Nijmegen, Netherlands
Nijmegen, Netherlands

Time filter

Source Type

Zandstra D.,Gelderse Vallei Hospital | Busser J.A.S.,Radboudumc University Medical Center | Aarts J.W.M.,Radboudumc University Medical Center | Nieboer T.E.,Radboudumc University Medical Center
European Journal of Obstetrics Gynecology and Reproductive Biology | Year: 2017

This review studies women's preferences for shared decision-making about heavy menstrual bleeding treatment and evaluates interventions that support shared decision-making and their effectiveness. PubMed, Cochrane, Embase, Medline and ClinicalTrials.gov were searched. Three research questions were predefined: 1) What is the range of perspectives gathered in studies that examine women facing a decision related to heavy menstrual bleeding management?; 2) What types of interventions have been developed to support shared decision-making for women experiencing heavy menstrual bleeding?; and 3) In what way might women benefit from interventions that support shared decision-making? All original studies were included if the study population consisted of women experiencing heavy menstrual bleeding. We used the TIDieR (Template for Intervention: Description and Replication) checklist to assess the quality of description and the reproducibility of interventions. Interventions were categorized using Grande et al. guidelines and collated and summarized outcomes measures into three categories: 1) patient-reported outcomes; 2) observer-reported outcomes; and 3) doctor-reported outcomes. Fifteen studies were included. Overall, patients preferred to decide together with their doctor (74%). Women's previsit preference was the strongest predictor for treatment choice in two studies. Information packages did not have a statistically significant effect on treatment choice or satisfaction. However, adding a structured interview or decision aid to increase patient involvement did show a positive effect on treatment choice and results, patient satisfaction and shared decision-making related outcomes. In conclusion shared decision-making is becoming more important in the care of women with heavy menstrual bleeding. Structured interviews or well-designed (computerized) tools such as decision aids seem to facilitate this process, but there is room for improvement. A shared treatment choice is only possible after careful provision of information, elicitation of patients’ preferences and integrating those preferences. Interventions should be designed accordingly. © 2017 Elsevier B.V.


Pieterse A.H.,Leiden University | Falkenberg R.,Maastricht University | Stiggelbout A.M.,Leiden University | van der Weijden T.,Maastricht University | Aarts J.A.W.M.,Radboudumc University Medical Center
Patient Education and Counseling | Year: 2016

Objective: The 12-item "observing patient involvement" (OPTION12)-instrument is commonly used to assess the extent to which healthcare providers involve patients in health-related decision-making. The five-item version (OPTION5) claims to be a more efficient measure. In this study we compared the Dutch versions of the OPTION-instruments in terms of inter-rater agreement and correlation in outpatient doctor-patient consultations in various settings, to learn if we can safely switch to the shorter OPTION5-instrument. Methods: Two raters coded 60 audiotaped vascular surgery and oncology patient consultations using OPTION12 and OPTION5. Unweighted Cohen's kappa was used to compute inter-rater agreement on item-level. The association between the total scores of the two OPTION-instruments was investigated using Pearson's correlation coefficient (r) and a Bland & Altman plot. Results: After fine-tuning the OPTION-manuals, inter-rater agreement for OPTION12 and OPTION5 was good to excellent (kappa range 0.69-0.85 and 0.63-0.72, respectively). Mean total scores were 23.7 (OPTION12; SD = 7.8) and 39.3 (OPTION5; SD = 12.7). Correlation between the total scores was high (r = 0.71; p = 0.01). OPTION5 scored systematically higher with a wider range than OPTION12. Conclusion: Both OPTION-instruments had a good inter-rater agreement and correlated well. OPTION5 seems to differentiate better between various levels of patient involvement. Practical implication: The OPTION5-instrument is recommended for clinical application. © 2015 Elsevier Ireland Ltd.


PubMed | Leiden University, Radboudumc University Medical Center and Maastricht University
Type: Journal Article | Journal: Patient education and counseling | Year: 2016

The 12-item observing patient involvement (OPTION(12))-instrument is commonly used to assess the extent to which healthcare providers involve patients in health-related decision-making. The five-item version (OPTION(5)) claims to be a more efficient measure. In this study we compared the Dutch versions of the OPTION-instruments in terms of inter-rater agreement and correlation in outpatient doctor-patient consultations in various settings, to learn if we can safely switch to the shorter OPTION(5)-instrument.Two raters coded 60 audiotaped vascular surgery and oncology patient consultations using OPTION(12) and OPTION(5). Unweighted Cohens kappa was used to compute inter-rater agreement on item-level. The association between the total scores of the two OPTION-instruments was investigated using Pearsons correlation coefficient (r) and a Bland & Altman plot.After fine-tuning the OPTION-manuals, inter-rater agreement for OPTION(12) and OPTION(5) was good to excellent (kappa range 0.69-0.85 and 0.63-0.72, respectively). Mean total scores were 23.7 (OPTION(12); SD=7.8) and 39.3 (OPTION(5); SD=12.7). Correlation between the total scores was high (r=0.71; p=0.01). OPTION(5) scored systematically higher with a wider range than OPTION(12).Both OPTION-instruments had a good inter-rater agreement and correlated well. OPTION(5) seems to differentiate better between various levels of patient involvement.The OPTION(5)-instrument is recommended for clinical application.


Van Houdt C.I.A.,Radboudumc University Medical Center | Preethanath R.S.,Radboudumc University Medical Center | Preethanath R.S.,King Saud University | Van Oirschot B.A.J.A.,Radboudumc University Medical Center | And 5 more authors.
Journal of Biomedical Materials Research - Part A | Year: 2016

This work aimed to compare in vitro degradation of dense PLGA microspheres and milled PLGA particles as porogens within CPC, considering that the manufacturing of milled PLGA is more cost-effective when compared with PLGA microspheres. Additionally, we aimed to examine the effect of porogen amount within CPC/PLGA on degradation and bone formation. Our in vitro results showed no differences between both forms of PLGA particles (as porogens in CPC; spherical for microspheres, irregular for milled) regarding morphology, porosity, and degradation. Using milled PLGA as porogens within CPC/PLGA, we evaluated the effect of porogen amount on degradation and bone forming capacity in vivo. Titanium landmarks surrounded by CPC/PLGA with 30 and 50 wt % PLGA, were implanted in forty femoral bone defects of twenty male Wistar rats. Histomorphometrical results showed a significant temporal decrease in the amount of CPC, for both formulas, and confirmed that 50 wt % PLGA degrades faster than 30 wt%, and allows for a 1.5-fold higher amount of newly formed bone. Taken together, this study demonstrated that (i) milled PLGA particles perform equal to PLGA microspheres, and (ii) tuning of the PLGA content in CPC/PLGA is a feasible approach to leverage material degradation and bone formation. © 2015 Wiley Periodicals, Inc.


PubMed | King Saud University, Radboudumc University medical center and Radboudumc
Type: Journal Article | Journal: Journal of biomedical materials research. Part A | Year: 2016

This work aimed to compare in vitro degradation of dense PLGA microspheres and milled PLGA particles as porogens within CPC, considering that the manufacturing of milled PLGA is more cost-effective when compared with PLGA microspheres. Additionally, we aimed to examine the effect of porogen amount within CPC/PLGA on degradation and bone formation. Our in vitro results showed no differences between both forms of PLGA particles (as porogens in CPC; spherical for microspheres, irregular for milled) regarding morphology, porosity, and degradation. Using milled PLGA as porogens within CPC/PLGA, we evaluated the effect of porogen amount on degradation and bone forming capacity in vivo. Titanium landmarks surrounded by CPC/PLGA with 30 and 50 wt % PLGA, were implanted in forty femoral bone defects of twenty male Wistar rats. Histomorphometrical results showed a significant temporal decrease in the amount of CPC, for both formulas, and confirmed that 50 wt % PLGA degrades faster than 30 wt%, and allows for a 1.5-fold higher amount of newly formed bone. Taken together, this study demonstrated that (i) milled PLGA particles perform equal to PLGA microspheres, and (ii) tuning of the PLGA content in CPC/PLGA is a feasible approach to leverage material degradation and bone formation.


Kampman C.J.G.,Public Health Service Twente | Koedijk F.D.H.,Public Health Service Twente | Driessen-Hulshof H.C.M.,Public Health Service West Brabant | Hautvast J.L.A.,Radboudumc University Medical Center | Van Den Broek I.V.F.,National Institute for Public Health and the Environment
Sexually Transmitted Infections | Year: 2016

Objectives The objective of this study is to assess the effect of reminder text messages 6 months after the initial treatment on retest and chlamydia reinfection rates in young heterosexuals compared with a historical control group and to assess factors associated with both outcomes. Methods Heterosexual people (aged 16â€"23 years), testing positive for urogenital chlamydia, were offered a retest after 6 months. Participants received a text message reminder at 6 months after the initial chlamydia diagnosis. Rates of retest uptake and the result of the retest were analysed using Cox regression. Prevalence ratios (PRs) were calculated to identify factors associated with these outcomes. Furthermore, the retest rate was compared with the retest rate of a historical control group. Results 30.6% (253/838) of the study group returned within 5â€"8 months compared with 9.2% (140/1530) in the historical control group. Women and persons who were not notified for a sexually transmitted infection (STI) at inclusion were more likely to return for a retest. 20.4% (56/275) of participants had a chlamydia reinfection upon retesting. Reinfection was higher in participants reporting STI-related symptoms (PR 3.2, 95% CI1.8 to 5.6) and in participants who were notified for an STI at retest (PR 5.3, 95% CI 2.4 to 11.5). Conclusions A text message reminder appeared to have a clear, positive impact on the resulting retest rate. These results also indicate that retesting is necessary to identify chlamydia reinfections.


PubMed | National Institute for Public Health and the Environment, Public Health Service Twente, Radboudumc University Medical Center and Public Health Service West Brabant
Type: Comparative Study | Journal: Sexually transmitted infections | Year: 2016

The objective of this study is to assess the effect of reminder text messages 6months after the initial treatment on retest and chlamydia reinfection rates in young heterosexuals compared with a historical control group and to assess factors associated with both outcomes.Heterosexual people (aged 16-23years), testing positive for urogenital chlamydia, were offered a retest after 6months. Participants received a text message reminder at 6months after the initial chlamydia diagnosis. Rates of retest uptake and the result of the retest were analysed using Cox regression. Prevalence ratios (PRs) were calculated to identify factors associated with these outcomes. Furthermore, the retest rate was compared with the retest rate of a historical control group.30.6% (253/838) of the study group returned within 5-8months compared with 9.2% (140/1530) in the historical control group. Women and persons who were not notified for a sexually transmitted infection (STI) at inclusion were more likely to return for a retest. 20.4% (56/275) of participants had a chlamydia reinfection upon retesting. Reinfection was higher in participants reporting STI-related symptoms (PR 3.2, 95% CI 1.8 to 5.6) and in participants who were notified for an STI at retest (PR 5.3, 95% CI 2.4 to 11.5).A text message reminder appeared to have a clear, positive impact on the resulting retest rate. These results also indicate that retesting is necessary to identify chlamydia reinfections.

Loading Radboudumc University Medical Center collaborators
Loading Radboudumc University Medical Center collaborators