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2. The impact of chest computed tomography and chest radiography on clinical management of cystic fibrosis lung disease

Author

Belessis, Y., Bremont, F., Bui, S., Casciaro, R., Cavicchi, M.C., Cox, D.M., Da Dalt, L., De Gregorio, F., Dubus, J.C., Gartner, S., Geerdink, M., Hansen, C.R., Honková, L., Jenkins, L.E., Jung, A., Karpati, F., Mainguy, C., Möller, A., Neri, A.S., Pressler, T., Proesmans, M., Raia, V., Reid, A.J.M., Rietschel, E., Robinson, P.D., Robinson, P.J., Rossi, P., Rovira, S., Schultz, A., Sepe, O., Skalická, V., Stick, S., Švabe, V., Tai, A., Tosco, A., Vazquez, C., Bortoluzzi, Carla F., Pontello, Eleonora, Pintani, Emily, de Winter-de Groot, Karin M., D'Orazio, Ciro, Assael, Baroukh M., Hunink, M.G. Myriam, Tiddens, Harm A.W.M., and Caudri, Daan

Published
2020
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6. Cardiovascular and Renal Benefits of Novel Diabetes Drugs by Baseline Cardiovascular Risk: A Systematic Review, Meta-analysis, and Meta-regression

Author

Rodriguez-Valadez, José M., primary, Tahsin, Malak, additional, Fleischmann, Kirsten E., additional, Masharani, Umesh, additional, Yeboah, Joseph, additional, Park, Meyeon, additional, Li, Lihua, additional, Weber, Ellerie, additional, Li, Yan, additional, Berkalieva, Asem, additional, Max, Wendy, additional, Hunink, M.G. Myriam, additional, and Ferket, Bart S., additional

Published
2023
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7. Abstract P140: Potential Mediators for Cardiovascular Benefits of Novel Diabetes Medications: A Meta-Regression Analysis

Author

Rodriguez Valadez, Jose M, primary, Tahsin, Malak, additional, Masharani, Umesh, additional, Park, Meyeon, additional, Hunink, M.G. Myriam, additional, Yeboah, Joseph, additional, Li, Lihua, additional, Weber, Ellerie, additional, Li, Yan, additional, Berkalieva, Asem, additional, Avezaat, Luuk, additional, Max, Wendy, additional, Fleischmann, Kirsten E, additional, and Ferket, Bart S, additional

Published
2023
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15. PET-Based Staging Is Cost-Effective in Early-Stage Follicular Lymphoma

Author

Lo, Andrea C., primary, James, Lyndon P., additional, Prica, Anca, additional, Raymakers, Adam, additional, Peacock, Stuart, additional, Qu, Melody, additional, Louie, Alex V., additional, Savage, Kerry J., additional, Sehn, Laurie H., additional, Hodgson, David, additional, Yang, Joanna C., additional, Eich, Hans T.T., additional, Wirth, Andrew, additional, and Hunink, M.G. Myriam, additional

Published
2021
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16. Endovascular Revascularization Plus Supervised Exercise Versus Supervised Exercise Only for Intermittent Claudication: A Cost-Effectiveness Analysis

Author

Fakhry, Farzin, primary, Rouwet, Ellen V., additional, Spillenaar Bilgen, Reinier, additional, van der Laan, Lijckle, additional, Wever, Jan J., additional, Teijink, Joep A.W., additional, Hoffmann, Wolter H., additional, van Petersen, Andre, additional, van Brussel, Jerome P., additional, Stultiens, Guido N.M., additional, Derom, Alex, additional, den Hoed, P. Ted, additional, Ho, Gwan H., additional, van Dijk, Lukas C., additional, Verhofstad, Nicole, additional, Orsini, Mariella, additional, Hulst, Ingrid, additional, van Sambeek, Marc R.H.M., additional, Rizopoulos, Dimitris, additional, Moelker, Adriaan, additional, and Hunink, M.G. Myriam, additional

Published
2021
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18. Clinical consequences of posttraumatic bone bruise in the knee

Author

Boks, Simone S., Vroegindeweij, Dammis, Koes, Bart W., Bernsen, Roos M.D., Hunink, M.G. Myriam, and Bierma-Zeinstra, Sita M.A.

Subjects
Knee -- Injuries, Pain -- Care and treatment -- Analysis -- Complications and side effects, Sports injuries -- Complications and side effects -- Care and treatment, Cohort analysis -- Analysis, Health, Sports and fitness, Care and treatment, Analysis, Complications and side effects
Abstract

Background: Bone bruise is often seen in posttraumatic knees, but the clinical relevance is unclear. Hypothesis: The presence of bone bruise is associated with increased pain severity in patients with [...]

Published
2007

21. Diagnostic performance of hyperaemic myocardial blood flow index obtained by dynamic computed tomography: does it predict functionally significant coronary lesions?

Author

Rossi, Alexia, Dharampal, Anoeshka, Wragg, Andrew, Davies, L. Ceri, van Geuns, Robert Jan, Anagnostopoulos, Costantinos, Klotz, Ernst, Kitslaar, Pieter, Broersen, Alexander, Mathur, Anthony, Nieman, Koen, Hunink, M.G. Myriam, de Feyter, Pim J., Petersen, Steffen E., and Pugliese, Francesca

Published
2014
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23. A clinical prediction rule for the diagnosis of coronary artery disease: validation, updating, and extension

Author

Genders, Tessa S.S., Steyerberg, Ewout W., Alkadhi, Hatem, Leschka, Sebastian, Desbiolles, Lotus, Nieman, Koen, Galema, Tjebbe W., Meijboom, W. Bob, Mollet, Nico R., de Feyter, Pim J., Cademartiri, Filippo, Maffei, Erica, Dewey, Marc, Zimmermann, Elke, Laule, Michael, Pugliese, Francesca, Barbagallo, Rossella, Sinitsyn, Valentin, Bogaert, Jan, Goetschalckx, Kaatje, Schoepf, U. Joseph, Rowe, Garrett W., Schuijf, Joanne D., Bax, Jeroen J., de Graaf, Fleur R., Knuuti, Juhani, Kajander, Sami, van Mieghem, Carlos A.G., Meijs, Matthijs F.L., Cramer, Maarten J., Gopalan, Deepa, Feuchtner, Gudrun, Friedrich, Guy, Krestin, Gabriel P., and Hunink, M.G. Myriam

Published
2011
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24. The impact of chest computed tomography and chest radiography on clinical management of cystic fibrosis lung disease

Author

Bortoluzzi, Carla F., primary, Pontello, Eleonora, additional, Pintani, Emily, additional, de Winter-de Groot, Karin M., additional, D'Orazio, Ciro, additional, Assael, Baroukh M., additional, Hunink, M.G. Myriam, additional, Tiddens, Harm A.W.M., additional, Caudri, Daan, additional, Belessis, Y., additional, Bremont, F., additional, Bui, S., additional, Casciaro, R., additional, Cavicchi, M.C., additional, Cox, D.M., additional, Da Dalt, L., additional, De Gregorio, F., additional, Dubus, J.C., additional, Gartner, S., additional, Geerdink, M., additional, Hansen, C.R., additional, Honková, L., additional, Jenkins, L.E., additional, Jung, A., additional, Karpati, F., additional, Mainguy, C., additional, Möller, A., additional, Neri, A.S., additional, Pressler, T., additional, Proesmans, M., additional, Raia, V., additional, Reid, A.J.M., additional, Rietschel, E., additional, Robinson, P.D., additional, Robinson, P.J., additional, Rossi, P., additional, Rovira, S., additional, Schultz, A., additional, Sepe, O., additional, Skalická, V., additional, Stick, S., additional, Švabe, V., additional, Tai, A., additional, Tosco, A., additional, and Vazquez, C., additional

Published
2020
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25. Public Health and Cost Benefits of Successful Reperfusion After Thrombectomy for Stroke

Author

Kunz, W.G. (Wolfgang), Almekhlafi, M. (Mohammed), Menon, B.K. (Bijoy K.), Saver, J.L. (Jeffery L.), Hunink, M.G. (Myriam G.), Dippel, D.W.J. (Diederik), Majoie, C.B.L.M. (Charles B L M), Liebeskind, D.S. (David S.), Jovin, T.G. (Tudor G.), Davalos, A. (Antoni), Bracard, S. (Serge), Guillemin, F. (Francis), Campbell, B.C.V. (Bruce C. V.), Mitchell, P.J. (Peter J.), White, P. (Philip), Muir, K.W. (Keith), Brown, S. (Scott), Demchuk, A.M. (Andrew), Hill, M.D. (Michael D.), Goyal, M. (Mayank), Kunz, W.G. (Wolfgang), Almekhlafi, M. (Mohammed), Menon, B.K. (Bijoy K.), Saver, J.L. (Jeffery L.), Hunink, M.G. (Myriam G.), Dippel, D.W.J. (Diederik), Majoie, C.B.L.M. (Charles B L M), Liebeskind, D.S. (David S.), Jovin, T.G. (Tudor G.), Davalos, A. (Antoni), Bracard, S. (Serge), Guillemin, F. (Francis), Campbell, B.C.V. (Bruce C. V.), Mitchell, P.J. (Peter J.), White, P. (Philip), Muir, K.W. (Keith), Brown, S. (Scott), Demchuk, A.M. (Andrew), Hill, M.D. (Michael D.), and Goyal, M. (Mayank)

Abstract

Background and Purpose- The benefit that endovascular thrombectomy offers to patients with stroke with large vessel occlusions depends strongly on reperfusion grade as defined by the expanded Thrombolysis in Cerebral Infarction (eTICI) scale. Our aim was to determine the lifetime health and cost consequences of the quality of reperfusion for patients, healthcare systems, and society. Methods- A Markov model estimated lifetime quality-adjusted life years (QALY) and lifetime costs of endovascular thrombectomy-treated patients with stroke based on eTICI grades. The analysis was performed over a lifetime horizon in a United States setting, adopting healthcare and societal perspectives. The reference case analysis was conducted for stroke at 65 years of age. National health and cost consequences of improved eTICI 2c/3 reperfusion rates were estimated. Input parameters were based on best available evidence. Results- Lifetime QALYs increased for every grade of improved reperfusion (median QALYs for eTICI 0/1: 2.62; eTICI 2a: 3.46; eTICI 2b: 5.42; eTICI 2c: 5.99; eTICI 3: 6.73). Achieving eTICI 3 over eTICI 2b reperfusion resulted on average in 1.31 incremental QALYs as well as healthcare and societal cost savings of $10 327 and $20 224 per patient. A 10% increase in the eTICI 2c/3 reperfusion rate of all annually endovascular thrombectomy-treated patients with stroke in the United States is estimated to yield additional 3656 QALYs and save $21.0 million and $36.8 million for the healthcare system and society, respectively. Conclusions- Improved reperfusion grants patients with stroke additional QALYs and leads to long-term cost savings. Procedural strategies to achieve complete reperfusion should be assessed for safety and feasibility, even when initial reperfusion seems to be adequate.

Published
2020
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31. Personalized prediction of lifetime benefits with statin therapy for asymptomatic individuals: a modeling study

Author

Ferket, Bart S., van Kempen, Bob J.H., Heeringa, Jan, Spronk, Sandra, Fleischmann, Kirsten E., Nijhuis, Rogier L.G., Hofman, Albert, Steyerberg, Ewout W., and Hunink, M.G. Myriam

Subjects
Statins -- Physiological aspects -- Health aspects, Prevalence studies (Epidemiology) -- Research, Cardiovascular diseases -- Physiological aspects -- Prevention -- Care and treatment, Biological sciences
Abstract

Background: Physicians need to inform asymptomatic individuals about personalized outcomes of statin therapy for primary prevention of cardiovascular disease (CVD). However, current prediction models focus on short-term outcomes and ignore the competing risk of death due to other causes. We aimed to predict the potential lifetime benefits with statin therapy, taking into account competing risks. Methods and Findings: A microsimulation model based on 5-y follow-up data from the Rotterdam Study, a population-based cohort of individuals aged 55 y and older living in the Ommoord district of Rotterdam, the Netherlands, was used to estimate lifetime outcomes with and without statin therapy. The model was validated in-sample using 10-y follow-up data. We used baseline variables and model output to construct (1) a web-based calculator for gains in total and CVD-free life expectancy and (2) color charts for comparing these gains to the Systematic Coronary Risk Evaluation (SCORE) charts. In 2,428 participants (mean age 67.7 y, 35.5% men), statin therapy increased total life expectancy by 0.3 y (SD 0.2) and CVD-free life expectancy by 0.7 y (SD 0.4). Age, sex, smoking, blood pressure, hypertension, lipids, diabetes, glucose, body mass index, waist-to-hip ratio, and creatinine were included in the calculator. Gains in total and CVD-free life expectancy increased with blood pressure, unfavorable lipid levels, and body mass index after multivariable adjustment. Gains decreased considerably with advancing age, while SCORE 10-y CVD mortality risk increased with age. Twenty-five percent of participants with a low SCORE risk achieved equal or larger gains in CVD-free life expectancy than the median gain in participants with a high SCORE risk. Conclusions: We developed tools to predict personalized increases in total and CVD-free life expectancy with statin therapy. The predicted gains we found are small. If the underlying model is validated in an independent cohort, the tools may be useful in discussing with patients their individual outcomes with statin therapy. Please see later in the article for the Editors' Summary., Introduction Current guidelines recommend that asymptomatic individuals at high cardiovascular disease (CVD) risk be identified for statin therapy. For this purpose, risk assessment is performed using prediction models estimating short-term, [...]

Published
2012
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32. A clinical prediction rule for the diagnosis of coronary artery disease: validation, updating, and extension

Author

Genders, Tessa S.S., Steyerberg, Ewout W., Alkadhi, Hatem, Leschka, Sebastian, Desbiolles, Lotus, Nieman, Koen, Galema, Tjebbe W., Meijboom, W. Bob, Mollet, Nico R., de Feyter, Pim J., Cademartiri, Filippo, Maffei, Erica, Dewey, Marc, Zimmermann, Elke, Laule, Michael, Pugliese, Francesca, Barbagallo, Rossella, Sinitsyn, Valentin, Bogaert, Jan, Goetschalckx, Kaatje, Schoepf, U. Joseph, Rowe, Garrett W., Schuijf, Joanne D., Bax, Jeroen J., de Graaf, Fleur R., Knuuti, Juhani, Kajander, Sami, van Mieghem, Carlos A.G., Meijs, Matthijs F.L., Cramer, Maarten J., Gopalan, Deepa, Feuchtner, Gudrun, Friedrich, Guy, Krestin, Gabriel P., Hunink, M.G. Myriam, Genders, Tessa S.S., Steyerberg, Ewout W., Alkadhi, Hatem, Leschka, Sebastian, Desbiolles, Lotus, Nieman, Koen, Galema, Tjebbe W., Meijboom, W. Bob, Mollet, Nico R., de Feyter, Pim J., Cademartiri, Filippo, Maffei, Erica, Dewey, Marc, Zimmermann, Elke, Laule, Michael, Pugliese, Francesca, Barbagallo, Rossella, Sinitsyn, Valentin, Bogaert, Jan, Goetschalckx, Kaatje, Schoepf, U. Joseph, Rowe, Garrett W., Schuijf, Joanne D., Bax, Jeroen J., de Graaf, Fleur R., Knuuti, Juhani, Kajander, Sami, van Mieghem, Carlos A.G., Meijs, Matthijs F.L., Cramer, Maarten J., Gopalan, Deepa, Feuchtner, Gudrun, Friedrich, Guy, Krestin, Gabriel P., and Hunink, M.G. Myriam

Abstract

Aims The aim was to validate, update, and extend the Diamond-Forrester model for estimating the probability of obstructive coronary artery disease (CAD) in a contemporary cohort. Methods and results Prospectively collected data from 14 hospitals on patients with chest pain without a history of CAD and referred for conventional coronary angiography (CCA) were used. Primary outcome was obstructive CAD, defined as ≥50% stenosis in one or more vessels on CCA. The validity of the Diamond-Forrester model was assessed using calibration plots, calibration-in-the-large, and recalibration in logistic regression. The model was subsequently updated and extended by revising the predictive value of age, sex, and type of chest pain. Diagnostic performance was assessed by calculating the area under the receiver operating characteristic curve (c-statistic) and reclassification was determined. We included 2260 patients, of whom 1319 had obstructive CAD on CCA. Validation demonstrated an overestimation of the CAD probability, especially in women. The updated and extended models demonstrated a c-statistic of 0.79 (95% CI 0.77-0.81) and 0.82 (95% CI 0.80-0.84), respectively. Sixteen per cent of men and 64% of women were correctly reclassified. The predicted probability of obstructive CAD ranged from 10% for 50-year-old females with non-specific chest pain to 91% for 80-year-old males with typical chest pain. Predictions varied across hospitals due to differences in disease prevalence. Conclusion Our results suggest that the Diamond-Forrester model overestimates the probability of CAD especially in women. We updated the predictive effects of age, sex, type of chest pain, and hospital setting which improved model performance and we extended it to include patients of 70 years and older

Published
2017

33. PERFORMANCE OF CARDIAC CT COMPARED TO FUNCTIONAL TESTING IN WOMEN AND MEN WITH SUSPECTED CORONARY ARTERY DISEASE: THE MULTICENTER, RANDOMIZED CRESCENT TRIAL

Author

Lubbers, Marisa, primary, Dedic, Admir, additional, Coenen, Adriaan, additional, Galema, Tjebbe, additional, Akkerhuis, Jurgen, additional, Bruning, Tobias, additional, Krenning, Boudewijn, additional, Musters, Paul, additional, Ouhlous, Mohamed, additional, Liem, Anho, additional, Niezen, Andre, additional, Hunink, M.G. Myriam, additional, van Domburg, Ron, additional, de Feijter, Pim, additional, and Nieman, Koen, additional

Published
2016
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41. Comparative Effectiveness and Cost-Effectiveness of Computed Tomography Screening for Coronary Artery Calcium in Asymptomatic Individuals

Author

van Kempen, Bob J.H., primary, Spronk, Sandra, additional, Koller, Michael T., additional, Elias-Smale, Suzette E., additional, Fleischmann, Kirsten E., additional, Ikram, M. Arfan, additional, Krestin, Gabriel P., additional, Hofman, Albert, additional, Witteman, Jacqueline C.M., additional, and Hunink, M.G. Myriam, additional

Published
2011
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48. A clinical prediction rule for the diagnosis of coronary artery disease: validation, updating, and extension

Author

Genders, Tessa S.S., Steyerberg, Ewout W., Alkadhi, Hatem, Leschka, Sebastian, Desbiolles, Lotus, Nieman, Koen, Galema, Tjebbe W., Meijboom, W. Bob, Mollet, Nico R., de Feyter, Pim J., Cademartiri, Filippo, Maffei, Erica, Dewey, Marc, Zimmermann, Elke, Laule, Michael, Pugliese, Francesca, Barbagallo, Rossella, Sinitsyn, Valentin, Bogaert, Jan, Goetschalckx, Kaatje, Schoepf, U. Joseph, Rowe, Garrett W., Schuijf, Joanne D., Bax, Jeroen J., de Graaf, Fleur R., Knuuti, Juhani, Kajander, Sami, van Mieghem, Carlos A.G., Meijs, Matthijs F.L., Cramer, Maarten J., Gopalan, Deepa, Feuchtner, Gudrun, Friedrich, Guy, Krestin, Gabriel P., Hunink, M.G. Myriam, Genders, Tessa S.S., Steyerberg, Ewout W., Alkadhi, Hatem, Leschka, Sebastian, Desbiolles, Lotus, Nieman, Koen, Galema, Tjebbe W., Meijboom, W. Bob, Mollet, Nico R., de Feyter, Pim J., Cademartiri, Filippo, Maffei, Erica, Dewey, Marc, Zimmermann, Elke, Laule, Michael, Pugliese, Francesca, Barbagallo, Rossella, Sinitsyn, Valentin, Bogaert, Jan, Goetschalckx, Kaatje, Schoepf, U. Joseph, Rowe, Garrett W., Schuijf, Joanne D., Bax, Jeroen J., de Graaf, Fleur R., Knuuti, Juhani, Kajander, Sami, van Mieghem, Carlos A.G., Meijs, Matthijs F.L., Cramer, Maarten J., Gopalan, Deepa, Feuchtner, Gudrun, Friedrich, Guy, Krestin, Gabriel P., and Hunink, M.G. Myriam

Abstract

Aims The aim was to validate, update, and extend the Diamond-Forrester model for estimating the probability of obstructive coronary artery disease (CAD) in a contemporary cohort. Methods and results Prospectively collected data from 14 hospitals on patients with chest pain without a history of CAD and referred for conventional coronary angiography (CCA) were used. Primary outcome was obstructive CAD, defined as ≥50% stenosis in one or more vessels on CCA. The validity of the Diamond-Forrester model was assessed using calibration plots, calibration-in-the-large, and recalibration in logistic regression. The model was subsequently updated and extended by revising the predictive value of age, sex, and type of chest pain. Diagnostic performance was assessed by calculating the area under the receiver operating characteristic curve (c-statistic) and reclassification was determined. We included 2260 patients, of whom 1319 had obstructive CAD on CCA. Validation demonstrated an overestimation of the CAD probability, especially in women. The updated and extended models demonstrated a c-statistic of 0.79 (95% CI 0.77-0.81) and 0.82 (95% CI 0.80-0.84), respectively. Sixteen per cent of men and 64% of women were correctly reclassified. The predicted probability of obstructive CAD ranged from 10% for 50-year-old females with non-specific chest pain to 91% for 80-year-old males with typical chest pain. Predictions varied across hospitals due to differences in disease prevalence. Conclusion Our results suggest that the Diamond-Forrester model overestimates the probability of CAD especially in women. We updated the predictive effects of age, sex, type of chest pain, and hospital setting which improved model performance and we extended it to include patients of 70 years and older

49. From statistics to knowledge.

Author

Hunink, M.G. Myriam

Subjects
BOOKS, MEDICAL care, STATISTICS, HEALTH
Abstract

The article presents information on the book "Dicing with Death: Chance, Risk and Health," by Stephen Senn. In the book Senn explains statistical concepts as they are relevant to healthcare, by answering questions such as interpretation of data from medical studies and the best decision based on that data. He discusses how to assess the value of data and emphasizes that collecting reliable statistics is demanding. He highlights the fact that statistical modeling is complex and that good quantitative prediction is extremely difficult. Finally, Senn describes the investigation of causality and how to assess our ability to affect health.

Published
2004
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