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22. Evidence-based behandeling van hoofdpijn in de klinische praktijk : hands-on versus hands-off

Author

Cagnie, B., Chys, M., de Meulenmeester, K., de Pauw, R., Dewitte, V., Mukthar, N., and Meeus, Mira

Subjects
Human medicine
Abstract

Hoofdpijn is een veelvoorkomende klacht in de praktijk van de kinesitherapeut/fysiotherapeut. Migraine, spanningshoofdpijn en cervicogene hoofdpijn zijn de hoofdpijnvormen die het vaakst in de fysiotherapeutische praktijk voorkomen. Voor therapeuten is het de uitdaging om bij iedere patiënt de juiste behandeling te vinden. Dit wordt bemoeilijkt doordat de effectiviteit van fysiotherapie bij ieder hoofdpijntype verschillend is. Voor een evidencebased aanpak is het belangrijk om dit niet alleen te onderbouwen met wetenschappelijk onderzoek, maar ook te baseren op de klinische expertise van de fysiotherapeut zelf. Dit artikel inventariseert de wetenschappelijke evidentie voor de fysiotherapeutische aanpak van hoofdpijn en integreert dit met de klinische expertise aan de hand van de resultaten van een in 2021 gepubliceerde Delphi-studie.

Published
2021

24. Artificial intelligence outperforms pulmonologists in the interpretation of pulmonary function tests

Author

Topalovic, Marko, Das, Nilakash, Burgel, Pierre-Regis, Daenen, Marc, Derom, Eric, Haenebalcke, Christel, Janssen, Rob, Kerstjens, Huib AM, Liistro, Giuseppe, Louis, Renaud, Ninane, Vincent, Pison, Christophe, Schlesser, Marc, Vercauter, Piet, Vogelmeier, Claus F, Wouters, Emiel, Wynants, Jokke, Janssens, Wim, De Pauw, R, Depuydt, C, Haenebalcke, C, Muyldermans, S, Ringoet, V, Stevens, D, Bayat, S, Benet, J, Catho, E, Claustre, J, Fedi, A, Ferjani, MA, Guzun, R, Isnard, M, Nicolas, S, Pierret, T, Pison, C, Rouches, S, Wuyam, B, Corhay, JL, Guiot, J, Ghysen, K, Renaud, L, Sibille, A, De La Barriere, H, Charpentier, C, Corhut, S, Hamdan, KA, Schlesser, M, Wirtz, G, Alabadan, E, Birsen, G, Burgel, PR, Chohra, A, Hamard, C, Lemarie, B, Lothe, MN, Martin, C, Sainte-Marie, AC, Sebane, L, Berk, Y, de Brouwer, B, Janssen, R, Kerkhoff, J, Spaanderman, A, Stegers, M, Termeer, A, van Grimbergen, I, van Veen, A, van Ruitenbeek, L, Vermeer, L, Zaal, R, Zijlker, M, Aumann, J, Cuppens, K, Degraeve, D, Demuynck, K, Dieriks, B, Pat, K, Spaas, L, Van Puijenbroek, R, Weytjens, K, Wynants, J, Adam, V, Berendes, BJ, Hardeman, E, Jordens, P, Munghen, E, Tournoy, K, Vercauter, P, Alame, T, Bruyneel, M, Gabrovska, M, Muylle, I, Ninane, V, Rozen, D, Rummens, P, Van den Broecke, S, Froidure, A, Gohy, S, Liistro, G, Pieters, T, Pilette, C, Pirson, F, Kerstjens, H, Van den Berge, M, Ten Hacken, N, Duiverman, M, Koster, D, Vosse, B, Conemans, L, Maus, M, Bischoff, M, Rutten, M, Agterhuis, D, Sprooten, R, Beutel, B, Jerrentrup, A, Klemmer, A, Viniol, C, Vogelmeier, C, Bode, H, Dooms, C, Gullentops, D, Janssens, W, Nackaerts, K, Rutens, D, Wauters, E, Wuyts, W, Derom, E, Dobbelaere, S, Loof, S, Serry, G, Putman, B, Van Acker, L, Vandeweygaerde, Y, Criel, M, Daenen, M, Gubbelmans, R, Klerkx, S, Michiels, E, Thomeer, M, Vanhauwaert, A, UCL - (SLuc) Service de pneumologie, Groningen Research Institute for Asthma and COPD (GRIAC), Lifestyle Medicine (LM), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire [Grenoble] (CHU), Laboratory of Fundamental and Applied Bioenergetics = Laboratoire de bioénergétique fondamentale et appliquée (LBFA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), RS: NUTRIM - R3 - Respiratory & Age-related Health, MUMC+: MA Longziekten (3), Pulmonologie, MUMC+: MA Med Staf Spec Longziekten (9), and MUMC+: MA Med Staf Artsass Longziekten (9)

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, Pulmonary function, STRATEGIES, Pulmonary Function Study Investigators, Context (language use), DIAGNOSIS, GUIDELINES, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Pulmonary function testing, 03 medical and health sciences, 0302 clinical medicine, Clinical history, Artificial Intelligence, Pulmonary Medicine, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Medical diagnosis, Pulmonologists, Aged, Aged, 80 and over, Interpretation (logic), business.industry, Gold standard (test), STANDARDIZATION, PERFORMANCE, Middle Aged, 3. Good health, Respiratory Function Tests, Clinical Practice, 030228 respiratory system, Female, Artificial intelligence, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Software
Abstract

The interpretation of pulmonary function tests (PFTs) to diagnose respiratory diseases is built on expert opinion that relies on the recognition of patterns and the clinical context for detection of specific diseases. In this study, we aimed to explore the accuracy and interrater variability of pulmonologists when interpreting PFTs compared with artificial intelligence (AI)-based software that was developed and validated in more than 1500 historical patient cases.120 pulmonologists from 16 European hospitals evaluated 50 cases with PFT and clinical information, resulting in 6000 independent interpretations. The AI software examined the same data. American Thoracic Society/European Respiratory Society guidelines were used as the gold standard for PFT pattern interpretation. The gold standard for diagnosis was derived from clinical history, PFT and all additional tests.The pattern recognition of PFTs by pulmonologists (senior 73%, junior 27%) matched the guidelines in 74.4±5.9% of the cases (range 56-88%). The interrater variability of κ=0.67 pointed to a common agreement. Pulmonologists made correct diagnoses in 44.6±8.7% of the cases (range 24-62%) with a large interrater variability (κ=0.35). The AI-based software perfectly matched the PFT pattern interpretations (100%) and assigned a correct diagnosis in 82% of all cases (p

Published
2018

25. Validity and Test-Retest Reliability of the Dutch Modified Perceived Deficits Questionnaire to Examine Cognitive Symptoms in Women with Chronic Whiplash, Chronic Idiopathic Neck Pain, and Fibromyalgia

Author

Lenoir, D., Lenoir, D., De Pauw, R., Ickmans, K., Schumacher, C., Timmers, I., Kregel, J., Coppieters, I., Lenoir, D., Lenoir, D., De Pauw, R., Ickmans, K., Schumacher, C., Timmers, I., Kregel, J., and Coppieters, I.

Abstract

IntroductionUntil now, only reliability and validity of the English version of the modified Perceived Deficits Questionnaire (mPDQ) have been investigated. ObjectiveThe aim of this study was to translate the mPDQ into Dutch and evaluate its validity and reliability as an assessment tool for self-perceived cognitive problems in patients with chronic whiplash-associated disorders (CWAD), chronic idiopathic neck pain (CINP), and fibromyalgia (FM). MethodsA case-control study was performed with a volunteer sample of 13 women with CWAD, 18 with CINP, and 33 with FM, and 33 women who were healthy and free of pain. The mPDQ was first translated into Dutch, and its test-retest reliability, internal consistency, and discriminative power were examined. ResultsThe intraclass correlation coefficients were higher than 0.74. Cronbach's values ranged between 0.71 and 0.95. Total mPDQ scores were significantly higher (P<0.017) in FM and CWAD patients compared to healthy controls. Furthermore, participants performed the Stroop task and the psychomotor vigilance task (PVT), 2 neuropsychological computer-based cognitive performance tests. Correlations between the mPDQ total score and the cognitive performance tests were evaluated. Significant moderate to high correlations were found in all study samples between total mPDQ score and objective cognitive tests (Spearman correlation coefficient=0.35 to 0.80; P<0.05). ConclusionTherefore, the Dutch version of the mPDQ showed high test-retest reliability and high internal consistency, and was able to distinguish CWAD and FM patients from healthy controls. PerspectiveThis article presents the validity and test-retest reliability of the Dutch mPDQ. This measure could help clinicians who seek a reliable and user-friendly way to assess cognitive symptoms in chronic pain patients.

Published
2018

35. Airways resistance and specific conductance for the diagnosis of obstructive airways diseases.

Author

Nguyen D., Rodenstein D., Delaunois L., Marchand E., Vandenplas O., Haenebalcke C., Ringoet V., Van Renterghem D., Carlier A., Colle D., De Cock C., Lamont J., Brancaleone P., Vander Stappen M., Peche R., Pierard, Quarre P., Van Meerhaeghe A., Cataldo D., Corhay J.L., Duysinx B., Heinen V., Naldi M., Renaud L., Cotils M., Duchatelet P., Gocmen A., Lenclud C., Lebrun, Noel J., Fremault A., Bertrand, Bouckaert B., Demedts I., Demuynck P., Frans E., Heremans A., Lauwerier T., Roelandts J., Bral G., Declercq I., Malysse I., Van Damme V., Martinot, Vandenbrande P., Bruyneel M., Muylle I., Ninane V., Collard, Liistro G., Mwenge Gimbada B., Pieters T.H., Pilette C., Pirson F., De Backer W., Germonpre P., Janssens A., Vrints A., Decramer M., Janssens W., Van Bleyenbergh P., Verleden G., Wuyts W., Brusselle G., Derom E., Joos G., Tournoy K., Vermaelen K., Alexander P., Gysbrechts C., Bedert L., Bomans, De Beukelaar, De Droogh E., Galdermans D., Ingelbrecht, Lefebure, Slabbynck H., Van Mulders, Van Schaardenburg, Verbuyst, Daenen M., Topalovic M., Osadnik C.R., Troosters T., Vanherreweghe R., Deman R., Deryke S., Ghesyens B., Haerens M., Maddens S., Bultynck W., Temmerman W., Van Zandweghe L., De Pauw R., Depuydt C., Nguyen D., Rodenstein D., Delaunois L., Marchand E., Vandenplas O., Haenebalcke C., Ringoet V., Van Renterghem D., Carlier A., Colle D., De Cock C., Lamont J., Brancaleone P., Vander Stappen M., Peche R., Pierard, Quarre P., Van Meerhaeghe A., Cataldo D., Corhay J.L., Duysinx B., Heinen V., Naldi M., Renaud L., Cotils M., Duchatelet P., Gocmen A., Lenclud C., Lebrun, Noel J., Fremault A., Bertrand, Bouckaert B., Demedts I., Demuynck P., Frans E., Heremans A., Lauwerier T., Roelandts J., Bral G., Declercq I., Malysse I., Van Damme V., Martinot, Vandenbrande P., Bruyneel M., Muylle I., Ninane V., Collard, Liistro G., Mwenge Gimbada B., Pieters T.H., Pilette C., Pirson F., De Backer W., Germonpre P., Janssens A., Vrints A., Decramer M., Janssens W., Van Bleyenbergh P., Verleden G., Wuyts W., Brusselle G., Derom E., Joos G., Tournoy K., Vermaelen K., Alexander P., Gysbrechts C., Bedert L., Bomans, De Beukelaar, De Droogh E., Galdermans D., Ingelbrecht, Lefebure, Slabbynck H., Van Mulders, Van Schaardenburg, Verbuyst, Daenen M., Topalovic M., Osadnik C.R., Troosters T., Vanherreweghe R., Deman R., Deryke S., Ghesyens B., Haerens M., Maddens S., Bultynck W., Temmerman W., Van Zandweghe L., De Pauw R., and Depuydt C.

Abstract

Background: Airway resistance (RAW) and specific airway conductance (sGAW) are measures that reflect the patency of airways. Little is known of the variability of these measures between different lung diseases. This study investigated the contribution of RAW and sGAW to a diagnosis of obstructive airways disease and their role in differentiating asthma from COPD. Method(s): 976 subjects admitted for the first time to a pulmonary practice in Belgium were included. Clinical diagnoses were based on complete pulmonary function tests and supported by investigations of physicians' discretion. 651 subjects had a final diagnosis of obstructive diseases, 168 had another respiratory disease and 157 subjects had no respiratory disease (healthy controls). Result(s): RAW and sGAW were significantly different (p < 0.0001) between obstructive and other groups. Abnormal RAW and sGAW were found in 39 % and 18 % of the population, respectively, in which 81 % and 90 % had diagnosed airway obstruction. Multiple regression revealed sGAW to be a significant and independent predictor of an obstructive disorder. To differentiate asthma from COPD, RAW was found to be more relevant and statistically significant. In asthma patients with normal FEV1/FVC ratio, both RAW and sGAW were more specific than sensitive diagnostic tests in differentiating asthma from healthy subjects. Conclusion(s): RAW and sGAW are significant factors that contribute to the diagnosis and differentiation of obstructive airways diseases.Copyright © 2015 Topalovic et al.

Published
2015

38. Are pain, disability, quality of life, psychological factors and central sensitization related to quantitative sensory testing in chronic whiplash associated disorders?

Author

Lenoir, D., Willaert, W., Ickmans, K., Bernaers, L., Nijs, J., Malfliet, A., Danneels, L., Leysen, L., De Pauw, R., Cagnie, B., Coppieters, I., and Meeus, M.

Subjects
WHIPLASH injuries, FUNCTIONAL status, CHRONIC diseases, CONFERENCES & conventions, PAIN threshold, QUALITY of life, PSYCHOLOGY of the sick, DISEASE complications
Abstract

Introduction: Chronic Whiplash Associated Disorders (CWAD) are characterized by long-lasting symptoms of neck pain occurring after an acceleration-deceleration injury. Central sensitization (CS) has been suggested as the possible underlying mechanism for these symptoms, and is characterized by changes in the central nervous system. Besides CS, psychological factors are believed to play an important role in the experience of (chronic) pain. Methods: 72 CWAD patients and 55 healthy controls underwent electrical stimuli-based quantitative sensory testing (QST). Detection and pain thresholds (EPT), temporal summation (TS) and conditioned pain modulation (CPM) were examined. Spearman correlations and linear mixed models analyses were performed to assess respectively the hypothesized associations with and group differences in QST. Results: The Pain Catastrophizing magnification subscale correlated with left wrist EPT (r = -0.332; p = 0.004), and the Pain Anxiety Symptom Scale-20 with left wrist (r = -0.325; p = 0.005) and ankle (r = -0.330; p = 0.005) EPT. TS at the ankle correlated with the CS Inventory (r = 0.303; p = 0.010), Short Form 36 pain subscale (r = -0.325; p = 0.005), and Illness Perception Questionnaire revised consequences subscale (r = 0.325; p = 0.005). EPTs of left (p = 0.011) and right wrist (p = 0.023) were lower in the CWAD group, but CPM and TS did not differ between groups. Discussion: QST outcomes relate to psychological constructs, rather than to self-reported pain intensity and distribution. Local hyperalgesia was found in CWAD patients, but no differences in endogenous pain facilitation nor inhibition. Process evaluation: Both CWAD patients reporting unilateral as bilateral neck pain were included, which complicated the interpretation of distal hyperalgesia. [ABSTRACT FROM AUTHOR]

Published
2022
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39. The value of endoscopic ultrasound after bronchoscopy to diagnose thoracic sarcoidosis

Author

UCL - Cliniques universitaires Saint-Luc, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, Tournoy, K. G., Pieters, Thierry, Bolly, A., Aerts, J. G., Pierard, P., De Pauw, R., Leduc, D., Leloup, Anne-Marie, Slabbynck, H., Janssens, A., Carron, K., Schrevens, L., Pat, K., De Keukeleire, T., Dooms, C., UCL - Cliniques universitaires Saint-Luc, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, Tournoy, K. G., Pieters, Thierry, Bolly, A., Aerts, J. G., Pierard, P., De Pauw, R., Leduc, D., Leloup, Anne-Marie, Slabbynck, H., Janssens, A., Carron, K., Schrevens, L., Pat, K., De Keukeleire, T., and Dooms, C.

Abstract

A clinicoradiological presentation of thoracic sarcoidosis requires histopathology in order to establish the diagnosis. Flexible bronchoscopy has a reasonable diagnostic yield and is the procedure of first choice for diagnosis. Endoscopic ultrasound (endoscopic ultrasound-guided fine needle aspiration/endobronchial ultrasound-guided transbronchial needle aspiration) can help in the diagnosis of sarcoidosis. An implementation strategy of endoscopic ultrasound for the diagnosis of sarcoidosis following negative flexible bronchoscopy results was examined prospectively in 15 clinics. A total of 137 patients (92 males; median age 43 yrs) were included, and sarcoidosis was found in 115 (84%). Alternative diagnoses were tuberculosis, lymphangitis carcinomatosa, pneumoconiosis and alveolitis. All patients were sent for flexible bronchoscopy, which was performed in 121 (88%), resulting in a definite diagnosis in 57 (42%). A total of 80 patients were sent for endoscopic ultrasound, which could be performed in 72 (90%), yielding a definite diagnosis in 47 (59%). Endoscopic ultrasound following negative flexible bronchoscopy avoided a surgical procedure in 47 out of 80 patients. The sensitivity of flexible bronchoscopy for sarcoidosis was 45% (95% confidence interval 35-54%), but 62% (50-72%) if biopsy specimens were taken. The sensitivity of endoscopic ultrasound following negative flexible bronchoscopy results was 71% (58-82%). With this strategy, 97 out of 115 (84% (76-90%)) of proven sarcoidosis was diagnosed using endoscopy. This large prospective implementation study (trial number NCT00888212; ClinicalTrials.gov) shows that endoscopic ultrasound is valuable for diagnosing sarcoidosis after negative flexible bronchoscopy results.

Published
2010

40. The value of endoscopic ultrasound after bronchoscopy to diagnose thoracic sarcoidosis

Author

Tournoy, K. G., primary, Bolly, A., additional, Aerts, J. G., additional, Pierard, P., additional, De Pauw, R., additional, Leduc, D., additional, Leloup, A., additional, Pieters, T., additional, Slabbynck, H., additional, Janssens, A., additional, Carron, K., additional, Schrevens, L., additional, Pat, K., additional, De Keukeleire, T., additional, and Dooms, C., additional

Published
2009
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41. The presence of central sensitization in the continuum of migraine: A case control study.

Author

Cnockaert, E., Cagnie, B., Meeus, M., Van Oosterwijck, J., and De Pauw, R.

Subjects
MIGRAINE, CASE-control method, CONFERENCES & conventions, CENTRAL nervous system
Abstract

Introduction: Migraine is conceptualized as a continuum, with at the one hand episodic migraine and at the other hand chronic migraine (CM) which is more frequent1. Recent studies support the presence of central sensitization (CS) in migraine patients2,3, but controversial evidence exists about where in the continuum exactly CS appears and which mechanisms are underlying. Therefore this study aims to determine the occurrence and mechanisms of CS within the migraine continuum. Methods: Self-reported and psychophysiological data will be collected from 30 migraine patients and 30 healthy controls. Pain sensitivity will be evaluated using Quantitative Sensory Testing including mechanical and thermal thresholds. Pain facilitation and inhibition will be assessed by using respectively temporal summation and conditioned pain modulation paradigms. Assessments are performed unilateral at the painful side and interictally. Results: Widespread pain and impaired pain facilitation and inhibition are expected to be more pronounced in patients with more migraine days (further along the continuum) than in those with less migraine days. Discussion: This research will show whether signs of CS are present in migraine patients, where in the migraine continuum these symptoms are appearing, and whether impaired pain inhibition and/or facilitation underlie these symptoms. Process evaluation: Data collection is currently going on. Testing patients with CM interictally is a challenge. [ABSTRACT FROM AUTHOR]

Published
2022
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42. Event-related potentials following cutaneous electrical stimulation in patients with chronic whiplash associated disorders.

Author

Lenoir, D., Willaert, W., Ickmans, K., Nijs, J., Cagnie, B., Meeus, M., Vonck, K., Delbeke, J., De Pauw, R., and Coppieters, I.

Subjects
NEURAL transmission, WHIPLASH injuries, CHRONIC diseases, CONFERENCES & conventions, ELECTRIC stimulation, DISEASE complications
Abstract

Introduction: Whiplash injuries typically occur from a motor vehicle collision and lead to chronic whiplash associated disorders (CWAD) in 20-50% of cases. Changes in neurotransmission, metabolism and networks seem to play a role in the pathogenic mechanisms of CWAD. Methods: This case-control study (CWAD patients/healthy controls (HC):50/50), investigated ankle and wrist electrical pain thresholds (EPT) and the amplitude and latency of event-related potentials (ERPs) resulting from 20 electrical stimuli at the intensity of 1,4xEPT. Linear mixed effect models were applied to detect group differences in EPTs and ERP characteristics. Correlations between ERP characteristics, EPT, self-reported pain, disability, pain catastrophizing and symptoms of central sensitisation (CS) were investigated. Results: In CWAD patients, left wrist P3 latency (t = -2.283; p = 0.023) was prolonged, and their ankle EPT correlated with ankle P1 (ρs = 0.293; p = 0.044) and P3 amplitude (ρs = 0.306; p = 0.033), and left wrist P3 amplitude (ρs = 0.343; p = 0.017). Symptoms of CS correlated with right wrist P3 amplitude (ρs = 0.308; p = 0.030) and latency (ρs = -0.341; p = 0.015), and the worst pain during the week before the assessment correlated with left wrist P1 latency (ρs = 0.319; p = 0.029). Discussion: CWAD patients did not show signs of hypersensitivity, but their ERP characteristics seemed to be related to the intensity of the stimulus, self-reported symptoms of CS, and worst pain during the week before the assessment. Process evaluation: Self-reported disability had changed between time of inclusion and baseline assessment, resulting in the inclusion of 8 CWAD patients with low disability at baseline. [ABSTRACT FROM AUTHOR]

Published
2022
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48. Inheritance of loose smut (Ustilago tritici) resistance in two hexaploid wheat (Triticum aestivum) lines

Author

Knox, R. E., Fernandez, M. R., Bruleacute;-Babel, A.L., and De Pauw, R. M.

Abstract

The genetics of resistance in wheat (Triticum aestivum L.) to loose smut caused by Ustilago tritici (Pers.) Rostr. is not well understood. In this study the inheritance of loose smut resistance was studied in two androgenetically derived doubled haploid populations and two inbred random head-to-row populations. The loose smut resistant experimental wheat line HY377 was crossed with the loose smut susceptible line L8474-D1 and the resistant line SC8021V2. Androgenetically derived doubled haploid populations and F4-derived random inbred line populations were produced from each of the crosses HY377/L8474-D1 and HY377/SC8021V2. Lines derived from each cross were grown in the growth room and inoculated with individual and a mixture of races of loose smut. The segregation of resistance between HY377 and L8474-D1 to races T2, T10, T19, and T39 in both doubled haploid and random inbred line populations fit the expected ratio for a single major gene. The same populations inoculated to race T15 showed a different disease incidence phenotype. These results indicated at least one major gene and one minor gene segregating for resistance to race T15. Transgressive segregation for resistance to race T19 occurred in the progeny of the cross of HY377 and SC8021V2, indicating that these parents differed in genes for resistance to the race. Both the doubled haploid and random inbred line populations from the HY377/SC8021V2 cross showed the same pattern of segregation. The interpretations of inheritance drawn from random inbred line populations and doubled haploid populations were the same.

Published
1999
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