Publications by authors named "Boersma L"
Purpose: Artificial intelligence (AI) applications in radiotherapy (RT) are expected to save time and improve quality, but implementation remains limited. Therefore, we used implementation science to develop a format for designing an implementation strategy for AI. This study aimed to (1) apply this format to develop an AI implementation strategy for our center; (2) identify insights gained to enhance AI implementation using this format; and (3) assess the feasibility and acceptability of this format to design a center-specific implementation strategy for departments aiming to implement AI.
View Article and Find Full Text PDFBridging the care gap: patients' needs and experiences regarding shared decision-making in radiotherapy.
Clin Transl Radiat Oncol
January 2025
Background And Purpose: Shared decision-making (SDM), a collaborative process in which patients and physicians jointly determine further treatment, has been associated with numerous positive effects. However, its implementation into routine clinical practice faces challenges. In radiotherapy (RT) it may have additional challenges, since patients are referred from another oncologist, often "to undergo RT".
View Article and Find Full Text PDFIntroduction: High-density (HD) substrate mapping may increase success of catheter ablation targeting ventricular tachycardia (VT). However, despite its use, recurrent VT is not uncommon. We aim to investigate factors that are associated with outcomes after HD mapping-guided substrate ablation procedures for VT in patients with ischemic cardiomyopathy.
View Article and Find Full Text PDFArticle Synopsis
- Many patients with atrial fibrillation (AF) are not receiving or are stopping oral anticoagulation therapy, despite its importance for stroke prevention.
- While direct oral anticoagulants (DOACs) are available, issues like bleeding risks, poor compliance, and aversion to treatment contribute to this problem.
- A recent expert consensus guide highlights left atrial appendage closure (LAAC) as a safe alternative for stroke prevention in patients who cannot use long-term anticoagulation, detailing the devices, implantation technique, and follow-up requirements for non-implanting physicians.
Article Synopsis
- Inappropriate therapy (IAT) is a significant issue associated with implantable cardiac defibrillator (ICD) therapy, particularly highlighted in early subcutaneous ICD (S-ICD) studies which showed high rates of inappropriate shocks (IAS).
- The PRAETORIAN trial, an international study with 849 patients, found no major differences in IAT and IAS rates between S-ICD and transvenous ICD (TV-ICD) groups, as both groups had similar cumulative incidences.
- Key predictors for IAT varied between the two groups, with TV-ICD patients experiencing IAT mainly from supraventricular tachycardias, while S-ICD patients faced issues from cardiac oversensing
Article Synopsis
- The S-ICD was created to eliminate lead-related issues found in the TV-ICD, as it is an external device that sits under the skin rather than using leads inside the body.
- This analysis comes from the PRAETORIAN trial, where patients were randomly assigned to either S-ICD or TV-ICD and assessed for quality of life through various questionnaires at different stages.
- Results showed no significant differences in physical and mental well-being between the groups, but patients who experienced a shock recently reported lower social functioning and emotional health compared to those who did not.
Background: Oral anticoagulation is recommended after ablation for atrial fibrillation among patients at high risk for stroke. Left atrial appendage closure is a mechanical alternative to anticoagulation, but data regarding its use after atrial fibrillation ablation are lacking.
Methods: We conducted an international randomized trial involving 1600 patients with atrial fibrillation who had an elevated score (≥2 in men and ≥3 in women) on the CHADS-VASc scale (range, 0 to 9, with higher scores indicating a greater risk of stroke) and who underwent catheter ablation.
Article Synopsis
- * The meeting involves discussion of pre-selected topics by working groups, which are informed by systematic reviews and surveys reflecting current clinical practices.
- * The Assisi Working Group specifically examines lobular carcinoma, offering recommendations for locoregional therapy, especially radiation therapy for non-metastatic cases.
Article Synopsis
- Patients with a heart condition called atrial fibrillation (AF) who have strokes can still be at very high risk of having more strokes, even when taking medication to prevent them.
- Left atrial appendage occlusion (LAAO) is a special procedure aimed at helping these patients avoid future strokes.
- A study compared two groups – one that had LAAO and one that only continued their usual medication – and found that there was still a risk of strokes in both groups over a two-year period.
Unlabelled: The EORTC 22922/10925 trial aimed to investigate the impact on overall survival (OS) of elective internal mammary and medial supraclavicular (IM-MS) radiation therapy (RT) in breast cancer stage I-III. Surgery for the primary tumour and axillary lymph nodes, chest wall RT, boost RT after whole breast RT in breast conserving therapy (BCT), RT to operated axilla, and systemic therapy were per physician's preference. The aim of the current analysis is to assess breast cancer outcomes according to different locoregional and systemic therapy used in the trial.
View Article and Find Full Text PDFArticle Synopsis
- The study evaluates the long-term performance and safety of the extravascular implantable cardioverter-defibrillator (EV ICD) after initial findings showed its effectiveness for 6 months.
- A total of 316 patients were enrolled, with a successful implant in 299 cases, experiencing various arrhythmic events that were effectively treated using antitachycardia pacing (ATP) and shocks.
- The results indicated high success rates for both ATP (77.1%) and shock therapy (100%), with low rates of complications and inappropriate shocks over the three-year study period.
Objectives: To systematically review risk factors for patient-reported arm symptoms (AS) in breast cancer (BC), considering radiotherapy (RT) impact, using the EORTC QLQ-BR23 questionnaire (BR23).
Methods: PubMed, Embase, Cochrane Library, MEDLINE, and Web of Science were searched using the keywords "breast neoplasms", "radiotherapy", and "BR23" up to March 5th, 2024.
Inclusion Criteria: both univariate and multivariate analyses.
Aims: The extravascular implantable cardioverter-defibrillator (EV ICD) has been shown to be safe and effective for patients at risk of sudden cardiac death, but little is known about EV ICD lead removal in humans. This analysis aimed to characterize the EV ICD lead removal experience thus far.
Methods And Results: This was a retrospective analysis of lead removals from the EV ICD Pilot, Pivotal, and Continued Access Studies.
Unlabelled: The current project is part of the Spatial location of breast cancer local rECurRence aftEr masTectomy (SECRET) study (NCT06130111). Herein we compared the chest wall thickness after non-skin sparing mastectomy (non-SSM) with the chest wall thickness after SSM, as a surrogate for residual breast tissue after mastectomy.
Methods: The study was approved by the ethics committee of relevant institutions.
Introduction: Conventional implantable cardioverter-defibrillators (ICDs) and pacemakers carry a risk of pocket- and lead-related complications in particular. To avoid these complications, extravascular devices (EVDs) have been developed, such as the subcutaneous ICD (S-ICD) and leadless pacemaker (LP). However, data on patient or centre characteristics related to the actual adoption of EVDs are lacking.
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- - Study aimed to determine factors influencing early mortality after left atrial appendage occlusion (LAAO) to improve patient selection and cost-effectiveness for stroke prevention.
- - Analyzed data from 1,020 patients, finding a 2-year mortality rate of 16.4%, with 50% of deaths attributed to non-cardiovascular causes, and identified six key predictors of mortality including age and heart failure.
- - Concluded that as the number of risk factors in patients increased, the mortality rate rose significantly, underscoring the need for careful patient selection for LAAO procedures.
Article Synopsis
- Patients who underwent left atrial appendage occlusion (LAAO) have an increased risk of bleeding and thromboembolic events, leading researchers to investigate the role of hematological markers in predicting these risks.
- Data from 1,315 patients revealed that while the platelet count was somewhat associated with thromboembolic events, none of the hematological markers were linked to major bleeding events.
- Key factors influencing thromboembolism included age and previous thromboembolic history, while major bleeding risks were tied to prior events, renal disease, and dual antiplatelet therapy upon discharge.
Background: The first aim of this study was to examine trends in the risk of ipsilateral invasive breast cancer (iIBC) after breast-conserving surgery (BCS) of ductal carcinoma in situ (DCIS). A second aim was to analyse the association between DCIS grade and the risk of iIBC following BCS.
Patients And Methods: In this population-based, retrospective cohort study, the Netherlands Cancer Registry collected information on 25,719 women with DCIS diagnosed in the period 1989-2021 who underwent BCS.
A BRILLIANT-BRCA study: residual breast tissue after mastectomy and reconstruction.
Breast Cancer Res Treat
November 2024
Introduction: Different types of mastectomies leave different amounts of residual breast tissue. The significance of the residual breast volume (RBV) is not clear. Therefore, we developed an MRI tool that allows to easily assess the RBV.
View Article and Find Full Text PDFBackground: Early recurrence of atrial tachyarrhythmias (ERAT) within 3 months of thermal ablation for atrial fibrillation (AF) is common and often considered transient. Pulsed field ablation (PFA) is a nonthermal energy source in which ERAT is not well described.
Objective: The purpose of this study was to analyze ERAT in patients with AF undergoing PFA in the Pulsed Field Ablation to Irreversibly Electroporate Tissue and Treat AF (PULSED AF) trial.