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1. Cost-effectiveness of general practitioner- versus surgeon-led colon cancer survivorship care: an economic evaluation alongside a randomised controlled trial

Author

Vos, Julien A. M., El Alili, Mohamed, Duineveld, Laura A. M., Wieldraaijer, Thijs, Wind, Jan, Sert, Edanur, Donkervoort, Sandra C., Govaert, Marc J. P. M., van Geloven, Nanette A. W., van de Ven, Anthony W. H., Heuff, Gijsbert, van Weert, Henk C. P. M., Bosmans, Judith E., and van Asselt, Kristel M.

Published
2024
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3. The Effectiveness of Phrase Skip-Gram in Primary Care NLP for the Prediction of Lung Cancer

Author

Luik, Torec T., Rios, Miguel, Abu-Hanna, Ameen, van Weert, Henk C. P. M., Schut, Martijn C., Goos, Gerhard, Founding Editor, Hartmanis, Juris, Founding Editor, Bertino, Elisa, Editorial Board Member, Gao, Wen, Editorial Board Member, Steffen, Bernhard, Editorial Board Member, Woeginger, Gerhard, Editorial Board Member, Yung, Moti, Editorial Board Member, Tucker, Allan, editor, Henriques Abreu, Pedro, editor, Cardoso, Jaime, editor, Pereira Rodrigues, Pedro, editor, and Riaño, David, editor

Published
2021
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10. Reasons for No Colonoscopy After an Unfavorable Screening Result in Dutch Colorectal Cancer Screening: A Nationwide Questionnaire

Author

Bertels, Lucinda S., van Asselt, Kristel M., van Weert, Henk C. P. M., Dekker, Evelien, Knottnerus, Bart J., General practice, ACS - Heart failure & arrhythmias, APH - Personalized Medicine, CCA - Cancer Treatment and Quality of Life, Amsterdam Gastroenterology Endocrinology Metabolism, APH - Quality of Care, APH - Health Behaviors & Chronic Diseases, and Gastroenterology and Hepatology

Subjects
mass screening, family, physicians, Colonoscopy, follow-up studies, physicians, family, counseling, Cross-Sectional Studies, Surveys and Questionnaires, Humans, Dutch, Colorectal Neoplasms, Family Practice, Early Detection of Cancer, Original Research
Abstract

PURPOSE: We aimed to assess participant-reported factors associated with non–follow-up with colonoscopy in colorectal cancer (CRC) screening. METHODS: In May 2019, we distributed a nationwide cross-sectional questionnaire (n = 4,009) to participants in the Dutch CRC screening program who received a positive fecal immunochemical test (FIT). Among respondents who reported no colonoscopy, we assessed the presence of a contraindication, and those without were compared with those who reported colonoscopy by logistic regression analysis. RESULTS: Of 2,225 respondents (56% response rate), 730 (33%) reported no colonoscopy. A contraindication was reported by 55% (n = 404). Decisional difficulties (odds ratio [OR] = 0.29; 95% CI, 0.18-0.47), lacking the opportunity to discuss the FIT outcome (OR = 0.45; 95% CI, 0.28-0.72), and a low estimated risk of CRC (OR = 0.45; 95% CI, 0.26-0.76) were negatively associated with follow-up. Knowledge items negatively associated with follow-up included having an alternative explanation for the positive FIT (OR = 0.3; 95% CI, 0.21-0.43), having trust in the ability to self-detect CRC (OR = 0.42; 95% CI, 0.27-0.65), and thinking that polyp removal is ineffective (OR = 0.59; 95% CI, 0.43-0.82). The belief that the family physician would support colonoscopy showed the strongest positive association with follow-up (OR = 2.84; 95% CI, 2.01-4.02) CONCLUSIONS: Because decisional difficulties and certain convictions regarding CRC and screening are associated with non–follow-up, personalized screening counseling might be an intervention worth exploring as a means of improving follow-up in the Dutch CRC screening program. Involving family physicians might also prove beneficial.

Published
2022
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13. Detection of colon cancer recurrences during follow-up care by general practitioners versus surgeons

Author

Vos, Julien A. M., Sert, Eda, Busschers, Wim B., Duineveld, Laura A. M., Wieldraaijer, Thijs, Wind, Jan, Donkervoort, Sandra C., Govaert, Marc, Beverdam, Frédérique H., Smits, Anke, Bemelman, Wilhelmus A., Heuff, Gijsbert, van Weert, Henk C. P. M., van Asselt, Kristel M., General practice, Graduate School, APH - Personalized Medicine, CCA - Cancer Treatment and Quality of Life, APH - Methodology, Amsterdam Gastroenterology Endocrinology Metabolism, Surgery, APH - Quality of Care, ACS - Heart failure & arrhythmias, CCA - Imaging and biomarkers, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
Cancer Research, Oncology
Abstract

Background In the I CARE study, colon cancer patients were randomly assigned to receive follow-up care from either a general practitioner (GP) or a surgeon. Here, we address a secondary outcome, namely, detection of recurrences and effect on time to detection of transferring care from surgeon to GP. Methods Pattern, stage, and treatment of recurrences were described after 3 years. Time to event was defined as date of surgery, until date of recurrence or last follow-up, with death as competing event. Effects on time to recurrence and death were estimated as hazard ratios (HRs) using Cox regression. Restricted mean survival times were estimated. Results Of 303 patients, 141 were randomly assigned to the GP and 162 to the surgeon. Patients were male (67%) with a mean age of 68.0 (8.4) years. During follow-up, 46 recurrences were detected; 18 (13%) in the GP vs 28 (17%) in the surgeon group. Most recurrences were detected via abnormal follow-up tests (74%) and treated with curative intent (59%). Hazard ratio for recurrence was 0.75 (95% confidence interval [CI] = 0.41 to 1.36) in GP vs surgeon group. Patients in the GP group remained in the disease-free state slightly longer (2.76 vs 2.71 years). Of the patients, 38 died during follow-up; 15 (11%) in the GP vs 23 (14%) in the surgeon group. Of these, 21 (55%) deaths were related to colon cancer. There were no differences in overall deaths between the groups (HR = 0.76, 95% CI = 0.39 to 1.46). Conclusion Follow-up provided by GPs vs surgeons leads to similar detection of recurrences. Also, no differences in mortality were found.

Published
2023

16. Early detection of colorectal cancer by leveraging Dutch primary care consultation notes with free text embeddings.

Author

Luik, Torec T., Abu-Hanna, Ameen, van Weert, Henk C. P. M., and Schut, Martijn C.

Subjects
EARLY detection of cancer, PRIMARY care, MEDICAL specialties & specialists, COLORECTAL cancer, PREDICTION models, MEDICAL record databases
Abstract

We aimed to assess the added predictive performance that free-text Dutch consultation notes provide in detecting colorectal cancer in primary care, in comparison to currently used models. We developed, evaluated and compared three prediction models for colorectal cancer (CRC) in a large primary care database with 60,641 patients. The prediction model with both known predictive features and free-text data (with TabTxt AUROC: 0.823) performs statistically significantly better (p < 0.05) than the other two models with only tabular (as used nowadays) and text data, respectively (AUROC Tab: 0.767; Txt: 0.797). The specificity of the two models that use demographics and known CRC features (with specificity Tab: 0.321; TabTxt: 0.335) are higher than that of the model with only free-text (specificity Txt: 0.234). The Txt and, to a lesser degree, TabTxt model are well calibrated, while the Tab model shows slight underprediction at both tails. As expected with an outcome prevalence below 0.01, all models show much uncalibrated predictions in the extreme upper tail (top 1%). Free-text consultation notes show promising results to improve the predictive performance over established prediction models that only use structured features. Clinical future implications for our CRC use case include that such improvement may help lowering the number of referrals for suspected CRC to medical specialists. [ABSTRACT FROM AUTHOR]

Published
2023
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20. Detection of atrial fibrillation in primary care with radial pulse palpation, electronic blood pressure measurement and handheld single-lead electrocardiography: a diagnostic accuracy study

Author

Verbiest-van Gurp, Nicole, primary, Uittenbogaart, Steven B, additional, Lucassen, Wim A M, additional, Erkens, Petra M G, additional, Knottnerus, J André, additional, Winkens, Bjorn, additional, Stoffers, Henri E J H, additional, and van Weert, Henk C P M, additional

Published
2022
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27. Delivering colon cancer survivorship care in primary care; a qualitative study on the experiences of general practitioners

Author

Vos, Julien A. M., de Best, Robin, Duineveld, Laura A. M., van Weert, Henk C. P. M., van Asselt, Kristel M., General practice, Graduate School, APH - Personalized Medicine, APH - Quality of Care, CCA - Cancer Treatment and Quality of Life, ACS - Heart failure & arrhythmias, and APH - Health Behaviors & Chronic Diseases

Subjects
Colon Cancer, Primary Health Care, Colon, education, Survivorship, Cancer survivorship care, Normalisation process theory, Cancer Survivors, General Practitioners, Qualitative research, Neoplasms, Humans, Research Article, Implementation sciences
Abstract

Background With more patients in need of oncological care, there is a growing interest to transfer survivorship care from specialist to general practitioner (GP). The ongoing I CARE study was initiated in 2015 in the Netherlands to compare (usual) surgeon- to GP-led survivorship care, with or without access to a supporting eHealth application (Oncokompas). Methods Semi-structured interviews were held at two separate points in time (i.e. after 1- and 5-years of care) to explore GPs’ experiences with delivering this survivorship care intervention, and study its implementation into daily practice. Purposive sampling was used to recruit 17 GPs. Normalisation Process Theory (NPT) was used as a conceptual framework. Results Overall, delivering survivorship care was not deemed difficult and dealing with cancer repercussions was already considered part of a GPs’ work. Though GPs readily identified advantages for patients, caregivers and society, differences were seen in GPs’ commitment to the intervention and whether it felt right for them to be involved. Patients’ initiative with respect to planning, absence of symptoms and regular check-ups due to other chronic care were considered to facilitate the delivery of care. Prominent barriers included GPs’ lack of experience and routine, but also lack of clarity regarding roles and responsibilities for organising care. Need for a monitoring system was often mentioned to reduce the risk of non-compliance. GPs were reticent about a possible future transfer of survivorship care towards primary care due to increases in workload and financial constraints. GPs were not aware of their patients’ use of eHealth. Conclusions GPs’ opinions and beliefs about a possible future role in colon cancer survivorship care vary. Though GPs recognize potential benefit, there is no consensus about transferring survivorship care to primary care on a permanent basis. Barriers and facilitators to implementation highlight the importance of both personal and system level factors. Conditions are put forth relating to time, reorganisation of infrastructure, extra personnel and financial compensation. Trial registration Netherlands Trial Register; NTR4860. Registered on the 2nd of October 2014.

Published
2021

31. Discovery of predictors of sudden cardiac arrest in diabetes: rationale and outline of the RESCUED (REcognition of Sudden Cardiac arrest vUlnErability in Diabetes) project

Author

van Dongen, Laura H, primary, Harms, Peter P, additional, Hoogendoorn, Mark, additional, Zimmerman, Dominic S, additional, Lodder, Elisabeth M, additional, 't Hart, Leen M, additional, Herings, Ron, additional, van Weert, Henk C P M, additional, Nijpels, Giel, additional, Swart, Karin M A, additional, van der Heijden, Amber A, additional, Blom, Marieke T, additional, Elders, Petra J, additional, and Tan, Hanno L, additional

Published
2021
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34. Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression : individual participant data meta-analysis

Author

Akena, Dickens, Arroll, Bruce, Ayalon, Liat, Azar, Marleine, Baradaran, Hamid R, Baron, Murray, Benedetti, Andrea, Bombardier, Charles H, Boruff, Jill, Butterworth, Peter, Carter, Gregory, Chagas, Marcos H, Chan, Juliana C N, Chiovitti, Matthew J, Clover, Kerrie, Conwell, Yeates, Cuijpers, Pim, de Man-van Ginkel, Janneke M, Delgadillo, Jaime, Fann, Jesse R, Fischer, Felix H, Fung, Daniel, Gelaye, Bizu, Gilbody, Simon, Goodyear-Smith, Felicity, Greeno, Catherine G, Hall, Brian J, Hambridge, John, Harrison, Patricia A, Härter, Martin, Hegerl, Ulrich, Hides, Leanne, Hobfoll, Stevan E, Hudson, Marie, Inagaki, Masatoshi, Ioannidis, John P.A., Ismail, Khalida, Jetté, Nathalie, Khamseh, Mohammad E, Kiely, Kim M, Kloda, Lorie A, Kwan, Yunxin, Levis, Alexander W, Levis, Brooke, Liu, Shen-Ing, Lotrakul, Manote, Loureiro, Sonia R, Löwe, Bernd, Marsh, Laura, McGuire, Anthony, McMillan, Dean, Mohd Sidik, Sherina, Munhoz, Tiago N, Muramatsu, Kumiko, Osório, Flávia L, Patel, Vikram, Patten, Scott B, Pence, Brian W, Persoons, Philippe, Picardi, Angelo, Rice, Danielle B, Riehm, Kira E, Reuter, Katrin, Rooney, Alasdair G, Saadat, Nazanin, Sanchez, Tatiana A, Santos, Iná S, Shaaban, Juwita, Sidebottom, Abbey, Simning, Adam, Shrier, Ian, Stafford, Lesley, Sung, Sharon C, Tan, Pei Lin Lynnette, Thombs, Brett D, Turner, Alyna, Van Der Feltz-Cornelis, Christina Maria, van Weert, Henk C P M, Vöhringer, Paul A, White, Jennifer, Whooley, Mary A, Winkley, Kirsty, Yamada, Mitsuhiko, Ziegelstein, Roy C, and Zhang, Yuying

Abstract

OBJECTIVE: To determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression. DESIGN: Individual participant data meta-analysis. DATA SOURCES: Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, and Web of Science (January 2000-February 2015). INCLUSION CRITERIA: Eligible studies compared PHQ-9 scores with major depression diagnoses from validated diagnostic interviews. Primary study data and study level data extracted from primary reports were synthesized. For PHQ-9 cut-off scores 5-15, bivariate random effects meta-analysis was used to estimate pooled sensitivity and specificity, separately, among studies that used semistructured diagnostic interviews, which are designed for administration by clinicians; fully structured interviews, which are designed for lay administration; and the Mini International Neuropsychiatric (MINI) diagnostic interviews, a brief fully structured interview. Sensitivity and specificity were examined among participant subgroups and, separately, using meta-regression, considering all subgroup variables in a single model. RESULTS: Data were obtained for 58 of 72 eligible studies (total n=17 357; major depression cases n=2312). Combined sensitivity and specificity was maximized at a cut-off score of 10 or above among studies using a semistructured interview (29 studies, 6725 participants; sensitivity 0.88, 95% confidence interval 0.83 to 0.92; specificity 0.85, 0.82 to 0.88). Across cut-off scores 5-15, sensitivity with semistructured interviews was 5-22% higher than for fully structured interviews (MINI excluded; 14 studies, 7680 participants) and 2-15% higher than for the MINI (15 studies, 2952 participants). Specificity was similar across diagnostic interviews. The PHQ-9 seems to be similarly sensitive but may be less specific for younger patients than for older patients; a cut-off score of 10 or above can be used regardless of age.. CONCLUSIONS: PHQ-9 sensitivity compared with semistructured diagnostic interviews was greater than in previous conventional meta-analyses that combined reference standards. A cut-off score of 10 or above maximized combined sensitivity and specificity overall and for subgroups. REGISTRATION: PROSPERO CRD42014010673.

Published
2019

35. The Accuracy of the Patient Health Questionnaire-9 Algorithm for Screening to Detect Major Depression : An Individual Participant Data Meta-Analysis

Author

He, Chen, Levis, Brooke, Riehm, Kira E, Saadat, Nazanin, Levis, Alexander W, Azar, Marleine, Rice, Danielle B, Krishnan, Ankur, Wu, Yin, Sun, Ying, Imran, Mahrukh, Boruff, Jill, Cuijpers, Pim, Gilbody, Simon, Ioannidis, John P A, Kloda, Lorie A, McMillan, Dean, Patten, Scott B, Shrier, Ian, Ziegelstein, Roy C, Akena, Dickens H, Arroll, Bruce, Ayalon, Liat, Baradaran, Hamid R, Baron, Murray, Beraldi, Anna, Bombardier, Charles H, Butterworth, Peter, Carter, Gregory, Chagas, Marcos Hortes Nisihara, Chan, Juliana C N, Cholera, Rushina, Clover, Kerrie, Conwell, Yeates, de Man-van Ginkel, Janneke M, Fann, Jesse R, Fischer, Felix H, Fung, Daniel, Gelaye, Bizu, Goodyear-Smith, Felicity, Greeno, Catherine G, Hall, Brian J, Harrison, Patricia A, Härter, Martin, Hegerl, Ulrich, Hides, Leanne, Hobfoll, Stevan E, Hudson, Marie, Hyphantis, Thomas N, Inagaki, Masatoshi, Ismail, Khalida, Jetté, Nathalie, Khamseh, Mohammad E, Kiely, Kim M, Kwan, Yunxin, Lamers, Femke, Liu, Shen-Ing, Lotrakul, Manote, Loureiro, Sonia R, Löwe, Bernd, Marsh, Laura, McGuire, Anthony, Mohd-Sidik, Sherina, Munhoz, Tiago N, Muramatsu, Kumiko, Osório, Flávia L, Patel, Vikram, Pence, Brian W, Persoons, Philippe, Picardi, Angelo, Reuter, Katrin, Rooney, Alasdair G, da Silva Dos Santos, Iná S, Shaaban, Juwita, Sidebottom, Abbey, Simning, Adam, Stafford, Lesley, Sung, Sharon, Tan, Pei Lin Lynnette, Turner, Alyna, van Weert, Henk C P M, White, Jennifer, Whooley, Mary A, Winkley, Kirsty, Yamada, Mitsuhiko, Thombs, Brett D, Benedetti, Andrea, He, Chen, Levis, Brooke, Riehm, Kira E, Saadat, Nazanin, Levis, Alexander W, Azar, Marleine, Rice, Danielle B, Krishnan, Ankur, Wu, Yin, Sun, Ying, Imran, Mahrukh, Boruff, Jill, Cuijpers, Pim, Gilbody, Simon, Ioannidis, John P A, Kloda, Lorie A, McMillan, Dean, Patten, Scott B, Shrier, Ian, Ziegelstein, Roy C, Akena, Dickens H, Arroll, Bruce, Ayalon, Liat, Baradaran, Hamid R, Baron, Murray, Beraldi, Anna, Bombardier, Charles H, Butterworth, Peter, Carter, Gregory, Chagas, Marcos Hortes Nisihara, Chan, Juliana C N, Cholera, Rushina, Clover, Kerrie, Conwell, Yeates, de Man-van Ginkel, Janneke M, Fann, Jesse R, Fischer, Felix H, Fung, Daniel, Gelaye, Bizu, Goodyear-Smith, Felicity, Greeno, Catherine G, Hall, Brian J, Harrison, Patricia A, Härter, Martin, Hegerl, Ulrich, Hides, Leanne, Hobfoll, Stevan E, Hudson, Marie, Hyphantis, Thomas N, Inagaki, Masatoshi, Ismail, Khalida, Jetté, Nathalie, Khamseh, Mohammad E, Kiely, Kim M, Kwan, Yunxin, Lamers, Femke, Liu, Shen-Ing, Lotrakul, Manote, Loureiro, Sonia R, Löwe, Bernd, Marsh, Laura, McGuire, Anthony, Mohd-Sidik, Sherina, Munhoz, Tiago N, Muramatsu, Kumiko, Osório, Flávia L, Patel, Vikram, Pence, Brian W, Persoons, Philippe, Picardi, Angelo, Reuter, Katrin, Rooney, Alasdair G, da Silva Dos Santos, Iná S, Shaaban, Juwita, Sidebottom, Abbey, Simning, Adam, Stafford, Lesley, Sung, Sharon, Tan, Pei Lin Lynnette, Turner, Alyna, van Weert, Henk C P M, White, Jennifer, Whooley, Mary A, Winkley, Kirsty, Yamada, Mitsuhiko, Thombs, Brett D, and Benedetti, Andrea

Published
2020

36. The Accuracy of the Patient Health Questionnaire-9 Algorithm for Screening to Detect Major Depression: An Individual Participant Data Meta-Analysis

Author

Verplegingswetenschap, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Brain, He, Chen, Levis, Brooke, Riehm, Kira E, Saadat, Nazanin, Levis, Alexander W, Azar, Marleine, Rice, Danielle B, Krishnan, Ankur, Wu, Yin, Sun, Ying, Imran, Mahrukh, Boruff, Jill, Cuijpers, Pim, Gilbody, Simon, Ioannidis, John P A, Kloda, Lorie A, McMillan, Dean, Patten, Scott B, Shrier, Ian, Ziegelstein, Roy C, Akena, Dickens H, Arroll, Bruce, Ayalon, Liat, Baradaran, Hamid R, Baron, Murray, Beraldi, Anna, Bombardier, Charles H, Butterworth, Peter, Carter, Gregory, Chagas, Marcos Hortes Nisihara, Chan, Juliana C N, Cholera, Rushina, Clover, Kerrie, Conwell, Yeates, de Man-van Ginkel, Janneke M, Fann, Jesse R, Fischer, Felix H, Fung, Daniel, Gelaye, Bizu, Goodyear-Smith, Felicity, Greeno, Catherine G, Hall, Brian J, Harrison, Patricia A, Härter, Martin, Hegerl, Ulrich, Hides, Leanne, Hobfoll, Stevan E, Hudson, Marie, Hyphantis, Thomas N, Inagaki, Masatoshi, Ismail, Khalida, Jetté, Nathalie, Khamseh, Mohammad E, Kiely, Kim M, Kwan, Yunxin, Lamers, Femke, Liu, Shen-Ing, Lotrakul, Manote, Loureiro, Sonia R, Löwe, Bernd, Marsh, Laura, McGuire, Anthony, Mohd-Sidik, Sherina, Munhoz, Tiago N, Muramatsu, Kumiko, Osório, Flávia L, Patel, Vikram, Pence, Brian W, Persoons, Philippe, Picardi, Angelo, Reuter, Katrin, Rooney, Alasdair G, da Silva Dos Santos, Iná S, Shaaban, Juwita, Sidebottom, Abbey, Simning, Adam, Stafford, Lesley, Sung, Sharon, Tan, Pei Lin Lynnette, Turner, Alyna, van Weert, Henk C P M, White, Jennifer, Whooley, Mary A, Winkley, Kirsty, Yamada, Mitsuhiko, Thombs, Brett D, Benedetti, Andrea, Verplegingswetenschap, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Brain, He, Chen, Levis, Brooke, Riehm, Kira E, Saadat, Nazanin, Levis, Alexander W, Azar, Marleine, Rice, Danielle B, Krishnan, Ankur, Wu, Yin, Sun, Ying, Imran, Mahrukh, Boruff, Jill, Cuijpers, Pim, Gilbody, Simon, Ioannidis, John P A, Kloda, Lorie A, McMillan, Dean, Patten, Scott B, Shrier, Ian, Ziegelstein, Roy C, Akena, Dickens H, Arroll, Bruce, Ayalon, Liat, Baradaran, Hamid R, Baron, Murray, Beraldi, Anna, Bombardier, Charles H, Butterworth, Peter, Carter, Gregory, Chagas, Marcos Hortes Nisihara, Chan, Juliana C N, Cholera, Rushina, Clover, Kerrie, Conwell, Yeates, de Man-van Ginkel, Janneke M, Fann, Jesse R, Fischer, Felix H, Fung, Daniel, Gelaye, Bizu, Goodyear-Smith, Felicity, Greeno, Catherine G, Hall, Brian J, Harrison, Patricia A, Härter, Martin, Hegerl, Ulrich, Hides, Leanne, Hobfoll, Stevan E, Hudson, Marie, Hyphantis, Thomas N, Inagaki, Masatoshi, Ismail, Khalida, Jetté, Nathalie, Khamseh, Mohammad E, Kiely, Kim M, Kwan, Yunxin, Lamers, Femke, Liu, Shen-Ing, Lotrakul, Manote, Loureiro, Sonia R, Löwe, Bernd, Marsh, Laura, McGuire, Anthony, Mohd-Sidik, Sherina, Munhoz, Tiago N, Muramatsu, Kumiko, Osório, Flávia L, Patel, Vikram, Pence, Brian W, Persoons, Philippe, Picardi, Angelo, Reuter, Katrin, Rooney, Alasdair G, da Silva Dos Santos, Iná S, Shaaban, Juwita, Sidebottom, Abbey, Simning, Adam, Stafford, Lesley, Sung, Sharon, Tan, Pei Lin Lynnette, Turner, Alyna, van Weert, Henk C P M, White, Jennifer, Whooley, Mary A, Winkley, Kirsty, Yamada, Mitsuhiko, Thombs, Brett D, and Benedetti, Andrea

Published
2020

38. Experiences with screening for atrial fibrillation: a qualitative study in general practice.

Author

Uittenbogaart, Steven B., Becker, Stéphanie J. E., Hoogsteyns, Maartje, van Weert, Henk C. P. M., and Lucassen, Wim A. M.

Subjects
ATRIAL fibrillation diagnosis, GENERAL practitioners, WORK, ATTITUDES of medical personnel, RESEARCH methodology, MEDICAL screening, INTERVIEWING, PRIMARY health care, QUALITATIVE research, EXPERIENTIAL learning, PSYCHOSOCIAL factors, MEDICAL assistants, NURSE practitioners
Abstract

Background: Guidelines recommend screening for atrial fibrillation (AF). Currently, screening is not considered standard care among GPs. Aim: To explore the experiences of primary care workers with different methods of screening for AF and with implementation in daily practice. Design & setting: A qualitative study using semi-structured interviews with GPs, nurses, and healthcare assistants (HCAs) who were experienced with implementing different methods of screening. Method: Two independent researchers audio-recorded and analysed interviews using a thematic approach. They asked participants about their experiences with the different methods used for screening AF and which obstacles they faced when implementing screening in daily practice. Results: In total 15 GPs, nurse practitioners, and HCAs from seven different practices were interviewed. The GP's office is suited for screening for AF, which ideally should be integrated with standard care. Participants considered pulse palpation, automated sphygmomanometer with AF detection, and single-lead electrocardiography (ECG) as practical tests. Participants trusted pulse palpation over the algorithm of the devices. The follow-up of a positive test with a time-consuming 12-lead ECG hindered integration of screening. The single-lead ECG device reduced the need for immediate follow-up because it can record a rhythm strip. The extra workload of screening and lack of financial coverage form obstacles for implementation. Conclusion: Pulse palpation, automated blood pressure measure monitors with AF detection, and single-lead ECGs might facilitate screening in a general practice setting. When implementing screening, focus should be on how to avoid disruption of consultation hours by unplanned 12-lead ECGs. [ABSTRACT FROM AUTHOR]

Published
2022
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44. Evaluation of general practitioners' single-lead electrocardiogram interpretation skills: a case-vignette study.

Author

Karregat, Evert P M, Himmelreich, Jelle C L, Lucassen, Wim A M, Busschers, Wim B, Weert, Henk C P M van, Harskamp, Ralf E, and van Weert, Henk C P M

Subjects
GENERAL practitioners, ARRHYTHMIA, ATRIAL fibrillation, ELECTROCARDIOGRAPHY, ATRIAL flutter, ATRIAL fibrillation diagnosis, RESEARCH, RESEARCH evaluation, RESEARCH methodology, MEDICAL cooperation, EVALUATION research, COMPARATIVE studies
Abstract

Background: Handheld single-lead electrocardiograms (1L-ECG) present a welcome addition to the diagnostic arsenal of general practitioners (GPs). However, little is known about GPs' 1L-ECG interpretation skills, and thus its reliability in real-world practice.Objective: To determine the diagnostic accuracy of GPs in diagnosing atrial fibrillation or flutter (AF/Afl) based on 1L-ECGs, with and without the aid of automatic algorithm interpretation, as well as other relevant ECG abnormalities.Methods: We invited 2239 Dutch GPs for an online case-vignette study. GPs were asked to interpret four 1L-ECGs, randomly drawn from a pool of 80 case-vignettes. These vignettes were obtained from a primary care study that used smartphone-operated 1L-ECG recordings using the AliveCor KardiaMobile. Interpretation of all 1L-ECGs by a panel of cardiologists was used as reference standard.Results: A total of 457 (20.4%) GPs responded and interpreted a total of 1613 1L-ECGs. Sensitivity and specificity for AF/Afl (prevalence 13%) were 92.5% (95% CI: 82.5-97.0%) and 89.8% (95% CI: 85.5-92.9%), respectively. PPV and NPV for AF/Afl were 45.7% (95% CI: 22.4-70.9%) and 98.8% (95% CI: 97.1-99.5%), respectively. GP interpretation skills did not improve in case-vignettes where the outcome of automatic AF-detection algorithm was provided. In detecting any relevant ECG abnormality (prevalence 22%), sensitivity, specificity, PPV and NPV were 96.3% (95% CI: 92.8-98.2%), 68.8% (95% CI: 62.4-74.6%), 43.9% (95% CI: 27.7-61.5%) and 97.9% (95% CI: 94.9-99.1%), respectively.Conclusions: GPs can safely rule out cardiac arrhythmias with 1L-ECGs. However, whenever an abnormality is suspected, confirmation by an expert-reader is warranted. [ABSTRACT FROM AUTHOR]

Published
2021
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49. Methods for Evaluating Medical Tests and Biomarkers

Author

Gopalakrishna, Gowri, Langendam, Miranda, Scholten, Rob, Bossuyt, Patrick, Leeflang, Mariska, Noel-Storr, Anna, Thomas, James, Marshall, Iain, Wallace, Byron, Whiting, Penny, Davenport, Clare, GopalaKrishna, Gowri, de Salis, Isabel, Mallett, Sue, Wolff, Robert, Riley, Richard, Westwood, Marie, Kleinen, Jos, Collins, Gary, Reitsma, Hans, Moons, Karel, Zapf, Antonia, Hoyer, Annika, Kramer, Katharina, Kuss, Oliver, Ensor, J., Deeks, J. J., Martin, E. C., Riley, R. D., Rücker, Gerta, Steinhauser, Susanne, Schumacher, Martin, Ensor, Joie, Snell, Kym, Willis, Brian, Debray, Thomas, Deeks, Jon, di Ruffano, Lavinia Ferrante, Taylor-Phillips, Sian, Hyde, Chris, Taylor, Stuart A., Batnagar, Gauraang, Di Ruffano, Lavinia Ferrante, Seedat, Farah, Clarke, Aileen, Byron, Sarah, Nixon, Frances, Albrow, Rebecca, Walker, Thomas, Deakin, Carla, Zhelev, Zhivko, Hunt, Harriet, Yang, Yaling, Abel, Lucy, Buchanan, James, Fanshawe, Thomas, Shinkins, Bethany, Wynants, Laure, Verbakel, Jan, Van Huffel, Sabine, Timmerman, Dirk, Van Calster, Ben, Zwinderman, Aeliko, Oke, Jason, O’Sullivan, Jack, Perera, Rafael, Nicholson, Brian, Bromley, Hannah L., Roberts, Tracy E., Francis, Adele, Petrie, Denniis, Mann, G. Bruce, Malottki, Kinga, Smith, Holly, Billingham, Lucinda, Sitch, Alice, Gerke, Oke, Holm-Vilstrup, Mie, Segtnan, Eivind Antonsen, Halekoh, Ulrich, Høilund-Carlsen, Poul Flemming, Francq, Bernard G., Dinnes, Jac, Parkes, Julie, Gregory, Walter, Hewison, Jenny, Altman, Doug, Rosenberg, William, Selby, Peter, Asselineau, Julien, Perez, Paul, Paye, Aïssatou, Bessede, Emilie, Proust-Lima, Cécile, Naaktgeboren, Christiana, de Groot, Joris, Rutjes, Anne, Reitsma, Johannes, Ogundimu, Emmanuel, Cook, Jonathan, Le Manach, Yannick, Vergouwe, Yvonne, Pajouheshnia, Romin, Groenwold, Rolf, Moons, Karen, Peelen, Linda, Nieboer, Daan, De Cock, Bavo, Pencina, Micael J., Steyerberg, Ewout W., Cooper, Jennifer, Parsons, Nick, Stinton, Chris, Smith, Steve, Dickens, Andy, Jordan, Rachel, Enocson, Alexandra, Fitzmaurice, David, Adab, Peymane, Boachie, Charles, Vidmar, Gaj, Freeman, Karoline, Connock, Martin, Court, Rachel, Moons, Carl, Harris, Jessica, Mumford, Andrew, Plummer, Zoe, Lee, Kurtis, Reeves, Barnaby, Rogers, Chris, Verheyden, Veerle, Angelini, Gianni D., Murphy, Gavin J., Huddy, Jeremy, Ni, Melody, Good, Katherine, Cooke, Graham, Hanna, George, Ma, Jie, Moons, K. G. M. (Carl), de Groot, Joris A. H., Altman, Doug G., Reitsma, Johannes B., Collins, Gary S., Moons, Karel G. M., Altman, Douglas G., Kamarudin, Adina Najwa, Kolamunnage-Dona, Ruwanthi, Cox, Trevor, Borsci, Simone, Pérez, Teresa, Pardo, M.Carmen, Candela-Toha, Angel, Muriel, Alfonso, Zamora, Javier, Sanghera, Sabina, Mohiuddin, Syed, Martin, Richard, Donovan, Jenny, Coast, Joanna, Seo, Mikyung Kelly, Cairns, John, Mitchell, Elizabeth, Smith, Alison, Wright, Judy, Hall, Peter, Messenger, Michael, Calder, Nicola, Wickramasekera, Nyantara, Vinall-Collier, Karen, Lewington, Andrew, Damen, Johanna, Cairns, David, Hutchinson, Michelle, Sturgeon, Cathie, Mitchel, Liz, Kift, Rebecca, Christakoudi, Sofia, Rungall, Manohursingh, Mobillo, Paula, Montero, Rosa, Tsui, Tjir-Li, Kon, Sui Phin, Tucker, Beatriz, Sacks, Steven, Farmer, Chris, Strom, Terry, Chowdhury, Paramit, Rebollo-Mesa, Irene, Hernandez-Fuentes, Maria, Damen, Johanna A. A. G., Debray, Thomas P. A., Heus, Pauline, Hooft, Lotty, Scholten, Rob J. P. M., Schuit, Ewoud, Tzoulaki, Ioanna, Lassale, Camille M., Siontis, George C. M., Chiocchia, Virginia, Roberts, Corran, Schlüssel, Michael Maia, Gerry, Stephen, Black, James A., van der Schouw, Yvonne T., Peelen, Linda M., Spence, Graeme, McCartney, David, van den Bruel, Ann, Lasserson, Daniel, Hayward, Gail, Vach, Werner, de Jong, Antoinette, Burggraaff, Coreline, Hoekstra, Otto, Zijlstra, Josée, de Vet, Henrica, Graziadio, Sara, Allen, Joy, Johnston, Louise, O’Leary, Rachel, Power, Michael, Johnson, Louise, Waters, Ray, Simpson, John, Fanshawe, Thomas R., Phillips, Peter, Plumb, Andrew, Helbren, Emma, Halligan, Steve, Gale, Alastair, Sekula, Peggy, Sauerbrei, Willi, Forman, Julia R., Dutton, Susan J., Takwoingi, Yemisi, Hensor, Elizabeth M., Nichols, Thomas E., Kempf, Emmanuelle, Porcher, Raphael, de Beyer, Jennifer, Altman, Douglas, Hopewell, Sally, Dennis, John, Shields, Beverley, Jones, Angus, Henley, William, Pearson, Ewan, Hattersley, Andrew, Scheibler, Fueloep, Rummer, Anne, Sturtz, Sibylle, Großelfinger, Robert, Banister, Katie, Ramsay, Craig, Azuara-Blanco, Augusto, Burr, Jennifer, Kumarasamy, Manjula, Bourne, Rupert, Uchegbu, Ijeoma, Murphy, Jennifer, Carter, Alex, Murphy, Jen, Marti, Joachim, Eatock, Julie, Robotham, Julie, Dudareva, Maria, Gilchrist, Mark, Holmes, Alison, Monaghan, Phillip, Lord, Sarah, StJohn, Andrew, Sandberg, Sverre, Cobbaert, Christa, Lennartz, Lieselotte, Verhagen-Kamerbeek, Wilma, Ebert, Christoph, Horvath, Andrea, Jenniskens, Kevin, Peters, Jaime, Grigore, Bogdan, Ukoumunne, Obi, Levis, Brooke, Benedetti, Andrea, Levis, Alexander W., Ioannidis, John P. A., Shrier, Ian, Cuijpers, Pim, Gilbody, Simon, Kloda, Lorie A., McMillan, Dean, Patten, Scott B, Steele, Russell J., Ziegelstein, Roy C, Bombardier, Charles H., Osório, Flavia de Lima, Fann, Jesse R., Gjerdingen, Dwenda, Lamers, Femke, Lotrakul, Manote, Loureiro, Sonia R, Löwe, Bernd, Shaaban, Juwita, Stafford, Lesley, van Weert, Henk C. P. M., Whooley, Mary A., Williams, Linda S., Wittkampf, Karin A., Yeung, Albert S., Thombs, Brett D., Cooper, Chris, Nieto, Tom, Smith, Claire, Tucker, Olga, Dretzke, Janine, Beggs, Andrew, Rai, Nirmala, Bayliss, Sue, Stevens, Simon, Mallet, Sue, Sundar, Sudha, Hall, Emma, Porta, Nuria, Estelles, David Lorente, and de Bono, Johann

Subjects
Faecal Immunochemical Test, Chronic Obstructive Pulmonary Disorder, Circulate Tumour Cell Count, Apply Health Research, Meeting Abstracts, Faecal Immunochemical Test Result
Abstract

unKnown

Published
2017

Catalog

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