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Biomedical subjects

Eric van Sonderen

Publications and source records attributed to Eric van Sonderen.

11 recordsLinked to original sources

A self-rating scale for patient-perceived side effects of inhaled corticosteroids.

BACKGROUND: Patient-reported side effect questionnaires offer a simple method for the systematic measurement of drug-related side effects. In order to measure patients' inhaled corticosteroids (ICS) related side effect perceptions the 14-day retrospective Inhaled Corticosteroid Questionnaire (ICQ) was developed. In this research we aim to assess the construct validity and reliability of the ICQ and test its responsiveness to dose changes in adult asthma patients. METHODS: In a cross-sectional study, current inhaler users with asthma completed the ICQ (27 with non ICS inhaler; 61 BDP equivalent daily ICS low dose < or =400 microg; 62 mid dose 401-800 microg; and 105 with high dose >800 microg). We generated 3 construct validity hypotheses: 1) a hierarchical dose-response pattern for scoring of the individual items on the ICQ, and statistically significant differences in the scores of each of the 15 ICQ domains by ICS dose group 2) an association between ICS dose and ICQ scoring after adjusting for appropriate confounders in multiple regression; 3) greater convergence between local side effect domains than between systemic and local domains of the scale. Test-retest reliability was assessed on a randomly selected subgroup of patients (n = 73) who also completed the ICQ a second time after 7 days. In a separate longitudinal study, 61 patients with asthma completed the ICQ at baseline and after changing their daily ICS dose, at 2- and 6- months, in order to test the ICQ's responsiveness. RESULTS: All three construct validity hypotheses were well supported: 1) a statistically significant difference existed in scores for 14 domains, the high ICS dose group scoring highest; 2) ICS dose independently predicted ICQ scoring after adjusting for confounders; 3) greater convergence existed between local ICQ domains than between local and systemic domains. The ICQ had good reproducibility: test-retest intraclass correlation coefficients were > or =0.69 for all but the 'Facial Oedema' domain. In the longitudinal study, ICQ scores for 'Voice Problems' changed significantly at 2- and 6-months from baseline and other ICQ domains displayed trends in scoring change accordant with dose modulation at 6-months. CONCLUSION: The ICQ has good dose-related discriminative properties, is valid, reliable, and shows potential responsiveness to ICS dose change.

Administration, Inhalation↗

Recall bias did not affect perceived magnitude of change in health-related functional status.

BACKGROUND AND OBJECTIVE: It was hypothesized that within an invasively treated group and within a group that improved in angina pectoris no difference in effect size would occur between prospective and retrospective measures. Furthermore, it was hypothesized that assessment of perceived change at post-test may be invalid because of recall bias and present-state bias. STUDY DESIGN AND SETTING: Effect sizes (as standardized response means) were used as indicators of magnitude of change. Linear structural equation analysis (with LISREL) was used to investigate the relationship between the estimates of recall accuracy and retrospectively assessed change. RESULTS: No significant differences were found between prospective and retrospective measures of change over time in health-related functional status. Recall bias was not associated with retrospective measurement of change within a 12-week interval. An expected present-state effect was found in a structural equation model. CONCLUSION: Prospective and retrospective indices of magnitude of change were similar between groups receiving treatment of known efficacy. Recall bias seems to be an acceptable risk in short-term follow-up studies.

Adult↗

Does marriage protect older people from distress? The role of equity and recency of bereavement.

The association between marital status and distress was examined in a largely neglected group, namely older people (65 and older; N = 1,649). In this 2-wave study, married persons were less distressed than single persons, but perceived equity within the marriage and recency of bereavement qualified these findings. Married persons who felt inequitably treated were more distressed than persons who had always been single. Married persons reported less distress than recently (= 2 years ago) widowed persons, but only equitably treated married persons reported less distress than persons widowed for more than 2 years. Increased distress between the 2 waves occurred in recently widowed persons, and there was a decrease in distress in persons who were widowed shortly before the 1st wave. No gender effects were found.

Adaptation, Psychological↗

Risk and protective factors of different functional trajectories in older persons: are these the same?

We examined whether risk and protective factors of different functional trajectories were the same in 1,765 Dutch older persons. We assessed disability in 1993 and reassessed it in 2001. For 2001 as compared with 1993, we distinguished three trajectory groups: substantially poorer, somewhat poorer, and no change or better functioning. We assessed sociodemographic, health, and psychosocial potential risk or protective factors in 1993. When we analyzed them separately, risk and protective factors had similar (but mirrored) associations with functional trajectories. However, in a multivariate approach, we identified old age, depressive symptoms, and low mastery as risk factors for functional decline, whereas we identified young age, good perceived health, and self-efficacy expectancies as factors that predicted trajectories of healthy functioning. Risk and protective factors of functional trajectories in older persons are not the same.

Aged↗

Differences between participants and non-participants in an RCT on physical activity and psychological interventions for older persons.

BACKGROUND AND AIMS: Volunteer bias in intervention studies on successful aging has been poorly explored. This paper investigated differences between participants and non-participants of the Groningen Intervention Study on Successful Aging (GISSA) over a wide range of demographic, physical, psychological and social subject characteristics. METHODS: Subjects were recruited among a longitudinal cohort study (Groningen Longitudinal Aging Study) and included 558 men and 711 women, aged 65-96 years, who were invited to participate in the GISSA. Measures were obtained by questionnaires at the moment of invitation and eight years before invitation. Participants were compared with three groups of non-participants: persons who refused to participate, those who did not respond after a reminder, and those who intended to participate but withdrew before pre-test. RESULTS: At the moment of invitation, participants were younger, better educated, and functionally and physically more active than the three groups of non-participants. They also had better scores on the physical functioning subscale of the medical outcome scale, better ADL, iADL and vigorous ADL functions and fewer depressive symptoms, and perceived less social support in everyday and problem situations. Participants reported a less strong rate of decline in physical and psychological functioning in the eight years prior to the invitation than did the other groups. CONCLUSION: Due to volunteer bias, results of intervention studies on successful aging may have limited generalizability.

Activities of Daily Living↗

Comparison of oral psoralen-UV-A with a portable tanning unit at home vs hospital-administered bath psoralen-UV-A in patients with chronic hand eczema: an open-label randomized controlled trial of efficacy.

OBJECTIVE: To study whether oral psoralen-UV-A (PUVA) with a portable tanning unit at home is as effective as hospital-administered bath PUVA in patients with chronic hand eczema. DESIGN: Open-label randomized controlled trial, with a 10-week treatment period and an 8-week follow-up period. SETTING: Two university hospital dermatology departments in the Netherlands, specializing in hand eczema. PATIENTS: One hundred fifty-eight patients with moderate to severe chronic hand eczema (more than 1 year in duration). INTERVENTIONS: Oral PUVA using methoxsalen capsules and a simple portable commercial facial tanning unit, or hospital-administered bath PUVA with trioxsalen. MAIN OUTCOME MEASURES: The primary outcome was clinical assessment by a hand eczema score (evaluation of desquamation, erythema, vesiculation, infiltration, fissures, itch, and pain, each on a 4-point scale) after 10 weeks of treatment. The secondary outcome was hand eczema score at 8 weeks of follow-up, after completion of treatment. The tertiary outcome was travel cost and time off work. RESULTS: Both groups showed a comparable and substantial decrease in hand eczema score (meaningful clinical improvement). This decrease was maintained during the follow-up period. Patients treated with oral PUVA at home had lower travel costs and less time off work. CONCLUSIONS: Oral PUVA at home has a clinically relevant efficacy, similar to that of hospital-administered bath PUVA. This effect was maintained during an 8-week follow-up period. It resulted in lower travel costs and less time off work.

Administration, Oral↗

Statistical significant change versus relevant or important change in (quasi) experimental design: some conceptual and methodological problems in estimating magnitude of intervention-related change in health services research.

This paper aims to identify problems in estimating and the interpretation of the magnitude of intervention-related change over time or responsiveness assessed with health outcome measures. Responsiveness is a problematic construct and there is no consensus on how to quantify the appropriate index to estimate change over time between baseline and post-test designs. This paper gives an overview of several responsiveness indices. Thresholds for effect size (or responsiveness index) interpretation were introduced some thirty years ago by Cohen who standardised the difference-scores (d) with the pooled standard deviation (d/SD(pooled)). However, many effect sizes (ES) have been introduced since Cohen's original work and in the formula of one of these ES, the mean change scores are standardised with the SD of those change scores (d/SD(change)). When health outcome questionnaires are used, this effect size is applied on a wide scale and is represented as the Standardized Response Mean (SRM). However, its interpretation is problematic when it is used as an estimate of magnitude of change over time and interpreted with the thresholds, set by Cohen for effect size (ES) which is based on SD(pooled). Thus, in the case of using the SRM, application of these well-known cut-off points for pooled standard deviation units namely: 'trivial' (ES < 0.20), 'small' (ES > or = 0.20 < 0.50), 'moderate' (ES > or = 0.50 < 0.80), or large (ES > or = 0.80), may lead to over- or underestimation of the magnitude of intervention-related change over time due to the correlation between baseline and outcome assessments. Consequently, taking Cohen's thresholds for granted for every version of effect size indices as estimates of intervention-related magnitude of change, may lead to over- or underestimation of this magnitude of intervention-related change over time.

Journal Article↗

Psychological attributes and changes in disability among low-functioning older persons: does attrition affect the outcomes?

The impact of attrition was studied in a two-wave panel study on the associations between psychological attributes (mastery, self-efficacy expectancies) and disability increase among low-functioning older persons (n = 753, 76.4% participated at the follow-up 2 years later). The results showed that: (1) attrition at follow-up was clearly associated with age and level of disability at baseline. Older persons and those with higher levels of disability did not participate in the follow-up; and (2) the strength of the association between the selected psychological attributes and the increase in disability did not substantially alter when (a) missing follow-up scores of disability were replaced by several values (e.g., lower, equal or higher compared to those who actually participated at the follow-up), or (b) associations were computed excluding those participants at follow-up with highest increase in disability. We conclude that attrition may affect the descriptive outcomes of aging studies, particularly when such studies focus on health and function, but that attrition not always seems to be a serious problem when associations between variables are the focus of study.

Activities of Daily Living↗

Temporal and reciprocal relationship between IADL/ADL disability and depressive symptoms in late life.

A strong association between functional disability and depressive symptoms in older people has frequently been reported. Some studies attribute this association to the disabling effects of depression, others to the depressogenic effects of physical health-related disability. The authors examined the reciprocal effects between depressive symptoms and functional disability and their temporal character in a community-based cohort of 753 older people with physical limitations who were assessed at yearly intervals. They compared structural equation models that differed in terms of direction and speed of effects between patient-reported disability in instrumental and basic activities of daily living (IADL/ADLs) and depressive symptoms. The association between disability and depression could be separated into three components: (a) a strong contemporaneous effect of change in disability on depressive symptoms, (b) a weaker 1-year lagged effect of change in depressive symptoms on disability (probably indirect through physical health), and (c) a weak correlation between the trait (or stable) components of depression and disability. IADL/ADL disability and depressive symptoms are thus mutually reinforcing over time. Compensatory forces like effective treatment and age-related adaptation may protect elders against this potential downward trend. To improve quality of life in elderly adults, treatment should target disability when it is new and depression when it is persistent.

Activities of Daily Living↗

An English language version of the social support list: preliminary reliability.

The 34-item Social Support List developed in The Netherlands combines measures of support satisfaction and support interactions in six subscales plus a total score. The present study was designed to assess the applicability of the list in a different cultural context. Data from 421 American undergraduates were consistent with Dutch findings and support the efficacy of the English language version.

Adolescent↗

Depressive symptoms in elderly patients after a somatic illness event: prevalence, persistence, and risk factors.

Elderly patients with somatic illness are at increased risk of depression. The authors studied the prevalence and persistence of depressive symptoms during the first year after the events of myocardial infarction, congestive heart failure, fall-related injury, and the diagnosis of cancer and their putative pre-event risk factors. The GLAS study contains data from 614 patients who experienced post-baseline myocardial infarction, cancer, heart failure, or fall-related injury of the extremities within 5 years after the baseline assessment. Follow-up was conducted 8 weeks, 6 months, and 1 year after the somatic event. The authors studied the relative importance of 21 baseline risk factors for experiencing significant depressive symptoms during follow-up and the persistence of depression. Depressive symptoms were prevalent in 38.3% of the subjects during the post-event year; in about 19.1%, symptoms were mild. For a majority of patients (67.5%), symptoms persisted until the next assessment. Significant pre-event risk factors were depressive symptoms at baseline, age, smoking, poor general health, poor well-being, and neuroticism. Within the depressed group, only neuroticism was related to the persistence of symptoms. Neuroticism increases the risk of experiencing post-event depressive symptoms and is related to their persistence, which suggests the existence of a depression-prone personality.

Accidental Falls↗