Sendai Framework for Disaster Risk Reduction 2015–2030 and the Paris Agreement on Climate Change, has galvanized pursuits for policy coherence. The report Climate change adaptation and disaster risk reduction in Europe: enhancing coherence of the knowledge base, policies and practices of the European Environment Agency identified several ways for how coherence and resilience can be built through knowledge sharing, collaboration and investments.

Published
2018

31. Development of diagnostic prediction tools for bacteraemia caused by 3rd generation cephalosporin-resistant Enterobacteriaceae in suspected bacterial infections: a nested case-control study

Author

Rottier, Wouter C, van Werkhoven, Cornelis H., Bamberg, Yara R P, Dorigo-Zetsma, J Wendelien, van de Garde, Ewoudt M, van Hees, Babette C, Kluytmans, Jan A J W, Kuck, Emile M, Van Der Linden, Paul D., Prins, Jan M., Thijsen, Steven F T, Verbon, Annelies, Vlaminckx, Bart J.M., Ammerlaan, Heidi S M, Bonten, Marc J M, Afd Pharmacoepi & Clinical Pharmacology, and Pharmacoepidemiology and Clinical Pharmacology

Subjects
Risk factors, Enterobacteria, Clinical prediction models, Taverne, Scoring systems, Extended-spectrum β-lactamases, Empirical antibiotic therapy
Abstract

OBJECTIVES: Current guidelines for empiric antibiotic treatment poorly predict the presence of 3rd generation cephalosporin-resistant Enterobacteriaceae bacteraemia (3GCR-E-Bac) as a cause of infection, thereby increasing unnecessary carbapenem use. We aimed to develop diagnostic scoring systems to better predict the presence of 3GCR-E-Bac. METHODS: A retrospective nested case-control study was performed that included patients ≥18 years from eight Dutch hospitals in whom blood cultures were obtained and intravenous antibiotics were initiated. Each patient with 3GCR-E-Bac was matched to four control infection episodes within the same hospital, based on blood culture date and onset location (community or hospital). Starting from 32 commonly described clinical risk factors available at infection onset, selection strategies were used to derive scoring systems for the probability of community- and hospital-onset 3GCR-E-Bac. RESULTS: 3GCR-E-Bac occurred in 90 of 22,506 (0.4%) community-onset and in 82 of 8,110 (1.0%) hospital-onset infections, and these cases were matched to 360 community-onset and 328 hospital-onset control episodes. The derived community-onset and hospital-onset scoring systems consisted of 6 and 9 predictors, respectively. With selected score cutoffs, the models identified 3GCR-E-Bac with equal sensitivity as existing guidelines (community-onset: 54.3%; hospital-onset: 81.5%). Yet, they reduced the proportion of patients classified as at risk for 3GCR-E-Bac (i.e. eligible for empiric carbapenem therapy) with 40% (95% confidence interval 21-56%) and 49% (95% confidence interval 39-58%) in, respectively, community-onset and hospital-onset infection. CONCLUSIONS: These prediction scores for 3GCR-E-Bac, specifically geared towards the initiation of empiric antibiotic treatment, may improve the balance between inappropriate antibiotics and carbapenem overuse.

Published
2018

32. Nieuwe antibiotica : een overzicht

Author

Lemkes, Bregtje A., Richel, Olivier, Bonten, Marc J., van der Linden, Paul D., Wiersinga, W. Joost, Lemkes, Bregtje A., Richel, Olivier, Bonten, Marc J., van der Linden, Paul D., and Wiersinga, W. Joost

Published
2019

33. Confounding by indication of the safety of de-escalation in community-acquired pneumonia : A simulation study embedded in a prospective cohort

Author

van Heijl, Inger, Schweitzer, Valentijn A, Boel, C H Edwin, Oosterheert, Jan Jelrik, Huijts, Susanne M, Dorigo-Zetsma, Wendelien, van der Linden, Paul D, Bonten, Marc J M, van Werkhoven, Cornelis H, van Heijl, Inger, Schweitzer, Valentijn A, Boel, C H Edwin, Oosterheert, Jan Jelrik, Huijts, Susanne M, Dorigo-Zetsma, Wendelien, van der Linden, Paul D, Bonten, Marc J M, and van Werkhoven, Cornelis H

Published
2019

34. Confounding by indication of the safety of de-escalation in community-acquired pneumonia: A simulation study embedded in a prospective cohort

Author

Epi Infectieziekten Team 1, Infection & Immunity, MMB opleiding Arts microbioloog, MMB Medische Staf, MS Interne Geneeskunde, Arts Assistenten Longziekten, Epi Infectieziekten, MMB, JC onderzoeksprogramma Infectieziekten, van Heijl, Inger, Schweitzer, Valentijn A, Boel, C H Edwin, Oosterheert, Jan Jelrik, Huijts, Susanne M, Dorigo-Zetsma, Wendelien, van der Linden, Paul D, Bonten, Marc J M, van Werkhoven, Cornelis H, Epi Infectieziekten Team 1, Infection & Immunity, MMB opleiding Arts microbioloog, MMB Medische Staf, MS Interne Geneeskunde, Arts Assistenten Longziekten, Epi Infectieziekten, MMB, JC onderzoeksprogramma Infectieziekten, van Heijl, Inger, Schweitzer, Valentijn A, Boel, C H Edwin, Oosterheert, Jan Jelrik, Huijts, Susanne M, Dorigo-Zetsma, Wendelien, van der Linden, Paul D, Bonten, Marc J M, and van Werkhoven, Cornelis H

Published
2019

35. Nieuwe antibiotica: een overzicht

Author

UMC Utrecht, Epi Infectieziekten, MMB, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Lemkes, Bregtje A., Richel, Olivier, Bonten, Marc J., van der Linden, Paul D., Wiersinga, W. Joost, UMC Utrecht, Epi Infectieziekten, MMB, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Lemkes, Bregtje A., Richel, Olivier, Bonten, Marc J., van der Linden, Paul D., and Wiersinga, W. Joost

Published
2019

37. Confounding by indication of the safety of de-escalation in community-acquired pneumonia: A simulation study embedded in a prospective cohort

Author

van Heijl, Inger, primary, Schweitzer, Valentijn A., additional, Boel, C. H. Edwin, additional, Oosterheert, Jan Jelrik, additional, Huijts, Susanne M., additional, Dorigo-Zetsma, Wendelien, additional, van der Linden, Paul D., additional, Bonten, Marc J. M., additional, and van Werkhoven, Cornelis H., additional

Published
2019
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39. The ESEP study: Salpingostomy versus salpingectomy for tubal ectopic pregnancy; The impact on future fertility: A randomised controlled trial

Author

van Mello Norah M, Nilsson Kerstin, Klinte Ingemar, Hogström Lars, Hoek Annemieke, Thurkow Andreas L, Graziosi Giuseppe CM, van der Linden Paul JQ, Koks Carolien AM, Verhoeve Harold R, Yalcinkaya Tamer, Jurkovic Davor, Strandell Annika, Mol Femke, Ankum Willem M, van der Veen Fulco, Mol Ben WM, and Hajenius Petra J

Subjects
Gynecology and obstetrics, RG1-991, Public aspects of medicine, RA1-1270
Abstract

Abstract Background For most tubal ectopic pregnancies (EP) surgery is the treatment of first choice. Whether surgical treatment should be performed conservatively (salpingostomy) or radically (salpingectomy) in women wishing to preserve their reproductive capacity, is subject to debate. Salpingostomy preserves the tube, but bears the risks of both persistent trophoblast and repeat ipsilateral tubal EP. Salpingectomy, avoids these risks, but leaves only one tube for reproductive capacity. This study aims to reveal the trade-off between both surgical options: whether the potential advantage of salpingostomy, i.e. a better fertility prognosis as compared to salpingectomy, outweighs the potential disadvantages, i.e. persistent trophoblast and an increased risk for a repeat EP. Methods/Design International multi centre randomised controlled trial comparing salpingostomy versus salpingectomy in women with a tubal EP without contra lateral tubal pathology. Hemodynamically stable women with a presumptive diagnosis of tubal EP, scheduled for surgery, are eligible for inclusion. Patients pregnant after in vitro fertilisation (IVF) and/or known documented tubal pathology are excluded. At surgery, a tubal EP must be confirmed. Only women with a tubal EP amenable to both interventions and a healthy contra lateral tube are included. Salpingostomy and salpingectomy are performed according to standard procedures of participating hospitals. Up to 36 months after surgery, women will be contacted to assess their fertility status at six months intervals starting form the day of the operation. The primary outcome measure is the occurrence of spontaneous viable intra uterine pregnancy. Secondary outcome measures are persistent trophoblast, repeat EP, all pregnancies including those resulting from IVF and financial costs. The analysis will be performed according to the intention to treat principle. A cost-effectiveness analysis will be performed within a decision analysis framework, based on costs per live birth, including IVF treatment whenever a spontaneous pregnancy does not occur. Patients' preferences will be assessed using a discrete choice experiment. Discussion This trial will provide evidence on the trade off between salpingostomy and salpingectomy for tubal EP in view of the pros and cons of both interventions and will offer guidance to clinicians in making the right treatment choice. Trial registration Current Controlled Trials ISRCTN37002267

Published
2008
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41. Influence of endometrial thickness on pregnancy rates in modified natural cycle frozen-thawed embryo transfer

Author

Groenewoud, Eva R., Cohlen, Ben J., Al-Oraiby, Amani, Brinkhuis, Egbert A., Broekmans, Frank J.M., de Bruin, Jan Peter, van Dool, Grada, Fleisher, Katrin, Friederich, Jaap, Goddijn, Mariëtte, Hoek, Annemieke, Hoozemans, Diederik A., Kaaijk, Eugenie M., Koks, Caroliene A.M., Laven, Joop S.E., van der Linden, Paul J.Q., Manger, A. Petra, van Rumste, Minouche, Spinder, Taeke, Macklon, Nick S., Groenewoud, Eva R., Cohlen, Ben J., Al-Oraiby, Amani, Brinkhuis, Egbert A., Broekmans, Frank J.M., de Bruin, Jan Peter, van Dool, Grada, Fleisher, Katrin, Friederich, Jaap, Goddijn, Mariëtte, Hoek, Annemieke, Hoozemans, Diederik A., Kaaijk, Eugenie M., Koks, Caroliene A.M., Laven, Joop S.E., van der Linden, Paul J.Q., Manger, A. Petra, van Rumste, Minouche, Spinder, Taeke, and Macklon, Nick S.

Published
2018

43. Glucose variability during delirium in diabetic and non-diabetic intensive care unit patients: A prospective cohort study

Author

Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, van Keulen, Kris, Knol, Wilma, Belitser, Svetlana V, Zaal, Irene J, van der Linden, Paul D, Heerdink, Eibert R, Egberts, Toine C G, Slooter, Arjen J C, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, van Keulen, Kris, Knol, Wilma, Belitser, Svetlana V, Zaal, Irene J, van der Linden, Paul D, Heerdink, Eibert R, Egberts, Toine C G, and Slooter, Arjen J C

Published
2018

44. Development of diagnostic prediction tools for bacteraemia caused by 3rd generation cephalosporin-resistant Enterobacteriaceae in suspected bacterial infections: a nested case-control study

Author

Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, Rottier, Wouter C, van Werkhoven, Cornelis H., Bamberg, Yara R P, Dorigo-Zetsma, J Wendelien, van de Garde, Ewoudt M, van Hees, Babette C, Kluytmans, Jan A J W, Kuck, Emile M, Van Der Linden, Paul D., Prins, Jan M., Thijsen, Steven F T, Verbon, Annelies, Vlaminckx, Bart J.M., Ammerlaan, Heidi S M, Bonten, Marc J M, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, Rottier, Wouter C, van Werkhoven, Cornelis H., Bamberg, Yara R P, Dorigo-Zetsma, J Wendelien, van de Garde, Ewoudt M, van Hees, Babette C, Kluytmans, Jan A J W, Kuck, Emile M, Van Der Linden, Paul D., Prins, Jan M., Thijsen, Steven F T, Verbon, Annelies, Vlaminckx, Bart J.M., Ammerlaan, Heidi S M, and Bonten, Marc J M

Published
2018

45. Diabetes and Glucose Dysregulation and Transition to Delirium in ICU Patients

Author

Sub Pharmacotherapy, Theoretical, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, van Keulen, Kris, Knol, Wilma, Belitser, Svetlana V, van der Linden, Paul D, Heerdink, Eibert R, Egberts, Toine C G, Slooter, Arjen J C, Sub Pharmacotherapy, Theoretical, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, van Keulen, Kris, Knol, Wilma, Belitser, Svetlana V, van der Linden, Paul D, Heerdink, Eibert R, Egberts, Toine C G, and Slooter, Arjen J C

Published
2018

46. Inappropriate Use of Antimicrobials for Lower Respiratory Tract Infections in Elderly Patients: Patient- and Community-Related Implications and Possible Interventions

Author

Epi Infectieziekten Team 1, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Unit Opleiding Aios, van Heijl, Inger, Schweitzer, Valentijn A., Zhang, Lufang, van der Linden, Paul D., van Werkhoven, Cornelis H., Postma, Douwe F., Epi Infectieziekten Team 1, Infection & Immunity, JC onderzoeksprogramma Infectieziekten, Unit Opleiding Aios, van Heijl, Inger, Schweitzer, Valentijn A., Zhang, Lufang, van der Linden, Paul D., van Werkhoven, Cornelis H., and Postma, Douwe F.

Published
2018

47. Diabetes and glucose dysregulation and transition to delirium in ICU patients

Author

MS Geriatrie, Circulatory Health, Apotheek Onderzoek, Brain, Child Health, Infection & Immunity, Regenerative Medicine and Stem Cells, Apotheek, Medische Staf Intensive Care, Van Keulen, Kris, Knol, Wilma, Belitser, Svetlana V., Van Der Linden, Paul D., Heerdink, Eibert R., Egberts, Toine C.G., Slooter, Arjen J.C., MS Geriatrie, Circulatory Health, Apotheek Onderzoek, Brain, Child Health, Infection & Immunity, Regenerative Medicine and Stem Cells, Apotheek, Medische Staf Intensive Care, Van Keulen, Kris, Knol, Wilma, Belitser, Svetlana V., Van Der Linden, Paul D., Heerdink, Eibert R., Egberts, Toine C.G., and Slooter, Arjen J.C.

Published
2018

48. Glucose variability during delirium in diabetic and non-diabetic intensive care unit patients: A prospective cohort study

Author

MS Geriatrie, Circulatory Health, AIOS Anesthesiologie, Brain, Apotheek Onderzoek, Child Health, Infection & Immunity, Regenerative Medicine and Stem Cells, Medische Staf Intensive Care, van Keulen, Kris, Knol, Wilma, Belitser, Svetlana V., Zaal, Irene J., van der Linden, Paul D., Heerdink, Eibert R., Egberts, Toine C.G., Slooter, Arjen J.C., MS Geriatrie, Circulatory Health, AIOS Anesthesiologie, Brain, Apotheek Onderzoek, Child Health, Infection & Immunity, Regenerative Medicine and Stem Cells, Medische Staf Intensive Care, van Keulen, Kris, Knol, Wilma, Belitser, Svetlana V., Zaal, Irene J., van der Linden, Paul D., Heerdink, Eibert R., Egberts, Toine C.G., and Slooter, Arjen J.C.

Published
2018

49. Influence of endometrial thickness on pregnancy rates in modified natural cycle frozen-thawed embryo transfer

Author

MS VPG/Gynaecologie, Child Health, Circulatory Health, Groenewoud, Eva R., Cohlen, Ben J., Al-Oraiby, Amani, Brinkhuis, Egbert A., Broekmans, Frank J.M., de Bruin, Jan Peter, van Dool, Grada, Fleisher, Katrin, Friederich, Jaap, Goddijn, Mariëtte, Hoek, Annemieke, Hoozemans, Diederik A., Kaaijk, Eugenie M., Koks, Caroliene A.M., Laven, Joop S.E., van der Linden, Paul J.Q., Manger, A. Petra, van Rumste, Minouche, Spinder, Taeke, Macklon, Nick S., MS VPG/Gynaecologie, Child Health, Circulatory Health, Groenewoud, Eva R., Cohlen, Ben J., Al-Oraiby, Amani, Brinkhuis, Egbert A., Broekmans, Frank J.M., de Bruin, Jan Peter, van Dool, Grada, Fleisher, Katrin, Friederich, Jaap, Goddijn, Mariëtte, Hoek, Annemieke, Hoozemans, Diederik A., Kaaijk, Eugenie M., Koks, Caroliene A.M., Laven, Joop S.E., van der Linden, Paul J.Q., Manger, A. Petra, van Rumste, Minouche, Spinder, Taeke, and Macklon, Nick S.

Published
2018

50. Influence of endometrial thickness on pregnancy rates in modified natural cycle frozen-thawed embryo transfer

Author

Groenewoud, Eva R, Cohlen, Ben J, Al-Oraiby, Amani, Brinkhuis, Egbert A, Broekmans, Frank J M, de Bruin, Jan-Peter, van Dool, Grada, Fleisher, Katrin, Friederich, Jaap, Goddijn, Mariëtte, Hoek, Annemieke, Hoozemans, Diederik A, Kaaijk, Eugenie M, Koks, Caroliene A M, Laven, Joop S E, van der Linden, Paul J Q, Manger, A Petra, van Rumste, Minouche, Spinder, Taeke, Macklon, Nick S, Groenewoud, Eva R, Cohlen, Ben J, Al-Oraiby, Amani, Brinkhuis, Egbert A, Broekmans, Frank J M, de Bruin, Jan-Peter, van Dool, Grada, Fleisher, Katrin, Friederich, Jaap, Goddijn, Mariëtte, Hoek, Annemieke, Hoozemans, Diederik A, Kaaijk, Eugenie M, Koks, Caroliene A M, Laven, Joop S E, van der Linden, Paul J Q, Manger, A Petra, van Rumste, Minouche, Spinder, Taeke, and Macklon, Nick S

Abstract

INTRODUCTION: Pregnancy after frozen-thawed embryo transfer (FET) is a multifactorial process. Although embryo quality is a key factor in determining pregnancy, other factors, including maternal determinants, are also considered to be predictive. Even though an association between endometrial thickness measured by transvaginal ultrasound and pregnancy rates has been reported in patients undergoing various assisted reproductive technology treatments, whether endometrial thickness predicts achieving pregnancy after natural cycle FET (NC-FET) remains unclear.MATERIAL AND METHODS: In this cohort study, 463 patients allocated to the modified NC-FET (mNC-FET) arm of a previously published randomized controlled trial were included. Monitoring in mNC-FET cycles consisted of regular ultrasound scans, measuring both dominant follicle and endometrial thickness. When the dominant follicle reached a size of 16-20 mm, an injection of human chorionic gonadotrophin was administered and embryo thawing and transfer planned. No minimal endometrial thickness was defined below which transfer was to be deferred. The primary endpoint was ongoing pregnancy rate.RESULTS: Overall, the ongoing pregnancy rate per started FET cycle was 12.5%. Multivariate regression analyses showed that embryo quality was the only significant predictor for ongoing pregnancy. Mean endometrial thickness did not differ between patients achieving ongoing pregnancy and those who did not (9.0 vs. 8.8 mm, p = 0.4). Comparable results were obtained with regard to clinical pregnancy, live birth and miscarriage rates. The area under the receiver operator curve was 0.5, indicating little discriminatory value of endometrial thickness.CONCLUSIONS: Given that endometrial thickness was not found to be predictive of pregnancy after mNC-FET, cancellation based on endometrial thickness alone may not be justified.

Published
2018

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