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4. Diagnostic accuracy of endoscopic ultrasonography-guided tissue acquisition prior to resection of pancreatic carcinoma: a nationwide analysis

Author

Quispel, Rutger, Schutz, Hannah M., Keultjes, Augustinus W.P., Erler, Nicole S., Janssen, Quisette P., van Hooft, Jeanin E., Venneman, Niels G., Honkoop, Pieter, Hol, Lieke, Scheffer, Robert C., Bisseling, Tanya M., Voermans, Rogier P., Vleggaar, Frank P., Schwartz, Matthijs P., Verdonk, Robert C., Hoge, Chantal V., Kuiken, Sjoerd D., Curvers, Wouter L., van Vilsteren, Frederike G.I., Poen, Alexander C., Spanier, Marcel B., Bruggink, Annette H., Smedts, Frank M., van Velthuysen, Marie-Louise F., van Eijck, Casper H., Besselink, Marc G., Veldt, Bart J., Koerkamp, Bas G., van Driel, Lydi M.J.W., and Bruno, Marco J.

Published
2023
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5. TOP-401-YI Improvement of liver stiffness during nucleo (s)tide analogue treatment in patients with chronic hepatitis B and advanced fibrosis is not associated with a reduction in hepatocellular carcinoma risk

Author

Patmore, Lesley A., primary, Liang, Yan, additional, Kilany, Mai, additional, d'Almeida, Arno Furquim, additional, Wong, Vincent Wai-Sun, additional, Vanwolleghem, Thomas, additional, Honkoop, Pieter, additional, Blokzijl, Hans, additional, Koc, Ozgur, additional, Janssen, Harry L.A., additional, Kramer, Matthijs, additional, de Bruijne, Joep, additional, Kaewdech, A., additional, de Man, Robert A., additional, Takkenberg, R. Bart, additional, Wong, Grace Lai-Hung, additional, Feld, Jordan J., additional, and Sonneveld, Milan J., additional

Published
2024
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6. Patient profiled data for treatment decision-making:valuable as an add-on to hepatitis C clinical guidelines?

Author

Brakenhoff, Sylvia M., Theijse, Thymen, van Wijngaarden, Peter, Trautwein, Christian, Brozat, Jonathan F., Tacke, Frank, Honkoop, Pieter, Vanwolleghem, Thomas, Posthouwer, Dirk, Zeuzem, Stefan, Mihm, Ulrike, Wedemeyer, Heiner, Berg, Thomas, Schalm, Solko W., de Knegt, Robert J., Brakenhoff, Sylvia M., Theijse, Thymen, van Wijngaarden, Peter, Trautwein, Christian, Brozat, Jonathan F., Tacke, Frank, Honkoop, Pieter, Vanwolleghem, Thomas, Posthouwer, Dirk, Zeuzem, Stefan, Mihm, Ulrike, Wedemeyer, Heiner, Berg, Thomas, Schalm, Solko W., and de Knegt, Robert J.

Abstract

Background and Aims: Systematic reviews and medical guidelines are widely used in clinical practice. However, these are often not up-to-date and focussed on the average patient. We therefore aimed to evaluate a guideline add-on, TherapySelector (TS), which is based on monthly updated data of all available high-quality studies, classified in specific patient profiles. Methods: We evaluated the TS for the treatment of hepatitis C (HCV) in an international cohort of patients treated with direct-acting antivirals between 2015 and 2020. The primary outcome was the number of patients receiving one of the two preferred treatment options of the HCV TS, based on the highest level of evidence, cure rate, absence of ribavirin-associated adverse effects, and treatment duration. Results: We enrolled 567 patients. The number of patients treated with one of the two preferred treatment options according to the HCV TS ranged between 27% (2015) and 60% (2020; p < 0.001). Most of the patients received a regimen with a longer treatment-duration (up to 34%) and/or addition of ribavirin (up to 14%). The effect on the expected cure-rate was minimal (1–6% higher) when the first preferred TherapySelector option was given compared to the actual treatment.Conclusions: Medical decision-making can be optimised by a guideline add-on; in HCV its use appears to minimise adverse effects and cost. The use of such an add-on might have a greater impact in diseases with suboptimal cure-rates, high costs or adverse effects, for which treatment options rely on specific patient characteristics.

Published
2024

7. Sustained response and HBsAg loss after nucleo(s)tide analogue discontinuation in chronic hepatitis B patients:the prospective SNAP study

Author

Brakenhoff, Sylvia M., Claassen, Mark, Honkoop, Pieter, de Knegt, Robert J., van der Eijk, Annemiek A., Boonstra, André, de Man, Robert A., Sonneveld, Milan J., Brakenhoff, Sylvia M., Claassen, Mark, Honkoop, Pieter, de Knegt, Robert J., van der Eijk, Annemiek A., Boonstra, André, de Man, Robert A., and Sonneveld, Milan J.

Abstract

Background & Aim(s): Current guidelines suggest that nucleos(t)ide analogues (NA) can be discontinued before HBsAg loss in a selected group of chronic hepatitis B (CHB) patients. We aimed to study the safety and off-treatment response after NA cessation. Methods: This is a prospective, multicentre, cohort study in which eligible patients discontinued NA therapy. Adult patients, with a CHB mono-infection, HBeAg-negative, without a (history of) liver cirrhosis, who had achieved long-term viral suppression were eligible. Follow-up visits were planned at week 2-4-8-12-24-36-48-72-96. Re-treatment criteria included severe hepatitis (ALT >10x ULN), signs of imminent liver failure (bilirubin >1.5x ULN or INR >1.5), or at the physician's own discretion. Results: In total, 33 patients were enrolled. Patients were predominantly Caucasian (45.5%) and had genotype A/B/C/D/unknown in 3/4/6/10/10 (9.1/12.1/18.2/30.3/30.3%). At week 48, 15 patients (45.5%) achieved a sustained response (HBV DNA <2,000 IU/mL). At week 96, 13 patients (39.4%) achieved a sustained response, 4 (12.1%) achieved HBsAg loss, and 12 (36.4%) were re-treated. Severe hepatitis was the main reason for re-treatment (n=7, 21.2%). One patient with severe hepatitis developed jaundice, without signs of hepatic decompensation. Re-treatment was successful in all patients.Conclusion: NA therapy can be ceased in a highly selected group of CHB patients if close follow-up can be guaranteed. Treatment cessation may increase the chance of HBsAg loss in selected patients, which is counterbalanced by a significant risk of severe hepatitis.

Published
2024

9. Pancreatic cyst surveillance imposes low psychological burden

Author

Bruno, M.J., Cahen, D.L., van Riet, P.A., Overbeek, K.A., Levink, I.J.M., Koopmann, B., Besselink, M.G.H., del Chiaro, M., Lerch, M.M., Wallace, M.B., van Ballegooijen, M., Biermann, K., Bleiker, E.M.A., Bollen, T.H.L., Fockens, P., de Kok, I.M.C.M., Looijenga, L.H.J., Peppelenbosch, M.P., Verhagen-Oldenampsen, J.H.E., Arcidiacono, P.G., Capurso, G., Bergmann, J., van Berkel, A., Beyer, G., Bijlsma, R., Braat, H., Carrara, S., Czakó, L., van Erp-van der Steen, H., Ganesh, S., van Geenen, E., Gonda, T., Hoge, C., Honkoop, P., van Hooft, J.E., Jansen, J., Larghi, A., van Leeuwenburgh, I., Laukkarinen, J., Lelyveld, N., Lerch, M., di Marco, M.C., Ricci, C., Casadei, R., Rau, E.P., Perk, L., Polkowski, M., Pukitits, A., Quispel, R., Radenkovic, D., Seicean, A., Schwartz, T., Schoon, E.J., van Soest, E., Tan, A., Venneman, N.G., Vos, P., Voorburg, A., van der Waaij, L.A., Wijkerslooth, L.R.H., Zerboni, G., della Fave, G., Zonderhuis, B., Overbeek, Kasper A., Kamps, Anne, van Riet, Priscilla A., Di Marco, Mariacristina, Zerboni, Giulia, van Hooft, Jeanin E., Carrara, Silvia, Ricci, Claudio, Gonda, Tamas A., Schoon, Erik, Polkowski, Marcin, Beyer, Georg, Honkoop, Pieter, van der Waaij, Laurens A., Casadei, Riccardo, Capurso, Gabriele, Erler, Nicole S., Bruno, Marco J., Bleiker, Eveline M.A., and Cahen, Djuna L.

Published
2019
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10. Small cyst size and slow growth rate are soothing features in individuals with pancreatic cysts undergoing surveillance

Author

Levink, Iris, primary, Koopmann, Brechtje, additional, Jaarsma, Sanne, additional, van Riet, Priscilla, additional, Overbeek, Kasper, additional, Meziani, Jihane, additional, Sprij, Marloes, additional, Gorris, Myrte, additional, Van Hooft, Jeanin, additional, Casadei, Riccardo, additional, Ingaldi, Carlo, additional, Wallace, Michael, additional, Hoogenboom, Sanne, additional, Honkoop, Pieter, additional, Polkowski, Marcin, additional, Carrara, Silvia, additional, Schoon, Erik, additional, Gemma, Rossi, additional, van der Waaij, Laurens, additional, Beyer, Georg, additional, Bergmann, Jilling, additional, Pando, Elizabeth, additional, Venneman, Niels, additional, Laukkarinen, Johanna, additional, Berkel, Anne-Marie van, additional, Van Vilsteren, Frederike, additional, Schwartz, Thijs, additional, Azopardi, Neville, additional, Hoge, Chantal, additional, van Soest, Ellert, additional, Smits, Marianne, additional, Quispel, Rutger, additional, Vos, Patrick, additional, Tan, Adriaan, additional, Czacko, Laszlo, additional, Leeuwenburgh, Ivonne, additional, Bruno, Marco, additional, and Cahen, Djuna, additional

Published
2023
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11. The additive value of CA19.9 monitoring in a pancreatic cyst surveillance program

Author

Levink, Iris J.M., Jaarsma, Sanne C., Koopmann, Brechtje D.M., van Riet, Priscilla A., Overbeek, Kasper A., Meziani, Jihane, Sprij, Marloes L.J.A., Casadei, Riccardo, Ingaldi, Carlo, Polkowski, Marcin, Engels, Megan M.L., van der Waaij, Laurens A., Carrara, Silvia, Pando, Elizabeth, Vornhülz, Marlies, Honkoop, Pieter, Schoon, Erik J., Laukkarinen, Johanna, Bergmann, Jilling F., Rossi, Gemma, van Vilsteren, Frederike G.I., van Berkel, Anne Marie, Tabone, Trevor, Schwartz, Matthijs P., Tan, Adriaan C.I.T.L., van Hooft, Jeanin E., Quispel, Rutger, van Soest, Ellert, Czacko, Laszlo, Bruno, Marco J., Cahen, Djuna L., Levink, Iris J.M., Jaarsma, Sanne C., Koopmann, Brechtje D.M., van Riet, Priscilla A., Overbeek, Kasper A., Meziani, Jihane, Sprij, Marloes L.J.A., Casadei, Riccardo, Ingaldi, Carlo, Polkowski, Marcin, Engels, Megan M.L., van der Waaij, Laurens A., Carrara, Silvia, Pando, Elizabeth, Vornhülz, Marlies, Honkoop, Pieter, Schoon, Erik J., Laukkarinen, Johanna, Bergmann, Jilling F., Rossi, Gemma, van Vilsteren, Frederike G.I., van Berkel, Anne Marie, Tabone, Trevor, Schwartz, Matthijs P., Tan, Adriaan C.I.T.L., van Hooft, Jeanin E., Quispel, Rutger, van Soest, Ellert, Czacko, Laszlo, Bruno, Marco J., and Cahen, Djuna L.

Abstract

Background:Surveillance of pancreatic cysts focuses on the detection of (mostly morphologic) features warranting surgery. European guidelines consider elevated CA19.9 as a relative indication for surgery. We aimed to evaluate the role of CA19.9 monitoring for early detection and management in a cyst surveillance population. Methods: The PACYFIC-registry is a prospective collaboration that investigates the yield of pancreatic cyst surveillance performed at the discretion of the treating physician. We included participants for whom at least one serum CA19.9 value was determined by a minimum follow-up of 12 months.Results: Of 1865 PACYFIC participants, 685 met the inclusion criteria for this study (mean age 67 years, SD 10; 61% female). During a median follow-up of 25 months (IQR 24, 1966 visits), 29 participants developed high-grade dysplasia (HGD) or pancreatic cancer. At baseline, CA19.9 ranged from 1 to 591 kU/L (median 10 kU/L [IQR 14]), and was elevated (≥37 kU/L) in 64 participants (9%). During 191 of 1966 visits (10%), an elevated CA19.9 was detected, and these visits more often led to an intensified follow-up (42%) than those without an elevated CA19.9 (27%; p < 0.001). An elevated CA19.9 was the sole reason for surgery in five participants with benign disease (10%). The baseline CA19.9 value was (as continuous or dichotomous variable at the 37 kU/L threshold) not independently associated with HGD or pancreatic cancer development, whilst a CA19.9 of ≥ 133 kU/L was (HR 3.8, 95% CI 1.1–13, p = 0.03). Conclusions: In this pancreatic cyst surveillance cohort, CA19.9 monitoring caused substantial harm by shortening surveillance intervals (and performance of unnecessary surgery). The current CA19.9 cutoff was not predictive of HGD and pancreatic cancer, whereas a higher cutoff may decrease false-positive values. The role of CA19.9 monitoring should be critically appraised prior to imp

Published
2023

12. Diagnostic accuracy of endoscopic ultrasonography-guided tissue acquisition prior to resection of pancreatic carcinoma:a nationwide analysis

Author

Quispel, Rutger, Schutz, Hannah M., Keultjes, Augustinus W.P., Erler, Nicole S., Janssen, Quisette P., van Hooft, Jeanin E., Venneman, Niels G., Honkoop, Pieter, Hol, Lieke, Scheffer, Robert C., Bisseling, Tanya M., Voermans, Rogier P., Vleggaar, Frank P., Schwartz, Matthijs P., Verdonk, Robert C., Hoge, Chantal V., Kuiken, Sjoerd D., Curvers, Wouter L., van Vilsteren, Frederike G.I., Poen, Alexander C., Spanier, Marcel B., Bruggink, Annette H., Smedts, Frank M., van Velthuysen, Marie Louise F., van Eijck, Casper H., Besselink, Marc G., Veldt, Bart J., Koerkamp, Bas G., van Driel, Lydi M.J.W., Bruno, Marco J., Quispel, Rutger, Schutz, Hannah M., Keultjes, Augustinus W.P., Erler, Nicole S., Janssen, Quisette P., van Hooft, Jeanin E., Venneman, Niels G., Honkoop, Pieter, Hol, Lieke, Scheffer, Robert C., Bisseling, Tanya M., Voermans, Rogier P., Vleggaar, Frank P., Schwartz, Matthijs P., Verdonk, Robert C., Hoge, Chantal V., Kuiken, Sjoerd D., Curvers, Wouter L., van Vilsteren, Frederike G.I., Poen, Alexander C., Spanier, Marcel B., Bruggink, Annette H., Smedts, Frank M., van Velthuysen, Marie Louise F., van Eijck, Casper H., Besselink, Marc G., Veldt, Bart J., Koerkamp, Bas G., van Driel, Lydi M.J.W., and Bruno, Marco J.

Abstract

Introduction: Endoscopic ultrasonography guided tissue acquisition (EUS + TA) is used to provide a tissue diagnosis in patients with suspected pancreatic cancer. Key performance indicators (KPI) for these procedures are rate of adequate sample (RAS) and sensitivity for malignancy (SFM). Aim: assess practice variation regarding KPI of EUS + TA prior to resection of pancreatic carcinoma in the Netherlands. Patients and methods: Results of all EUS + TA prior to resection of pancreatic carcinoma from 2014–2018, were extracted from the national Dutch Pathology Registry (PALGA). Pathology reports were classified as: insufficient for analysis (b1), benign (b2), atypia (b3), neoplastic other (b4), suspected malignant (b5), and malignant (b6). RAS was defined as the proportion of EUS procedures yielding specimen sufficient for analysis. SFM was calculated using a strict definition (malignant only, SFM-b6), and a broader definition (SFM-b5+6). Results: 691 out of 1638 resected patients (42%) underwent preoperative EUS + TA. RAS was 95% (range 89–100%), SFM-b6 was 44% (20–77%), and SFM-b5+6 was 65% (53–90%). All centers met the performance target RAS>85%. Only 9 out of 17 met the performance target SFM-b5+6 > 85%. Conclusion: This nationwide study detected significant practice variation regarding KPI of EUS + TA procedures prior to surgical resection of pancreatic carcinoma. Therefore, quality improvement of EUS + TA is indicated.

Published
2023

13. Patients treated with rituximab are poorly screened for hepatitis B infection:Data from a low-incidence country

Author

Brakenhoff, Sylvia M., Hoekstra, Roos, Honkoop, Pieter, Roomer, Robert, den Hollander, Jan G., Bezemer, Geert, de Knegt, Robert J., Sonneveld, Milan J., de Man, Robert A., Brakenhoff, Sylvia M., Hoekstra, Roos, Honkoop, Pieter, Roomer, Robert, den Hollander, Jan G., Bezemer, Geert, de Knegt, Robert J., Sonneveld, Milan J., and de Man, Robert A.

Abstract

Background & Aims: Patients with chronic or resolved hepatitis B are at risk of hepatitis B reactivation (HBVr) when treated with high-risk immunosuppressive therapy such as rituximab. Therefore, international guidelines recommend HBV screening prior to rituximab treatment and subsequent antiviral prophylaxis among patients with a (resolved) infection. In this study, we evaluated the adherence to those recommendations. Methods: This is a retrospective multicentre study including patients treated with rituximab between 2000-2021. Performance of correct screening was assessed, defined as the measurement of hepatitis B surface antigen (HBsAg) and hepatitis B core antibodies (anti-HBc). Next, initiation of antiviral prophylaxis and HBVr rate among patients with a chronic or resolved HBV infection was studied. Results: We enrolled 3,176 patients of whom 1,448 (46%) were screened correctly. Screening rates differed significantly between academic and non-academic hospitals; respectively 65% vs 32% (p<0.001). In addition, screening rates differed across specialties and improved throughout the years; from 32% before 2012 to 75% after 2020 among academic prescribers, versus 1% to 60% among non-academic prescribers (both p<0.001). Antiviral prophylaxis was initiated in 58% vs 36% of the patients with a chronic or resolved HBV infection. Seven patients experienced HBVr, including one fatal liver decompensation. Conclusions: Many patients treated with rituximab were not correctly screened for HBV infection and antiviral prophylaxis was often not initiated. Although screening rates improved over time, rates remain suboptimal. With the increasing number of indications for rituximab and other immunosuppressive agents these findings could raise awareness among all medical specialties prescribing these agents.

Published
2023

14. The additive value of CA19.9 monitoring in a pancreatic cyst surveillance program

Author

Levink, Iris J. M., Jaarsma, Sanne C., Koopmann, Brechtje D. M., Riet, Priscilla A., Overbeek, Kasper A., Meziani, Jihane, Sprij, Marloes L. J. A., Casadei, Riccardo, Ingaldi, Carlo, Polkowski, Marcin, Engels, Megan M. L., Waaij, Laurens A., Carrara, Silvia, Pando, Elizabeth, Vornhülz, Marlies, Honkoop, Pieter, Schoon, Erik J., Laukkarinen, Johanna, Bergmann, Jilling F., Rossi, Gemma, Vilsteren, Frederike G. I., Berkel, Anne‐Marie, Tabone, Trevor, Schwartz, Matthijs P., Tan, Adriaan C. I. T. L., Hooft, Jeanin E., Quispel, Rutger, Soest, Ellert, Czacko, Laszlo, Bruno, Marco J., and Cahen, Djuna L.

Abstract

Surveillance of pancreatic cysts focuses on the detection of (mostly morphologic) features warranting surgery. European guidelines consider elevated CA19.9 as a relative indication for surgery. We aimed to evaluate the role of CA19.9 monitoring for early detection and management in a cyst surveillance population. The PACYFIC‐registry is a prospective collaboration that investigates the yield of pancreatic cyst surveillance performed at the discretion of the treating physician. We included participants for whom at least one serum CA19.9 value was determined by a minimum follow‐up of 12 months. Of 1865 PACYFIC participants, 685 met the inclusion criteria for this study (mean age 67 years, SD 10; 61% female). During a median follow‐up of 25 months (IQR 24, 1966 visits), 29 participants developed high‐grade dysplasia (HGD) or pancreatic cancer. At baseline, CA19.9 ranged from 1 to 591 kU/L (median 10 kU/L [IQR 14]), and was elevated (≥37 kU/L) in 64 participants (9%). During 191 of 1966 visits (10%), an elevated CA19.9 was detected, and these visits more often led to an intensified follow‐up (42%) than those without an elevated CA19.9 (27%; p< 0.001). An elevated CA19.9 was the sole reason for surgery in five participants with benign disease (10%). The baseline CA19.9 value was (as continuous or dichotomous variable at the 37 kU/L threshold) not independently associated with HGD or pancreatic cancer development, whilst a CA19.9 of ≥ 133 kU/L was (HR 3.8, 95% CI 1.1–13, p= 0.03). In this pancreatic cyst surveillance cohort, CA19.9 monitoring caused substantial harm by shortening surveillance intervals (and performance of unnecessary surgery). The current CA19.9 cutoff was not predictive of HGD and pancreatic cancer, whereas a higher cutoff may decrease false‐positive values. The role of CA19.9 monitoring should be critically appraised prior to implementation in surveillance programs and guidelines.

Published
2023
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15. Comparison of lumen-apposing metal stents versus double-pigtail plastic stents for infected necrotising pancreatitis

Author

Boxhoorn, Lotte, primary, Verdonk, Robert C, additional, Besselink, Marc G, additional, Boermeester, Marja, additional, Bollen, Thomas L, additional, Bouwense, Stefan AW, additional, Cappendijk, Vincent C, additional, Curvers, Wouter L, additional, Dejong, Cornelis H, additional, van Dijk, Sven M, additional, van Dullemen, Hendrik M, additional, van Eijck, Casper HJ, additional, van Geenen, Erwin JM, additional, Hadithi, Muhammed, additional, Hazen, Wouter L, additional, Honkoop, Pieter, additional, van Hooft, Jeanin E, additional, Jacobs, Maarten AJM, additional, Kievits, June EC, additional, Kop, Marnix PM, additional, Kouw, Eva, additional, Kuiken, Sjoerd D, additional, Ledeboer, Michiel, additional, Nieuwenhuijs, Vincent B, additional, Perk, Lars E, additional, Poley, Jan-Werner, additional, Quispel, Rutger, additional, de Ridder, Rogier JJ, additional, van Santvoort, Hjalmar C, additional, Sperna Weiland, Christina J, additional, Stommel, Martijn WJ, additional, Timmerhuis, Hester C, additional, Witteman, Ben J, additional, Umans, Devica S, additional, Venneman, Niels G, additional, Vleggaar, Frank P, additional, van Wanrooij, Roy LJ, additional, Bruno, Marco J, additional, Fockens, Paul, additional, and Voermans, Rogier P, additional

Published
2022
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16. Cumulative sum learning curves guiding multicenter multidisciplinary quality improvement of EUS-guided tissue acquisition of solid pancreatic lesions

Author

Schutz, Hannah M, Quispel, Rutger, Veldt, Bart J, Smedts, Frank M M, Anten, Marie-Paule G F, Hoogduin, Klaas J, Honkoop, Pieter, van Nederveen, Francien H, Hol, Lieke, Kliffen, Mike, Fitzpatrick, Claire E, Erler, Nicole S, Bruno, Marco J, van Driel, Lydi M J W, Schutz, Hannah M, Quispel, Rutger, Veldt, Bart J, Smedts, Frank M M, Anten, Marie-Paule G F, Hoogduin, Klaas J, Honkoop, Pieter, van Nederveen, Francien H, Hol, Lieke, Kliffen, Mike, Fitzpatrick, Claire E, Erler, Nicole S, Bruno, Marco J, and van Driel, Lydi M J W

Abstract

Background and study aims In this study, we evaluated the performance of community hospitals involved in the Dutch quality in endosonography team regarding yield of endoscopic ultrasound (EUS)-guided tissue acquisition (TA) of solid pancreatic lesions using cumulative sum (CUSUM) learning curves. The aims were to assess trends in quality over time and explore potential benefits of CUSUM as a feedback-tool. Patients and methods All consecutive EUS-guided TA procedures for solid pancreatic lesions were registered in five community hospitals between 2015 and 2018. CUSUM learning curves were plotted for overall performance and for performance per center. The American Society of Gastrointestinal Endoscopy-defined key performance indicators, rate of adequate sample (RAS), and diagnostic yield of malignancy (DYM) were used for this purpose. Feedback regarding performance was provided on multiple occasions at regional interest group meetings during the study period. Results A total of 431 EUS-guided TA procedures in 403 patients were included in this study. The overall and per center CUSUM curves for RAS improved over time. CUSUM curves for DYM revealed gradual improvement, reaching the predefined performance target (70 %) overall, and in three of five contributing centers in 2018. Analysis of a sudden downslope development in the CUSUM curve of DYM in one center revealed temporary absence of a senior cytopathologist to have had a temporary negative impact on performance. Conclusions CUSUM-derived learning curves allow for assessment of best practices by comparison among peers in a multidisciplinary multicenter quality improvement initiative and proved to be a valuable and easy-to-interpret means to evaluate EUS performance over time.

Published
2022

19. Comparison of lumen-apposing metal stents versus double-pigtail plastic stents for infected necrotising pancreatitis.

Author

Boxhoorn, Lotte, Verdonk, Robert C., Besselink, Marc G., Boermeester, Marja, Bollen, Thomas L., Bouwense, Stefan A. W., Cappendijk, Vincent C., Curvers, Wouter L., Dejong, Cornelis H., van Dijk, Sven M., van Dullemen, Hendrik M., van Eijck, Casper H. J., van Geenen, Erwin J. M., Hadithi, Muhammed, Hazen, Wouter L., Honkoop, Pieter, van Hooft, Jeanin E., Jacobs, Maarten A. J. M., Kievits, June E. C., and Kop, Marnix P. M.

Subjects
NECROTIZING pancreatitis, ENDOSCOPIC retrograde cholangiopancreatography, NONINVASIVE ventilation, MEDICAL ethics, PANCREATITIS
Published
2023
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21. ID: 3519933 LUMEN-APPOSING METAL STENTS VERSUS DOUBLE-PIGTAIL PLASTIC STENTS IN THE ENDOSCOPIC STEP-UP APPROACH FOR INFECTED NECROTIZING PANCREATITIS

Author

Boxhoorn, Lotte, primary, Verdonk, Robert C., additional, Besselink, Marc G., additional, Boermeester, Marja A., additional, Bollen, Thomas, additional, Bouwense, Stefan A., additional, Cappendijk, Vincent C., additional, Curvers, Wouter, additional, Dejong, Cornelis H., additional, van Dijk, Sven M., additional, Van Dullemen, Hendrik M., additional, Van Eijck, Casper H., additional, Van Geenen, Erwin-Jan M., additional, Hadithi, Muhammed, additional, Hazen, Wouter L., additional, Honkoop, Pieter, additional, van Hooft, Jeanin E., additional, Jacobs, Maarten, additional, Kouw, Eva, additional, Kuiken, Sjoerd D., additional, Ledeboer, Michiel, additional, Nieuwenhuijs, Vincent B., additional, Perk, Lars, additional, Poley, Jan-Werner, additional, Quispel, Rutger, additional, De Ridder, Rogier, additional, Van Santvoort, Hjalmar C., additional, Stommel, Martijn W.J., additional, Timmerhuis, Hester C., additional, Witteman, Ben, additional, Umans, Devica S., additional, Venneman, Niels G., additional, Vleggaar, Frank P., additional, Wanrooij, Roy V., additional, Sperna Weiland, Christina J., additional, Bruno, Marco J., additional, Fockens, Paul, additional, and Voermans, Rogier P., additional

Published
2021
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25. Healthy Cotwins Share Gut Microbiome Signatures With Their Inflammatory Bowel Disease Twins and Unrelated Patients

Author

Brand, Eelco C., primary, Klaassen, Marjolein A.Y., additional, Gacesa, Ranko, additional, Vich Vila, Arnau, additional, Ghosh, Hiren, additional, de Zoete, Marcel R., additional, Boomsma, Dorret I., additional, Hoentjen, Frank, additional, Horjus Talabur Horje, Carmen S., additional, van de Meeberg, Paul C., additional, Willemsen, Gonneke, additional, Fu, Jingyuan, additional, Wijmenga, Cisca, additional, van Wijk, Femke, additional, Zhernakova, Alexandra, additional, Oldenburg, Bas, additional, Weersma, Rinse K., additional, Brand, Eelco C., additional, Honkoop, Pieter, additional, Jacobs, Rutger J., additional, Ponsioen, Cyriel Y., additional, de Boer, Nanne K.H., additional, Alderlieste, Yasser A., additional, van Herwaarden, Margot A., additional, van Tuyl, Sebastiaan A.C., additional, Lutgens, Maurice W., additional, Janneke van der Woude, C., additional, Mares, Wout G.M., additional, de Koning, Daan B., additional, Bosman, Joukje H., additional, Vecht, Juda, additional, de Schryver, Anneke M.P., additional, van der Meulen-de Jong, Andrea E., additional, Pierik, Marieke J., additional, Boekema, Paul J., additional, Verburg, Robert J., additional, Jharap, Bindia, additional, Jansen, Jeroen M., additional, Stokkers, Pieter C.F., additional, Quispel, Rutger, additional, Mahmmod, Nofel, additional, West, Rachel L., additional, Willems, Marleen, additional, Minderhoud, Itta M., additional, Fidder, Herma H., additional, van Schaik, Fiona D.M., additional, Hirdes, Meike M.C., additional, Boontje, Nynke A., additional, Müskens, Bart L.M., additional, and Romberg-Camps, Marielle J.L., additional

Published
2021
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26. Low value of second-look endoscopy for detecting residual colorectal cancer after endoscopic removal

Author

MS MDL 1, Cancer, Gijsbers, Kim M., Post, Zoë, Schrauwen, Ruud W.M., Tang, Thjon J., Bisseling, Tanya M., Bac, Dirk J., Veenstra, Renzo P., Schreuder, Ramon Michel, Epping Stippel, Ludger S.M., de Vos tot Nederveen Cappel, Wouter H., Slangen, Rob M.E., van Lelyveld, Niels, Witteman, Ellen M., van Milligen de Wit, Marc A.W.M., Honkoop, Pieter, Alderlieste, Yasser, ter Borg, Pieter J.C., van Roermund, Rolf, Schmittgens, Stephan, Dekker, Evelien, Leeuwenburgh, Ivonne, de Ridder, Rogier J.J., Zonneveld, Anke M., Hadithi, Muhammed, van Leerdam, Monique E., Bruno, Marco J., Vleggaar, Frank P., Moons, Leon M.G., Koch, Arjun D., ter Borg, Frank, MS MDL 1, Cancer, Gijsbers, Kim M., Post, Zoë, Schrauwen, Ruud W.M., Tang, Thjon J., Bisseling, Tanya M., Bac, Dirk J., Veenstra, Renzo P., Schreuder, Ramon Michel, Epping Stippel, Ludger S.M., de Vos tot Nederveen Cappel, Wouter H., Slangen, Rob M.E., van Lelyveld, Niels, Witteman, Ellen M., van Milligen de Wit, Marc A.W.M., Honkoop, Pieter, Alderlieste, Yasser, ter Borg, Pieter J.C., van Roermund, Rolf, Schmittgens, Stephan, Dekker, Evelien, Leeuwenburgh, Ivonne, de Ridder, Rogier J.J., Zonneveld, Anke M., Hadithi, Muhammed, van Leerdam, Monique E., Bruno, Marco J., Vleggaar, Frank P., Moons, Leon M.G., Koch, Arjun D., and ter Borg, Frank

Published
2020

29. Optimizing cytological specimens of EUS‐FNA of solid pancreatic lesions: A pilot study to the effect of a smear preparation training for endoscopy personnel on sample quality and accuracy

Author

Riet, Priscilla A., primary, Quispel, Rutger, additional, Cahen, Djuna L., additional, Erler, Nicole S., additional, Snijders‐Kruisbergen, Mieke C., additional, Van Loenen, Petri, additional, Poley, Jan‐Werner, additional, Driel, Lydi M.J.W., additional, Mulder, Sanna A., additional, Veldt, Bart J., additional, Leeuwenburgh, Ivonne, additional, Anten, Marie‐Paule G.F., additional, Honkoop, Pieter, additional, Thijssen, Annemieke Y., additional, Hol, Lieke, additional, Hadithi, Mohammed, additional, Fitzpatrick, Claire E., additional, Schot, Ingrid, additional, Bergmann, Jilling F., additional, Bhalla, Abha, additional, Bruno, Marco J., additional, and Biermann, Katharina, additional

Published
2020
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30. Low value of second-look endoscopy for detecting residual colorectal cancer after endoscopic removal

Author

Gijsbers, Kim M., primary, Post, Zoë, additional, Schrauwen, Ruud W.M., additional, Tang, Thjon J., additional, Bisseling, Tanya M., additional, Bac, Dirk J., additional, Veenstra, Renzo P., additional, Schreuder, Ramon-Michel, additional, Epping Stippel, Ludger S.M., additional, de Vos tot Nederveen Cappel, Wouter H., additional, Slangen, Rob M.E., additional, van Lelyveld, Niels, additional, Witteman, Ellen M., additional, van Milligen de Wit, Marc A.W.M., additional, Honkoop, Pieter, additional, Alderlieste, Yasser, additional, ter Borg, Pieter J.C., additional, van Roermund, Rolf, additional, Schmittgens, Stephan, additional, Dekker, Evelien, additional, Leeuwenburgh, Ivonne, additional, de Ridder, Rogier J.J., additional, Zonneveld, Anke M., additional, Hadithi, Muhammed, additional, van Leerdam, Monique E., additional, Bruno, Marco J., additional, Vleggaar, Frank P., additional, Moons, Leon M.G., additional, Koch, Arjun D., additional, and ter Borg, Frank, additional

Published
2020
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31. Diagnostic yield and agreement on fine-needle specimens from solid pancreatic lesions: comparing the smear technique to liquid-based cytology

Author

van Riet, Priscilla A., additional, Quispel, Rutger, additional, Cahen, Djuna L., additional, Snijders-Kruisbergen, Mieke C., additional, van Loenen, Petri, additional, Erler, Nicole S., additional, Poley, Jan-Werner, additional, van Driel, Lydi M. J. W., additional, Mulder, Sanna A., additional, Veldt, Bart J., additional, Leeuwenburgh, Ivonne, additional, Anten, Marie-Paule G. F., additional, Honkoop, Pieter, additional, Thijssen, Annemieke Y., additional, Hol, Lieke, additional, Hadithi, Mohammed, additional, Fitzpatrick, Claire E., additional, Schot, Ingrid, additional, Bergmann, Jilling F., additional, Bhalla, Abha, additional, Bruno, Marco J., additional, and Biermann, Katharina, additional

Published
2020
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32. Pancreatic cyst surveillance imposes low psychological burden

Author

Overbeek, Kasper A., primary, Kamps, Anne, additional, van Riet, Priscilla A., additional, Di Marco, Mariacristina, additional, Zerboni, Giulia, additional, van Hooft, Jeanin E., additional, Carrara, Silvia, additional, Ricci, Claudio, additional, Gonda, Tamas A., additional, Schoon, Erik, additional, Polkowski, Marcin, additional, Beyer, Georg, additional, Honkoop, Pieter, additional, van der Waaij, Laurens A., additional, Casadei, Riccardo, additional, Capurso, Gabriele, additional, Erler, Nicole S., additional, Bruno, Marco J., additional, Bleiker, Eveline M.A., additional, Cahen, Djuna L., additional, Bruno, M.J., additional, Cahen, D.L., additional, van Riet, P.A., additional, Overbeek, K.A., additional, Levink, I.J.M., additional, Koopmann, B., additional, Besselink, M.G.H., additional, del Chiaro, M., additional, Lerch, M.M., additional, Wallace, M.B., additional, van Ballegooijen, M., additional, Biermann, K., additional, Bleiker, E.M.A., additional, Bollen, T.H.L., additional, Fockens, P., additional, de Kok, I.M.C.M., additional, Looijenga, L.H.J., additional, Peppelenbosch, M.P., additional, Verhagen-Oldenampsen, J.H.E., additional, Arcidiacono, P.G., additional, Capurso, G., additional, Bergmann, J., additional, van Berkel, A., additional, Beyer, G., additional, Bijlsma, R., additional, Braat, H., additional, Carrara, S., additional, Czakó, L., additional, van Erp-van der Steen, H., additional, Ganesh, S., additional, van Geenen, E., additional, Gonda, T., additional, Hoge, C., additional, Honkoop, P., additional, van Hooft, J.E., additional, Jansen, J., additional, Larghi, A., additional, van Leeuwenburgh, I., additional, Laukkarinen, J., additional, Lelyveld, N., additional, Lerch, M., additional, di Marco, M.C., additional, Ricci, C., additional, Casadei, R., additional, Rau, E.P., additional, Perk, L., additional, Polkowski, M., additional, Pukitits, A., additional, Quispel, R., additional, Radenkovic, D., additional, Seicean, A., additional, Schwartz, T., additional, Schoon, E.J., additional, van Soest, E., additional, Tan, A., additional, Venneman, N.G., additional, Vos, P., additional, Voorburg, A., additional, van der Waaij, L.A., additional, Wijkerslooth, L.R.H., additional, Zerboni, G., additional, della Fave, G., additional, and Zonderhuis, B., additional

Published
2019
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43. Optimizing cytological specimens of EUS‐FNA of solid pancreatic lesions: A pilot study to the effect of a smear preparation training for endoscopy personnel on sample quality and accuracy.

Author

Riet, Priscilla A., Quispel, Rutger, Cahen, Djuna L., Erler, Nicole S., Snijders‐Kruisbergen, Mieke C., Van Loenen, Petri, Poley, Jan‐Werner, Driel, Lydi M.J.W., Mulder, Sanna A., Veldt, Bart J., Leeuwenburgh, Ivonne, Anten, Marie‐Paule G.F., Honkoop, Pieter, Thijssen, Annemieke Y., Hol, Lieke, Hadithi, Mohammed, Fitzpatrick, Claire E., Schot, Ingrid, Bergmann, Jilling F., and Bhalla, Abha

Published
2021
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44. Pancreatic cyst surveillance imposes low psychological burden: preliminary results of the PACYFIC study

Author

Overbeek, Kasper, primary, Kamps, Anne, additional, Van Riet, Priscilla, additional, Di Marco, Mariacristina, additional, Zerboni, Giulia, additional, Van Hooft, Jeanin, additional, Carrara, Silvia, additional, Ricci, Claudio, additional, Gonda, Tamas, additional, Schoon, Erik, additional, Polkowski, Marcin, additional, Beyer, Georg, additional, Honkoop, Pieter, additional, Van der Waaij, Laurens, additional, Casadei, Riccardo, additional, Capurso, Gabriele, additional, Bruno, Marco, additional, Bleiker, Eveline, additional, and Cahen, Djuna, additional

Published
2018
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45. Su1336 - Pancreatic Cyst Surveillance Imposes Low Psychological Burden: Preliminary Results of the Pacyfic Study

Author

Overbeek, Kasper A., primary, Kamps, Anne, additional, van Riet, Priscilla A., additional, Di Marco, Maria C., additional, Zerboni, Giulia, additional, van Hooft, Jeanin E., additional, Carrara, Silvia, additional, Gonda, Tamas A., additional, Schoon, Erik, additional, Polkowski, Marcin, additional, Beyer, Georg, additional, Honkoop, Pieter, additional, Van der Waaij, Laurens, additional, Casadei, Riccardo, additional, Capurso, Gabriele, additional, Bruno, Marco J., additional, Bleiker, Eveline M., additional, and Cahen, Djuna, additional

Published
2018
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46. Management of asthma in primary care

Author

Honkoop, Pieter Jacob, Kievit, J., Assendelft, W.J.J., Sont, J.K., and Leiden University

Subjects
immune system diseases, Action-plan, Control, Cost-effectiveness, Exacerbation, FeNO, Online, Asthma, respiratory tract diseases, Action point
Abstract

Asthma is a common non-communicable respiratory disease. In this thesis we analysed three different management strategies for adult patients with asthma in primary care. In the first, we targeted the currently recommended aim of __Controlled asthma__, which means patients experience hardly any symptoms. The second targeted __Partly Controlled asthma__, which allowed some symptoms. The third additionally used a FeNO-measurement to assess current control. Aiming for Partly Controlled asthma significantly reduced medication usage compared to Controlled asthma, while exacerbation-rate, quality of life and asthma control were similar. FeNO-guided Controlled asthma also significantly reduced medication usage compared to Controlled asthma and additionally significantly improved asthma control compared to Partly Controlled asthma. Aiming for FeNO-guided Controlled asthma is therefore the optimal strategy. In this thesis we also analysed daily measurements of symptoms and peak-flow, which are recorded in Written Asthma Action Plans, or in apps. Hereby we were able to predict future asthma exacerbations several days in advance with reasonable accuracy. Finally, we compared an online assessment of asthma control by a questionnaire with the results of the same questionnaire assessed by a practice nurse. We showed that asthma control is perceived as better when interacting with a caregiver than by online self-assessment.

Published
2016

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