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3. MA-cont:pre/post effect size: An interactive tool for the meta-analysis of continuous outcomes using R Shiny

Author

Papadimitropoulou, K., Riley, R.D., Dekkers, O.M., Stijnen, T., and Cessie, S. le

Subjects
ANCOVA, pseudo individual participant data, Meta-Analysis as Topic, shiny, R735, baseline imbalance, Humans, RA, R1, Software, Education
Abstract

Meta-analysis is a widely used methodology to combine evidence from different sources examining a common research phenomenon, to obtain a quantitative summary of the studied phenomenon. In the medical field, multiple studies investigate the effectiveness of new treatments and meta-analysis is largely performed to generate the summary (average) treatment effect. In the meta-analysis of aggregate continuous outcomes measured in a pretest-posttest design using differences in means as the effect measure, a plethora of methods exist: analysis of final (follow-up) scores, analysis of change scores and analysis of covariance (ANCOVA). Specialised and general purpose statistical software is used to apply the various methods, yet, often the choice among them depends on data availability and statistical affinity. We present a new web-based tool, MA-cont:pre/post effect size, to conduct meta-analysis of continuous data assessed pre- and post-treatment using the aforementioned approaches on aggregate data and a more flexible approach of generating and analysing pseudo individual participant data (IPD). The interactive web environment, available by R Shiny, is used to create this free-to-use statistical tool, requiring no programming skills by the users. A basic statistical understanding of the methods running in the background is a prerequisite and we encourage the users to seek advice from technical experts when necessary. This article is protected by copyright. All rights reserved.

Published
2022

11. Bivariate Random Effects Meta-Analysis of ROC Curves

Author

Arends, L.R., Hamza, T.H., van Houwelingen, J.C., Heijenbrok-Kal, M.H., Hunink, M.G.M., and Stijnen, T.

Subjects
Medical tests -- Usage -- Methods -- Analysis -- Psychological aspects, Decision-making -- Psychological aspects -- Analysis -- Methods -- Usage, Signal detection (Psychology) -- Analysis -- Psychological aspects -- Methods -- Usage, Health, Psychological aspects, Usage, Analysis, Methods
Abstract

Byline: L.R. Arends, PhD (Department of Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands, Institute of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands, l.arends@erasmusmc.nl); T.H. Hamza, PhD (Department of [...]

Published
2008
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13. Anti-infective-treated central venous catheters: a systematic review of randomized controlled trials

Author

NiA<<l-Weise, B. S., Stijnen, T., and Broek, P. J.

Subjects
Central venous catheters -- Health aspects, Central venous catheters -- Research, Blood-borne diseases -- Care and treatment, Blood-borne diseases -- Research, Anti-infective agents -- Usage, Anti-infective agents -- Research, Health care industry
Abstract

Objective: This systematic review assesses the effect of anti-infective-treated central venous catheters (CVCs) on catheter-related bloodstream infection (CRBSI) in the acute care setting. Methods: Randomized controlled trials were retrieved from Medline and the Cochrane Library up to 15 January 2007. Two reviewers independently assessed trial quality and extracted data. Data for CRBSI were combined where appropriate, using a random effects model. The impact of the risk for CRBSI in the control group (baseline risk) on the benefit of anti-infective CVCs was studied by using meta-regression based on the binomial normal bivariate meta-analysis model. Results: Twenty-one trials were included in the review. Mainly intensive care (IC) patients were studied. Eighteen trials showed that anti-infective CVCs reduced the risk of CRBSI. The number needed to treat (NNT) varied from 182 to 12, with baseline risks ranging from 1% to 10%. Nearly all trials had serious methodological shortcomings. Three trials comparing minocycline-rifampicin-treated catheters with antiseptic-treated catheters showed inconsistent results. One trial suggested that there is not any difference in CRBSI between heparin- and antiseptic-treated CVCs. Conclusion: Because the NNT is large when the baseline risk is low, the use of anti-infective-treated CVCs in the acute care setting should only be considered in situations in which background rates of CRBSI are high. The magnitude of benefit as calculated in this review should be interpreted with caution because of strong arguments in favor of a systematic overestimation of the effect. Which type of anti-infective catheter is most effective could not be established from the available data. Keywords Central venous catheter * Catheter-related bloodstream infection * Systematic review * Randomized controlled trial

Published
2007

14. Cellular senescence and chronological age in various human tissues: A systematic review and meta-analysis

Author

Tuttle, CSL, Waaijer, MEC, Slee-Valentijn, MS, Stijnen, T, Westendorp, R, Maier, AB, Tuttle, CSL, Waaijer, MEC, Slee-Valentijn, MS, Stijnen, T, Westendorp, R, and Maier, AB

Abstract

Senescent cells in tissues and organs are considered to be pivotal to not only the aging process but also the onset of chronic disease. Accumulating evidence from animal experiments indicates that the magnitude of senescence can vary within and between aged tissue samples from the same animal. However, whether this variation in senescence translates across to human tissue samples is unknown. To address this fundamental question, we have conducted a systematic review and meta-analysis of all available literature investigating the magnitude of senescence and its association with chronological age in human tissue samples. While senescence is higher in aged tissue samples, the magnitude of senescence varies considerably depending upon tissue type, tissue section, and marker used to detect senescence. These findings echo animal experiments demonstrating that senescence levels may vary between organs within the same animal.

Published
2020

26. Prediction models for SNP data

Author

Ghidey, W., Stijnen, T., Houwing-Duistermaat, J. J., Heijmans, B. T., Beekman, M., Westendorp, R. G.J., Slagboom, P. E., and van Houwelingen, H. C.

Published
2008

36. Growth hormone treatment in growth-retarded adolescents after renal transplant

Author

Hokken-Koelega, A.C.S., Stijnen, T., Ridder, M.A.J. de, Muinck Keizer-Schrama, S.M.P.F. de, Wolff, E.D., Jong, M.C.J.W. de, Donckerwolcke, R.A., Groothoff, J.W., Blum, W.F., and Drop, S.L.S.

Subjects
Dwarfism -- Care and treatment, Somatotropin -- Health aspects, Organ transplant recipients -- Physiological aspects, Teenagers -- Diseases, Kidneys -- Transplantation
Published
1994

40. Effectiveness and cost-effectiveness of proactive and multidisciplinary integrated care for older people with complex problems in general practice: an individual participant data meta-analysis

Author

Blom, J.W., Hout, W.B. van den, Elzen, W.P.J. den, Drewes, Y.M., Bleijenberg, N., Fabbricotti, I.N., Jansen, A.P.D., Kempen, G.I.J.M., Koopmans, R., Looman, W.M., Melis, R.J.F., Metzelthin, S.F., Charante, E.P.M. van, Muntinga, M.E., Numans, M.E., Ruikes, F.G.H., Spoorenberg, S.L.W., Stijnen, T., Suijker, J.J., Wit, N.J. de, Wynia, K., Wind, A.W., Gussekloo, J., and TOPICS-MDS Res Consortium

Subjects
older people, aged, primary care, integrated care
Published
2018

46. Effectiveness and cost-effectiveness of proactive and multidisciplinary integrated care for older people with complex problems in general practice: an individual participant data meta-analysis

Author

Blom, J. W., Van den Hout, W. B., Den Elzen, W. P. J., Drewes, Y. M., Bleijenberg, N., Fabbricotti, I. N., Jansen, A. P. D., Kempen, G. I. J. M., Koopmans, R., Looman, W. M., Melis, R. J. F., Metzelthin, S. F., van Charante, E. P. Moll, Muntinga, M. E., Numans, M. E., Ruikes, F. G. H., Spoorenberg, S. L. W., Stijnen, T., Suijker, J. J., De Wit, N. J., Wynia, K., Wind, A. W., Gussekloo, J., Blom, J. W., Van den Hout, W. B., Den Elzen, W. P. J., Drewes, Y. M., Bleijenberg, N., Fabbricotti, I. N., Jansen, A. P. D., Kempen, G. I. J. M., Koopmans, R., Looman, W. M., Melis, R. J. F., Metzelthin, S. F., van Charante, E. P. Moll, Muntinga, M. E., Numans, M. E., Ruikes, F. G. H., Spoorenberg, S. L. W., Stijnen, T., Suijker, J. J., De Wit, N. J., Wynia, K., Wind, A. W., and Gussekloo, J.

Published
2018

47. Effectiveness and cost-effectiveness of proactive and multidisciplinary integrated care for older people with complex problems in general practice: An individual participant data meta-analysis

Author

Blom, J.W. (Jeanet), Hout, W.B. (Wilbert) van den, Elzen, W.P.J. (Wendy) den, Drewes, Y.M. (Yvonne M.), Bleijenberg, N. (Nienke), Fabbricotti, I.N. (Isabelle), Jansen, A.P.D. (Aaltje), Kempen, G.I.J.M. (Gertrudis), Koopmans, R. (R.), Looman, W.M. (Willemijn), Melis, R.J.F. (René), Metzelthin, S.F. (S. F.), Van Charante, E.P.M. (E.P. Moll), Muntinga, M.E. (Maaike E.), Numans, M.E. (Mattijs), Ruikes, F.G.H. (F. G.H.), Spoorenberg, S.L.W. (S. L.W.), Stijnen, T. (T.), Suijker, J.J. (J. J.), De Wit, N.J. (N. J.), Wynia, K. (K.), Wind, A.W. (Annet), Gussekloo, J. (Jacobijn), Blom, J.W. (Jeanet), Hout, W.B. (Wilbert) van den, Elzen, W.P.J. (Wendy) den, Drewes, Y.M. (Yvonne M.), Bleijenberg, N. (Nienke), Fabbricotti, I.N. (Isabelle), Jansen, A.P.D. (Aaltje), Kempen, G.I.J.M. (Gertrudis), Koopmans, R. (R.), Looman, W.M. (Willemijn), Melis, R.J.F. (René), Metzelthin, S.F. (S. F.), Van Charante, E.P.M. (E.P. Moll), Muntinga, M.E. (Maaike E.), Numans, M.E. (Mattijs), Ruikes, F.G.H. (F. G.H.), Spoorenberg, S.L.W. (S. L.W.), Stijnen, T. (T.), Suijker, J.J. (J. J.), De Wit, N.J. (N. J.), Wynia, K. (K.), Wind, A.W. (Annet), and Gussekloo, J. (Jacobijn)

Abstract

Purpose: to support older people with several healthcare needs in sustaining adequate functioning and independence, more proactive approaches are needed. This purpose of this study is to summarise the (cost-) effectiveness of proactive, multidisciplinary, integrated care programmes for older people in Dutch primary care. Methods design: individual patient data (IPD) meta-analysis of eight clinically controlled trials. Setting: primary care sector. Interventions: combination of (i) identification of older people with complex problems by means of screening, followed by (ii) a multidisciplinary integrated care programme for those identified. Main outcome: activities of daily living, i.e. a change on modified Katz-15 scale between baseline and 1-year follow-up. Secondary outcomes: quality of life (visual analogue scale 0-10), psychological (mental well-being scale Short Form Health Survey (SF)-36) and social well-being (single item, SF-36), quality-adjusted life years (Euroqol-5dimensions-3level (EQ-5D-3L)), healthcare utilisation and cost-effectiveness. Analysis: intention-to-treat analysis, two-stage IPD and subgroup analysis based on patient and intervention characteristics. Results: included were 8,678 participants: median age of 80.5 (interquartile range 75.3; 85.7) years; 5,496 (63.3%) women. On the modified Katz-15 scale, the pooled difference in change between the intervention and control group was -0.01 (95% confidence interval -0.10 to 0.08). No significant differences were found in the other patient outcomes or subgroup analyses. Compared to usual care, the probability of the intervention group to be cost-effective was less than 5%. Conclusion: compared to usual care at 1-year follow-up, strategies for identification of frail older people in primary care combined with a proactive integrated care intervention are probably not (cost-) effective.

Published
2018
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48. Effectiveness and cost-effectiveness of proactive and multidisciplinary integrated care for older people with complex problems in general practice: an individual participant data meta-analysis

Author

Verplegingswetenschap, Infection & Immunity, Unit Opleiding Aios, Medische staf Anesthesiologie, HAG Netwerken, General Practice & Nursing Science, Child Health, Cancer, JC Overig onderzoek, Blom, J. W., Van den Hout, W. B., Den Elzen, W. P. J., Drewes, Y. M., Bleijenberg, N., Fabbricotti, I. N., Jansen, A. P. D., Kempen, G. I. J. M., Koopmans, R., Looman, W. M., Melis, R. J. F., Metzelthin, S. F., van Charante, E. P. Moll, Muntinga, M. E., Numans, M. E., Ruikes, F. G. H., Spoorenberg, S. L. W., Stijnen, T., Suijker, J. J., De Wit, N. J., Wynia, K., Wind, A. W., Gussekloo, J., Verplegingswetenschap, Infection & Immunity, Unit Opleiding Aios, Medische staf Anesthesiologie, HAG Netwerken, General Practice & Nursing Science, Child Health, Cancer, JC Overig onderzoek, Blom, J. W., Van den Hout, W. B., Den Elzen, W. P. J., Drewes, Y. M., Bleijenberg, N., Fabbricotti, I. N., Jansen, A. P. D., Kempen, G. I. J. M., Koopmans, R., Looman, W. M., Melis, R. J. F., Metzelthin, S. F., van Charante, E. P. Moll, Muntinga, M. E., Numans, M. E., Ruikes, F. G. H., Spoorenberg, S. L. W., Stijnen, T., Suijker, J. J., De Wit, N. J., Wynia, K., Wind, A. W., and Gussekloo, J.

Published
2018

49. Effectiveness and cost-effectiveness of proactive and multidisciplinary integrated care for older people with complex problems in general practice: an individual participant data meta-analysis

Author

Blom, JW, van den Hout, W, den Elzen, WPJ, Drewes, YM, Bleijenberg, N, Fabbricotti, Isabelle, Jansen, APD, Kempen, GIJM, Koopmans, R, Looman, Willemijn, Melis, RJF, Metzelthin, SF, Moll van Charante, EP, Muntinga, ME, Numans, ME, Ruikes, FGH, Spoorenberg, SLW, Stijnen, T, Suijker, JJ, De Wit, NJ, Wynia, K, Wind, AW, Gussekloo, J, Blom, JW, van den Hout, W, den Elzen, WPJ, Drewes, YM, Bleijenberg, N, Fabbricotti, Isabelle, Jansen, APD, Kempen, GIJM, Koopmans, R, Looman, Willemijn, Melis, RJF, Metzelthin, SF, Moll van Charante, EP, Muntinga, ME, Numans, ME, Ruikes, FGH, Spoorenberg, SLW, Stijnen, T, Suijker, JJ, De Wit, NJ, Wynia, K, Wind, AW, and Gussekloo, J

Published
2018

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