Stefan Visscher

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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)
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)
BACKGROUND In 2009 the pandemic influenza virus A(H1N1)pdm09 emerged with guidance that people at risk should be vaccinated. It is unclear how this event affected the underlying seasonal vaccination rate in subsequent years. PURPOSE To investigate the association of pandemic influenza A(H1N1)pdm09 and seasonal flu vaccination status in 2009 with(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)
Bacterial respiratory tract colonization predisposes critically ill patients to intensive care unit (ICU)-acquired infections. It is unclear to what extent systemic antibiotics affect colonization persistence. Persistence of respiratory tract colonization, and the effects of systemic antibiotics hereon, were determined in a cohort of ICU patients. Clinical(More)
To determine the diagnostic performance of a Bayesian Decision-Support System (BDSS) for ventilator-associated pneumonia (VAP). 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 by two(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)
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 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)