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7. Haematology dimension reduction, a large scale application to regular care haematology data.

Author

Joosse, Huibert-Jan, Chumsaeng-Reijers, Chontira, Huisman, Albert, Hoefer, Imo E., van Solinge, Wouter W., Haitjema, Saskia, and van Es, Bram

Abstract

Background: The routine diagnostic process increasingly entails the processing of high-volume and high-dimensional data that cannot be directly visualised. This processing may provide scaling issues that limit the implementation of these types of data into research as well as integrated diagnostics in routine care. Here, we investigate whether we can use existing dimension reduction techniques to provide visualisations and analyses for a complete bloodcount (CBC) while maintaining representativeness of the original data. We considered over 3 million CBC measurements encompassing over 70 parameters of cell frequency, size and complexity from the UMC Utrecht UPOD database. We evaluated PCA as an example of a linear dimension reduction techniques and UMAP, TriMap and PaCMAP as non-linear dimension reduction techniques. We assessed their technical performance using quality metrics for dimension reduction as well as biological representation by evaluating preservation of diurnal, age and sex patterns, cluster preservation and the identification of leukemia patients. Results: We found that, for clinical hematology data, PCA performs systematically better than UMAP, TriMap and PaCMAP in representing the underlying data. Biological relevance was retained for periodicity in the data. However, we also observed a decrease in predictive performance of the reduced data for both age and sex, as well as an overestimation of clusters within the reduced data. Finally, we were able to identify the diverging patterns for leukemia patients after use of dimensionality reduction methods. Conclusions: We conclude that for hematology data, the use of unsupervised dimension reduction techniques should be limited to data visualization applications, as implementing them in diagnostic pipelines may lead to decreased quality of integrated diagnostics in routine care. [ABSTRACT FROM AUTHOR]

Published
2025
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14. The Effect of Artificial Intelligence on Patient-Physician Trust: Cross-Sectional Vignette Study

Author

Zondag, Anna G.M., Rozestraten, Raoul, Grimmelikhuijsen, Stephan G., Jongsma, Karin R., van Solinge, Wouter W., Bots, Michiel L., Vernooij, Robin W.M., Haitjema, Saskia, Zondag, Anna G.M., Rozestraten, Raoul, Grimmelikhuijsen, Stephan G., Jongsma, Karin R., van Solinge, Wouter W., Bots, Michiel L., Vernooij, Robin W.M., and Haitjema, Saskia

Abstract

BACKGROUND: Clinical decision support systems (CDSSs) based on routine care data, using artificial intelligence (AI), are increasingly being developed. Previous studies focused largely on the technical aspects of using AI, but the acceptability of these technologies by patients remains unclear. OBJECTIVE: We aimed to investigate whether patient-physician trust is affected when medical decision-making is supported by a CDSS. METHODS: We conducted a vignette study among the patient panel (N=860) of the University Medical Center Utrecht, the Netherlands. Patients were randomly assigned into 4 groups-either the intervention or control groups of the high-risk or low-risk cases. In both the high-risk and low-risk case groups, a physician made a treatment decision with (intervention groups) or without (control groups) the support of a CDSS. Using a questionnaire with a 7-point Likert scale, with 1 indicating "strongly disagree" and 7 indicating "strongly agree," we collected data on patient-physician trust in 3 dimensions: competence, integrity, and benevolence. We assessed differences in patient-physician trust between the control and intervention groups per case using Mann-Whitney U tests and potential effect modification by the participant's sex, age, education level, general trust in health care, and general trust in technology using multivariate analyses of (co)variance. RESULTS: In total, 398 patients participated. In the high-risk case, median perceived competence and integrity were lower in the intervention group compared to the control group but not statistically significant (5.8 vs 5.6; P=.16 and 6.3 vs 6.0; P=.06, respectively). However, the effect of a CDSS application on the perceived competence of the physician depended on the participant's sex (P=.03). Although no between-group differences were found in men, in women, the perception of the physician's competence and integrity was significantly lower in the intervention compared to the control group (P=.00

Published
2024

15. The Effect of Artificial Intelligence on Patient-Physician Trust: Cross-Sectional Vignette Study

Author

CDL Upod, Bioethics & Health Humanities, Child Health, Regenerative Medicine and Stem Cells, Centraal Diagnostisch Laboratorium, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Nefrologie, CDL Cluster Speciële Diagnostiek, Zondag, Anna G M, Rozestraten, Raoul, Grimmelikhuijsen, Stephan G, Jongsma, Karin R, van Solinge, Wouter W, Bots, Michiel L, Vernooij, Robin W M, Haitjema, Saskia, CDL Upod, Bioethics & Health Humanities, Child Health, Regenerative Medicine and Stem Cells, Centraal Diagnostisch Laboratorium, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Nefrologie, CDL Cluster Speciële Diagnostiek, Zondag, Anna G M, Rozestraten, Raoul, Grimmelikhuijsen, Stephan G, Jongsma, Karin R, van Solinge, Wouter W, Bots, Michiel L, Vernooij, Robin W M, and Haitjema, Saskia

Published
2024

16. Comparison of the Response to an Electronic Versus a Traditional Informed Consent Procedure in Terms of Clinical Patient Characteristics: Observational Study

Author

CDL Upod, Medical Humanities Onderzoek Team 1, Bioethics & Health Humanities, Child Health, Circulatory Health, JC onderzoeksprogramma Methodologie, Team Medisch, Centraal Diagnostisch Laboratorium, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Nefrologie, CDL Cluster Speciële Diagnostiek, Zondag, Anna G M, Hollestelle, Marieke J, van der Graaf, Rieke, Nathoe, Hendrik M, van Solinge, Wouter W, Bots, Michiel L, Vernooij, Robin W M, Haitjema, Saskia, UCC CVRM study group, CDL Upod, Medical Humanities Onderzoek Team 1, Bioethics & Health Humanities, Child Health, Circulatory Health, JC onderzoeksprogramma Methodologie, Team Medisch, Centraal Diagnostisch Laboratorium, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Nefrologie, CDL Cluster Speciële Diagnostiek, Zondag, Anna G M, Hollestelle, Marieke J, van der Graaf, Rieke, Nathoe, Hendrik M, van Solinge, Wouter W, Bots, Michiel L, Vernooij, Robin W M, Haitjema, Saskia, and UCC CVRM study group

Published
2024

17. Metabolic blood profile and response to treatment with the pyruvate kinase activator mitapivat in patients with sickle cell disease

Author

CDL Rode cel, Unit Opleiding Aios, Genetica Sectie Metabole Diagnostiek, Poli Van Creveldkliniek Medisch, Circulatory Health, CDL Research analisten, Haematologie patientenzorg, Child Health, Infection & Immunity, Centraal Diagnostisch Laboratorium, Brain, CDL Cluster Speciële Diagnostiek, van Dijk, Myrthe J, Ruiter, Titine J J, van der Veen, Sigrid, Rab, Minke A E, van Oirschot, Brigitte A, Bos, Jennifer, Derichs, Cleo, Rijneveld, Anita W, Cnossen, Marjon H, Nur, Erfan, Biemond, Bart J, Bartels, Marije, Schutgens, Roger E G, van Solinge, Wouter W, Jans, Judith J M, van Beers, Eduard J, van Wijk, Richard, CDL Rode cel, Unit Opleiding Aios, Genetica Sectie Metabole Diagnostiek, Poli Van Creveldkliniek Medisch, Circulatory Health, CDL Research analisten, Haematologie patientenzorg, Child Health, Infection & Immunity, Centraal Diagnostisch Laboratorium, Brain, CDL Cluster Speciële Diagnostiek, van Dijk, Myrthe J, Ruiter, Titine J J, van der Veen, Sigrid, Rab, Minke A E, van Oirschot, Brigitte A, Bos, Jennifer, Derichs, Cleo, Rijneveld, Anita W, Cnossen, Marjon H, Nur, Erfan, Biemond, Bart J, Bartels, Marije, Schutgens, Roger E G, van Solinge, Wouter W, Jans, Judith J M, van Beers, Eduard J, and van Wijk, Richard

Published
2024

18. Improving acute kidney injury alerts in tertiary care by linking primary care data: An observational cohort using routine care data

Author

CDL Arcadia, CDL Cluster Front office & ext. business, MS Nefrologie, CDL Upod, Other research (not in main researchprogram), Centraal Diagnostisch Laboratorium, Circulatory Health, CDL Cluster Speciële Diagnostiek, Joosse, Huibert-Jan, Groenestege, Wouter Tiel, Vernooij, Robin Wm, De Groot, Mark Ch, Hoefer, Imo E, van Solinge, Wouter W, Kok, Maarten B, Haitjema, Saskia, CDL Arcadia, CDL Cluster Front office & ext. business, MS Nefrologie, CDL Upod, Other research (not in main researchprogram), Centraal Diagnostisch Laboratorium, Circulatory Health, CDL Cluster Speciële Diagnostiek, Joosse, Huibert-Jan, Groenestege, Wouter Tiel, Vernooij, Robin Wm, De Groot, Mark Ch, Hoefer, Imo E, van Solinge, Wouter W, Kok, Maarten B, and Haitjema, Saskia

Published
2024

19. Metabolic blood profile and response to treatment with the pyruvate kinase activator mitapivat in patients with sickle cell disease

Author

van Dijk, Myrthe J., Ruiter, Titine J.J., van der Veen, Sigrid, Rab, Minke A.E., van Oirschot, Brigitte A., Bos, Jennifer, Derichs, Cleo, Rijneveld, Anita W., Cnossen, Marjon H., Nur, Erfan, Biemond, Bart J., Bartels, Marije, Schutgens, Roger E.G., van Solinge, Wouter W., Jans, Judith J.M., van Beers, Eduard J., van Wijk, Richard, van Dijk, Myrthe J., Ruiter, Titine J.J., van der Veen, Sigrid, Rab, Minke A.E., van Oirschot, Brigitte A., Bos, Jennifer, Derichs, Cleo, Rijneveld, Anita W., Cnossen, Marjon H., Nur, Erfan, Biemond, Bart J., Bartels, Marije, Schutgens, Roger E.G., van Solinge, Wouter W., Jans, Judith J.M., van Beers, Eduard J., and van Wijk, Richard

Abstract

Mitapivat is an investigational, oral, small-molecule allosteric activator of pyruvate kinase (PK). PK is a regulatory glycolytic enzyme that is key in providing the red blood cell (RBC) with sufficient amounts of adenosine triphosphate (ATP). In sickle cell disease (SCD), decreased 2,3-DPG levels increase the oxygen affinity of hemoglobin, thereby preventing deoxygenation and polymerization of sickle hemoglobin. The PK activator mitapivat has been shown to decrease levels of 2,3-DPG and increase levels of ATP in RBCs in patients with SCD. In this phase 2, investigator-initiated, open-label study (https://www.clinicaltrialsregister.eu/ NL8517; EudraCT 2019-003438-18), untargeted metabolomics was used to explore the overall metabolic effects of 8-week treatment with mitapivat in the dose-finding period. In total, 1773 unique metabolites were identified in dried blood spots of whole blood from ten patients with SCD and 42 healthy controls (HCs). The metabolic phenotype of patients with SCD revealed alterations in 139/1773 (7.8%) metabolites at baseline when compared to HCs (false discovery rate-adjusted p < 0.05), including increases of (derivatives of) polyamines, purines, and acyl carnitines. Eight-week treatment with mitapivat in nine patients with SCD altered 85/1773 (4.8%) of the total metabolites and 18/139 (12.9%) of the previously identified altered metabolites in SCD (unadjusted p < 0.05). Effects were observed on a broad spectrum of metabolites and were not limited to glycolytic intermediates. Our results show the relevance of metabolic profiling in SCD, not only to unravel potential pathophysiological pathways and biomarkers in multisystem diseases but also to determine the effect of treatment.

Published
2024

20. A novel composition of endogenous metabolic modulators improves red blood cell properties in sickle cell disease

Author

CDL Rode cel, Unit Opleiding Aios, Cancer, Genetica Sectie Metabole Diagnostiek, CDL Research analisten, Centraal Diagnostisch Laboratorium, Brain, Child Health, Poli Van Creveldkliniek Medisch, CDL Cluster Speciële Diagnostiek, Circulatory Health, van Dijk, Myrthe J, Traets, Marissa J M, van Oirschot, Brigitte A, Ruiter, Titine J J, de Wilde, Jonathan R A, Bos, Jennifer, van Solinge, Wouter W, Koziel, Margaret J, Jans, Judith J M, Wani, Revati, van Beers, Eduard J, van Wijk, Richard, Rab, Minke A E, CDL Rode cel, Unit Opleiding Aios, Cancer, Genetica Sectie Metabole Diagnostiek, CDL Research analisten, Centraal Diagnostisch Laboratorium, Brain, Child Health, Poli Van Creveldkliniek Medisch, CDL Cluster Speciële Diagnostiek, Circulatory Health, van Dijk, Myrthe J, Traets, Marissa J M, van Oirschot, Brigitte A, Ruiter, Titine J J, de Wilde, Jonathan R A, Bos, Jennifer, van Solinge, Wouter W, Koziel, Margaret J, Jans, Judith J M, Wani, Revati, van Beers, Eduard J, van Wijk, Richard, and Rab, Minke A E

Published
2024

23. Seasonal changes in gene expression represent cell-type composition in whole blood

Author

De Jong, Simone, Neeleman, Marjolein, Luykx, Jurjen J, Berg, Maarten J Ten, Strengman, Eric, Breeijen, Hanneke H Den, Stijvers, Leon C, Buizer-Voskamp, Jacobine E, Bakker, Steven C, Kahn, René S, Horvath, Steve, Van Solinge, Wouter W, and Ophoff, Roel A

Subjects
Genetics, Aetiology, 2.1 Biological and endogenous factors, Adult, Blood Proteins, Female, Humans, Longitudinal Studies, Male, Periodicity, Reticulocyte Count, Seasons, Transcriptome, Biological Sciences, Medical and Health Sciences, Genetics & Heredity
Abstract

Seasonal patterns in behavior and biological parameters are widespread. Here, we examined seasonal changes in whole blood gene expression profiles of 233 healthy subjects. Using weighted gene co-expression network analysis, we identified three co-expression modules showing circannual patterns. Enrichment analysis suggested that this signal stems primarily from red blood cells and blood platelets. Indeed, a large clinical database with 51 142 observations of blood cell counts over 3 years confirmed a corresponding seasonal pattern of counts of red blood cells, reticulocytes and platelets. We found no direct evidence that these changes are linked to genes known to be key players in regulating immune function or circadian rhythm. It is likely, however, that these seasonal changes in cell counts and gene expression profiles in whole blood represent biological and clinical relevant phenomena. Moreover, our findings highlight possible confounding factors relevant to the study of gene expression profiles in subjects collected at geographical locations with disparaging seasonality patterns.

Published
2014

27. Low-Density Lipoprotein Cholesterol Target Attainment in Patients With Established Cardiovascular Disease: Analysis of Routine Care Data

Author

Groenhof, T Katrien J, Kofink, Daniel, Bots, Michiel L, Nathoe, Hendrik M, Hoefer, Imo E, Van Solinge, Wouter W, Lely, A Titia, Asselbergs, Folkert W, and Haitjema, Saskia

Subjects
Computer applications to medicine. Medical informatics, R858-859.7
Abstract

BackgroundDirect feedback on quality of care is one of the key features of a learning health care system (LHS), enabling health care professionals to improve upon the routine clinical care of their patients during practice. ObjectiveThis study aimed to evaluate the potential of routine care data extracted from electronic health records (EHRs) in order to obtain reliable information on low-density lipoprotein cholesterol (LDL-c) management in cardiovascular disease (CVD) patients referred to a tertiary care center. MethodsWe extracted all LDL-c measurements from the EHRs of patients with a history of CVD referred to the University Medical Center Utrecht. We assessed LDL-c target attainment at the time of referral and per year. In patients with multiple measurements, we analyzed LDL-c trajectories, truncated at 6 follow-up measurements. Lastly, we performed a logistic regression analysis to investigate factors associated with improvement of LDL-c at the next measurement. ResultsBetween February 2003 and December 2017, 250,749 LDL-c measurements were taken from 95,795 patients, of whom 23,932 had a history of CVD. At the time of referral, 51% of patients had not reached their LDL-c target. A large proportion of patients (55%) had no follow-up LDL-c measurements. Most of the patients with repeated measurements showed no change in LDL-c levels over time: the transition probability to remain in the same category was up to 0.84. Sequence clustering analysis showed more women (odds ratio 1.18, 95% CI 1.07-1.10) in the cluster with both most measurements off target and the most LDL-c measurements furthest from the target. Timing of drug prescription was difficult to determine from our data, limiting the interpretation of results regarding medication management. ConclusionsRoutine care data can be used to provide feedback on quality of care, such as LDL-c target attainment. These routine care data show high off-target prevalence and little change in LDL-c over time. Registrations of diagnosis; follow-up trajectory, including primary and secondary care; and medication use need to be improved in order to enhance usability of the EHR system for adequate feedback.

Published
2020
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32. One-year safety and efficacy of mitapivat in sickle cell disease:follow-up results of a phase 2, open-label study

Author

van Dijk, Myrthe J., Rab, Minke A.E., van Oirschot, Brigitte A., Bos, Jennifer, Derichs, Cleo, Rijneveld, Anita W., Cnossen, Marjon H., Nur, Erfan, Biemond, Bart J., Bartels, Marije, Jans, Judith J.M., van Solinge, Wouter W., Schutgens, Roger E.G., van Wijk, Richard, van Beers, Eduard J., van Dijk, Myrthe J., Rab, Minke A.E., van Oirschot, Brigitte A., Bos, Jennifer, Derichs, Cleo, Rijneveld, Anita W., Cnossen, Marjon H., Nur, Erfan, Biemond, Bart J., Bartels, Marije, Jans, Judith J.M., van Solinge, Wouter W., Schutgens, Roger E.G., van Wijk, Richard, and van Beers, Eduard J.

Published
2023

33. A cluster of blood-based protein biomarkers associated with decreased cerebral blood flow relates to future cardiovascular events in patients with cardiovascular disease

Author

Overmars, L. Malin, Kuipers, Sanne, van Es, Bram, Bresser, Jeroen de, Bron, Esther E., Hoefer, Imo E., Van Solinge, Wouter W., Kappelle, L. Jaap, van Osch, Matthias J.P., Teunissen, Charlotte E., Biessels, Geert Jan, Haitjema, Saskia, Overmars, L. Malin, Kuipers, Sanne, van Es, Bram, Bresser, Jeroen de, Bron, Esther E., Hoefer, Imo E., Van Solinge, Wouter W., Kappelle, L. Jaap, van Osch, Matthias J.P., Teunissen, Charlotte E., Biessels, Geert Jan, and Haitjema, Saskia

Published
2023

34. Sexual dimorphism in peripheral blood cell characteristics linked to recanalization success of endovascular thrombectomy in acute ischemic stroke

Author

CDL Upod, Centraal Diagnostisch Laboratorium, Onderzoek Vrouw Hart & Vaatziekten, Circulatory Health, Neurologen, Brain, Stroke, CDL Cluster Speciële Diagnostiek, Overmars, L Malin, van Solinge, Wouter W, Ruijter, Hester M den, van der Worp, H Bart, Van Es, Bram, Hulsbergen-Veelken, Cornelia A R, Biessels, Geert Jan, Exalto, Lieza G, Haitjema, Saskia, CDL Upod, Centraal Diagnostisch Laboratorium, Onderzoek Vrouw Hart & Vaatziekten, Circulatory Health, Neurologen, Brain, Stroke, CDL Cluster Speciële Diagnostiek, Overmars, L Malin, van Solinge, Wouter W, Ruijter, Hester M den, van der Worp, H Bart, Van Es, Bram, Hulsbergen-Veelken, Cornelia A R, Biessels, Geert Jan, Exalto, Lieza G, and Haitjema, Saskia

Published
2023

35. Characteristics of peripheral blood cells are independently related to major adverse cardiovascular events after carotid endarterectomy

Author

CDL Upod, Zorgeenheid Vaatchirurgie Medisch, Centraal Diagnostisch Laboratorium, Experimental Cardiology Laboratory, Experimentele Afd. Cardiologie 2, Circulatory Health, Infection & Immunity, Regenerative Medicine and Stem Cells, CDL Onderzoek Pasterkamp, CDL Cluster Speciële Diagnostiek, Overmars, L. Malin, Mekke, Joost M., van Solinge, Wouter W., De Jager, Saskia C.A., Hulsbergen-Veelken, Cornelia A.R., Hoefer, Imo E., de Kleijn, Dominique P.V., de Borst, Gert J., van der Laan, Sander W., Haitjema, Saskia, CDL Upod, Zorgeenheid Vaatchirurgie Medisch, Centraal Diagnostisch Laboratorium, Experimental Cardiology Laboratory, Experimentele Afd. Cardiologie 2, Circulatory Health, Infection & Immunity, Regenerative Medicine and Stem Cells, CDL Onderzoek Pasterkamp, CDL Cluster Speciële Diagnostiek, Overmars, L. Malin, Mekke, Joost M., van Solinge, Wouter W., De Jager, Saskia C.A., Hulsbergen-Veelken, Cornelia A.R., Hoefer, Imo E., de Kleijn, Dominique P.V., de Borst, Gert J., van der Laan, Sander W., and Haitjema, Saskia

Published
2023

36. In-vitro and in-silico evidence for oxidative stress as drivers for RDW

Author

CDL Upod, CDL Rode cel, CDL Nanomedicine, Circulatory Health, Centraal Diagnostisch Laboratorium, CDL Cluster Speciële Diagnostiek, Child Health, CDL Cluster 24/7 centraal laboratorium, Other research (not in main researchprogram), Joosse, Huibert Jan, van Oirschot, Brigitte A., Kooijmans, Sander A.A., Hoefer, Imo E., van Wijk, Richard A.H., Huisman, Albert, van Solinge, Wouter W., Haitjema, Saskia, CDL Upod, CDL Rode cel, CDL Nanomedicine, Circulatory Health, Centraal Diagnostisch Laboratorium, CDL Cluster Speciële Diagnostiek, Child Health, CDL Cluster 24/7 centraal laboratorium, Other research (not in main researchprogram), Joosse, Huibert Jan, van Oirschot, Brigitte A., Kooijmans, Sander A.A., Hoefer, Imo E., van Wijk, Richard A.H., Huisman, Albert, van Solinge, Wouter W., and Haitjema, Saskia

Published
2023

37. Anemiediagnostiek in de eerste lijn: Reflextesten, reflecteren en algoritmes?

Author

CDL Cluster 24/7 centraal laboratorium, Other research (not in main researchprogram), Centraal Diagnostisch Laboratorium, Huisman, Albert, van Solinge, Wouter W, Cals, Jochen W L, CDL Cluster 24/7 centraal laboratorium, Other research (not in main researchprogram), Centraal Diagnostisch Laboratorium, Huisman, Albert, van Solinge, Wouter W, and Cals, Jochen W L

Published
2023

38. Acht misvattingen over AI in de zorg

Author

UMC Utrecht Academie, Medical Humanities Onderzoek Team 2, Child Health, JC onderzoeksprogramma Methodologie, Centraal Diagnostisch Laboratorium, CDL Cluster Speciële Diagnostiek, Circulatory Health, Jongsma, Karin R., van Solinge, Wouter W., Haitjema, Saskia, UMC Utrecht Academie, Medical Humanities Onderzoek Team 2, Child Health, JC onderzoeksprogramma Methodologie, Centraal Diagnostisch Laboratorium, CDL Cluster Speciële Diagnostiek, Circulatory Health, Jongsma, Karin R., van Solinge, Wouter W., and Haitjema, Saskia

Published
2023

39. Added diagnostic value of routinely measured hematology variables in diagnosing immune checkpoint inhibitor mediated toxicity in the emergency department

Author

CDL Upod, Medische Staf Spoedeisende Hulp, NVIC bedrijfsvoering, MS Medische Oncologie, Cancer, Infection & Immunity, Centraal Diagnostisch Laboratorium, CDL Cluster Front office & ext. business, CDL Cluster Speciële Diagnostiek, Circulatory Health, Niemantsverdriet, Michael S A, Vrijsen, Bram E L, Visser 't Hooft, Therese, Suijkerbuijk, Karijn P M, van Solinge, Wouter W, Ten Berg, Maarten J, Haitjema, Saskia, CDL Upod, Medische Staf Spoedeisende Hulp, NVIC bedrijfsvoering, MS Medische Oncologie, Cancer, Infection & Immunity, Centraal Diagnostisch Laboratorium, CDL Cluster Front office & ext. business, CDL Cluster Speciële Diagnostiek, Circulatory Health, Niemantsverdriet, Michael S A, Vrijsen, Bram E L, Visser 't Hooft, Therese, Suijkerbuijk, Karijn P M, van Solinge, Wouter W, Ten Berg, Maarten J, and Haitjema, Saskia

Published
2023

40. Design, validation and implementation of an automated e-alert for acute kidney injury: 6-month pilot study shows increased awareness

Author

CDL Upod, CDL Cluster Front office & ext. business, MS Nefrologie, Centraal Diagnostisch Laboratorium, Circulatory Health, Epi Infectieziekten, CDL Cluster Speciële Diagnostiek, Niemantsverdriet, Michael S A, Tiel Groenestege, Wouter M, Khairoun, M, Hoefer, Imo E, van Solinge, Wouter W, Bellomo, Domenico, van Vliet, Martin H, Kaasjager, Karin A H, Haitjema, Saskia, CDL Upod, CDL Cluster Front office & ext. business, MS Nefrologie, Centraal Diagnostisch Laboratorium, Circulatory Health, Epi Infectieziekten, CDL Cluster Speciële Diagnostiek, Niemantsverdriet, Michael S A, Tiel Groenestege, Wouter M, Khairoun, M, Hoefer, Imo E, van Solinge, Wouter W, Bellomo, Domenico, van Vliet, Martin H, Kaasjager, Karin A H, and Haitjema, Saskia

Published
2023

42. Comparison of the Response to an Electronic Versus a Traditional Informed Consent Procedure in Terms of Clinical Patient Characteristics: Observational Study.

Author

Zondag, Anna G M, Hollestelle, Marieke J, van der Graaf, Rieke, Nathoe, Hendrik M, van Solinge, Wouter W, Bots, Michiel L, Vernooij, Robin W M, and Haitjema, Saskia

Subjects
ELECTRONIC health records, GLYCOSYLATED hemoglobin, ACADEMIC medical centers, C-reactive protein, GENERAL practitioners
Abstract

Background: Electronic informed consent (eIC) is increasingly used in clinical research due to several benefits including increased enrollment and improved efficiency. Within a learning health care system, a pilot was conducted with an eIC for linking data from electronic health records with national registries, general practitioners, and other hospitals. Objective: We evaluated the eIC pilot by comparing the response to the eIC with the former traditional paper-based informed consent (IC). We assessed whether the use of eIC resulted in a different study population by comparing the clinical patient characteristics between the response categories of the eIC and former face-to-face IC procedure. Methods: All patients with increased cardiovascular risk visiting the University Medical Center Utrecht, the Netherlands, were eligible for the learning health care system. From November 2021 to August 2022, an eIC was piloted at the cardiology outpatient clinic. Prior to the pilot, a traditional face-to-face paper-based IC approach was used. Responses (ie, consent, no consent, or nonresponse) were assessed and compared between the eIC and face-to-face IC cohorts. Clinical characteristics of consenting and nonresponding patients were compared between and within the eIC and the face-to-face cohorts using multivariable regression analyses. Results: A total of 2254 patients were included in the face-to-face IC cohort and 885 patients in the eIC cohort. Full consent was more often obtained in the eIC than in the face-to-face cohort (415/885, 46.9% vs 876/2254, 38.9%, respectively). Apart from lower mean hemoglobin in the full consent group of the eIC cohort (8.5 vs 8.8; P =.0021), the characteristics of the full consenting patients did not differ between the eIC and face-to-face IC cohorts. In the eIC cohort, only age differed between the full consent and the nonresponse group (median 60 vs 56; P =.0002, respectively), whereas in the face-to-face IC cohort, the full consent group seemed healthier (ie, higher hemoglobin, lower glycated hemoglobin [HbA1c], lower C-reactive protein levels) than the nonresponse group. Conclusions: More patients provided full consent using an eIC. In addition, the study population remained broadly similar. The face-to-face IC approach seemed to result in a healthier study population (ie, full consenting patients) than the patients without IC, while in the eIC cohort, the characteristics between consent groups were comparable. Thus, an eIC may lead to a better representation of the target population, increasing the generalizability of results. [ABSTRACT FROM AUTHOR]

Published
2024
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43. The Effect of Artificial Intelligence on Patient-Physician Trust: Cross-Sectional Vignette Study.

Author

Zondag, Anna G M, Rozestraten, Raoul, Grimmelikhuijsen, Stephan G, Jongsma, Karin R, van Solinge, Wouter W, Bots, Michiel L, Vernooij, Robin W M, and Haitjema, Saskia

Subjects
CLINICAL decision support systems, PHYSICIAN-patient relations, DECISION support systems, PHYSICIANS' attitudes, ARTIFICIAL intelligence
Abstract

Background: Clinical decision support systems (CDSSs) based on routine care data, using artificial intelligence (AI), are increasingly being developed. Previous studies focused largely on the technical aspects of using AI, but the acceptability of these technologies by patients remains unclear. Objective: We aimed to investigate whether patient-physician trust is affected when medical decision-making is supported by a CDSS. Methods: We conducted a vignette study among the patient panel (N=860) of the University Medical Center Utrecht, the Netherlands. Patients were randomly assigned into 4 groups—either the intervention or control groups of the high-risk or low-risk cases. In both the high-risk and low-risk case groups, a physician made a treatment decision with (intervention groups) or without (control groups) the support of a CDSS. Using a questionnaire with a 7-point Likert scale, with 1 indicating "strongly disagree" and 7 indicating "strongly agree," we collected data on patient-physician trust in 3 dimensions: competence, integrity, and benevolence. We assessed differences in patient-physician trust between the control and intervention groups per case using Mann-Whitney U tests and potential effect modification by the participant's sex, age, education level, general trust in health care, and general trust in technology using multivariate analyses of (co)variance. Results: In total, 398 patients participated. In the high-risk case, median perceived competence and integrity were lower in the intervention group compared to the control group but not statistically significant (5.8 vs 5.6; P =.16 and 6.3 vs 6.0; P =.06, respectively). However, the effect of a CDSS application on the perceived competence of the physician depended on the participant's sex (P =.03). Although no between-group differences were found in men, in women, the perception of the physician's competence and integrity was significantly lower in the intervention compared to the control group (P =.009 and P =.01, respectively). In the low-risk case, no differences in trust between the groups were found. However, increased trust in technology positively influenced the perceived benevolence and integrity in the low-risk case (P =.009 and P =.04, respectively). Conclusions: We found that, in general, patient-physician trust was high. However, our findings indicate a potentially negative effect of AI applications on the patient-physician relationship, especially among women and in high-risk situations. Trust in technology, in general, might increase the likelihood of embracing the use of CDSSs by treating professionals. [ABSTRACT FROM AUTHOR]

Published
2024
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45. Additional file 1 of Asking informed consent may lead to significant participation bias and suboptimal cardiovascular risk management in learning healthcare systems

Author

Zondag, Anna G. M., Groenhof, T. Katrien J., van der Graaf, Rieke, van Solinge, Wouter W., Bots, Michiel L., and Haitjema, Saskia

Abstract

Additional file 1: Supplement 1. STROBE checklist for reporting. Supplement 2. UCC-CVRM questionnaire. Supplement 3. Missingness. Supplement 4. Patient inclusion flow-chart. Supplement 5. Sensitivity analysis to explore age distributions. Supplement 6. Determinants of non-consent. Supplement 7. Determinants of non-response (exploratory analysis).

Published
2023
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48. An Endogenous Metabolic Modulator Composition Improves Hydration Status and Decreases Adhesion Properties of Red Blood Cells from Patients with Sickle Cell Disease

Author

van Dijk, Myrthe J., primary, Traets, Marissa J.M., additional, van Oirschot, Brigitte A., additional, de Wilde, Jonathan R.A., additional, Bos, Jennifer, additional, van Solinge, Wouter W., additional, Koziel, Margaret J., additional, Wani, Revati, additional, van Beers, Eduard J., additional, Wijk, Richard van, additional, and Rab, Minke A.E., additional

Published
2022
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