Papers by Patrick Bossuyt
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, Jan 7, 2016
The ProTWIN Trial (NTR1858) showed that in women with a multiple pregnancy and a cervical length ... more The ProTWIN Trial (NTR1858) showed that in women with a multiple pregnancy and a cervical length less than the 25(th) percentile (38mm), prophylactic use of a cervical pessary reduced the risk of adverse perinatal outcome. We investigated whether other maternal or pregnancy characteristics collected at baseline can improve identification of women with the most probable benefit from pessary placement. ProTWIN is a multicenter randomized trial in which 808 women with a multiple pregnancy were assigned to pessary or control. Using this data we developed a multivariable logistic model comprising treatment, cervical length, chorionicity, pregnancy history and number of fetuses and the interaction of these variables with treatment as predictors of adverse perinatal outcome. Short cervix, monochorionicity and nulliparity were predictive factors for a benefit from pessary insertion. History of previous preterm birth and triplet pregnancy were predictive factors of possible harm from pessary...
Portwine stain (PWS) response to flashlamp pumped pulsed dye laser (FPPDL) treatment is variable ... more Portwine stain (PWS) response to flashlamp pumped pulsed dye laser (FPPDL) treatment is variable and unpredictable. Our aim was to develop a model to predict treatment outcome and the required number of treatments. We hypothesized that PWS clearance decreases exponentially with the number of treatments, as a consequence of the exponential decrease of laser light fluence in human skin. Of 70 patients with a PWS in the head/neck area, the color difference between normal skin and PWS was measured with a chromameter, prior to, and at several stages during FPPDL treatment. Through the obtained values of each of the four color parameters, DeltaL*, Deltaa*, Deltab*, and DeltaE, mono-exponentially decreasing functions were fitted. All four color parameters showed decreasing exponential functions, with decay rates that were not significantly different, and a mean R(2) of 0.6, indicating a reliable fit-quality. Our model suggests that individual prediction of treatment outcome and the required number of treatments is possible in an early stage of FPPDL treatment of PWS, in theory already after one single laser treatment.
Skeletal Radiology, May 1, 1998
gold standard for early diagnosis (within 48 h) of a lateral ankle ligament rupture.
Journal of Clinical Epidemiology, 2016
The current format of Summary-of-Findings (SoF) tables for presenting effect estimates and associ... more The current format of Summary-of-Findings (SoF) tables for presenting effect estimates and associated quality of evidence improve understanding and assist users finding key information in systematic reviews. Users of SoF Tables have demanded alternative formats to express findings from systematic reviews. We conducted a randomized controlled trial among systematic review users to compare the relative merits of a new format with the current formats of SoF tables regarding understanding, accessibility of information, satisfaction, and preference. Our primary goal was to show that the new format is not inferior to the current format. Of 390 potentially eligible subjects, 290 were randomized. Of 7 items testing understanding, 3 showed similar results, 2 showed small differences favoring the new format, and two (understanding risk difference and quality of the evidence associated with a treatment effect) showed large differences favoring the new format (63% (95% CI 55-71) and 62% (95% CI 52-71) more correct answers, respectively). Respondents rated information in the alternative format as more accessible overall and preferred the new format over the current format. While providing at least similar levels of understanding for some items and increased understanding for others users prefer the new format of SoF tables.
Reprod Biomed Online, 2011
Couples with recurrent miscarriage (RM) and men with poor semen quality may undergo genetic testi... more Couples with recurrent miscarriage (RM) and men with poor semen quality may undergo genetic testing as part of the diagnostic work-up. This study explored their knowledge and perception of genetic testing, evaluated psychological wellbeing and identified associated variables. A prospective questionnaire study was conducted in seven clinical genetics centres and referring gynaecological departments in couples with RM or poor semen quality. Questionnaires were completed before disclosure of genetic test results. Main outcome measures were knowledge, perceived risk, anxiety and depression. Of 439 participants, 256 were not aware genetic testing was part of the diagnostic work-up. One-third (36% RM, 33% poor semen quality) indicated they had not received information about the genetic test from their doctor. Perceived risk of receiving an abnormal genetic test result was higher than objective risk. Anxiety was highly correlated with perceived risk. Women with RM were more anxious than women in the poor semen quality group or men (P < 0.01). These couples undergoing genetic testing have a suboptimal understanding of the nature of testing, overestimate the risks of receiving an abnormal result and some show high levels of anxiety. The results of this study can be used to improve patient counselling before genetic testing. RBMOnline Reproductive BioMedicine Online (2011) 23, 525-533 w w w . s c i e n c e d i r e c t . c o m w w w . r b m o n l i n e . c o m
American Journal of Perinatology, Feb 1, 2011
Randomized trials on the clinical utility of fetal fibronectin in women with symptoms of preterm ... more Randomized trials on the clinical utility of fetal fibronectin in women with symptoms of preterm labor have thus far failed to demonstrate benefits. We systematically reviewed the methodology of these trials to assess if these negative results may be related to their study designs. We searched the literature for randomized trials that evaluated fibronectin testing in women with symptoms of preterm labor. Study results were evaluated and five methodological criteria were assessed: (1) randomization of discordant test results, (2) use of a fixed management protocol, (3) description of interventions in relation to the test result, (4) evaluation of a learning curve, and (5) sample size calculation in agreement with the prevalence of the test results. We detected four randomized trials that met inclusion criteria. All trials allocated women to a strategy with or without availability of fibronectin results without using a discordancy design or a fixed management protocol. One study reported the given treatment in relation to the test results. Learning curves were evaluated in one study. Two studies used transport sample size calculations. The negative results of randomized trials on fetal fibronectin may be due to particular choices in their study design.
Fertility and Sterility, Jan 9, 2008
Objective: To assess whether pregnancy history can predict the occurrence of a spontaneous ongoin... more Objective: To assess whether pregnancy history can predict the occurrence of a spontaneous ongoing pregnancy in subfertile couples. Design: Prospective cohort study. Setting: Thirty fertility centers in the Netherlands. Patient(s): Subfertile, ovulatory women with at least one patent tube and male partners without severely impaired semen quality. Intervention(s): Fertility work-up, including a detailed pregnancy history. Main Outcome Measure(s): Spontaneous ongoing pregnancy. Result(s): We included 4445 couples, of whom 793 (18%) had a spontaneous ongoing pregnancy within 1 year of follow-up. Previous live birth and miscarriage in current partnership were both associated with higher fecundity as compared with primary infertility (hazard rate ratios for spontaneous pregnancy [HR] 1.4; 95% CI, 1.2-1.7 and 1.3; 95% CI, 1.0-1.5, respectively). Pregnancies in a woman's previous partnerships did not affect the fecundity of the couple. A pregnancy in a previous partnership of the male partner was associated with lower fecundity (HR 0.76; 95% CI, 0.58-0.99). A previous pregnancy after fertility treatment also was associated with lower fecundity (HR 0.52; 95% CI, 0.30-0.90). Conclusion(s): Accurate prediction of the future fertility of a couple requires an exact assessment of the fertility history of both partners. (Fertil Steril Ò 2008;90:521-7.
Eur J Nucl Med Mol Imaging, 2005
Acta Orthopaedica Scandinavica, 1996
We prospectively enrolled 160 consecutive patients with inversion trauma of the ankle in a diagno... more We prospectively enrolled 160 consecutive patients with inversion trauma of the ankle in a diagnostic protocol that included physical examination within 2 days and at 5 days after trauma, arthrography, stress radiography, and ultrasonography. 135 patients had pathological lateral ligament laxity on the later physical examination or lateral ligament rupture diagnosed on arthrography and they were operated on 122 of these patients had ligament ruptures. At clinical follow-up after a minimum of half a year, all of the patients who were not operated on had stable joints without signs of previous ligament ruptures. Delayed physical examination at 5 days after the injury led to the highest overall sensitivity (96%) and specificity (84%) for the detection of a ligament rupture. Additional diagnostic procedures, at a considerable cost, yielded little additional information.
Gastroenterology, Jul 1, 2002
Radiology, Oct 27, 2014
Purpose To evaluate how diagnostic accuracy study reports published in 2012 adhered to the Standa... more Purpose To evaluate how diagnostic accuracy study reports published in 2012 adhered to the Standards for Reporting of Diagnostic Accuracy (STARD) statement and whether there were any differences in reporting compared with 2000 and 2004. Materials and Methods PubMed was searched for studies published in 12 high-impact-factor journals in 2012 that evaluated the accuracy of one or more diagnostic tests against a clinical reference standard. Two independent reviewers scored reporting completeness of each article with the 25-item STARD checklist. Mixed-effects modeling was used to analyze differences in reporting with previous evaluations from articles published in 2000 and 2004. Results Included were 112 articles. The overall mean number of STARD items reported in 2012 was 15.3 ± 3.9 (standard deviation; range, 6.0-23.5). There was an improvement of 3.4 items (95% confidence interval: 2.6, 4.3) compared with studies published in 2000, and an improvement of 1.7 items (95% confidence interval: 0.9, 2.5) compared with studies published in 2004. Significantly more items were reported for single-gate studies compared with multiple-gate studies (16.8 vs 12.1, respectively; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001) and for studies that evaluated imaging tests compared with laboratory tests and other types of tests (17.0 vs 14.0 vs 14.5, respectively; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). Conclusion Completeness of reporting improved in the 10 years after the launch of STARD, but it remains suboptimal for many articles. Reporting of inclusion criteria and sampling methods for recruiting patients, information about blinding, and confidence intervals for accuracy estimates are in need of further improvement. (©) RSNA, 2014 Online supplemental material is available for this article.
Nederlands Tijdschrift Voor Geneeskunde, 1999
Journal of Clinical Epidemiology, 2009
Background: Several studies and systematic reviews have reported results that indicate that sensi... more Background: Several studies and systematic reviews have reported results that indicate that sensitivity and specificity may vary with prevalence.
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Papers by Patrick Bossuyt