Roger E. G. Schutgens

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BACKGROUND Serial ultrasonography is reliable for the diagnosis of deep venous thrombosis in symptomatic patients, but the low prevalence of thrombosis in this group renders the approach costly and inconvenient to patients. We studied the clinical validity of the combination of a pretest clinical probability score and a D-dimer test in the initial(More)
In persons with hemophilia, life expectancy is now approaching that of the general male population, at least in countries that can afford regular replacement therapy with coagulation factor concentrates. The new challenges for comprehensive treatment centers are thus to provide optimal health care for this aging population of patients, who often present not(More)
OBJECTIVE To assess the accuracy of the Wells rule for excluding deep vein thrombosis and whether this accuracy applies to different subgroups of patients. DESIGN Meta-analysis of individual patient data. DATA SOURCES Authors of 13 studies (n = 10,002) provided their datasets, and these individual patient data were merged into one dataset. ELIGIBILITY(More)
BACKGROUND AND OBJECTIVES Venous thromboembolism can be related to malignancy, but routine screening for cancer in patients with deep vein thrombosis (DVT) is not a recommended practice. The aim of this study was to evaluate the value of D-dimer concentration in predicting cancer in patients with DVT. DESIGN AND METHODS D-dimer levels were measured in(More)
BACKGROUND D-dimer testing to rule out deep vein thrombosis is less useful in older patients because of a lower specificity. An age-adjusted D-dimer cut-off value increased the proportion of older patients (>50 years) in whom pulmonary embolism could be excluded. We retrospectively validated the efficacy of this cut-off combined with clinical probability(More)
Dear Editor, In transfusion medicine, it can be a challenge to obtain compatible blood for patients who have clinically important alloantibodies to high-prevalence antigens. We describe a case which examples the decision process for autologous blood deposition in the Dutch health care system. In September 2006, a 56-year-old man was admitted to the(More)
BACKGROUND There is a marked lack of evidence on the optimal prevention of ischaemic stroke and other thromboembolic events in patients with non-valvular atrial fibrillation and a recent intracerebral haemorrhage during treatment with oral anticoagulation. These patients are currently treated with oral anticoagulants, antiplatelet drugs, or no(More)
showed the group performance of one laboratory on a single exam in comparison with peer laboratories. A complete picture of the laboratory's competency will emerge over the next few exams, as more sediment structures are tested. Urinalysis-CA offers the following improvements over our previous diskette-based software: • It allows anonymous, intergroup(More)
OBJECTIVES To evaluate the extent of delay in the diagnosis of pulmonary embolism (PE) in primary care, and to identify determinants that are associated with such diagnostic delay. DESIGN Retrospective observational study. SETTING 6 primary care practices across the Netherlands. PARTICIPANTS Data from patients with an objectively confirmed diagnosis(More)
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