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  1. Article ; Online: Intra-and inter-observer variability of point of care ultrasound measurements to evaluate hemodynamic parameters in healthy volunteers.

    Blanca, Deborah / Schwarz, Esther C / Olgers, Tycho Joan / Ter Avest, Ewoud / Azizi, Nasim / Bouma, Hjalmar R / Ter Maaten, Jan Cornelis

    The ultrasound journal

    2023  Volume 15, Issue 1, Page(s) 22

    Abstract: Background: Point-of-care ultrasound (POCUS) is a valuable tool for assessing the hemodynamic status of acute patients. Even though POCUS often uses a qualitative approach, quantitative measurements have potential advantages in evaluating hemodynamic ... ...

    Abstract Background: Point-of-care ultrasound (POCUS) is a valuable tool for assessing the hemodynamic status of acute patients. Even though POCUS often uses a qualitative approach, quantitative measurements have potential advantages in evaluating hemodynamic status. Several quantitative ultrasound parameters can be used to assess the hemodynamic status and cardiac function. However, only limited data on the feasibility and reliability of the quantitative hemodynamic measurements in the point-of-care setting are available. This study investigated the intra- and inter-observer variability of PoCUS measurements of quantitative hemodynamic parameters in healthy volunteers.
    Methods: In this prospective observational study, three sonographers performed three repeated measurements of eight different hemodynamic parameters in healthy subjects. An expert panel of two experienced sonographers evaluated the images' quality. The repeatability (intra-observer variability) was determined by calculating the coefficient of variation (CV) between the separate measurements for each observer. The reproducibility (inter-observer variability) was assessed by determining the intra-class correlation coefficient (ICC).
    Results: 32 subjects were included in this study, on whom, in total, 1502 images were obtained for analysis. All parameters were in a normal physiological range. Stroke volume (SV), cardiac output (CO), and inferior vena cava diameter (IVC-D) showed high repeatability (CV under 10%) and substantial reproducibility (ICC 0.61-0.80). The other parameters had only moderate repeatability and reproducibility.
    Conclusions: We demonstrated good inter-observer reproducibility and good intra-observer repeatability for CO, SV and IVC-D taken in healthy subjects by emergency care physicians.
    Language English
    Publishing date 2023-05-05
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2965029-X
    ISSN 2524-8987 ; 2036-3176
    ISSN (online) 2524-8987
    ISSN 2036-3176
    DOI 10.1186/s13089-023-00322-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Serious Games for Improving Technical Skills in Medicine: Scoping Review.

    Olgers, Tycho Joan / Bij de Weg, Anne Akke / Ter Maaten, Jan Cornelis

    JMIR serious games

    2021  Volume 9, Issue 1, Page(s) e24093

    Abstract: Background: Serious games are being used to train specific technical skills in medicine, and most research has been done for surgical skills. It is not known if these games improve technical skills in real life as most games have not been completely ... ...

    Abstract Background: Serious games are being used to train specific technical skills in medicine, and most research has been done for surgical skills. It is not known if these games improve technical skills in real life as most games have not been completely validated.
    Objective: This scoping review aimed to evaluate the current use of serious games for improving technical skills in medicine and to determine their current validation state using a validation framework specifically designed for serious games.
    Methods: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A multidatabase search strategy was adopted, after which a total of 17 publications were included in this review.
    Results: These 17 publications described five different serious games for improving technical skills. We discuss these games in detail and report about their current validation status. Only one game was almost fully validated. We also discuss the different frameworks that can be used for validation of serious games.
    Conclusions: Serious games are not extensively used for improving technical skills in medicine, although they may represent an attractive alternative way of learning. The validation of these games is mostly incomplete. Additionally, several frameworks for validation exist, but it is unknown which one is the best. This review may assist game developers or educators in validating serious games.
    Language English
    Publishing date 2021-01-25
    Publishing country Canada
    Document type Journal Article ; Review
    ZDB-ID 2798265-8
    ISSN 2291-9279
    ISSN 2291-9279
    DOI 10.2196/24093
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Incomplete recovery in patients with minor head injury directly discharged home from the emergency department: a prospective cohort follow-up study.

    Coffeng, Sophie Maria / Jacobs, Bram / Kim, Laura Jane / Ter Maaten, Jan Cornelis / van der Naalt, Joukje

    BMJ open

    2022  Volume 12, Issue 6, Page(s) e057308

    Abstract: Objectives: To determine the frequency of post-traumatic complaints and recovery rate of non-hospitalised patients with minor head injury (MHI) and their relationship with demographic and injury characteristics. We also evaluated the differences between ...

    Abstract Objectives: To determine the frequency of post-traumatic complaints and recovery rate of non-hospitalised patients with minor head injury (MHI) and their relationship with demographic and injury characteristics. We also evaluated the differences between patient groups in this least severe category of brain and head injury.
    Design: Prospective cohort follow-up study.
    Setting: Patients admitted to the emergency department (ED) of a tertiary hospital in the Netherlands.
    Participants: 242 patients with MHI (n=100 with head injury only and n=142 with mild traumatic brain injury (mTBI)) discharged home directly after evaluation at the ED.
    Outcome measures: The primary outcome measure was incomplete recovery at 3 months measured by the Glasgow Outcome Scale-Extended score <8. Secondary outcome measures were number of post-traumatic complaints assessed 2 weeks and 3 months postinjury by a standardised questionnaire. Also the number of patients that visited their general practitioner because of persistent complaints was determined.
    Results: Three months postinjury 48% of patients reported more than one post-traumatic complaint. Half (51%) of patients showed incomplete recovery. Incomplete recovery was associated with headache directly postinjury (OR 3.27, 95% CI 1.28 to 8.34), age (OR 1.02, 95% CI 1.00 to 1.05) and the number of post-traumatic complaints (OR 1.24, 95% CI 1.09 to 1.40) and depression (OR 6.31, 95% CI 1.24 to 32.00) 2 weeks postinjury. Incomplete recovery was comparable between the head injury only and mTBI group (55% vs 50%, 95% CI -12.5 to -23.0). In total 36 MHI patients (28%) visited their general practitioner because of complaints related to their head injury.
    Conclusion: Half of the non-hospitalised patients with MHI experienced incomplete recovery after 3 months without differences between head injury only and mTBI patients. Therefore, early identification of patients at risk for incomplete recovery must be started at the ED to provide appropriate aftercare to avoid long-term post-traumatic complaints.
    MeSH term(s) Brain Concussion/complications ; Craniocerebral Trauma/complications ; Craniocerebral Trauma/epidemiology ; Emergency Service, Hospital ; Follow-Up Studies ; Humans ; Infant, Newborn ; Patient Discharge ; Prospective Studies
    Language English
    Publishing date 2022-06-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2021-057308
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Serious Games for Improving Technical Skills in Medicine

    Olgers, Tycho Joan / bij de Weg, Anne Akke / ter Maaten, Jan Cornelis

    JMIR Serious Games, Vol 9, Iss 1, p e

    Scoping Review

    2021  Volume 24093

    Abstract: BackgroundSerious games are being used to train specific technical skills in medicine, and most research has been done for surgical skills. It is not known if these games improve technical skills in real life as most games have not been completely ... ...

    Abstract BackgroundSerious games are being used to train specific technical skills in medicine, and most research has been done for surgical skills. It is not known if these games improve technical skills in real life as most games have not been completely validated. ObjectiveThis scoping review aimed to evaluate the current use of serious games for improving technical skills in medicine and to determine their current validation state using a validation framework specifically designed for serious games. MethodsWe used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A multidatabase search strategy was adopted, after which a total of 17 publications were included in this review. ResultsThese 17 publications described five different serious games for improving technical skills. We discuss these games in detail and report about their current validation status. Only one game was almost fully validated. We also discuss the different frameworks that can be used for validation of serious games. ConclusionsSerious games are not extensively used for improving technical skills in medicine, although they may represent an attractive alternative way of learning. The validation of these games is mostly incomplete. Additionally, several frameworks for validation exist, but it is unknown which one is the best. This review may assist game developers or educators in validating serious games.
    Keywords Information technology ; T58.5-58.64 ; Public aspects of medicine ; RA1-1270
    Subject code 700
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher JMIR Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: The satisfaction regarding handovers between ambulance and emergency department nurses: an observational study.

    Hovenkamp, Gijs Thomas / Olgers, Tycho Joan / Wortel, Remco Robert / Noltes, Milou Esmée / Dercksen, Bert / Ter Maaten, Jan Cornelis

    Scandinavian journal of trauma, resuscitation and emergency medicine

    2018  Volume 26, Issue 1, Page(s) 78

    Abstract: Background: A thorough handover in the emergency department (ED) is of great importance for improving the quality and safety in the chain of care. The satisfaction of handover may reflect the quality of handover. Research to discover the variables ... ...

    Abstract Background: A thorough handover in the emergency department (ED) is of great importance for improving the quality and safety in the chain of care. The satisfaction of handover may reflect the quality of handover. Research to discover the variables influencing the satisfaction of handovers is scarce. The goal of this study was to determine the factors influencing the satisfaction regarding handovers from ambulance and ED nurses.
    Methods: We performed a prospective observational study in the University Medical Center of Groningen. Data regarding prehospital-hospital handovers has been collected by observing handovers and assessing patient chart information. Data regarding the satisfaction has been collected with a questionnaire including a 5-point scale for the level of satisfaction.
    Results: In total, 97 handovers were observed and 97 ambulance nurses and 89 ED nurses completed the questionnaire. The satisfaction of ambulance nurses showed a negative correlation with the waiting time prior to handover (r = -.287, p = .004) and a positive correlation with the presence of a physician in the receiving team (r = .224, p = .028). The satisfaction of ED nurses showed a positive correlation with the use of the ABCDE (r = .288, p = .006) and AMPLE instrument (r = .208, p = .050).
    Conclusion: The satisfaction of ambulance and ED nurses as sender or receiver of the handover is determined by different factors. The satisfaction of ambulance nurses is mainly affected by the waiting time and presence of a physician, while the satisfaction of ED nurses is affected by the use of handover instruments and the completeness of medical information.
    MeSH term(s) Adult ; Aged ; Ambulances ; Attitude of Health Personnel ; Communication ; Emergency Service, Hospital ; Female ; Humans ; Job Satisfaction ; Male ; Middle Aged ; Nursing Staff, Hospital ; Patient Handoff ; Prospective Studies ; Surveys and Questionnaires
    Language English
    Publishing date 2018-09-10
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 2455990-8
    ISSN 1757-7241 ; 1757-7241
    ISSN (online) 1757-7241
    ISSN 1757-7241
    DOI 10.1186/s13049-018-0545-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Cohort profile of Acutelines: a large data/biobank of acute and emergency medicine.

    Ter Avest, Ewoud / van Munster, Barbara C / van Wijk, Raymond J / Tent, Sanne / Ter Horst, Sanne / Hu, Ting Ting / van Heijst, Lisanne E / van der Veer, Felien S / van Beuningen, Fleur E / Ter Maaten, Jan Cornelis / Bouma, Hjalmar R

    BMJ open

    2021  Volume 11, Issue 7, Page(s) e047349

    Abstract: Purpose: Research in acute care faces many challenges, including enrolment challenges, legal limitations in data sharing, limited funding and lack of singular ownership of the domain of acute care. To overcome these challenges, the Center of Acute Care ... ...

    Abstract Purpose: Research in acute care faces many challenges, including enrolment challenges, legal limitations in data sharing, limited funding and lack of singular ownership of the domain of acute care. To overcome these challenges, the Center of Acute Care of the University Medical Center Groningen in the Netherlands, has established a de novo data, image and biobank named 'Acutelines'.
    Participants: Clinical data, imaging data and biomaterials (ie, blood, urine, faeces, hair) are collected from patients presenting to the emergency department (ED) with a broad range of acute disease presentations. A deferred consent procedure (by proxy) is in place to allow collecting data and biomaterials prior to obtaining written consent. The digital infrastructure used ensures automated capturing of all bed-side monitoring data (ie, vital parameters, electrophysiological waveforms) and securely importing data from other sources, such as the electronic health records of the hospital, ambulance and general practitioner, municipal registration and pharmacy. Data are collected from all included participants during the first 72 hours of their hospitalisation, while follow-up data are collected at 3 months, 1 year, 2 years and 5 years after their ED visit.
    Findings to date: Enrolment of the first participant occurred on 1 September 2020. During the first month, 653 participants were screened for eligibility, of which 180 were approached as potential participants. In total, 151 (84%) provided consent for participation of which 89 participants fulfilled criteria for collection of biomaterials.
    Future plans: The main aim of Acutelines is to facilitate research in acute medicine by providing the framework for novel studies and issuing data, images and biomaterials for future research. The protocol will be extended by connecting with central registries to obtain long-term follow-up data, for which we already request permission from the participant.
    Trial registration number: NCT04615065.
    MeSH term(s) Biological Specimen Banks ; COVID-19 ; Emergency Medicine ; Humans ; Netherlands ; SARS-CoV-2 ; Treatment Outcome
    Language English
    Publishing date 2021-07-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2020-047349
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: The value of the clinical impression in recognizing and treating sepsis patients in the emergency department.

    van der Vegt, Anna Elizabeth / Holman, Mirjam / ter Maaten, Jan Cornelis

    European journal of emergency medicine : official journal of the European Society for Emergency Medicine

    2012  Volume 19, Issue 6, Page(s) 373–378

    Abstract: Objectives: Immediate bedside recognition of sepsis in the emergency department (ED) enables early treatment. This study aims to investigate whether the clinical impression score of different health care providers (a) is a good predictor of the severity ...

    Abstract Objectives: Immediate bedside recognition of sepsis in the emergency department (ED) enables early treatment. This study aims to investigate whether the clinical impression score of different health care providers (a) is a good predictor of the severity of sepsis, (b) is mutually agreed, and (c) correlates with the treatment provided in the ED.
    Methods: We performed a prospective observational study in the ED of a tertiary teaching hospital over a 3-month period. The vital signs of all patients of at least 18 years presenting with suspected infection or sepsis were measured on arrival at the ED. In patients with at least one of the 'Systemic Inflammatory Response Syndrome' criteria, the nurse, resident, and attending physician assigned a clinical impression score for the degree of acute illness, ranging from 1 (not ill) to 10 (extremely ill). Additional information collected included demographic and treatment data.
    Results: We included 123 patients with sepsis and 11 patients with a (suspected) infection with one 'Systemic Inflammatory Response Syndrome' criterion. The clinical impression scores of all health care providers increased significantly between the infection without sepsis, mild sepsis, and severe sepsis groups. The agreement between the health care providers ranged from moderate to good (weighted κ 0.54-0.62). The clinical impression score correlated with time to antibiotics (R=-0.33, P=0.001), amount of volume therapy (R=0.61-0.64, P≤0.001), and amount of oxygen therapy (R=0.58-0.63, P≤0.001).
    Conclusion: The clinical impression score is associated with the severity of sepsis, is mutually agreed between the different health care providers and is correlated with sepsis treatment provided in the ED.
    MeSH term(s) Adult ; Aged ; Anti-Bacterial Agents/therapeutic use ; Attitude of Health Personnel ; Early Diagnosis ; Emergency Service, Hospital/utilization ; Emergency Treatment ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Netherlands ; Practice Patterns, Physicians'/statistics & numerical data ; Sepsis/diagnosis ; Sepsis/drug therapy ; Severity of Illness Index ; Shock, Septic/diagnosis ; Time Factors ; Young Adult
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2012-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 1233544-7
    ISSN 1473-5695 ; 0969-9546
    ISSN (online) 1473-5695
    ISSN 0969-9546
    DOI 10.1097/MEJ.0b013e32834def59
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: The caval index: an adequate non-invasive ultrasound parameter to predict fluid responsiveness in the emergency department?

    de Valk, Silke / Olgers, Tycho Joan / Holman, Mirjam / Ismael, Farouq / Ligtenberg, Jack Johannes Maria / Ter Maaten, Jan Cornelis

    BMC anesthesiology

    2014  Volume 14, Page(s) 114

    Abstract: Background: Fluid therapy is the first important step in patients with signs of shock but assessment of the volume status is difficult and invasive measurements are not readily available in the emergency department. We have investigated whether the ... ...

    Abstract Background: Fluid therapy is the first important step in patients with signs of shock but assessment of the volume status is difficult and invasive measurements are not readily available in the emergency department. We have investigated whether the respiratory variation in diameter of the inferior vena cava is a reliable parameter to predict fluid responsiveness in spontaneous breathing emergency department patients with signs of shock.
    Methods: All patients admitted to the emergency department during a 15 week period were screened for signs of shock. If the attending physician planned to give a fluid challenge, the caval index was determined by transabdominal ultrasonography in supine position. Immediately afterwards 500 ml NaCl 0.9% was administered in 15 minutes and the clinical response was observed. An adequate response was defined as an increase in systolic blood pressure of at least 10 mm Hg. Based on this definition patients were divided into responders and non-responders.
    Results: After selection a total number of 45 patients was included. A low caval index (< 36.5%) in patients with signs of shock reliably predicted the absence of an adequate response to fluid therapy (negative predictive value 92%). The positive predictive value of a high caval index was much lower (48%) despite the fact that responders had a significantly higher pre-infusion caval index than non-responders (48.7% vs 31.8%, p 0.014).
    Conclusions: In spontaneously breathing patients with signs of shock in the emergency department, a high caval index (>36.5%) does not reliably predict fluid responsiveness in our study, while a low caval index (<36.5%) makes fluid responsiveness unlikely. An explanation for the absence of a blood pressure response in the group of patients with a low high caval index might be that these patients represent a group requiring more volume therapy than 500 ml.
    MeSH term(s) Abdomen/diagnostic imaging ; Adult ; Aged ; Blood Pressure/physiology ; Cross-Sectional Studies ; Emergency Service, Hospital ; Female ; Fluid Therapy/methods ; Humans ; Male ; Middle Aged ; Prospective Studies ; Shock, Septic/diagnostic imaging ; Shock, Septic/therapy ; Ultrasonography
    Language English
    Publishing date 2014
    Publishing country England
    Document type Journal Article ; Observational Study
    ISSN 1471-2253
    ISSN 1471-2253
    DOI 10.1186/1471-2253-14-114
    Database MEDical Literature Analysis and Retrieval System OnLINE

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