Publications by authors named "W J M van den Broek"

Erroneous and malpractice claim cases reflect knowledge gaps and complex contextual factors. Incorporating such cases into clinical reasoning education (CRE) may enhance learning and diagnostic skills. However, they may also elicit anxiety among learners, potentially impacting learning.

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By working out the Bethe sum rule, a boundary condition that takes the form of a linear equality is derived for the fine structure observed in ionization edges present in electron energy-loss spectra. This condition is subsequently used as a constraint in the estimation process of the elemental abundances, demonstrating starkly improved precision and accuracy and reduced sensitivity to the number of model parameters. Furthermore, the fine structure is reliably extracted from the spectra in an automated way, thus providing critical information on the sample's electronic properties that is hard or impossible to obtain otherwise.

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Aims: A genotype-guided P2Y12-inhibitor de-escalation strategy, switching acute coronary syndrome (ACS) patients without a CYP2C19 loss-of-function allele from ticagrelor or prasugrel to clopidogrel, has shown to reduce bleeding risk without affecting effectivity of therapy by increasing ischemic risk. We estimated the cost-effectiveness of this personalized approach compared to standard dual antiplatelet therapy (DAPT; aspirin plus ticagrelor/prasugrel) in the Netherlands.

Methods And Results: We developed a one-year decision tree based on results of the FORCE-ACS registry, comparing a cohort of ACS patients who underwent genotyping with a cohort of ACS patients treated with standard DAPT.

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Article Synopsis
  • The study investigates the frequency and reasons for changes in ticagrelor treatment among patients with acute coronary syndrome (ACS), revealing that many patients discontinue it prematurely.
  • Data from over 4,200 patients showed that 26.7% had physician-recommended discontinuations and 20.1% had alterations in their treatment within a year.
  • Treatment interruptions and disruptions significantly increased the risk of serious heart-related issues, while discontinuation and alterations did not show the same level of risk.
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Introduction: Diagnostic errors are often attributed to erroneous selection and interpretation of patients' clinical information, due to either cognitive biases or knowledge deficits. However, whether the selection or processing of clinical information differs between correct and incorrect diagnoses in written clinical cases remains unclear. We hypothesised that residents would spend more time processing clinical information that was relevant to their final diagnosis, regardless of whether their diagnosis was correct.

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