Marijke C Jansen-van der Weide

University of Groningen, Groningen, Province of Groningen, Netherlands

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Publications (25)61.53 Total impact

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    ABSTRACT: The aim of this study was to investigate the cumulative incidence and predictive variables of treatment failure with a whey-based extensively hydrolyzed formula (w-eHF) in children with cow's milk allergy (CMA). All children were diagnosed with CMA, using double-blind placebo-controlled food challenge (DBPCFC) with amino acid-based formula as placebo, and receive w-eHF treatment after diagnosis. Forty-nine children with CMA were included. w-eHF treatment failure was defined as incomplete resolution of original CMA symptoms upon w-eHF treatment and disappearance of these symptoms upon replacement of w-eHF with amino acid-based formula. A multiple logistic regression model was used to investigate which variables could predict treatment failure. Twenty-five (51 %; 95 % confidence interval (CI) 38-64 %) of the children with CMA failed on w-eHF. Only "gastrointestinal discomfort" was found to contribute independently to the probability of failing w-eHF, odds ratio (95 % CI) 8.994 (1.007-79.457). Conclusions: In half of the children with proven CMA, there is incomplete resolution of symptoms upon w-eHF treatment. This study needs to be repeated including DBPCFC with w-eHF to provide more definitive diagnosis, especially since gastrointestinal discomfort seems to be the sole predictive variable for treatment failure. In the meantime, a change in formula should be considered in children with incomplete symptom resolution upon w-eHF treatment.
    European Journal of Pediatrics 11/2014; · 1.98 Impact Factor
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    Tijdschrift voor kindergeneeskunde 02/2013; 81(1).
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    ABSTRACT: Many computed tomography (CT) studies have reported that lipid-rich, presumably rupture-prone atherosclerotic plaques can be characterized according to their Hounsfield Unit (HU) value. However, the published HU-based characterization criteria vary considerably. The present study aims to systematically analyze these values and empirically derive a hierarchical classification of the HU-based criteria which can be referred in clinical situation. A systematic search in PubMed and Embase for publications with HU-criteria to characterize lipid-rich and fibrous atherosclerotic plaques resulted in 36 publications, published between 1998 and 2011. The HU-criteria were systematically analyzed based on the characteristics of the reporting study. Significant differences between HU-criteria were checked using Student's t-test. Subsequently, a hierarchical classification of HU-criteria was developed based on the respective study characteristics. No correlation was found between HU-criteria and the reported lumen contrast-enhancement. Significant differences were found for HU-criteria when pooled according to the respective study characteristics: examination type, vessel type, CT-vendor, detector-rows, voltage-setting, and collimation-width. The hierarchical classification resulted in 21 and 22 CT attenuation value categories, for lipid-rich and fibrous plaque, respectively. More than 50% of the hierarchically classified HU-criteria were significantly different. In conclusion, variations in the reported CT attenuation values for lipid-rich and fibrous plaque are so large that generalized values are unreliable for clinical use. The proposed hierarchical classification can be used to determine reference CT attenuation values of lipid-rich and fibrous plaques for the local setting.
    PLoS ONE 01/2013; 8(9):e73460. · 3.53 Impact Factor
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    ABSTRACT: To determine the optimal cutoff of choline (Cho) concentration in quantitative multivoxel magnetic resonance (MR) spectroscopic data to safely prove benignancy in breast lesions. The study was institutional review board approved, and informed consent was obtained from each patient. Between July 2009 and July 2010, multivoxel MR spectroscopy was performed in 24 consecutive patients with 25 breast lesions assessed as Breast Imaging Reporting and Data System 3 or 4 and larger than 1 cm in diameter at mammography. Two-dimensional point-resolved spatially localized spectroscopy chemical shift imaging was first performed without signal suppression (repetition time msec/echo time msec, 1500/30) as reference measurement and was performed subsequently with suppression of water and fat signals (1500/135) to detect Cho. Differences in mean and highest Cho concentration in the breast lesions were tested for significance by using the independent sample t test. The final diagnosis was confirmed with pathologic findings. Fourteen of 25 breast lesions were malignant. The mean Cho concentration varied between 0.3 and 1.3 mmol/L (0.84 mmol/L ± 0.32 [standard deviation]) in benign lesions and between 1.3 and 9.5 mmol/L (3.10 mmol/L ± 2.21) in malignant lesions. The highest Cho concentrations in benign and malignant lesions were 0.4-1.5 mmol/L (1.19 mmol/L ± 0.33) and 1.7-11.8 mmol/L (4.08 mmol/L ± 2.81), respectively. Mean and highest Cho concentrations in benign and malignant breast lesions differed significantly (P = .02 for both). The study, in a relatively small patient population, shows that quantitative multivoxel MR spectroscopy can be applied to exclude benign breast lesions from further invasive diagnostic work-up with the implementation of a Cho concentration of 1.5 mmol/L or lower as a cutoff. Further larger studies will be needed to confirm these results.
    Radiology 04/2011; 259(3):695-703. · 6.34 Impact Factor
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    ABSTRACT: To evaluate the additional value of computer-aided detection (CAD) in breast MRI by assessing radiologists' accuracy in discriminating benign from malignant breast lesions. A literature search was performed with inclusion of relevant studies using a commercially available CAD system with automatic colour mapping. Two independent researchers assessed the quality of the studies. The accuracy of the radiologists' performance with and without CAD was presented as pooled sensitivity and specificity. Of 587 articles, 10 met the inclusion criteria, all of good methodological quality. Experienced radiologists reached comparable pooled sensitivity and specificity before and after using CAD (sensitivity: without CAD: 89%; 95% CI: 78-94%, with CAD: 89%; 95%CI: 81-94%) (specificity: without CAD: 86%; 95% CI: 79-91%, with CAD: 82%; 95% CI: 76-87%). For residents the pooled sensitivity increased from 72% (95% CI: 62-81%) without CAD to 89% (95% CI: 80-94%) with CAD, however, not significantly. Concerning specificity, the results were similar (without CAD: 79%; 95% CI: 69-86%, with CAD: 78%; 95% CI: 69-84%). CAD in breast MRI has little influence on the sensitivity and specificity of experienced radiologists and therefore their interpretation remains essential. However, residents or inexperienced radiologists seem to benefit from CAD concerning breast MRI evaluation.
    European Radiology 03/2011; 21(8):1600-8. · 4.34 Impact Factor
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    ABSTRACT: To compare left ventricular (LV) function assessment using five different software tools on the same dual source computed tomography (DSCT) datasets with the results of MRI. Twenty-six patients, undergoing cardiac contrast-enhanced DSCT were included (20 men, mean age 59±12 years). Reconstructions were made at every 10% of the RR-interval. Function analysis was performed with five different, commercially available workstations. In all software tools, semi-automatic LV function measurements were performed, with manual corrections if necessary. Within 0-22 days, all 26 patients were scanned on a 1.5 T MRI-system. Bland-Altman analysis was performed to calculate limits of agreement between DSCT and MRI. Pearson's correlation coefficient was calculated to assess the correlation between the different DSCT software tools and MRI. Repeated measurements were performed to determine intraobserver and interobserver variability. For all five DSCT workstations, mean LV functional parameters correlated well with measurements on MRI. Bland-Altman analysis of the comparison of DSCT and MRI showed acceptable limits of agreement. Best correlation and limits of agreement were obtained by DSCT software tools with software algorithms comparable to MRI software. The five different DSCT software tools we examined have interchangeable results of LV functional parameters compared to regularly analysed results by MRI. The best correlation and the narrowest limits of agreement were found when the same software algorithm was used for both DSCT and MRI examinations, therefore our advice for clinical practice is to always evaluate images with the same type of post-processing tools in follow-up.
    European journal of radiology 11/2010; 80(3):755-66. · 2.65 Impact Factor
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    ABSTRACT: Women with familial or genetic aggregation of breast cancer are offered screening outside the population screening programme. However, the possible benefit of mammography screening could be reduced due to the risk of radiation-induced tumours. A systematic search was conducted addressing the question of how low-dose radiation exposure affects breast cancer risk among high-risk women. A systematic search was conducted for articles addressing breast cancer, mammography screening, radiation and high-risk women. Effects of low-dose radiation on breast cancer risk were presented in terms of pooled odds ratios (OR). Of 127 articles found, 7 were selected for the meta-analysis. Pooled OR revealed an increased risk of breast cancer among high-risk women due to low-dose radiation exposure (OR = 1.3, 95% CI: 0.9- 1.8). Exposure before age 20 (OR = 2.0, 95% CI: 1.3-3.1) or a mean of ≥5 exposures (OR = 1.8, 95% CI: 1.1-3.0) was significantly associated with a higher radiation-induced breast cancer risk. Low-dose radiation increases breast cancer risk among high-risk women. When using low-dose radiation among high-risk women, a careful approach is needed, by means of reducing repeated exposure, avoidance of exposure at a younger age and using non-ionising screening techniques.
    European Radiology 11/2010; 20(11):2547-56. · 4.34 Impact Factor
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    ABSTRACT: To calculate the sensitivity and specificity of computed tomographic (CT) angiography in the diagnosis of cerebral aneurysms in patients with acute subarachnoid hemorrhage (SAH) at presentation. A systematic search for relevant studies was performed of the PubMed/MEDLINE and EMBASE databases. Two reviewers independently assessed the methodologic quality of each study by using the Quality Assessment of Diagnostic Accuracy Studies tool. The inclusion criteria were met by 50 studies. Heterogeneity was tested, and the presence of publication bias was visually assessed (by using a funnel plot). A meta-analysis of the reported sensitivity and specificity of each study with 95% confidence intervals (CIs) was performed on a per-patient level. Concerning sensitivity, the selected studies showed moderate heterogeneity. For specificity, low heterogeneity was observed. Moderate-heterogeneity studies that investigated only sensitivity or specificity were excluded from the pooled analyses by using a bivariate random effects model. The majority of the studies (n = 30) used a four-detector row CT scanner. The studies had good methodologic quality. Pooled sensitivity was 98% (95% CI: 97%, 99%), and pooled specificity was 100% (95% CI: 97%, 100%). Potential sources of variability among the studies were variations in the methodologic features (quality score), CT examination procedure (number of rows on the multidetector CT scanner), the standard of reference used, and the prevalence of ruptured intracranial aneurysms. There was evidence for publication bias, which may have led to overestimation of the diagnostic accuracy of CT angiography. Multidetector CT angiography can be used as a primary examination tool in the diagnostic work-up of patients with SAH.
    Radiology 10/2010; 258(1):134-45. · 6.34 Impact Factor
  • Ejc Supplements - EJC SUPPL. 01/2010; 8(3):232-232.
  • M. D. Dorrius, R. M. Pijnappel, M. C. Jansen-van der Weide, M. Oudkerk
    Ejc Supplements - EJC SUPPL. 01/2010; 8(3):231-231.
  • Ejc Supplements - EJC SUPPL. 01/2010; 8(3):239-239.
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    M D Dorrius, R M Pijnappel, M C Jansen-van der Weide, M Oudkerk
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    ABSTRACT: The probability of a mammographic Breast Imaging Reporting and Data System (BI-RADS) 3 lesion being cancer is considered to be less than 2%. Therefore, the work-up of a mammographic BI-RADS 3 lesion should be biopsy or follow-up mammography after 6 months. However, most patients referred for biopsy have benign disease. Although the negative predictive value (NPV) of magnetic resonance imaging (MRI) is highest of all imaging techniques, it is not yet common practice to use breast MRI as a problem-solving modality to exclude patients for further diagnostic work-up. Therefore, in this meta-analysis the usefulness of breast MRI as a problem-solving modality in mammographic BI-RADS 3 lesions is investigated. After a systematic search only 5 out of 61 studies met the inclusion criteria. The NPV in 2 of those studies was reported to be 100%. It was concluded that MRI can be used as an adjunctive tool to mammographic BI-RADS 3 findings to exclude patients for further diagnostic work-up. The other 3 studies assessed the accuracy of MRI in mammographic BI-RADS 3 microcalcifications. These studies reported an NPV of MRI between 76% and 97%. Therefore, MRI cannot be implemented as a diagnostic tool to evaluate mammographic microcalcifications at this time. The first solid data indicate that breast MRI might be useful as a problem-solving modality to exclude patients with non-calcified mammographic BI-RADS 3 lesions for further diagnostic work-up. However, further research is needed to verify these results.
    Cancer Imaging 01/2010; 10 Spec no A:S54-8. · 1.59 Impact Factor
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    ABSTRACT: For women with a BRCA1 or BRCA2 mutation or a strong family history of breast cancer, there is no clear estimation of the risk of tumour induction versus the beneficial effects of mammography screening available. This study aims to validate the Simulation Model on Radiation Risk and breast cancer Screening (SiMRiSc) model in these women, which can provide information on the benefits and risks of screening for breast cancer for various screening scenarios. The simulation model for breast cancer screening was developed and the values for model parameters including cancer induction due to radiation were derived from the literature. The simulation model was validated by comparing the outcome data of the model with the data from three published screening studies of women with an increased hereditary breast cancer risk. A sensitivity analysis was used to estimate the error margins of the outcome data and to analyse the sensitivity of the simulation model to each parameter. The model predicted 71+/-4% of the reported tumours. When excluding the excess number of incident tumours detected in the first screening round, the model predicted 85+/-6% of the tumours reported. The model was most sensitive to changes in the parameters related to lifetime breast cancer risk and sensitivity of mammography. We conclude that the simulation model is suitable for the provision of accurate benefits' and risks' estimations necessary for the refinement of the screening guidelines for women at an increased risk of breast cancer.
    European journal of cancer (Oxford, England: 1990) 11/2009; 46(3):495-504. · 4.12 Impact Factor
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    ABSTRACT: This study investigated the impact of a visit from a consulting physician on the patient and the relatives during the euthanasia procedure in The Netherlands. Data on experiences with the consultant's visit were collected from 86 relatives and 3,614 general practitioners, who described their most recent request for euthanasia or physician-assisted suicide. More than three-quarters of the patients experienced the visit as they had expected, or became more positive. Although about 1 out of 5 patients had negative experiences, this study indicates that, in general, a visit from a consulting physician is not perceived to be burdensome for patients.
    Death Studies 04/2009; 33(3):199-219. · 0.92 Impact Factor
  • EJC Supplements 04/2008; 6(7):95-96. · 2.71 Impact Factor
  • M. Dorrius, P. Kappert, R. E. Sijens, M. C. Jansen-van der Weide, M. Oudkerk
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    ABSTRACT: PURPOSE Diffusion Weighted Imaging (DWI) studies of human breasts reported discrepant Apparent Diffusion Coefficients (ADC), possibly due to the use of different sets of b-values. The purpose of this study is to evaluate the influence of using different DWI b-value combinations on ADC measurements obtained in normal fibroglandular tissue of the breast. METHOD AND MATERIALS Fifteen patients (25 breasts) underwent breast MRI using a 1.5 Tesla scanner (Avanto; Siemens) equipped with a dedicated bilateral breast coil. DWI was performed with single shot echo planar imaging with b-values of 50, 200, 500 and 800s/mm². The scan parameters were TR/TE 8000/91ms, bandwidth 1630Hz, FOV 340mm, slice thickness 4mm. ADC-maps were reconstructed from b-value pairs of 50-200, 50-500, 50-800s/mm² and all b-values together. ADC-values of 25 breasts were determined for regions of interest (ROI) in fibroglandular tissue appearing homogeneous on both ADC-map and T2-weighted images. ROI’s were first drawn on the ADC-map with b50-800s/mm² and subsequently reproduced on the other maps. A paired t-test was used for analyzing the statistical significance of differences between the ADC-values in the three b-value pair reconstructions compared to ADC derived from all b values together, serving as gold standard. RESULTS The mean ADC-value of normal fibroglandular tissue was 2.13±0.46x10-3 mm²/s for b50-200 and 2.19±0.33x10-3 mm²/s for b50-500. For b50-800 and the gold standard the mean ADC-values were almost similar:1.96±0.27x10-3 mm²/s and 1.97±0.29x10-3 mm²/s, respectively. ADCs calculated with b50-200 and b50-500 were significant higher than the ADC-value calculated with the gold standard (p=0.029 and p=0.000, respectively). No significant difference was found between b50-800 and the golden standard (p=0.231). CONCLUSION The ADC-value in normal fibroglandular tissue is strongly affected by the b-values of the DWI series from which the ADC-map is reconstructed. B-value pair 50-800 gives a precise and accurate ADC outcome, implicating that in clinical DWI of the breast, using just two scans for time saving, one scan should be acquired with a b-value of at least 800s/mm². CLINICAL RELEVANCE/APPLICATION Standardization of breast DWI-measurement conditions along the proposed guideline will improve the accuracy of ADC-maps and reduce discrepancies between the ADC-values reported by different studies.
    Ejc Supplements - EJC SUPPL. 01/2008; 6(7):64-64.
  • Marijke Catharina Jansen-van der Weide, Bregje Dorien Onwuteaka-Philipsen, Gerrit van der Wal
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    ABSTRACT: Consultation of another physician is one of the requirements for prudent practice. The project 'Support and Consultation on Euthanasia in the Netherlands' (SCEN) is aimed at professionalizing consultation. The objective of this study is to assess whether the quality of consultation was improved through SCEN. In four districts all general practitioners (GPs) received a pre-test questionnaire approximately six weeks before the start of the project in the period (n=1224, response 71%). In the period from April 2000 to December 2002, all GPs in districts in which SCEN had been implemented received a written post-test questionnaire one and a half years after the start of the project. This post-test questionnaire was returned by 60% of the GPs (n=3614). In SCEN consultations the attending physicians has no specific relation to the attending physician in 85% of consultations, while this is the case for 31% of other consultations. While before the start of SCEN in 71% of consultations six or seven of the seven criteria for good consultation were met, in SCEN consultations 83% of cases six or seven of these requirements were met. GPS who had consulted a SCEN physician generally were more positive about different aspects than those who consulted another consultant, such as considering the consultant to be able to make an independent judgement (totally agree 74% versus 59%). Although the quality of consultation appears to be high for both SCEN physicians and other consultants, the SCEN project further contributed to the quality of consultation. Since GPs attach importance to judgement of SCEN physician and have the intention to use it in future, and the quality of consultation stays high over time, this project is expected to maintain its value.
    Health Policy 02/2007; 80(1):97-106. · 1.55 Impact Factor
  • Marijke C Jansen-van der Weide, Bregje D Onwuteaka-Philipsen, Gerrit van der Wal
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    ABSTRACT: This study investigated the palliative options available when a patient requested euthanasia or physician-assisted suicide (EAS), the extent to which the options were applied, and changes in the patient's wishes. In an observational study, 3614 general practitioners (GPs) filled in a questionnaire and described their most recent request for EAS (if any) (n = 1,681). Palliative options were still available in 25% of cases. In these cases options were applied in 63%; in 46% of these cases patients withdrew their request. Medication other than antibiotics, which was most frequently mentioned as a palliative option (67%), and applied most frequently (79%), together with radiotherapy, most frequently resulted in patients withdrawing their request. GPs include the availability of palliative options in their decision making when considering EAS. The fact that not all options are applied or, if applied, the patient persists in the request is related to autonomy of the patient, the burden on the patient, and medical futility of the option.
    Palliative and Supportive Care 01/2007; 4(4):399-406. · 0.98 Impact Factor
  • B D Onwuteaka-Philipsen, M C Jansen-Van der Weide, G Van der Wal
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    ABSTRACT: To determine the characteristics of patients who request euthanasia or physician-assisted suicide and whether these characteristics differ among those whose request is granted, those who die before the procedure, those who die before completion of the approval process, those who withdraw their request, and lastly, those whose request is refused by the physician. Questionnaire study. All general practitioners in 18 of the 23 Dutch general practitioner districts received a written questionnaire in which they were asked to describe the most recent request for euthanasia or physician-assisted suicide that they had received (response 60%, n=3614). Of all explicit requests, 44% resulted in euthanasia or physician-assisted suicide. Thirteen percent of patients died before the procedure, 13% died before completion of the approval process, 13% withdrew their request and 12% were refused by the physician. The most prominent symptoms were 'feeling bad', 'tiredness', and 'lack of appetite'. The most frequently mentioned reasons for requesting euthanasia or physician-assisted suicide were 'pointless suffering', 'loss of dignity', and 'general weakness'. The patients' situation met the official requirements for accepted practice best in the group of requests that resulted in euthanasia or physician-assisted suicide and least in the group of refused requests. A lesser degree of competence and less unbearable and hopeless suffering had the strongest associations with the refusal of a request. The complexity of euthanasia or physician-assisted suicide decision-making is reflected in the fact that, besides granting and refusing a request, 3 other situations could be distinguished. The decisions physicians made, the reasons for their decisions and the way they arrived at their decisions appeared to be based on patient evaluations and on the official requirements for accepted practice.
    Nederlands tijdschrift voor geneeskunde 03/2006; 150(5):249-54.
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    ABSTRACT: In the Netherlands physicians are allowed to grant requests for euthanasia or physician-assisted suicide (EAS) if they meet several requirements of due care. According to jurisprudence, a physician is not allowed to end the life of a patient whose request for EAS is based on being 'tired of living', because such a request falls outside the medical domain. Our previous studies have shown that in spite of this, such requests are made approximately 400 times a year. To learn more about patients who request EAS because they are tired of living, and about factors that influence the decision of the physician. Questionnaires (n=4842) completed by general practitioners (n=3994). According to the physicians, 17% of patients who requested EAS were 'tired of living'. Of 139 patients in whose request for EAS being tired of living played a major role, 47% suffered from cancer, 25% suffered from another severe disease and 28% had no severe disease. In all three groups the same three symptoms occurred most frequently, 'feeling bad', 'tired', and 'not active'. Each of these symptoms occurred in more than half of the patients in each group. Most of the requests from patients with cancer were granted, but those from patients who had some other severe disease, or no severe disease at all, were refused. Factors that were related to granting a request were: the presence of unbearable and hopeless suffering, the absence of alternatives, and the absence of depressive symptoms. Being tired of living can play a major role in requests for EAS, both in the absence and the presence of a severe disease. The high occurrence of symptoms in the absence of a classifiable severe disease implies that physical symptoms are prevalent in this group of patients, leaving the legal requirement for EAS of 'a medical cause' open to interpretation in the more complex medical practice.
    Health Policy 11/2005; 74(2):157-66. · 1.55 Impact Factor

Publication Stats

157 Citations
61.53 Total Impact Points


  • 2010–2013
    • University of Groningen
      • Department of Radiology
      Groningen, Province of Groningen, Netherlands
  • 2011
    • Universitair Medisch Centrum Groningen
      Groningen, Groningen, Netherlands
  • 2004–2009
    • VU University Medical Center
      • • Department of Public and Occupational Health
      • • Department of Social Medicine
      Amsterdam, North Holland, Netherlands
  • 2005–2007
    • VU University Amsterdam
      • Department of Social Medicine
      Amsterdamo, North Holland, Netherlands