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6. Cost-effectiveness analysis of a school- and community-based intervention to promote a healthy lifestyle and prevent type 2 diabetes in vulnerable families across Europe: the Feel4Diabetes-study

Author

Willems, Ruben, Tsoutsoulopoulou, Konstantina, Brondeel, Ruben, Cardon, Greet, Makrilakis, Konstantinos, Liatis, Stavros, Lindström, Jaana, Kivelä, Jemina, González-Gil, Esther M., Giménez-Legarre, Natalia, Usheva, Natalya, Iotova, Violeta, Tankova, Tsvetalina, Antal, Emese, Rurik, Imre, Timpel, Patrick, Schwarz, Peter E.H., Manios, Yannis, and Annemans, Lieven

Published
2021
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8. Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS II) statement:a validated Dutch translation

Author

Werbrouck, Amber, de Bekker-Grob, Esther, Al, Maiwenn, Putman, Koen, Willems, Ruben, Werbrouck, Amber, de Bekker-Grob, Esther, Al, Maiwenn, Putman, Koen, and Willems, Ruben

Abstract

OBJECTIVES: This study primarily aimed to develop a validated Dutch translation of the 28 items of the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) II. A secondary aim was to provide a worked example of a scientifically valid translation process.METHODS: A four-step process was applied: (1) forward translation, (2) backward translation, (3) quantitative validation (two back-translated English versions vs. original English version), and (4) qualitative validation (one Dutch version vs. original English version), resulting in the final Dutch CHEERS II checklist.RESULTS: During quantitative validation, the average scores indicated high language comparability (1.88 (SD 0.70); 1.70 (SD 0.73)) and interpretation similarity (1.77 (SD 0.81); 1.54 (SD 0.74)). Four items required formal revision. In the qualitative validation step, feedback primarily focused on specific terms 'outcomes,' 'benefits and harms,' '(year of) conversion,' 'any,' and 'characterizing.'CONCLUSION: Despite English being the common language of science, translating research instruments remains relevant to enhance clarity, accessibility, and inclusivity. The Dutch translation can be used by students, regulators, researchers, or others to report and evaluate reporting of economic evaluations. Our detailed description of the applied methodology can facilitate future translations of research instruments.

Published
2024

9. Mental health services in Belgium.

Author

Willems, Ruben, Catthoor, Kirsten, Cools, Olivia, Morrens, Manuel, Snoeck, Piet, Tecco, Juan, and Dom, Geert

Subjects
*MENTAL health services, *MEDICAL personnel, *SUICIDE statistics, *SOCIAL security, *PRIMARY care, *EUTHANASIA laws
Abstract

AbstractBelgium exhibits a complex governmental structure with overlapping yet fragmented healthcare service responsibilities across various levels. The past decade has been characterized with major political reforms, and a continuing road towards deinstitutionalization, enhancing care intensity, and fortifying primary care services. This article provides a concise overview of recent epidemiological trends in Belgium, the organizational landscape of mental healthcare, the roles and financing mechanisms of key institutions and professions, and a selection of specific topics such as euthanasia. Mental healthcare has ascended on the political agenda with a declaration of interest to eliminate a historical underfunding. This is urgent because over one fifth of the adult population struggles with mental issues on a yearly basis, with suicide rates 50 to 60% above the European average. Beyond the individual toll, there is a burning societal impact, reflected in the 7.4 billion euro directly spend within the healthcare sector, alongside substantial additional costs incurred through social security and productivity losses. Policy measures are needed to tackle contemporary challenges such as the attraction, recruiting and retention of skilled healthcare personnel, ensuring equitable remuneration across institutions and professions, and addressing critical areas such as forensic, transcultural, and transition psychiatry. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Effectiveness, reach, uptake, and feasibility of digital health interventions for adults with hypertension: a systematic review and meta-analysis of randomised controlled trials

Author

Siopis, George, primary, Moschonis, George, additional, Eweka, Evette, additional, Jung, Jenny, additional, Kwasnicka, Dominika, additional, Asare, Bernard Yeboah-Asiamah, additional, Kodithuwakku, Vimarsha, additional, Willems, Ruben, additional, Verhaeghe, Nick, additional, Annemans, Lieven, additional, Vedanthan, Rajesh, additional, Oldenburg, Brian, additional, Manios, Yannis, additional, Gong, Enying, additional, Votis, Konstantinos, additional, Segkouli, Sofia, additional, Triantafyllidis, Andreas, additional, Kyparissis, Odysseas, additional, Paliokas, Ioannis, additional, Polychroniou, Eleftheria, additional, De Craemer, Dirk, additional, Anastasiou, Kostas, additional, Tserpes, Konstantinos, additional, Mavrogianni, Christina, additional, Karaglani, Eva, additional, Kalogerakou, Electra, additional, Maragkoudaki, Maria, additional, Ntzouvani, Agathi, additional, Kontochristopoulou, Katerina, additional, Dupont, Sabine, additional, Dupont, Elizabeth, additional, Dauzon, Leo, additional, Roskams, Maartje, additional, Lennox-Chhugani, Niamh, additional, Perrin, Martin, additional, Day, Niamh Daly, additional, Ferrer, Georgina, additional, Snook, Orla, additional, Aldasoro, Edelweiss, additional, Gil-Salmerón, Alejandro, additional, Peiró, Pilar Gangas, additional, Curran, Darren, additional, Lyne, Fiona, additional, Curreri, Nereide A., additional, Siopis, George, additional, Pierantozzi, Nazzareno, additional, D'Antonio, Claudia, additional, Vespasiani, Giacomo, additional, Almonti, Teresa, additional, Skouteris, Helen, additional, Taylor, Tracy, additional, Savaglio, Melissa, additional, Makrilakis, Konstantinos, additional, Stergiou, George, additional, Liatis, Stavros, additional, Karamanakos, George, additional, Koliaki, Chrysi, additional, Kollias, Anastasios, additional, Zikou, Eva, additional, Dimosthenopoulos, Haris, additional, Huang, Keng-Yen, additional, Adhikari, Samrachana, additional, Qian, Kun, additional, Dickhaus, Julia, additional, Carney, Kimberly, additional, Sahito, Farhan, additional, Pavlovic, Dusan, additional, Djokic, Djordje, additional, Sahito, Arzoo, additional, Battalova, Gisella, additional, Seghieri, Chiara, additional, Nutti, Sabina, additional, Vanieri, Milena, additional, Belle, Nicola, additional, Bertarelli, Gaia, additional, Cantarelli, Paola, additional, Ferre, Francesca, additional, Noci, Anna, additional, Tortu, Constanza, additional, Bozzi, Nadia, additional, Ferrari, Dina, additional, Borelli, Rachele, additional, Iotova, Violeta, additional, Yotov, Yoto, additional, Usheva, Natalia, additional, Kozhuharova, Anna, additional, Russeva, Vanya, additional, Marinova, Vanya, additional, Koleva, Sonya, additional, Atanasova, Virginia, additional, Stefanova, Tanya, additional, Tsochev, Kaloyan, additional, Aznar, Luis Moreno, additional, Botaya, Rosa Magallón, additional, Lozano, Gloria Bueno, additional, De Miguel-Etayo, Pilar, additional, Gonzalez-Gil, Esther Ma, additional, Miguel-Berges, María L., additional, Pérez, Susana, additional, Blázquez, Bárbara Oliván, additional, Giménez-Legarre, Natalia, additional, Toti, Florian, additional, Prifti, Skerdi, additional, Bombaj, Blerina, additional, Doracaj, Ditila, additional, Laze, Ornela, additional, Lapardhaja, Adriana, additional, and Bruka, Luftime, additional

Published
2023
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17. Effectiveness, reach, uptake, and feasibility of digital health interventions for adults with type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials

Author

Moschonis, George, primary, Siopis, George, additional, Jung, Jenny, additional, Eweka, Evette, additional, Willems, Ruben, additional, Kwasnicka, Dominika, additional, Asare, Bernard Yeboah-Asiamah, additional, Kodithuwakku, Vimarsha, additional, Verhaeghe, Nick, additional, Vedanthan, Rajesh, additional, Annemans, Lieven, additional, Oldenburg, Brian, additional, Manios, Yannis, additional, Gong, Enying, additional, Votis, Konstantinos, additional, Segkouli, Sofia, additional, Triantafyllidis, Andreas, additional, Kyparissis, Odysseas, additional, Paliokas, Ioannis, additional, Polychroniou, Eleftheria, additional, De Craemer, Dirk, additional, Anastasiou, Kostas, additional, Tserpes, Konstantinos, additional, Mavrogianni, Christina, additional, Karaglani, Eva, additional, Kalogerakou, Electra, additional, Maragkoudaki, Maria, additional, Ntzouvani, Agathi, additional, Kontochristopoulou, Katerina, additional, Dupont, Sabine, additional, Dupont, Elizabeth, additional, Dauzon, Leo, additional, Roskams, Maartje, additional, Lennox-Chhugani, Niamh, additional, Perrin, Martin, additional, Day, Niamh Daly, additional, Ferrer, Georgina, additional, Snook, Orla, additional, Aldasoro, Edelweiss, additional, Gil-Salmerón, Alejandro, additional, Peiró, Pilar Gangas, additional, Curran, Darren, additional, Lyne, Fiona, additional, Curreri, Nereide A., additional, Moschonis, George, additional, Pierantozzi, Nazzareno, additional, D'Antonio, Claudia, additional, Vespasiani, Giacomo, additional, Almonti, Teresa, additional, Skouteris, Helen, additional, Taylor, Tracy, additional, Savaglio, Melissa, additional, Makrilakis, Konstantinos, additional, Stergiou, George, additional, Liatis, Stavros, additional, Karamanakos, George, additional, Koliaki, Chrysi, additional, Kollias, Anastasios, additional, Zikou, Eva, additional, Dimosthenopoulos, Haris, additional, Huang, Keng-Yen, additional, Adhikari, Samrachana, additional, Qian, Kun, additional, Dickhaus, Julia, additional, Carney, Kimberly, additional, Sahito, Farhan, additional, Pavlovic, Dusan, additional, Djokic, Djordje, additional, Sahito, Arzoo, additional, Battalova, Gisella, additional, Seghieri, Chiara, additional, Nutti, Sabina, additional, Vanieri, Milena, additional, Belle, Nicola, additional, Bertarelli, Gaia, additional, Cantarelli, Paola, additional, Ferre, Francesca, additional, Noci, Anna, additional, Tortu, Constanza, additional, Bozzi, Nadia, additional, Ferrari, Dina, additional, Borelli, Rachele, additional, Iotova, Violeta, additional, Yotov, Yoto, additional, Usheva, Natalia, additional, Kozhuharova, Anna, additional, Russeva, Vanya, additional, Marinova, Vanya, additional, Koleva, Sonya, additional, Atanasova, Virginia, additional, Stefanova, Tanya, additional, Tsochev, Kaloyan, additional, Aznar, Luis Moreno, additional, Botaya, Rosa Magallón, additional, Lozano, Gloria Bueno, additional, De Miguel-Etayo, Pilar, additional, Gonzalez-Gil, Esther Ma, additional, Miguel-Berges, María L., additional, Pérez, Susana, additional, Blázquez, Bárbara Oliván, additional, Giménez-Legarre, Natalia, additional, Toti, Florian, additional, Prifti, Skerdi, additional, Bombaj, Blerina, additional, Doracaj, Ditila, additional, Laze, Ornela, additional, Lapardhaja, Adriana, additional, and Bruka, Luftime, additional

Published
2023
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19. S-28-3: COMPARATIVE EFFECTIVENESS AND IMPLEMENTATION OF DIGITAL HEALTH INTERVENTIONS FOR PEOPLE WITH HYPERTENSION: SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMISED CONTROLLED TRIALS

Author

Siopis, George, primary, Moschonis, George, additional, Eweka, Evette, additional, Jung, Jenny, additional, Kwasnicka, Dominika, additional, Asare, Bernard Yeboah-Asiamah, additional, Kodithuwakku, Vimarsha, additional, Willems, Ruben, additional, Verhaeghe, Nick, additional, Annemans, Lieven, additional, Vedanthan, Rajesh, additional, Oldenburg, Brian, additional, and Manios, Yannis, additional

Published
2023
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20. Cross-sectional and longitudinal associations between family meals frequency and children's overweight/obesity in families at high risk of type 2 diabetes: The Feel4Diabetes <scp>-</scp> study

Author

Mahmood, Lubna, Gonzalez-Gil, Esther M., Makrilakis, Konstantinos, Liatis, Stavros, Schwarz, Peter, Herrmann, Sandra, Willems, Ruben, Cardon, Greet, Latomme, Julie, Rurik, Imre, Radó, Sándorné, Iotova, Violeta, Usheva, Natalya, Tankova, Tsvetalina, Karaglani, Eva, Manios, Yannis, and Moreno, Luis A.

Subjects
obesity, body composition, Nutrition and Dietetics, children, Health Policy, Pediatrics, Perinatology and Child Health, Medicine and Health Sciences, Public Health, Environmental and Occupational Health, family meals frequency, body mass index, type 2 diabetes
Abstract

Summary Background: The frequency of family meals has been suggested as a protective factor against obesity among children. Objective: This study aimed to investigate the cross-sectional and longitudinal associations between family meals frequency and children's overweight/obesity in families at high risk of type 2 diabetes (T2D) across six European countries. Methods: 989 parent–child dyads (52% girls and 72% mothers) were included. Participants completed validated measures to assess the frequency of family meals and anthropometrics. Multivariable regression models were applied to examine the longitudinal associations between family meals frequency and overweight/obesity in children. Logistic regression was performed to predict the odds of having overweight/ obesity depending on changes in family meals frequency over a two-year follow-up period. Analyses were stratified for children's sex. Results: High frequency of family breakfasts and/or dinners was inversely associated with children's BMI in boys and girls at T2. Results showed decreased odds of overweight/ obesity at follow-up among both boys (OR = 0.65; 95% CI 0.41, 0.96) and girls (OR = 0.53; 95% CI 0.31, 0.87) who consumed minimum of three times family breakfasts and/or family dinners a week at baseline. An increase in family breakfasts and/or dinners frequency was associated with lower odds of overweight/obesity in both boys and girls at follow-up. Conclusion: A high frequency of family breakfasts and/or dinners but not lunch during childhood is associated with lower odds of overweight/obesity development in children from families at high risk of T2D. The promotion of family meals could help in preventing the development of overweight/obesity among children.

Published
2023

21. Last year of life of adults with congenital heart diseases: causes of death and patterns of care

Author

Van Bulck, Liesbet, Goossens, Eva, Morin, Lucas, Luyckx, Koen, Ombelet, Fouke, Willems, Ruben, Budts, Werner, De Groote, Katya, De Backer, Julie, Annemans, Lieven, Moniotte, Stéphane, de Hosson, Michèle, Marelli, Arianne, Moons, Philip, BELCODAC consortium, [missing], and BELCODAC Consortium

Subjects
Adult, Heart Defects, Congenital, Healthcare utilization, Cause of death, Cause of Death, FACILITATORS, Medicine and Health Sciences, Humans, POPULATION, Retrospective Studies, Hospitalizations, Terminal Care, BARRIERS, MORTALITY, Palliative Care, Congenital Heart Disease, TRENDS, Hospitalisations, Hospitalization, LONG, END, SURVIVAL, Human medicine, HEALTH, Cardiology and Cardiovascular Medicine, End-of-life
Abstract

Aims Although life expectancy in adults with congenital heart diseases (CHD) has increased dramatically over the past five decades, still a substantial number of patients dies prematurely. To gain understanding in the trajectories of dying in adults with CHD, the last year of life warrants further investigation. Therefore, our study aimed to (i) define the causes of death and (ii) describe the patterns of healthcare utilization in the last year of life of adults with CHD. Methods and results This retrospective mortality follow-back study used healthcare claims and clinical data from BELCODAC, which includes patients with CHD from Belgium. Healthcare utilization comprises cardiovascular procedures, CHD physician contacts, general practitioner visits, hospitalizations, emergency department (ED) visits, intensive care unit (ICU) admissions, and specialist palliative care, and was identified using nomenclature codes. Of the 390 included patients, almost half of the study population (45%) died from a cardiovascular cause. In the last year of life, 87% of patients were hospitalized, 78% of patients had an ED visit, and 19% of patients had an ICU admission. Specialist palliative care was provided to 17% of patients, and to only 4% when looking at the patients with cardiovascular causes of death. Conclusions There is a high use of intensive and potentially avoidable care at the end of life. This may imply that end-of-life care provision can be improved. Future studies should further examine end-of-life care provision in the light of patient’s needs and preferences, and how the healthcare system can adequately respond.

Published
2022

22. Parental food consumption and diet quality and its association with children’s food consumption in families at high risk of type 2 diabetes: the Feel4Diabetes-study

Author

Mahmood, Lubna, primary, Moreno, Luis A, additional, Flores-Barrantes, Paloma, additional, Mavrogianni, Christina, additional, Schwarz, Peter, additional, Makrilakis, Konstantinos, additional, Liatis, Stavros, additional, Cardon, Greet, additional, Willems, Ruben, additional, Rurik, Imre, additional, Radó, Sándorné, additional, Tankova, Tsvetalina, additional, Iotova, Violeta, additional, Usheva, Natalya, additional, Manios, Yannis, additional, and Gonzalez-Gil, Esther M, additional

Published
2022
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23. Process evaluation and implementation of mHealth interventions for management of type 2 diabetes mellitus and hypertension: A systematic review

Author

Kodithuwakku, Vimarsha, Asare, Bernard, Kwasnicka, Dominika, Oldenburg, Brian, Moschonis, George, Siopis, George, Vedanthan, Rajesh, Jung, Jenny, Eweka, Evette, Gong, Enying, Willems, Ruben, and Verhaeghe, Nick

Subjects
Cardiovascular Diseases, Medicine and Health Sciences, Diseases, Community Health and Preventive Medicine, Public Health, Endocrine System Diseases, Health Services Administration
Abstract

This review will explore the measures that are utilised in assessing process evaluation and implementation of mHealth interventions for management of type 2 diabetes mellitus and hypertension.

Published
2022
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24. Cross‐sectional and longitudinal associations between family meals frequency and children's overweight/obesity in families at high risk of type 2 diabetes: The Feel4Diabetes‐study.

Author

Mahmood, Lubna, Gonzalez‐Gil, Esther M., Makrilakis, Konstantinos, Liatis, Stavros, Schwarz, Peter, Herrmann, Sandra, Willems, Ruben, Cardon, Greet, Latomme, Julie, Rurik, Imre, Radó, Sándorné, Iotova, Violeta, Usheva, Natalya, Tankova, Tsvetalina, Karaglani, Eva, Manios, Yannis, and Moreno, Luis A.

Subjects
RISK of childhood obesity, FOOD habits, BODY composition, CONFIDENCE intervals, CROSS-sectional method, ANTHROPOMETRY, MULTIPLE regression analysis, TYPE 2 diabetes, RISK assessment, RESEARCH funding, DESCRIPTIVE statistics, QUALITY of life, FAMILY relations, BREAKFASTS, LOGISTIC regression analysis, BODY mass index, ODDS ratio, PARENT-child relationships, MEALS, LONGITUDINAL method, DISEASE risk factors
Abstract

Summary: Background: The frequency of family meals has been suggested as a protective factor against obesity among children. Objective: This study aimed to investigate the cross‐sectional and longitudinal associations between family meals frequency and children's overweight/obesity in families at high risk of type 2 diabetes (T2D) across six European countries. Methods: 989 parent–child dyads (52% girls and 72% mothers) were included. Participants completed validated measures to assess the frequency of family meals and anthropometrics. Multivariable regression models were applied to examine the longitudinal associations between family meals frequency and overweight/obesity in children. Logistic regression was performed to predict the odds of having overweight/obesity depending on changes in family meals frequency over a two‐year follow‐up period. Analyses were stratified for children's sex. Results: High frequency of family breakfasts and/or dinners was inversely associated with children's BMI in boys and girls at T2. Results showed decreased odds of overweight/obesity at follow‐up among both boys (OR = 0.65; 95% CI 0.41, 0.96) and girls (OR = 0.53; 95% CI 0.31, 0.87) who consumed minimum of three times family breakfasts and/or family dinners a week at baseline. An increase in family breakfasts and/or dinners frequency was associated with lower odds of overweight/obesity in both boys and girls at follow‐up. Conclusion: A high frequency of family breakfasts and/or dinners but not lunch during childhood is associated with lower odds of overweight/obesity development in children from families at high risk of T2D. The promotion of family meals could help in preventing the development of overweight/obesity among children. [ABSTRACT FROM AUTHOR]

Published
2023
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25. Can food parenting practices explain the association between parental education and children’s food intake? The Feel4Diabetes-study

Author

Flores-Barrantes, Paloma, primary, Mavrogianni, Christina, additional, Iglesia, Iris, additional, Mahmood, Lubna, additional, Willems, Ruben, additional, Cardon, Greet, additional, De Vylder, Flore, additional, Liatis, Stavros, additional, Makrilakis, Konstantinos, additional, Martinez, Remberto, additional, Schwarz, Peter, additional, Rurik, Imre, additional, Antal, Emese, additional, Iotova, Violeta, additional, Tsochev, Kaloyan, additional, Chakarova, Nevena, additional, Kivelä, Jemina, additional, Wikström, Katja, additional, Manios, Yannis, additional, and Moreno, Luis A, additional

Published
2022
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26. Different levels of care for follow-up of adults with congenital heart disease : a health economic approach

Author

Willems, Ruben

Subjects
Medicine and Health Sciences
Abstract

Aim To scrutinize the economic impact of different care levels, such as shared care, in the follow-up of adult congenital heart disease (ACHD) patients. Methods The BELgian COngenital heart disease Database combining Administrative and Clinical data (BELCODAC) was analyzed. Patients (N = 6579) were categorized into five care levels based on their cardiac follow-up pattern between 2006 and 2010. Medical costs, hospitalizations, and emergency department visits were measured between 2011 and 2015. Results In patients with moderate lesions, highly specialized cardiac care (HSC; exclusive follow-up by ACHD specialists) and shared care with predominantly specialized cardiac care (SC+) were associated with significantly lower medical costs and resource use compared to shared care with predominantly general cardiac care (SC-) and general cardiac care (GCC). In the patient population with mild lesions, HSC was associated with better economic outcomes than SC- and GCC, but SC+ was not. HSC was associated with fewer hospitalizations (- 33%) and less pharmaceutical costs (- 46.3%) compared to SC+. Patients with mild and moderate lesions in the no cardiac care (NCC) group had better economic outcomes than those in the GCC and SC- groups, but post-hoc analysis revealed that they had a different patient profile than patients under cardiac care. Conclusion More specialized care levels are associated with better economic outcomes in patients with mild or moderate lesions in cardiac follow-up. Shared care with strong involvement of ACHD specialists might be a management option to consider. Characteristics of patients without cardiac follow-up but good medium-term economic prospects should be further scrutinized.

Published
2022

27. Last year of life of adults with congenital heart diseases: causes of death and patterns of care.

Author

Bulck, Liesbet Van, Goossens, Eva, Morin, Lucas, Luyckx, Koen, Ombelet, Fouke, Willems, Ruben, Budts, Werner, Groote, Katya De, Backer, Julie De, Annemans, Lieven, Moniotte, Stéphane, Hosson, Michèle de, Marelli, Arianne, Moons, Philip, and consortium, BELCODAC

Subjects
CONGENITAL heart disease, CAUSES of death, TERMINAL care, INTENSIVE care units, ADULTS
Abstract

Aims Although life expectancy in adults with congenital heart diseases (CHD) has increased dramatically over the past five decades, still a substantial number of patients dies prematurely. To gain understanding in the trajectories of dying in adults with CHD, the last year of life warrants further investigation. Therefore, our study aimed to (i) define the causes of death and (ii) describe the patterns of healthcare utilization in the last year of life of adults with CHD. Methods and results This retrospective mortality follow-back study used healthcare claims and clinical data from BELCODAC, which includes patients with CHD from Belgium. Healthcare utilization comprises cardiovascular procedures, CHD physician contacts, general practitioner visits, hospitalizations, emergency department (ED) visits, intensive care unit (ICU) admissions, and specialist palliative care, and was identified using nomenclature codes. Of the 390 included patients, almost half of the study population (45%) died from a cardiovascular cause. In the last year of life, 87% of patients were hospitalized, 78% of patients had an ED visit, and 19% of patients had an ICU admission. Specialist palliative care was provided to 17% of patients, and to only 4% when looking at the patients with cardiovascular causes of death. Conclusions There is a high use of intensive and potentially avoidable care at the end of life. This may imply that end-of-life care provision can be improved. Future studies should further examine end-of-life care provision in the light of patient's needs and preferences, and how the healthcare system can adequately respond. [ABSTRACT FROM AUTHOR]

Published
2022
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28. Cost-effectiveness analysis of a school- and community-based intervention to promote a healthy lifestyle and prevent type 2 diabetes in vulnerable families across Europe: the Feel4Diabetes-study

Author

Willems, Ruben Tsoutsoulopoulou, Konstantina Brondeel, Ruben and Cardon, Greet Makrilakis, Konstantinos Liatis, Stavros and Lindstrom, Jaana Kivela, Jemina Gonzalez-Gil, Esther M. and Gimenez-Legarre, Natalia Usheva, Natalya Iotova, Violeta and Tankova, Tsvetalina Antal, Emese Rurik, Imre Timpel, Patrick and Schwarz, Peter E. H. Manios, Yannis Annemans, Lieven

Subjects
health care economics and organizations
Abstract

The Feel4Diabetes-study implemented a school- and community-based intervention to promote healthy lifestyle and prevent type 2 diabetes mellitus (T2DM) in six European countries. The intervention included a special focus on families at increased T2DM risk. The current study evaluates the intervention's cost-effectiveness. A Markov-type health economic model was developed to predict the incidence of T2DM and its complications. Incremental cost-effectiveness ratios (lifetime horizon, societal perspective) were calculated based on the overall intervention effect on health behaviour, and stratified for low- and high-risk families. Sensitivity analyses captured input parameters uncertainty. A budget impact analysis was performed. The increase in children's water consumption and physical activity led to a modest gain in quality adjusted life years (QALYs) at a low intervention cost and budget impact. Medical cost savings due to avoided illness could only be achieved on the very long-term (>30 years). The intervention in its entirety was cost-effective (more QALYs at a reasonable investment) in Belgium, Finland, Bulgaria, and Hungary, while being dominant (net savings and more QALYs) in Greece and Spain. Results were cost-effective for the low-risk families, who only received the school- and community-based intervention component. Results for the high-risk families were only cost-effective (with considerable uncertainty) in Greece and Spain, but not when the intervention would need to be repeated. The Feel4Diabetes-intervention is potentially cost-effective, especially in countries with a high overweight and obesity prevalence, at a limited budget impact. The incremental financial investments to reach and support high -risk families did not result in the hoped-for health benefits.

Published
2021

29. Different levels of care for follow-up of adults with congenital heart disease: a cost analysis scrutinizing the impact on medical costs, hospitalizations, and emergency department visits.

Author

UCL - SSS/IREC/PEDI - Pôle de Pédiatrie, UCL - (SLuc) Centre de malformations vasculaires congénitales, UCL - (SLuc) Service de cardiologie pédiatrique, UCL - (SLuc) Service de radiologie, Willems, Ruben, Ombelet, Fouke, Goossens, Eva, De Groote, Katya, Budts, Werner, Moniotte, Stéphane, de Hosson, Michèle, Van Bulck, Liesbet, Marelli, Ariane, Moons, Philip, De Backer, Julie, Annemans, Lieven, BELCODAC consortium, UCL - SSS/IREC/PEDI - Pôle de Pédiatrie, UCL - (SLuc) Centre de malformations vasculaires congénitales, UCL - (SLuc) Service de cardiologie pédiatrique, UCL - (SLuc) Service de radiologie, Willems, Ruben, Ombelet, Fouke, Goossens, Eva, De Groote, Katya, Budts, Werner, Moniotte, Stéphane, de Hosson, Michèle, Van Bulck, Liesbet, Marelli, Ariane, Moons, Philip, De Backer, Julie, Annemans, Lieven, and BELCODAC consortium

Abstract

To scrutinize the economic impact of different care levels, such as shared care, in the follow-up of adult congenital heart disease (ACHD) patients. The BELgian COngenital heart disease Database combining Administrative and Clinical data (BELCODAC) was analyzed. Patients (N = 6579) were categorized into five care levels based on their cardiac follow-up pattern between 2006 and 2010. Medical costs, hospitalizations, and emergency department visits were measured between 2011 and 2015. In patients with moderate lesions, highly specialized cardiac care (HSC; exclusive follow-up by ACHD specialists) and shared care with predominantly specialized cardiac care (SC+) were associated with significantly lower medical costs and resource use compared to shared care with predominantly general cardiac care (SC-) and general cardiac care (GCC). In the patient population with mild lesions, HSC was associated with better economic outcomes than SC- and GCC, but SC+ was not. HSC was associated with fewer hospitalizations (- 33%) and less pharmaceutical costs (- 46.3%) compared to SC+. Patients with mild and moderate lesions in the no cardiac care (NCC) group had better economic outcomes than those in the GCC and SC- groups, but post-hoc analysis revealed that they had a different patient profile than patients under cardiac care. More specialized care levels are associated with better economic outcomes in patients with mild or moderate lesions in cardiac follow-up. Shared care with strong involvement of ACHD specialists might be a management option to consider. Characteristics of patients without cardiac follow-up but good medium-term economic prospects should be further scrutinized.

Published
2021

30. Influenza Vaccination in Patients With Congenital Heart Disease in the Pre-COVID-19 Era: Coverage Rate, Patient Characteristics, and Outcomes.

Author

UCL - SSS/IREC/PEDI - Pôle de Pédiatrie, UCL - (SLuc) Centre de malformations vasculaires congénitales, UCL - (SLuc) Service de cardiologie pédiatrique, UCL - (SLuc) Service de radiologie, Moons, Philip, Fieuws, Steffen, Vandermeulen, Corinne, Ombelet, Fouke, Willems, Ruben, Goossens, Eva, Van Bulck, Liesbet, de Hosson, Michèle, Annemans, Lieven, Budts, Werner, De Backer, Julie, Moniotte, Stéphane, Marelli, Arianne, De Groote, Katya, BELCODAC Consortium, UCL - SSS/IREC/PEDI - Pôle de Pédiatrie, UCL - (SLuc) Centre de malformations vasculaires congénitales, UCL - (SLuc) Service de cardiologie pédiatrique, UCL - (SLuc) Service de radiologie, Moons, Philip, Fieuws, Steffen, Vandermeulen, Corinne, Ombelet, Fouke, Willems, Ruben, Goossens, Eva, Van Bulck, Liesbet, de Hosson, Michèle, Annemans, Lieven, Budts, Werner, De Backer, Julie, Moniotte, Stéphane, Marelli, Arianne, De Groote, Katya, and BELCODAC Consortium

Abstract

Influenza vaccination is the most commonly recommended immune prevention strategy. However, data on influenza vaccination in patients with congenital heart disease (CHD) are scarce. In this study, our goals were to: (1) measure vaccination coverage rates (VCRs) for influenza in a large cohort of children, adolescents, and adults with CHD; (2) identify patient characteristics as predictors for vaccination; and (3) investigate the effect of influenza vaccination on hospitalization. A nationwide cohort study in Belgium included 16,778 patients, representing 134,782 vaccination years, from the Belgian Congenital Heart Disease Database Combining Administrative and Clinical Data (BELCODAC). Data over 9 vaccination years (2006-2015) were used, and patients were stratified into 5 age cohorts: 6 months to 4 years; 5-17 years; 18-49 years; 50-64 years; and 65 years and older. In the respective age cohorts, the VCR was estimated to be 6.6%, 8.0%, 23.9%, 46.6%, and 72.8%. There was a steep increase in VCRs as of the age of 40 years. Multivariable logistic regression showed that higher anatomical complexity of CHD, older age, presence of genetic syndromes, and previous cardiac interventions were associated with significantly higher VCRs. Among adults, men had lower and pregnant women had higher VCRs. The association between influenza vaccination and all-cause hospitalization was not significant in this study. The influenza VCR in people with CHD is low, especially in children and adolescents. Older patients, particularly those with complex CHD, are well covered. Our findings should inform vaccination promotion strategies in populations with CHD.

Published
2021

31. Creating the BELgian COngenital heart disease database combining administrative and clinical data (BELCODAC): Rationale, design and methodology.

Author

UCL - SSS/IREC/PEDI - Pôle de Pédiatrie, UCL - (SLuc) Service de cardiologie pédiatrique, Ombelet, Fouke, Goossens, Eva, Willems, Ruben, Annemans, Lieven, Budts, Werner, De Backer, Julie, De Groote, Katya, Moniotte, Stéphane, Van Bulck, Liesbet, Marelli, Ariane, Moons, Philip, BELCODAC consortium, UCL - SSS/IREC/PEDI - Pôle de Pédiatrie, UCL - (SLuc) Service de cardiologie pédiatrique, Ombelet, Fouke, Goossens, Eva, Willems, Ruben, Annemans, Lieven, Budts, Werner, De Backer, Julie, De Groote, Katya, Moniotte, Stéphane, Van Bulck, Liesbet, Marelli, Ariane, Moons, Philip, and BELCODAC consortium

Abstract

Congenital heart disease (CHD) entails a broad spectrum of malformations with various degrees of severity and prognosis. Consequently, new and specific healthcare needs are emerging, requiring responsive healthcare provision. Research on this matter is predominantly performed on population-based databases, to inform clinicians, researchers and policy-makers on health outcomes and economic burden of CHD. Most databases contain data either from administrative sources or from clinical systems. We describe the methodological design of the BELgian COngenital Heart Disease Database combining Administrative and Clinical data (BELCODAC), to investigate patients with CHD. Data on clinical characteristics from three university hospitals in Belgium (Leuven, Ghent and Brussels) were merged with mortality and socio-economic data from the official Belgian statistical office (StatBel), and with healthcare use data from the InterMutualistic Agency, an overarching national organization that collects data from the seven sickness funds for all Belgian citizens. Over 60 variables with multiple entries over time are included in the database. BELCODAC contains data on 18,510 patients, of which 8926 patients (48%) have a mild, 7490 (41%) a moderately complex and 2094 (11%) a complex anatomical heart defect. The most prevalent diagnosis is Ventricular Septal Defect in 3879 patients (21%), followed by Atrial Septal Defect in 2565 patients (14%). BELCODAC comprises longitudinal data on patients with CHD in Belgium. This will help build evidence-based provision of care to the changing CHD population.

Published
2020

32. Long-Term Healthcare Utilization, Medical Cost, and Societal Cost in Adult Congenital Heart Disease

Author

UCL - SSS/IREC/PEDI - Pôle de Pédiatrie, UCL - (SLuc) Service de cardiologie pédiatrique, Willems, Ruben, Ombelet, Fouke, Goossens, Eva, De Groote, Katya, Budts, Werner, Moniotte, Stéphane, de Hosson, Michèle, Van Bulck, Liesbet, Marelli, Arianne, Moons Julie De Backer, Philip, Annemans, Lieven, UCL - SSS/IREC/PEDI - Pôle de Pédiatrie, UCL - (SLuc) Service de cardiologie pédiatrique, Willems, Ruben, Ombelet, Fouke, Goossens, Eva, De Groote, Katya, Budts, Werner, Moniotte, Stéphane, de Hosson, Michèle, Van Bulck, Liesbet, Marelli, Arianne, Moons Julie De Backer, Philip, and Annemans, Lieven

Abstract

OBJECTIVE: Cost-of-illness studies in Adult Congenital Heart Disease (ACHD) have mainly been limited to hospitalizations. This is the first paper to provide a comprehensive overview from a societal perspective including inpatient and outpatient medical costs, and absenteeism-and unemployment-related societal costs. METHODS: A retrospective longitudinal (2006–2015) database analysis was performed in Belgium combining administrative and clinical databases (n = 10,572). Trends in resource use and costs per patient year were standardized to assess the impact of changes in the patient population composition. Generalized Linear Mixed Models assessed the impact of age, sex, lesion complexity, and time. Costs were converted to 2018 values. RESULTS: Medical costs per patient year increased from V3490 to V4536 with a milder increase in patients with severe lesions. Although unemployment-related costs decreased, total societal costs increased due to more long-term (≥1 yr) invalidity. An increase in long-term invalidity was particularly found in patients ≥30 yrs and in patients with mild or moderate lesions. Resource use (e.g., dental care, nursing care, physiotherapy, emergency department) increased substantially in all patient groups over time. The annual percentage of patients with severe lesions receiving any cardiac and specialized cardiac follow-up increased with respectively 11 and 13 percent points to 81% and 52%, with a simultaneous decrease in hospitalization rate. CONCLUSION: Medical cost increases in ACHD are most pronounced in patients with mild and moderate lesions, relatable to their higher age. Economic data are necessary to allocate resources efficiently to ensure sustainable, qualitative care in an ageing patient population with strong increases in medical and long-term invalidity-related costs.

Published
2020

33. Methodology of the health economic evaluation of the Feel4Diabetes-study

Author

Willems, Ruben, Pil, Lore, Lambrinou, Christina Paulina, Kivelä, Jemina, Wikström, Katja, Gonzalez-Gil, Esther M., De Miguel-Etayo, Pilar, Nánási, Anna, Semánová, Csilla, Van Stappen, Vicky, Cardon, Greet, Tsochev, Kaloyan, Iotova, Violeta, Chakarova, Nevena, Makrilakis, Konstantinos, Dafoulas, George, Timpel, Patrick, Schwarz, Peter, Manios, Yannis, Annemans, Lieven, Willems, Ruben, Pil, Lore, Lambrinou, Christina Paulina, Kivelä, Jemina, Wikström, Katja, Gonzalez-Gil, Esther M., De Miguel-Etayo, Pilar, Nánási, Anna, Semánová, Csilla, Van Stappen, Vicky, Cardon, Greet, Tsochev, Kaloyan, Iotova, Violeta, Chakarova, Nevena, Makrilakis, Konstantinos, Dafoulas, George, Timpel, Patrick, Schwarz, Peter, Manios, Yannis, and Annemans, Lieven

Abstract

Background: The clinical and economic burden of type 2 diabetes mellitus on society is rising. Effective and efficient preventive measures may stop the increasing prevalence, given that type 2 diabetes mellitus is mainly a lifestyle-driven disease. The Feel4Diabetes-study aimed to tackle unhealthy lifestyle (unhealthy diet, lack of physical activity, sedentary behaviour, and excess weight) of families with a child in the first grades of elementary school. These schools were located in regions with a relatively low socio-economic status in Belgium, Bulgaria, Finland, Greece, Hungary and Spain. Special attention was paid to families with a high risk of developing type 2 diabetes mellitus. Methods: The aim of this paper is to describe the detailed methodology of the intervention's cost-effectiveness analysis. Based on the health economic evaluation of the Toybox-study, both a decision analytic part and a Markov model have been designed to assess the long-term (time horizon of 70 year with one-year cycles) intervention's value for money. Data sources used for the calculation of health state incidences, transition probabilities between health states, health state costs, and health state utilities are listed. Intervention-related costs were collected by questionnaires and diaries, and attributed to either all families or high risk families only. Conclusions: The optimal use of limited resources is pivotal. The future results of the health economic evaluation of the Feel4Diabetes-study will contribute to the efficient use of those resources.

Published
2020

35. Creating the BELgian COngenital heart disease database combining administrative and clinical data (BELCODAC): Rationale, design and methodology

Author

Ombelet, Fouke, primary, Goossens, Eva, additional, Willems, Ruben, additional, Annemans, Lieven, additional, Budts, Werner, additional, De Backer, Julie, additional, De Groote, Katya, additional, Moniotte, Stéphane, additional, Van Bulck, Liesbet, additional, Marelli, Ariane, additional, and Moons, Philip, additional

Published
2020
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36. A Trial-Based Cost-Utility Analysis of Metastasis-Directed Therapy for Oligorecurrent Prostate Cancer

Author

De Bleser, Elise, primary, Willems, Ruben, additional, Decaestecker, Karel, additional, Annemans, Lieven, additional, De Bruycker, Aurélie, additional, Fonteyne, Valérie, additional, Lumen, Nicolaas, additional, Ameye, Filip, additional, Billiet, Ignace, additional, Joniau, Steven, additional, De Meerleer, Gert, additional, Ost, Piet, additional, and Bultijnck, Renée, additional

Published
2020
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38. A RE-USABLE HIGH RELIABILITY COMPUTER FOR AUTONOMOUS MISSIONS

Author

DE CUYPER, Steven and WILLEMS, Ruben

Subjects
ComputerApplications_COMPUTERSINOTHERSYSTEMS, AVIONICS, PARALLEL PROCESSING
Abstract

In this paper we present the selected QinetiQ Space On-Board Computer for the Re-Entry Module part of the Space Rider mission. Next to a general introduction of the features and its performance, we also clarify how our design meets the key mission and system challenges. We further focus on its reliability and the used calculation method. The results demonstrate the reliability of our solution and how this evolves throughout the lifetime of Space Rider over the various launches/mission profile.

Published
2019
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39. Different levels of care for follow-up of adults with congenital heart disease: a cost analysis scrutinizing the impact on medical costs, hospitalizations, and emergency department visits.

Author

Willems, Ruben, Ombelet, Fouke, Goossens, Eva, De Groote, Katya, Budts, Werner, Moniotte, Stéphane, de Hosson, Michèle, Van Bulck, Liesbet, Marelli, Ariane, Moons, Philip, De Backer, Julie, and Annemans, Lieven

Subjects
MEDICAL care costs, MEDICAL economics, CONGENITAL heart disease, HEART diseases, MEDICAL care
Abstract

Aim: To scrutinize the economic impact of different care levels, such as shared care, in the follow-up of adult congenital heart disease (ACHD) patients. Methods: The BELgian COngenital heart disease Database combining Administrative and Clinical data (BELCODAC) was analyzed. Patients (N = 6579) were categorized into five care levels based on their cardiac follow-up pattern between 2006 and 2010. Medical costs, hospitalizations, and emergency department visits were measured between 2011 and 2015. Results: In patients with moderate lesions, highly specialized cardiac care (HSC; exclusive follow-up by ACHD specialists) and shared care with predominantly specialized cardiac care (SC+) were associated with significantly lower medical costs and resource use compared to shared care with predominantly general cardiac care (SC−) and general cardiac care (GCC). In the patient population with mild lesions, HSC was associated with better economic outcomes than SC− and GCC, but SC+ was not. HSC was associated with fewer hospitalizations (− 33%) and less pharmaceutical costs (− 46.3%) compared to SC+. Patients with mild and moderate lesions in the no cardiac care (NCC) group had better economic outcomes than those in the GCC and SC− groups, but post-hoc analysis revealed that they had a different patient profile than patients under cardiac care. Conclusion: More specialized care levels are associated with better economic outcomes in patients with mild or moderate lesions in cardiac follow-up. Shared care with strong involvement of ACHD specialists might be a management option to consider. Characteristics of patients without cardiac follow-up but good medium-term economic prospects should be further scrutinized. [ABSTRACT FROM AUTHOR]

Published
2021
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46. Accident dosimetry with mobile phones: Real-time measurements by means of mobile phone applications & Post-accident dose reconstruction with SIM cards

Author

Willems, Ruben, LIEVENS, Luc, and DE FREITAS NASCIMENTO, Luana

Abstract

In deze masterproef werden smartfoon applicaties geëvalueerd op hun inzetbaarheid tijdens een ongeval met ioniserende straling. Tevens werden ook SIM-kaarten onderzocht voor retrospectieve dosis reconstructies bij de bevolking. De applicaties werden getest in het kalibratie laboratorium van SCK- CEN met 60Co en 137Cs bronnen, ook werden er testen uitgevoerd met X-stralen. De SIM kaarten werden gekarakteriseerd m.b.v 'continuous wave optically stimulated luminescence' (CW-OSL), hiervoor werd een 'TL/OSL Reader' (Risø) gebruikt waarbij er bestraald werd met een 90Sr/90Y '- bron en uitgelezen m.b.v blauwe LEDs. De experimenten toonden aan dat de app's een lange stabilistaitetijd hebben van minstens 10 min en zelfs langer voor natuurlijke achtergrond straling. Deze eigenschap beperkt ten sterkste het gebruik van app's tijdens ongevallen. Ook werd een GM buis voor smartfoons getest (Polismart PM1904), deze vertoonde een veel snellere stabilisatietijd, accuratere metingen en een betere dosistempo lineariteit. Bij de SIM-kaart testen werd er een relatief vlakke dosis respons (getest tot 4 Gy) en een significant verschil in de gevoeligheid van de verschillende kaarten gevonden. Het OSL signaal is reproduceerbaar met een afwijking van 10%. De kaarten kunnen gebruikt worden om dosissen boven 10 mGy te reconstrueren. Maar de sterkste limiterende eigenschap is signaalvervaging. Wanneer ze een paar uur, een dag of weken na het ongeval worden uitgelezen zal de signaalsterkte respectievelijk met 50%, 75% en 90% gedaald zijn.

Published
2015

47. Validation of the Psychological Empowerment Scale and Client-Centered Care Questionnaire in budget holders with disabilities.

Author

Pattyn, Eva, Gemmel, Paul, Willems, Ruben, Lagaert, Susan, and Trybou, Jeroen

Abstract

AbstractPurposeMethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONSeveral high-income countries install Cash-for-Care Schemes (CCSs) by granting budgets to care users. However, little quantitative evidence exist on empowerment and client-centered care levels, due to a lack of validated scales. This research aimed to validate the Psychological Empowerment Scale (PE scale) and Client-Centered Care Questionnaire (CCCQ) in budget holders with disabilities.A survey was developed based on a literature review and experts and budget holders input. Principal Axis Factoring with direct oblimin rotation, Cronbach’s Alpha, and hypotheses testing with socio-demographic and budget characteristics as independent variables, and PE scale and CCCQ as dependent, were undertaken to assess both scales’ internal consistency and validity.A convenience sample of 224 Flemish (proxy) budget holders completed the survey. Our analysis showed a two-factor solution for both scales; for the PE scale consisting of “meaning” and “competence,” and “self-determination” and “impact,” for CCCQ consisting of items 1–7 (conduct by caregiver) and items 8–15 (autonomy). Cronbach’s Alpha of both scales was 0.94. The majority of our hypotheses were confirmed.The findings show that both scales are valid and internally consistent, meaning that they can be further tested in a respondent sample of people with disabilities and in other care contexts.In light of the current trends in the (health)care sector to stimulate empowerment and client-centered care in care users, the monitoring of this experience is important.The Psychological Empowerment Scale (PE scale) measures empowerment by means of four cognitions (meaning, competence, impact, and self-determination), while the Client-Centered Care Questionnaire (CCCQ) measures the level of client-centered care.The PE scale and CCCQ are valid and internally consistent in our sample of (proxy) budget holders with disabilities.In light of the current trends in the (health)care sector to stimulate empowerment and client-centered care in care users, the monitoring of this experience is important.The Psychological Empowerment Scale (PE scale) measures empowerment by means of four cognitions (meaning, competence, impact, and self-determination), while the Client-Centered Care Questionnaire (CCCQ) measures the level of client-centered care.The PE scale and CCCQ are valid and internally consistent in our sample of (proxy) budget holders with disabilities. [ABSTRACT FROM AUTHOR]

Published
2024
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50. RADIATION DOSIMETRY PROPERTIES OF SMARTPHONE CMOS SENSORS.

Author

Van Hoey, Olivier, Salavrakos, Alexia, Marques, Antonio, Nagao, Alexandre, Willems, Ruben, Vanhavere, Filip, Cauwels, Vanessa, and Nascimento, Luana F.

Subjects
SMARTPHONES, RADIATION dosimetry, COMPLEMENTARY metal oxide semiconductors, DETECTORS, NUCLEAR counters, X-rays
Abstract

During the past years, several smartphone applications have been developed for radiation detection. These applications measure radiation using the smartphone camera complementary metaloxide-semiconductor sensor. They are potentially useful for data collection and personal dose assessment in case of a radiological incident. However, it is important to assess these applications. Six applications were tested by means of irradiations with calibrated X-ray and gamma sources. It was shown that the measurement stabilises only after at least 10-25 min. All applications exhibited a flat dose rate response in the studied ambient dose equivalent range from 2 to 1000 μSv h-1. Most applications significantly over-or underestimate the dose rate or are not calibrated in terms of dose rate. A considerable energy dependence was observed below 100 keV but not for the higher energy range more relevant for incident scenarios. Photon impact angle variation gave a measured signal variation of only about 10 %. [ABSTRACT FROM AUTHOR]

Published
2016
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