Stefan Visscher

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Diagnosing ventilator-associated pneumonia in mechanically ventilated patients in intensive care units is currently seen as a clinical challenge. The difficulty in diagnosing ventilator-associated pneumonia stems from the lack of a simple yet accurate diagnostic test. To assist clinicians in diagnosing and treating patients with pneumonia , a(More)
OBJECTIVE To determine the diagnostic performance of a Bayesian Decision-Support System (BDSS) for ventilator-associated pneumonia (VAP). DESIGN A previously developed BDSS, automatically obtaining patient data from patient information systems, provides likelihood predictions of VAP. In a prospectively studied cohort of 872 ICU patients, VAP was diagnosed(More)
OBJECTIVE Appropriate antimicrobial treatment of infections in critically ill patients should be started as soon as possible, as delay in treatment may reduce a patient's prognostic outlook considerably. Ventilator-associated pneumonia (VAP) occurs in patients in intensive care units who are mechanically ventilated and is almost always preceded by(More)
BACKGROUND Inappropriate medication prescription is a common cause of preventable adverse drug events among elderly persons in the primary care setting. OBJECTIVE The aim of this systematic review is to quantify the extent of inappropriate prescription to elderly persons in the primary care setting. METHODS We systematically searched Ovid-Medline and(More)
BACKGROUND We previously validated a Bayesian network (BN) model for diagnosing ventilator-associated pneumonia (VAP). Here, we report on the performance of the model to predict microbial causes of VAP and to select antibiotics. METHODS Pathogens were grouped into seven categories based upon the antibiotic susceptibility and epidemiological(More)
OBJECTIVE Large health care datasets normally have a hierarchical structure, in terms of levels, as the data have been obtained from different practices, hospitals, or regions. Multilevel regression is the technique commonly used to deal with such multilevel data. However, for the statistical analysis of interactions between entities from a domain,(More)
OBJECTIVES Although the course of single diseases can be studied using traditional epidemiologic techniques, these methods cannot capture the complex joint evolutionary course of multiple disorders. In this study, multilevel temporal Bayesian networks were adopted to study the course of multimorbidity in the expectation that this would yield new clinical(More)
OBJECTIVE To assess guideline adherence of co-prescribing NSAID and gastroprotective medications for elders in general practice over time, and investigate its potential association with the electronic medical record (EMR) system brand used. METHODS We included patients 65 years and older who received NSAIDs between 2005 and 2010. Prescription data were(More)
OBJECTIVE To determine adequacy of antithrombotic treatment in patients with non-valvular atrial fibrillation. To determine risk factors for under- and over-treatment. DESIGN Retrospective, cross-sectional study of electronic health records from 36 general practitioners in 2008. SETTING General practice in the Netherlands. SUBJECTS Primary care(More)