M. G. Myriam Hunink
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View article: Sex differences in inappropriate imaging requests: insights from the Medical Imaging Decision And Support (MIDAS) study
Sex differences in inappropriate imaging requests: insights from the Medical Imaging Decision And Support (MIDAS) study Open
Objective Inappropriate diagnostic imaging can lead to unnecessary radiation exposure, delayed diagnoses, and increased healthcare costs. While multiple factors contribute to inappropriate imaging, sex-based disparities remain understudied…
View article: Cost‐Effectiveness of Coronary Artery Calcium Scoring for Cardiovascular Disease Prevention in Diabetes: An Analysis From MESA
Cost‐Effectiveness of Coronary Artery Calcium Scoring for Cardiovascular Disease Prevention in Diabetes: An Analysis From MESA Open
Background Coronary artery calcium scoring ( CACS ) by computed tomography could enhance risk assessment and decision making for preventive medication in patients with diabetes. We performed a microsimulation study to compare costs and hea…
View article: A Decision-Analytic Model to Evaluate Cost-Effectiveness of Regional Implementation of a Mobile Stroke Unit
A Decision-Analytic Model to Evaluate Cost-Effectiveness of Regional Implementation of a Mobile Stroke Unit Open
Adding an MSU to the dispatch strategy for suspected stroke patients is expected to be cost-effective in our region. Our model facilitates evaluation of the cost-effectiveness of MSU implementation in different regions, settings, and scena…
View article: Challenges and insights from implementing clinical decision support systems for radiologic imaging: experience from the MIDAS trial
Challenges and insights from implementing clinical decision support systems for radiologic imaging: experience from the MIDAS trial Open
Clinical decision support systems (CDSSs) have been developed to give guidance for referring physicians to make appropriate decisions at the point of care. The MIDAS study, a multicenter cluster randomized trial at four German university h…
View article: Economic evaluations in undergraduate medical education: a systematic review
Economic evaluations in undergraduate medical education: a systematic review Open
Objectives Medical education profoundly impacts patients, students, educators and public resources. However, the economic dimensions necessary for informed decision-making remain underexplored. This systematic review examines how economic …
View article: Evaluation of a Clinical Decision Support System for Imaging Requests
Evaluation of a Clinical Decision Support System for Imaging Requests Open
Importance Given the widespread use of medical imaging, evaluating the effectiveness of interventions to improve appropriateness is crucial for optimizing health care resources and patient outcomes. Objective To assess the effects of imple…
View article: Directed Acyclic Graphs in Decision-Analytic Modeling: Bridging Causal Inference and Effective Model Design in Medical Decision Making
Directed Acyclic Graphs in Decision-Analytic Modeling: Bridging Causal Inference and Effective Model Design in Medical Decision Making Open
Decision-analytic models (DAMs) are essentially informative yet complex tools for solving questions in medical decision making. When their complexity grows, the need for causal inference techniques becomes evident as causal relationships b…
View article: Making Drug Approval Decisions in the Face of Uncertainty: Cumulative Evidence versus Value of Information
Making Drug Approval Decisions in the Face of Uncertainty: Cumulative Evidence versus Value of Information Open
Background The COVID-19 pandemic underscored the criticality and complexity of decision making for novel treatment approval and further research. Our study aims to assess potential decision-making methodologies, an evaluation vital for ref…
View article: Potential Mediators for Treatment Effects of Novel Diabetes Medications on Cardiovascular and Renal Outcomes: A Meta‐Regression Analysis
Potential Mediators for Treatment Effects of Novel Diabetes Medications on Cardiovascular and Renal Outcomes: A Meta‐Regression Analysis Open
Background Prior research suggests clinical effects of glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) and sodium‐glucose cotransporter‐2 inhibitors (SGLT2is) are mediated by changes in glycated hemoglobin, body weight, systolic blood…
View article: Surgical and non-surgical interventions for primary and salvage treatment of growth hormone-secreting pituitary adenomas in adults
Surgical and non-surgical interventions for primary and salvage treatment of growth hormone-secreting pituitary adenomas in adults Open
Within the context of GH-secreting pituitary adenomas, patient-relevant outcomes, such as disease-related complications, adverse events and disease recurrence were not, or only sparsely, reported. When reported, we found that surgery may h…
View article: Medical Imaging Decision And Support (MIDAS): Study protocol for a multi-centre cluster randomized trial evaluating the ESR iGuide
Medical Imaging Decision And Support (MIDAS): Study protocol for a multi-centre cluster randomized trial evaluating the ESR iGuide Open
View article: OC16.06: Health related quality of life and healthcare costs of first trimester 3D VR ultrasound: the VR FETUS study
OC16.06: Health related quality of life and healthcare costs of first trimester 3D VR ultrasound: the VR FETUS study Open
Many congenital anomalies can already be detected during the first trimester of pregnancy using ultrasound techniques with concomitant implications for diagnostics, counselling and follow-up for future parents (e.g. early reassurance). Thr…
View article: Twelve-year outcomes of watchful waiting versus surgery of mildly symptomatic or asymptomatic inguinal hernia in men aged 50 years and older: a randomised controlled trial
Twelve-year outcomes of watchful waiting versus surgery of mildly symptomatic or asymptomatic inguinal hernia in men aged 50 years and older: a randomised controlled trial Open
The initial trial was funded by the Netherlands Organisation for Health Research and Development (ZonMW). This long-term study did not receive funding.
View article: P11.06.B PERFUSION MRI IMPACTS MANAGEMENT IN PATIENTS WITH TREATED GLIOMA: FIRST RESULTS FROM THE PERISCOPE PROJECT
P11.06.B PERFUSION MRI IMPACTS MANAGEMENT IN PATIENTS WITH TREATED GLIOMA: FIRST RESULTS FROM THE PERISCOPE PROJECT Open
BACKGROUND Perfusion MRI (pMRI) is widely used for differentiation between progressive disease and pseudoprogression in patients with treated glioma. Although pMRI has long been available, its clinical relevance and utilization are not wel…
View article: From complexity to clarity: how directed acyclic graphs enhance the study design of systematic reviews and meta-analyses
From complexity to clarity: how directed acyclic graphs enhance the study design of systematic reviews and meta-analyses Open
While frameworks to systematically assess bias in systematic reviews and meta-analyses (SRMAs) and frameworks on causal inference are well established, they are less frequently integrated beyond the data analysis stages. This paper propose…
View article: The effect of mindfulness‐based interventions on reducing stress in future health professionals: A systematic review and meta‐analysis of randomized controlled trials
The effect of mindfulness‐based interventions on reducing stress in future health professionals: A systematic review and meta‐analysis of randomized controlled trials Open
Students in health professions often face high levels of stress due to demanding academic schedules, heavy workloads, disrupted work–life balance, and sleep deprivation. Addressing stress during their education can prevent negative consequ…
View article: Cardiovascular and Renal Benefits of Novel Diabetes Drugs by Baseline Cardiovascular Risk: A Systematic Review, Meta-Analysis, and Meta-Regression
Cardiovascular and Renal Benefits of Novel Diabetes Drugs by Baseline Cardiovascular Risk: A Systematic Review, Meta-Analysis, and Meta-Regression Open
Objective Eligibility for glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) has been expanded to patients with diabetes at lower cardiovascular risk, but it is no…
View article: Cardiovascular and Renal Benefits of Novel Diabetes Drugs by Baseline Cardiovascular Risk: A Systematic Review, Meta-Analysis, and Meta-Regression
Cardiovascular and Renal Benefits of Novel Diabetes Drugs by Baseline Cardiovascular Risk: A Systematic Review, Meta-Analysis, and Meta-Regression Open
Objective Eligibility for glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) has been expanded to patients with diabetes at lower cardiovascular risk, but it is no…
View article: Cardiovascular and Renal Benefits of Novel Diabetes Drugs by Baseline Cardiovascular Risk: A Systematic Review, Meta-analysis, and Meta-regression
Cardiovascular and Renal Benefits of Novel Diabetes Drugs by Baseline Cardiovascular Risk: A Systematic Review, Meta-analysis, and Meta-regression Open
BACKGROUND Eligibility for glucagon-like peptide 1 receptor agonists (GLP-1RA) and sodium–glucose cotransporter 2 inhibitors (SGLT2i) has been expanded to patients with diabetes at lower cardiovascular risk, but whether treatment benefits …
View article: Aspirin Monotherapy Is More Cost Effective than Rivaroxaban + Aspirin in Peripheral Arterial Disease Patients after Revascularization
Aspirin Monotherapy Is More Cost Effective than Rivaroxaban + Aspirin in Peripheral Arterial Disease Patients after Revascularization Open
View article: A Tutorial on Time-Dependent Cohort State-Transition Models in R Using a Cost-Effectiveness Analysis Example
A Tutorial on Time-Dependent Cohort State-Transition Models in R Using a Cost-Effectiveness Analysis Example Open
In an introductory tutorial, we illustrated building cohort state-transition models (cSTMs) in R, where the state transition probabilities were constant over time. However, in practice, many cSTMs require transitions, rewards, or both to v…
View article: DEcrease STress through RESilience training for Students (DESTRESS) Study: Protocol for a randomized controlled trial nested in a longitudinal observational cohort study
DEcrease STress through RESilience training for Students (DESTRESS) Study: Protocol for a randomized controlled trial nested in a longitudinal observational cohort study Open
View article: Cost-effectiveness of direct surgery versus preoperative octreotide therapy for growth-hormone secreting pituitary adenomas
Cost-effectiveness of direct surgery versus preoperative octreotide therapy for growth-hormone secreting pituitary adenomas Open
Purpose The objective of this study was to compare the cost-effectiveness of preoperative octreotide therapy followed by surgery versus the standard treatment modality for growth-hormone secreting pituitary adenomas, direct surgery (that i…
View article: Addition of FFRct in the diagnostic pathway of patients with stable chest pain to reduce unnecessary invasive coronary angiography (FUSION)
Addition of FFRct in the diagnostic pathway of patients with stable chest pain to reduce unnecessary invasive coronary angiography (FUSION) Open
View article: Update of the CHIP (CT in Head Injury Patients) decision rule for patients with minor head injury based on a multicenter consecutive case series
Update of the CHIP (CT in Head Injury Patients) decision rule for patients with minor head injury based on a multicenter consecutive case series Open
View article: An Introductory Tutorial on Cohort State-Transition Models in R Using a Cost-Effectiveness Analysis Example
An Introductory Tutorial on Cohort State-Transition Models in R Using a Cost-Effectiveness Analysis Example Open
Decision models can combine information from different sources to simulate the long-term consequences of alternative strategies in the presence of uncertainty. A cohort state-transition model (cSTM) is a decision model commonly used in med…
View article: Surveillance of Unruptured Intracranial Aneurysms
Surveillance of Unruptured Intracranial Aneurysms Open
Generally, the US and UK physicians should refrain from assigning patients, particularly older patients and those with few risk factors for aneurysm growth or rupture, to frequent MRI surveillance. In the Netherlands, annual follow-up is g…
View article: Emerging Therapies for COVID-19: The Value of Information From More Clinical Trials
Emerging Therapies for COVID-19: The Value of Information From More Clinical Trials Open
View article: Emerging Therapies for COVID-19: the value of information from more clinical trials
Emerging Therapies for COVID-19: the value of information from more clinical trials Open
Objectives The COVID-19 pandemic necessitates time-sensitive policy and implementation decisions regarding new therapies in the face of uncertainty. The aim of this study was to quantify consequences of approving therapies or pursuing furt…
View article: Lifetime Cardiovascular Disease Risk by Coronary Artery Calcium Score in Individuals With and Without Diabetes: An Analysis From the Multi-Ethnic Study of Atherosclerosis
Lifetime Cardiovascular Disease Risk by Coronary Artery Calcium Score in Individuals With and Without Diabetes: An Analysis From the Multi-Ethnic Study of Atherosclerosis Open
OBJECTIVE To assess lifetime cardiovascular disease (CVD) risk by coronary artery calcium (CAC) score in individuals with diabetes from the Multi-Ethnic Study of Atherosclerosis (MESA) and compare risk with that in individuals without diab…