Publications by authors named "Doorn W"

Background: Interest in prediction models, including machine learning (ML) models, based on laboratory data has increased tremendously. Uncertainty in laboratory measurements and predictions based on such data are inherently intertwined. This study developed a framework for assessing the impact of biological and analytical variation on the prediction uncertainty of categorical prediction models.

View Article and Find Full Text PDF
Article Synopsis
  • Hypodysfibrinogenemia is a rare genetic disorder affecting fibrinogen, leading to both bleeding and thrombotic complications, and requires careful patient management beyond standard tests.
  • A family case study identified a 60-year-old woman and her two daughters with the disorder, all of whom shared a specific genetic mutation causing abnormal fibrinogen function.
  • Advanced testing methods showed that the daughters had a hypercoagulable state, indicating increased blood clotting risk, which was not evident in routine coagulation tests, highlighting the need for specialized evaluation in such patients.
View Article and Find Full Text PDF

Background: As the healthcare sector evolves, Artificial Intelligence's (AI's) potential to enhance laboratory medicine is increasingly recognized. However, the adoption rates and attitudes towards AI across European laboratories have not been comprehensively analyzed. This study aims to fill this gap by surveying European laboratory professionals to assess their current use of AI, the digital infrastructure available, and their attitudes towards future implementations.

View Article and Find Full Text PDF
Article Synopsis
  • Clinical labs have gotten way better at using tech to manage and share medical data, thanks to advanced systems and software.
  • Although Laboratory Information Systems (LIS) have improved since the 1970s, they still struggle to handle all the extra information produced during testing.
  • The paper suggests splitting this information into two types—metadata (which describes data) and peridata (which helps understand test results)—to make it easier to use and improve healthcare technology.
View Article and Find Full Text PDF

Purpose: In older patients with kidney failure (KF) starting dialysis, there is a high rate of functional decline. Not much is known about the functional trajectory of patients receiving conservative kidney management (CKM). Therefore, the aim of this study is to assess this functional trajectory and explore clinical parameters associated with functional decline.

View Article and Find Full Text PDF
Article Synopsis
  • Cardiac troponin T (cTnT) is crucial for diagnosing heart attacks (MI) but is often elevated in patients with end-stage renal disease (ESRD), which complicates interpretation of results.
  • The study assessed how different blood collection methods (serum, lithium-heparin plasma, and EDTA plasma) affect cTnT composition and concentration in both MI and ESRD patients.
  • Findings showed that while cTnT concentration remains consistent across blood types, the degradation pattern of cTnT varies significantly, with MI patients showing larger proteoforms and ESRD patients displaying small fragments, which is important for developing accurate diagnostic assays.
View Article and Find Full Text PDF

Background: Many prediction models have been developed to help identify emergency department (ED) patients at high risk of poor outcome. However, these models often underperform in clinical practice and their actual clinical impact has hardly ever been evaluated. We aim to perform a clinical trial to investigate the clinical impact of a prediction model based on machine learning (ML) technology.

View Article and Find Full Text PDF
Article Synopsis
  • Researchers improved a model called Deep Embedded Clustering (DEC) to better handle different types of data, like numbers and categories.
  • They created a new version called X-DEC by using a special tool (an X-shaped variational autoencoder) to make it work better.
  • After testing both models on patients in intensive care, they found that while both created clear groups, X-DEC gave more consistent results.
View Article and Find Full Text PDF

Background: Risk stratification of patients presenting to the emergency department (ED) is important for appropriate triage. Diagnostic laboratory tests are an essential part of the workup and risk stratification of these patients. Using machine learning, the prognostic power and clinical value of these tests can be amplified greatly.

View Article and Find Full Text PDF

Introduction: Prediction models for identifying emergency department (ED) patients at high risk of poor outcome are often not externally validated. We aimed to perform a head-to-head comparison of the discriminatory performance of several prediction models in a large cohort of ED patients.

Methods: In this retrospective study, we selected prediction models that aim to predict poor outcome and we included adult medical ED patients.

View Article and Find Full Text PDF

Background: Cardiac troponin I and T are both used for diagnosing myocardial infarction (MI) after coronary artery bypass grafting (CABG), also known as type 5 MI (MI-5). Different MI-5 definitions have been formulated, using multiples of the 99th percentile upper reference limit (10×, 35×, or 70× URL), with or without supporting evidence. These definitions are arbitrarily chosen based on conventional assays and do not differentiate between troponin I and T.

View Article and Find Full Text PDF
Article Synopsis
  • Current guidelines for interpreting natriuretic peptide concentrations in emergency settings do not account for the time of day when patients present.
  • A study comparing diagnostic accuracy for acute heart failure in daytime versus evening/nighttime patients found significant diurnal variations in BNP and NT-proBNP levels, with lower concentrations at night affecting accuracy of diagnosis.
  • Results show that BNP and NT-proBNP have a distinct diurnal rhythm, which could lead to misdiagnosis if not considered, while MR-proANP levels remained consistent regardless of the time of day.
View Article and Find Full Text PDF

B-cells contribute to MS pathogenesis. The association of circulating B-cell phenotypes with combined unique active lesions (CUA) on MRI at 48 weeks follow-up was investigated in 50 interferon beta-treated MS patients. Transitional B-cell proportions were lower in participants with CUA at week 0 and 48 [p = 0.

View Article and Find Full Text PDF

Background: Closed-loop insulin delivery systems, which integrate continuous glucose monitoring (CGM) and algorithms that continuously guide insulin dosing, have been shown to improve glycaemic control. The ability to predict future glucose values can further optimize such devices. In this study, we used machine learning to train models in predicting future glucose levels based on prior CGM and accelerometry data.

View Article and Find Full Text PDF

Aims: CVD is the main cause of morbidity and mortality in individuals with diabetes. It is currently unclear whether daily glucose variability contributes to CVD. Therefore, we investigated whether glucose variability is associated with arterial measures that are considered important in CVD pathogenesis.

View Article and Find Full Text PDF

Cardiac troponin T (cTnT) is a sensitive and specific biomarker for detecting cardiac muscle injury. Its concentration in blood can be significantly elevated outside the normal reference range under several pathophysiological conditions. The classical analytical method in routine clinical analysis to detect cTnT in serum or plasma is a single commercial immunoassay, which is designed to quantify the intact cTnT molecule.

View Article and Find Full Text PDF

Introduction: Patients with sepsis who present to an emergency department (ED) have highly variable underlying disease severity, and can be categorized from low to high risk. Development of a risk stratification tool for these patients is important for appropriate triage and early treatment. The aim of this study was to develop machine learning models predicting 31-day mortality in patients presenting to the ED with sepsis and to compare these to internal medicine physicians and clinical risk scores.

View Article and Find Full Text PDF

Objective: Due to the high awareness of coeliac disease and improvement of serological tests, the number of requested laboratory tests has increased substantially over the years. In the current study we have evaluated the requesting behaviour of distinct clinical disciplines in relation to the prevalence of positive results and in the context of existing guidelines.

Methods: Data were retrospectively extracted from the laboratory information system over a time-span of 5 years in a tertiary hospital and compared with the situation in a secondary hospital.

View Article and Find Full Text PDF

Four Dendrobium Sonia 'Earsakul' lines were generated by insertion of one, two or three antisense copies of a Carica papaya gene encoding 1-aminocyclopropane-1-carboxylic acid oxidase (CpACO). Whole vegetative plants of the transgenic lines showed about 50% of the basal ethylene production rate, while the increase in ethylene production in floral buds during opening and open flowers prior to visible senescence was delayed. Detailed analysis of more than 100 parameters in flowering plants showed no effect of antisense ACO on plant morphology and coloration, except for shorter length and width of some of the sepals and petals.

View Article and Find Full Text PDF

Background: Cardiac troponin T (cTnT) is the preferred biomarker for the diagnosis of acute myocardial infarction (AMI). It has been suggested that cTnT is present predominantly in fragmented forms in human serum following AMI. In this study, we have used a targeted mass spectrometry assay and epitope mapping using Western blotting to confirm this hypothesis.

View Article and Find Full Text PDF