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Article ; Online: Improving Clinical Prognostic Model Methodology: Response.

Feijen, Stef / Struyf, Thomas / Kuppens, Kevin / Tate, Angela / Struyf, Filip

2021 Volume 49, Issue 6, Page(s) NP24–NP25

MeSH term(s)	Adolescent ; Humans ; Prognosis ; Shoulder Pain
Language	English
Publishing date	2021-04-30
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	197482-8
ISSN	1552-3365 ; 0363-5465
ISSN (online)	1552-3365
ISSN	0363-5465
DOI	10.1177/03635465211005717
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Article ; Online: Towards an international consensus on safety netting advice for acutely ill children presenting to ambulatory care: a modified e-Delphi procedure.

Burvenich, Ruben / Heytens, Stefan / De Sutter, An / Struyf, Thomas / Toelen, Jaan / Verbakel, Jan Y

Archives of disease in childhood

2024 Volume 109, Issue 2, Page(s) 93–99

Abstract: Objective: Develop a consensus on the content and form of safety netting advice (SNA) for parents of acutely ill children.: Design: Four-round modified e-Delphi using online questionnaires and feedback among clinical and research experts.: Setting!# ...

Abstract	Objective: Develop a consensus on the content and form of safety netting advice (SNA) for parents of acutely ill children. Design: Four-round modified e-Delphi using online questionnaires and feedback among clinical and research experts. Setting: Ambulatory care in high-income countries. Participants: Forty-one experts from 13 countries: 3 emergency physicians, 15 general practitioners, 4 nurses and 19 paediatricians. Results: The experts defined the content of SNA as advice on the normal, expected disease course of the provisional diagnosis, diagnostic uncertainty, alarm signs that indicate the need for medical help and information on where and how to find such help. Regarding the form of the SNA, the experts agree that a reliable source should give SNA verbally with paper or digital written or video/image resources at every appropriate healthcare encounter in a short and simple empowering fashion, specific to the child's situation and seek confirmatory feedback from parents. Conclusions: SNA needs to contain advice on the expected disease course, alarm signs and where and how to find help. It should be given verbally with written resources by a reliable healthcare professional or digital platform. Short, simple and specific, SNA needs to empower the parent whose understanding of the advice should be checked. The effectiveness of SNA resources coproduced by parents and experts should be assessed in different settings and those providing SNA require up-to-date and reliable training.
MeSH term(s)	Child ; Humans ; Consensus ; Ambulatory Care ; Surveys and Questionnaires ; Parents/education ; Uncertainty ; Delphi Technique
Language	English
Publishing date	2024-01-22
Publishing country	England
Document type	Journal Article
ZDB-ID	524-1
ISSN	1468-2044 ; 0003-9888 ; 1359-2998
ISSN (online)	1468-2044
ISSN	0003-9888 ; 1359-2998
DOI	10.1136/archdischild-2023-326370
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Article ; Online: Prediction of Shoulder Pain in Youth Competitive Swimmers: The Development and Internal Validation of a Prognostic Prediction Model.

Feijen, Stef / Struyf, Thomas / Kuppens, Kevin / Tate, Angela / Struyf, Filip

The American journal of sports medicine

2020 Volume 49, Issue 1, Page(s) 154–161

Abstract: Background: Knowledge of predictors for shoulder pain in swimmers can assist professionals working with the athlete in developing optimal prevention strategies. However, study methodology and limited available data have constrained a comprehensive ... ...

Abstract	Background: Knowledge of predictors for shoulder pain in swimmers can assist professionals working with the athlete in developing optimal prevention strategies. However, study methodology and limited available data have constrained a comprehensive understanding of which factors cause shoulder pain. Purpose: To investigate risk factors and develop and internally validate a multivariable prognostic model for the prediction of shoulder pain in swimmers. Study design: Cohort study; Level of evidence, 2. Methods: A total of 201 pain-free club- to international-level competitive swimmers were followed for 2 consecutive seasons. The cohort consisted of 96 male (mean ± SD age, 13.9 ± 2.2 years) and 105 female (13.9 ± 2.2 years) swimmers. Demographic, sport-specific, and musculoskeletal characteristics were assessed every 6 months. Swim-training exposure was observed prospectively. Shoulder pain interfering with training was the primary outcome. Multiple imputation was used to cope with missing data. The final model was estimated using multivariable logistic regression. We applied bootstrapping to internally validate the model and correct for overoptimism. Results: A total of 42 new cases of shoulder pain were recorded during the study. Average duration of follow-up was 1.1 years. Predictors included in the final model were acute:chronic workload ratio (odds ratio [OR], 4.31; 95% CI, 1.00-18.54), competitive level (OR, 0.19; 95% CI, 0.06-0.63), shoulder flexion range of motion, posterior shoulder muscle endurance (OR, 0.96; 95% CI, 0.92-0.99), and hand entry position error (OR, 0.37; 95% CI, 0.16-0.91). After internal validation, this model maintained good calibration and discriminative power (area under the receiver operating characteristic curve, 0.71; 95% CI, 0.60-0.94). Conclusion: Our model consists of parameters that are readily measurable in a swimming setting, allowing the identification of swimmers at risk for shoulder pain. Multivariable logistic regression showed the strongest predictors for shoulder pain were regional competitive swimming level, acute:chronic workload ratio, posterior shoulder muscle endurance, and hand entry error.
MeSH term(s)	Adolescent ; Child ; Cohort Studies ; Female ; Humans ; Male ; Predictive Value of Tests ; Prognosis ; Range of Motion, Articular ; Reproducibility of Results ; Shoulder/physiopathology ; Shoulder Pain/diagnosis ; Shoulder Pain/etiology ; Surveys and Questionnaires/standards ; Swimming
Language	English
Publishing date	2020-11-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	197482-8
ISSN	1552-3365 ; 0363-5465
ISSN (online)	1552-3365
ISSN	0363-5465
DOI	10.1177/0363546520969913
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Article ; Online: Corrigendum to "Inter- and intrarater reliability of two proprioception tests using clinical applicable measurement tools in subjects with and without knee osteoarthritis" [Musculoskel. Sci. Pract. 35 (2018) 105-109.

Baert, Isabel A C / Lluch, Enrique / Struyf, Thomas / Peeters, Greta / Van Oosterwijck, Sophie / Tuynman, Joanna / Rufai, Salim / Struyf, Filip

Musculoskeletal science & practice

2022 Volume 63, Page(s) 102683

Language	English
Publishing date	2022-10-26
Publishing country	Netherlands
Document type	Published Erratum
ZDB-ID	2888772-4
ISSN	2468-7812
ISSN (online)	2468-7812
DOI	10.1016/j.msksp.2022.102683
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Article ; Online: Are psychosocial variables, sleep characteristics or central pain processing prognostic factors for outcome following rotator cuff repair? A protocol for a prospective longitudinal cohort study.

Schwank, Ariane / Struyf, Thomas / Struyf, Filip / Blazey, Paul / Mertens, Michel / Gisi, David / Pisan, Markus / Meeus, Mira

BMJ open

2022 Volume 12, Issue 8, Page(s) e058803

Abstract: Introduction: Prognosis following surgical rotator cuff repair (RCR) is often established through the assessment of non-modifiable biomedical factors such as tear size. This understates the complex nature of recovery following RCR. There is a need to ... ...

Abstract	Introduction: Prognosis following surgical rotator cuff repair (RCR) is often established through the assessment of non-modifiable biomedical factors such as tear size. This understates the complex nature of recovery following RCR. There is a need to identify modifiable psychosocial and sleep-related variables, and to find out whether changes in central pain processing influence prognosis after RCR. This will improve our knowledge on how to optimise recovery, using a holistic rehabilitation approach. Methods and analysis: This longitudinal study will analyse 141 participants undergoing usual care for first time RCR. Data will be collected 1-21 days preoperatively (T1), then 11-14 weeks (T2) and 12-14 months (T3) postoperatively. We will use mixed-effects linear regression to assess relationships between potential prognostic factors and our primary and secondary outcome measures-the Western Ontario Rotator Cuff Index; the Constant-Murley Score; the Subjective Shoulder Value; Maximal Pain (Numeric Rating Scale); and Quality of Life (European Quality of Life, 5 dimensions, 5 levels). Potential prognostic factors include: four psychosocial variables; pain catastrophising, perceived stress, injury perceptions and patients' expectations for RCR; sleep; and four factors related to central pain processing (central sensitisation inventory, temporal summation, cold hyperalgesia and pressure pain threshold). Intercorrelations will be assessed to determine the strength of relationships between all potential prognostic indicators.Our aim is to explore whether modifiable psychosocial factors, sleep-related variables and altered central pain processing are associated with outcomes pre-RCR and post-RCR and to identify them as potential prognostic factors. Ethics and dissemination: The results of the study will be disseminated at conferences such as the European Pain Congress. One or more manuscripts will be published in a peer-reviewed SCI-ranked journal. Findings will be reported in accordance with the STROBE statement and PROGRESS framework. Ethical approval is granted by the Ethical commission of Canton of Zurich, Switzerland, No: ID_2018-02089 TRIAL REGISTRATION NUMBER: NCT04946149.
MeSH term(s)	Arthroscopy/methods ; Cohort Studies ; Humans ; Longitudinal Studies ; Pain ; Prognosis ; Prospective Studies ; Quality of Life ; Rotator Cuff/surgery ; Rotator Cuff Injuries/psychology ; Rotator Cuff Injuries/surgery ; Sleep ; Treatment Outcome
Language	English
Publishing date	2022-08-04
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-058803
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Article ; Online: Intrarater and Interrater Reliability of a Passive Shoulder Flexion Range of Motion Measurement for Latissimus Dorsi Flexibility in Young Competitive Swimmers.

Feijen, Stef / Tate, Angela / Kuppens, Kevin / Struyf, Thomas / Claes, Anke / Struyf, Filip

Journal of sport rehabilitation

2020 Volume 29, Issue 6, Page(s) 855–858

Abstract: Context: The latissimus dorsi plays a major role in generating the propulsive force during swimming. In addition, stiffness of this muscle may result in altered stroke biomechanics and predispose swimmers to shoulder pain. Measuring the flexibility of ... ...

Abstract	Context: The latissimus dorsi plays a major role in generating the propulsive force during swimming. In addition, stiffness of this muscle may result in altered stroke biomechanics and predispose swimmers to shoulder pain. Measuring the flexibility of the latissimus dorsi can be of interest to reduce injury. However, the reliability of such measurement has not yet been investigated in competitive swimmers. Objective: To assess the within-session intrarater and interrater reliability of a passive shoulder flexion range of motion measurement for latissimus dorsi flexibility in competitive swimmers. Design: Within-session intrarater and interrater reliability. Setting: Competitive swimming clubs in Flanders, Belgium. Participants: Twenty-six competitive swimmers (15.46 [2.98] y; 16 men and 10 women). Intervention: Each rater performed 2 alternating (eg, left-right-left-right) measurements of passive shoulder flexion range of motion twice, with a 30-second rest period in between. Main outcome measures: The intraclass correlation coefficients were calculated to assess intrarater and interrater reliability. Results: Interrater intraclass correlation coefficient ranged from .54 (95% confidence interval [CI], -.16 to .81) to .57 (95% CI, -.24 to .85). Results for the intrarater reliability ranged from .91 (95% CI, .81 to .96) to .94 (95% CI, .87 to .97). Conclusion: Results of this study suggest that shoulder flexion range of motion in young competitive swimmers can be measured reliably by a single rater within the same session.
MeSH term(s)	Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Range of Motion, Articular/physiology ; Reproducibility of Results ; Shoulder Joint/physiology ; Superficial Back Muscles/physiology ; Swimming/physiology ; Young Adult
Language	English
Publishing date	2020-02-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	1106769-x
ISSN	1543-3072 ; 1056-6716
ISSN (online)	1543-3072
ISSN	1056-6716
DOI	10.1123/jsr.2019-0294
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Article ; Online: Are psychosocial variables, sleep characteristics or central pain processing prognostic factors for outcome following rotator cuff repair? A protocol for a prospective longitudinal cohort study

Mira Meeus / Filip Struyf / Paul Blazey / Markus Pisan / Ariane Schwank / Thomas Struyf / Michel Mertens / David Gisi

BMJ Open, Vol 12, Iss

2022 Volume 8

Abstract: Introduction Prognosis following surgical rotator cuff repair (RCR) is often established through the assessment of non-modifiable biomedical factors such as tear size. This understates the complex nature of recovery following RCR. There is a need to ... ...

Abstract	Introduction Prognosis following surgical rotator cuff repair (RCR) is often established through the assessment of non-modifiable biomedical factors such as tear size. This understates the complex nature of recovery following RCR. There is a need to identify modifiable psychosocial and sleep-related variables, and to find out whether changes in central pain processing influence prognosis after RCR. This will improve our knowledge on how to optimise recovery, using a holistic rehabilitation approach.Methods and analysis This longitudinal study will analyse 141 participants undergoing usual care for first time RCR. Data will be collected 1–21 days preoperatively (T1), then 11–14 weeks (T2) and 12–14 months (T3) postoperatively. We will use mixed-effects linear regression to assess relationships between potential prognostic factors and our primary and secondary outcome measures—the Western Ontario Rotator Cuff Index; the Constant-Murley Score; the Subjective Shoulder Value; Maximal Pain (Numeric Rating Scale); and Quality of Life (European Quality of Life, 5 dimensions, 5 levels). Potential prognostic factors include: four psychosocial variables; pain catastrophising, perceived stress, injury perceptions and patients’ expectations for RCR; sleep; and four factors related to central pain processing (central sensitisation inventory, temporal summation, cold hyperalgesia and pressure pain threshold). Intercorrelations will be assessed to determine the strength of relationships between all potential prognostic indicators.Our aim is to explore whether modifiable psychosocial factors, sleep-related variables and altered central pain processing are associated with outcomes pre-RCR and post-RCR and to identify them as potential prognostic factors.Ethics and dissemination The results of the study will be disseminated at conferences such as the European Pain Congress. One or more manuscripts will be published in a peer-reviewed SCI-ranked journal. Findings will be reported in accordance with the STROBE statement and PROGRESS ...
Keywords	Medicine ; R
Subject code	170
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
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Article ; Online: Diagnostic value of biomarkers for paediatric urinary tract infections in primary care: systematic review and meta-analysis.

Boon, Hanne A / Struyf, Thomas / Bullens, Dominique / Van den Bruel, Ann / Verbakel, Jan Y

BMC family practice

2021 Volume 22, Issue 1, Page(s) 193

Abstract: Background: Accurate diagnosis of urinary tract infection is essential as children left untreated may suffer permanent renal injury.: Aim: To compare the diagnostic values of biomarkers or clinical prediction rules for urinary tract infections in ... ...

Abstract	Background: Accurate diagnosis of urinary tract infection is essential as children left untreated may suffer permanent renal injury. Aim: To compare the diagnostic values of biomarkers or clinical prediction rules for urinary tract infections in children presenting to ambulatory care. Design and setting: Systematic review and meta-analysis of ambulatory care studies. Methods: Medline, Embase, WOS, CINAHL, Cochrane library, HTA and DARE were searched until 21 May 2021. We included diagnostic studies on urine or blood biomarkers for cystitis or pyelonephritis in children below 18 years of age. We calculated sensitivity, specificity and likelihood ratios. Data were pooled using a bivariate random effects model and a Hierarchical Summary Receiver Operating Characteristic analysis. Results: Seventy-five moderate to high quality studies were included in this review and 54 articles in the meta-analyses. The area under the receiver-operating-characteristics curve to diagnose cystitis was 0.75 (95%CI 0.62 to 0.83, n = 9) for C-reactive protein, 0.71 (95% CI 0.62 to 0.80, n = 4) for procalcitonin, 0.93 (95% CI 0.91 to 0.96, n = 22) for the dipstick test (nitrite or leukocyte esterase ≥trace), 0.94 (95% CI 0.58 to 0.98, n = 9) for urine white blood cells and 0.98 (95% CI 0.92 to 0.99, n = 12) for Gram-stained bacteria. For pyelonephritis, C-reactive protein < 20 mg/l had LR- of 0.10 (95%CI 0.04-0.30) to 0.22 (95%CI 0.09-0.54) in children with signs suggestive of urinary tract infection. Conclusions: Clinical prediction rules including the dipstick test biomarkers can support family physicians while awaiting urine culture results. CRP and PCT have low accuracy for cystitis, but might be useful for pyelonephritis.
MeSH term(s)	Biomarkers ; C-Reactive Protein ; Child ; Humans ; Primary Health Care ; Pyelonephritis/diagnosis ; Sensitivity and Specificity ; Urinary Tract Infections/diagnosis
Chemical Substances	Biomarkers ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2021-09-27
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review
ISSN	1471-2296
ISSN (online)	1471-2296
DOI	10.1186/s12875-021-01530-9
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Article ; Online: Intra- and interrater reliability of the 'lumbar-locked thoracic rotation test' in competitive swimmers ages 10 through 18 years.

Feijen, Stef / Kuppens, Kevin / Tate, Angela / Baert, Isabel / Struyf, Thomas / Struyf, Filip

Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine

2018 Volume 32, Page(s) 140–144

Abstract: Objectives: Measuring thoracic spine mobility can be of interest to competitive swimmers as it has been associated with shoulder girdle function and scapular position in subjects with and without shoulder pain. At present, no reliability data of ... ...

Abstract	Objectives: Measuring thoracic spine mobility can be of interest to competitive swimmers as it has been associated with shoulder girdle function and scapular position in subjects with and without shoulder pain. At present, no reliability data of thoracic spine mobility measurements are available in the swimming population. This study aims to evaluate the within-session intra- and interrater reliability of the "lumbar-locked rotation test" for thoracic spine rotation in competitive swimmers aged 10 to 18 years. This reliability study is part of a larger prospective cohort study investigating potential risk factors for the development of shoulder pain in competitive swimmers. Design: Within-session, intra- and inter-rater reliability. Setting: Competitive swimming clubs in Belgium. Participants: 21 competitive swimmers. Main outcome measures: Intra- and inter-rater reliability of the lumbar-locked thoracic rotation test. Results: Intraclass correlation coefficients (ICCs) ranged from 0.91 (95% CI 0.78 to 0.96) to 0.96 (0.89-0.98) for intra-rater reliability. Results for inter-rater reliability ranged from 0.89 (0.72-0.95) to 0.86 (0.65-0.94) respectively for right and left thoracic rotation. Conclusion: Results suggest good to excellent reliability of the lumbar-locked thoracic rotation test, indicating this test can be used reliably in clinical practice.
MeSH term(s)	Adolescent ; Athletes ; Child ; Female ; Humans ; Lumbosacral Region/physiology ; Male ; Observer Variation ; Prospective Studies ; Range of Motion, Articular ; Reproducibility of Results ; Risk Factors ; Rotation ; Shoulder Pain/diagnosis ; Shoulder Pain/physiopathology ; Spine/physiology ; Swimming
Language	English
Publishing date	2018-07
Publishing country	England
Document type	Journal Article
ZDB-ID	2008604-0
ISSN	1873-1600 ; 1466-853X
ISSN (online)	1873-1600
ISSN	1466-853X
DOI	10.1016/j.ptsp.2018.04.012
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Article ; Online: Incidence rates and trends of childhood urinary tract infections and antibiotic prescribing: registry-based study in general practices (2000 to 2020).

Boon, Hanne A / Struyf, Thomas / Crèvecoeur, Jonas / Delvaux, Nicolas / Van Pottelbergh, Gijs / Vaes, Bert / Van den Bruel, Ann / Verbakel, Jan Y

BMC primary care

2022 Volume 23, Issue 1, Page(s) 177

Abstract: Background: To improve the management of childhood urinary tract infections, it is essential to understand the incidence rates, testing and treatment strategy.: Methods: A retrospective study using data from 45 to 104 general practices (2000 to 2020) ...

Abstract	Background: To improve the management of childhood urinary tract infections, it is essential to understand the incidence rates, testing and treatment strategy. Methods: A retrospective study using data from 45 to 104 general practices (2000 to 2020) in Flanders (Belgium). We calculated the incidence rates (per 1000 person-years) of cystitis, pyelonephritis, and lab-based urine tests per age (< 2, 2-4, 5-9 and 10-18 years)) and gender in children and performed an autoregressive time-series analysis and seasonality analysis. In children with UTI, we calculated the number of lab-based urine tests and antibiotic prescriptions per person-year and performed an autoregressive time-series analysis. Results: There was a statistically significant increase in the number of UTI episodes from 2000 to 2020 in each age group (p < 0.05), except in boys 2-4 years. Overall, the change in incidence rate was low. In 2020, the incidence rates of cystitis were highest in girls 2-4 years old (40.3 /1000 person-years 95%CI 34.5-46.7) and lowest in boys 10-18 (2.6 /1000 person-years 95%CI 1.8-3.6) The incidence rates of pyelonephritis were highest in girls 2-4 years (5.5, 95%CI 3.5-8.1 /1000 person-years) and children < 2 years of age (boys: 5.4, 95%CI 3.1-8.8 and girls: 4.9, 95%CI 2.7-8.8 /1000 person-years). In children 2-10 years, there was an increase in number of lab-based urine tests per cystitis episode per year and a decrease in total number of electronic antibiotic prescriptions per cystitis episode per year, from 2000 to 2020. In children with cystitis < 10 years in 2020, 51% (95%CI 47-56%) received an electronic antibiotic prescription, of which the majority were broad-spectrum agents. Conclusions: Over the last 21 years, there was a slight increase in the number of UTI episodes diagnosed in children in Flemish general practices, although the overall change was low. More targeted antibiotic therapy for cystitis in accordance with clinical guidelines is necessary to reduce the use of broad-spectrum agents in children below 10 years.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Child ; Child, Preschool ; Cystitis/drug therapy ; Female ; Humans ; Incidence ; Male ; Pyelonephritis/drug therapy ; Registries ; Retrospective Studies ; Urinary Tract Infections/drug therapy
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2022-07-20
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2731-4553
ISSN (online)	2731-4553
DOI	10.1186/s12875-022-01784-x
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