Biomedical subjects

Inger N Sierevelt

Publications and source records attributed to Inger N Sierevelt.

7 recordsLinked to original sources

PubMed2007

Perceptions and competence in evidence-based medicine: Are surgeons getting better? A questionnaire survey of members of the Dutch Orthopaedic Association.

BACKGROUND: The Journal of Bone and Joint Surgery, American Volume (The Journal) recently initiated a section called "Evidence-Based Orthopaedics." Furthermore, a level-of-evidence rating is now used in The Journal to help readers in clinical decision-making. Little is known about whether this recent emphasis has influenced surgeons' perceptions about and competence in evidence-based medicine. Therefore, we examined perceptions and competence in evidence-based medicine among Dutch orthopaedic surgeons. METHODS: Members of the Dutch Orthopaedic Association were surveyed to examine their attitudes toward evidence-based medicine and their competence in evidence-based medicine. We evaluated competences using a newly developed instrument tailored to surgical practice. RESULTS: Of the 611 members, 367 surgeons (60%) responded. Orthopaedic surgeons welcomed evidence-based medicine. Practical evidence-based medicine resources were perceived as the best method to move from opinion-based or experience-based to evidence-based practice. Four variables were significantly and positively associated with the competence instrument: (1) a younger age, particularly between thirty-six and forty-five years (p = 0.007), (2) experience of less than ten years (p = 0.032), (3) having a PhD degree (p < 0.001), and (4) working in an academic or teaching setting (p = 0.004). The majority of the respondents were aware of The Journal's evidence-based medicine section (84%) and level-of-evidence ratings (65%), and 20% used The Journal's evidence-based medicine abstracts in clinical decision-making. This increased awareness of evidence-based medicine was also reflected in the frequent use of Cochrane reviews in clinical decision-making (27% of the respondents). Surgeons who used and those who were aware of but did not use The Journal's evidence-based medicine abstracts or Cochrane reviews in clinical decision-making had significantly higher competence instrument scores than those who were unaware of these resources (p = 0.03 and p < 0.001, respectively). CONCLUSIONS: Evidence-based medicine is welcomed by Dutch orthopaedic surgeons. The recent emphasis on evidence-based medicine is reflected in an increased awareness about The Journal's evidence-based medicine section, levels of evidence, and the largest evidence-based medicine resource: the Cochrane reviews. Younger orthopaedic surgeons had better knowledge about evidence-based medicine. The development and use of evidence-based resources as well as preappraised summaries such as The Journal's evidence-based medicine abstracts and Cochrane reviews were perceived as the best way to move from opinion-based to evidence-based orthopaedic practice.

Adult↗

PubMed2006

Does a "Level I Evidence" rating imply high quality of reporting in orthopaedic randomised controlled trials?

BACKGROUND: The Levels of Evidence Rating System is widely believed to categorize studies by quality, with Level I studies representing the highest quality evidence. We aimed to determine the reporting quality of Randomised Controlled Trials (RCTs) published in the most frequently cited general orthopaedic journals. METHODS: Two assessors identified orthopaedic journals that reported a level of evidence rating in their abstracts from January 2003 to December 2004 by searching the instructions for authors of the highest impact general orthopaedic journals. Based upon a priori eligibility criteria, two assessors hand searched all issues of the eligible journal from 2003-2004 for RCTs. The assessors extracted the demographic information and the evidence rating from each included RCT and scored the quality of reporting using the reporting quality assessment tool, which was developed by the Cochrane Bone, Joint and Muscle Trauma Group. Scores were conducted in duplicate, and we reached a consensus for any disagreements. We examined the correlation between the level of evidence rating and the Cochrane reporting quality score. RESULTS: We found that only the Journal of Bone and Joint Surgery - American Volume (JBJS-A) used a level of evidence rating from 2003 to 2004. We identified 938 publications in the JBJS-A from January 2003 to December 2004. Of these publications, 32 (3.4%) were RCTs that fit the inclusion criteria. The 32 RCTs included a total of 3543 patients, with sample sizes ranging from 17 to 514 patients. Despite being labelled as the highest level of evidence (Level 1 and Level II evidence), these studies had low Cochrane reporting quality scores among individual methodological safeguards. The Cochrane reporting quality scores did not differ significantly between Level I and Level II studies. Correlations varied from 0.0 to 0.2 across the 12 items of the Cochrane reporting quality assessment tool (p > 0.05). Among items closely corresponding to the Levels of Evidence Rating System criteria assessors achieved substantial agreement (ICC = 0.80, 95% CI:0.60 to 0.90). CONCLUSION: Our findings suggest that readers should not assume that 1) studies labelled as Level I have high reporting quality and 2) Level I studies have better reporting quality than Level II studies. One should address methodological safeguards individually.

Bibliometrics↗

PubMed2006

Translation and validation of the Dutch version of the International Knee Documentation Committee Subjective Knee Form.

BACKGROUND: For knee-related surgery, there is a great demand for internationally useable subjective scoring systems. Before such measurements can be used, they should be translated and validated for the population they are used on. For the Dutch population, only the Western Ontario and McMaster Universities Osteoarthritis Index and Oxford 12 Questionnaire have been validated. However, these scores can only be used regarding osteoarthritis of the knee. In 2001, the International Knee Documentation Committee presented the Subjective Knee Form, which is a knee-specific rather than a disease-specific questionnaire. STUDY DESIGN: Cohort study (diagnosis/symptom prevalence); Level of evidence, 2. METHODS: The authors describe the translation procedure and validation of the Dutch Subjective Knee Form. After a forward-backward translation protocol, the reliability, validity, and content validity were tested. The responses of 145 consecutive knee patients on 2 questionnaires containing the Short Form-36, Western Ontario and McMaster Universities Osteoarthritis Index, Oxford 12 Questionnaire score, a visual analog scale, and the Dutch International Knee Documentation Committee Subjective Knee Form were used. Reliability was tested by measuring the test-retest reliability and internal consistency. Validity was tested by correlating the questionnaire to the other outcome measurements, and content validity was tested by measuring the floor and ceiling effects. RESULTS: The reliability proved excellent with an intraclass coefficient of 0.96 for test-retest. Internal consistency was strong (Cronbach alpha, .92). The construct, convergent, and divergent validities were good. The content validity was good; no floor or ceiling effect occurred. CONCLUSION: The validation procedure shows that the Dutch International Knee Documentation Committee Subjective Knee Form is an excellent evaluation instrument for Dutch patients with knee-related injuries.

Adult↗

PubMed2005

Two ankle joint laxity testers: reliability and validity.

Two test devices were manufactured to objectively measure ankle joint laxity: the dynamic anterior ankle tester (DAAT) and the quasi-static anterior ankle tester (QAAT). The primary aim was to analyse the reliability of both testers; The secondary aim was to assess validity in correlation with TELOS stress test and manual anterior drawer test. Twenty-four normal subjects and 14 patients 1 year after acute lateral ankle ligament injury were included. Both ankles were tested with the DAAT and QAAT by two different observers; one experienced orthopaedic surgeon performed the manual test; the TELOS stress X-rays were evaluated by one observer. Intra observer reliability for the DAAT varied between 0.81 and 0.94; for the QAAT between 0.71 and 0.94. Inter observer reliability for the DAAT varied between 0.84 and 0.94; for the QAAT between 0.76 and 0.82. Concurrent validity showed fair correlation between DAAT and QAAT for the first couple observers (0.71); however, a poor correlation was observed for the second couple (0.42). No significant correlations were found between neither DAAT and the TELOS and the manual test, nor QAAT and the TELOS and the manual test. In conclusion, reliability of both testers is high. Validity of the testers needs further investigation.

Adult↗

PubMed2005

Translation and validation of the Dutch version of the Oxford 12-item knee questionnaire for knee arthroplasty.

BACKGROUND: In 1998, the Oxford 12-item knee questionnnaire was developed by Dawson et al. as a self-administered disease- and site-specific questionnaire, specifically developed for knee arthroplasty patients. Since then,it has proven to be an effective outcome questionnaire, and is widely used. Despite the positive psychometric properties for the Total Knee Arthroplasty (TKA) population, the 12-item knee questionnaire has only been translated into a few languages. We thus translated and validated the Oxford 12-item knee questionnaire for the Dutch population. METHODS AND RESULTS: After translation according to a forward/backward protocol, 174 knee arthroplasty patients were asked to answer the questionnaire together with an SF-36, an AKSS and a VAS. The reliability, validity, content validity and the sensitivity to change were all tested. Our Dutch version of the Oxford 12-item knee questionnaire achieved excellent scores in all of these properties. INTERPRETATION: The Dutch Oxford 12-item knee questionnaire proved to be an excellent evaluation instrument for the Dutch orthopedic surgeon and can be used for all total knee arthroplasty patients.

Arthroplasty, Replacement, Knee↗

PubMed2004

Stiffness of the healing medial collateral ligament of the mouse.

The knee joints of mice can serve as a model for studying knee ligament properties. The goal of our study was to measure the structural stiffness of the medial collateral ligament (MCL) of the murine knee. A tensile test was developed for this purpose. First 84 femur-MCL-tibia complexes of 11-week-old C57Black6 mice were tested. Of four groups (n = 14 per group) the right MCL was ruptured. The mice were sacrificed at 1.5, 3, 6, and 9 weeks after the operation. The other two groups served as controls at 0 and 9 weeks after the operation. Absolute values of the structural stiffness of the healed MCLs at 1.5 weeks were initially significantly lower than their unoperated controls, but were not different from normal values at three, six, and nine weeks of healing. The structural stiffness of the unoperated controls increased by 11% at 20 weeks compared to 11 weeks of age.

Animals↗

PubMed2004

Intra-articular fractures of the distal femur: a long-term follow-up study of surgically treated patients.

OBJECTIVE: To analyze the long-term (5-25 years) functional and radiologic results of surgically treated intra-articular fractures of the distal femur. DESIGN: Retrospective study. SETTING: University hospital. PATIENTS AND METHODS: Sixty-seven surgically treated consecutive patients with 67 intra-articular distal femoral fractures were included in this study. All fractures were classified according to the AO classification. There were 36 men and 31 women. The mean age at time of accident was 45 years (range 16-94 years). There were 38 patients with isolated fractures and 29 with multiple fractures. Median hospital stay was 23 days (range 12-330 days). A 1-year follow-up was done in all 67 patients. Thirty-two of these patients were also seen for an additional long-term follow-up visit. Functional results of these 32 patients were graded using the Neer and HSS knee scores. Radiologic results were graded using the Ahlbäck score. Statistical analysis was performed by means of the SPSS data analysis program. RESULTS: At 1-year follow-up in 40 of 65 patients (62%), the fracture was fully healed, in 22 patients (34%) a fixation callus still existed, and 1 patient had a nonunion. In 2 patients, an arthrodesis was performed. The mean knee range of motion was 111 degrees (range 10-145 degrees). After a mean follow-up of 14 years (range 5-25 years), the mean knee range of motion was 118 degrees (range 10-145 degrees). The Neer score showed good to excellent results in 84% of the patients, and the HSS knee score showed good to excellent results in 75% of the patients. Patients with isolated fractures scored significantly better functionally (Neer/HSS 90 points) compared with those with multiple fractures. The Ahlbäck score showed a moderate to severe development of secondary osteoarthritis in 36% of all patients. Seventy-two percent of these patients still scored a good to excellent functional result. Seven patients (10%) had local complications in the form of a deep wound infection. Five of these patients were treated successfully, whereas 2 had a chronic infection that subsequently led to an arthrodesis. CONCLUSION: Surgical treatment of monocondylar and bicondylar femoral fractures shows good long-term results after open reduction and internal fixation. Knee function increases through time, though the range of motion does not increase after 1 year. The presence of secondary osteoarthritis does not mean less favorable functional results in most patients.

Adolescent↗