Johannes C Van der Wouden- PhD
- Professor (Associate) at Amsterdam University Medical Center
Johannes C Van der Wouden
- PhD
- Professor (Associate) at Amsterdam University Medical Center
About
524
Publications
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Introduction
Johannes C Van der Wouden currently works at the Departments of General Practice and of Medicine for Older People at Amsterdam University Medical Center.
His current research areas are all focused on primary care, and involve medically unexplained symptoms and somatoform disorders; dizziness; dementia; depression and dermatology.
Methods: observational studies; qualitative methods; randomized controlled trials; systematic reviews and meta-analyses.
Current institution
Additional affiliations
August 1984 - December 2011
January 2012 - July 2020
January 1984 - December 2011
Education
September 1974 - April 1980
Publications
Publications (524)
Background:
Dementia is a clinical syndrome with a number of different causes. It is characterised by deterioration in cognitive, behavioural, social and emotional functioning. Pharmacological interventions are available but have limited effect on many of the syndrome's features. However, receptivity to music may remain until the late phases of de...
Purpose
Geriatric rehabilitation is intended for older adults with vulnerability, comorbidity, and acute functional impairments. To explore and evaluate referral criteria, this study followed hospital patients referred for rehabilitation in nursing homes.
Design
Exploratory, retrospective cohort study.
Methods
Participants were community living b...
Objectives
Knowledge about the long-term course and prognosis of persistent somatic symptoms (PSS) is important to improve clinical decision-making and guidance for patients with PSS. Therefore, we aimed to: (1) identify distinct 5-year trajectories of symptom severity, physical and mental functioning in adult patients with PSS and (2) explore pati...
Introduction
General practitioners (GPs) often face challenges in explaining to patients with persistent physical symptoms (PPS) why their symptoms persist. Providing an explanation of the central sensitisation (CS) mechanism to patients could be helpful, yet GPs do not routinely test for signs of CS in these patients. The aim of this study was to...
Background
Transitioning older hospital patients to the appropriate type of post-acute care has become an urgent clinical issue within the context of changing demographics and limited duration of hospital stay.
Objective
Consensus on assessments that guide post-acute care decision making would benefit potential patients and support cooperation bet...
Purpose:
The aim of this explorative, qualitative study is to identify factors that potentially influence the execution of physical fitness training in inpatient orthopedic geriatric rehabilitation (GR), from the perspectives of patients, their relatives and professionals.
Materials and methods:
In GR wards of skilled nursing facilities in the N...
Background:
We assessed the vulnerability of patients aged ≥ 70 years during hospital admission based on the Short Dutch Safety Management Screening (DSMS). Screening of four geriatric domains aims to prevent adverse outcomes and may support targeted discharge planning for post-acute care. We explored whether the DSMS criteria for acutely admitted...
Purpose
To improve goal setting in Geriatric Rehabilitation (GR), by developing an evidence-based practical guideline for patient-centred goal setting.
Methods
Participatory action research (PAR) in a cyclical process, with GR professionals as co-researchers. Each cycle consisted of five phases: problem analysis, literature review, development, pr...
Background:
Vestibular rehabilitation (VR) is the preferred treatment for chronic vestibular symptoms such as dizziness and vertigo. An internet-based programme was developed to increase uptake of VR. The authors have previously reported that internet-based VR resulted in a clinically relevant decrease of vestibular symptoms for up to 6 months, co...
Objective:
Maladaptive cognitions and behaviors may influence symptoms and impairment in patients with persistent somatic symptoms (PSS). Aims of this study were to examine: (i) whether maladaptive cognitions and behaviors are associated with symptom severity and functional health over time; (ii) if these associations are the result of changes wit...
Introduction
GPs struggle to explain to patients with persistent physical symptoms (PPS) why their symptoms persist. Providing an explanation of the central sensitisation (CS) mechanism to patients could be helpful, yet GPs do not test for signs of CS in patients. Our aim was to explore whether applying a test for assessing CS is valuable for the e...
Objective:
To evaluate the effectiveness of psychosomatic therapy versus care as usual in primary care for patients with persistent somatic symptoms (PSS).
Methods:
We conducted a pragmatic, two-armed, randomised controlled trial among primary care patients with PSS in the Netherlands that included 39 general practices and 34 psychosomatic thera...
Objective
Reporting guidelines can improve dissemination and application of findings and help avoid research waste. Recent studies reveal opportunities to improve primary care (PC) reporting. Despite increasing numbers of guidelines, none exists for PC research. This study aims to prioritise candidate reporting items to inform a reporting guideline...
Sinds jaar en dag krijgen de diagnostiek en behandeling van urine-incontinentie weinig aandacht in de huisartsenpraktijk. Huisartsen hebben weinig vertrouwen in de behandelingsmogelijkheden en patiënten zijn niet altijd gemotiveerd om bijvoorbeeld een plasdagboek bij te houden. In dit retrospectieve cohortonderzoek zagen we dat huisartsen de NHG-S...
Objective
The goal of this study was to compare the 15-item Patient Health Questionnaire (PHQ-15) and the somatization subscale of the Four-Dimensional Symptoms Questionnaire (4DSQ-S) with respect to their latent structure and reliability, and to examine whether their scores are affected by age and gender, and whether the scales measure the same co...
Objective
Patients with persistent physical symptoms (PPS) require an explanation that is acceptable and comprehensible to them. Central sensitisation (CS) is an explanatory model for PPS and chronic pain that has been broadly applied in the context of pain medicine, but, until recently, not by general practitioners (GPs). We explored how GPs used...
Background:
GPs can play a central role in the care of patients with persistent somatic symptoms (PSS). To date, little is known about these patients' experiences relating to their coordination of care.
Aim:
To explore the experiences of patients with PSS relating to coordination of care - in particular by their GP - during their illness traject...
Objective
Psychological trauma is a well-known risk factor for the onset of persistent somatic symptoms (PSS). In contrast, little is known on the relation between potentially traumatic events (PTEs) and the severity of PSS, and on the protective effect of social support. We aimed to: (i) determine whether childhood, adulthood and recent PTEs are a...
Objectives
To present an overview of effectiveness and training characteristics of physical training on aerobic fitness, compared with alternative or no training, in adults aged over 65 years with various health statuses, providing a basis for guidelines for aerobic training of vulnerable older adults that can be used in geriatric rehabilitation....
Objective:
To investigate how GPs manage women with urinary incontinence (UI) in the Netherlands and to assess whether this is in line with the relevant Dutch GP guideline. Because UI has been an underreported and undertreated problem for decades despite appropriate guidelines being created for general practitioners (GPs).
Design:
Retrospective...
Background
The Vertigo Symptom Scale – Short Form (VSS-SF) is a widely used questionnaire to measure vestibular symptoms such as dizziness and vertigo. We aimed to translate and cross-culturally validate the Dutch version of the VSS-SF.
Methods
We performed a psychometric evaluation study in general practice. First, we followed international guidel...
Objective
Old or frail acutely hospitalised patients can benefit from geriatric rehabilitation but criteria concerning referral decisions are unclear. This review presents an overview of clinical factors associated with referral to geriatric rehabilitation that may further consensus between hospital and rehabilitation professionals on triage.
Desi...
Objectives
To explore the perceived working mechanisms of psychosomatic therapy according to patients with persistent somatic symptoms (PSS) and their psychosomatic therapists.
Design
Qualitative study using semistructured face-to-face interviews and focus groups. All interviews were audiorecorded, transcribed verbatim and analysed, by two researc...
Objective
To investigate whether an electronic health record (EHR)–integrated decision tool, combined with supportive interventions, results in more appropriate antibiotic prescribing in nursing home (NH) residents with suspected urinary tract infection (UTI), without negative consequences for residents.
Design
Cluster randomized controlled trial...
Introduction
Central sensitization (CS) may explain the persistence of symptoms in patients with chronic pain and persistent physical symptoms (PPS). There is a need for assessing CS in the consultation room. In a recently published systematic review, we made an inventory of tests for CS. In this study we aimed to assess which tests might have adde...
Objective By aggregating the literature, we evaluated the association between use of specific antihypertensive drugs and the risk of hip fractures compared with nonuse.
Study design and Setting We systematically searched the Pubmed, Embase, and Cochrane databases from inception of each database until July 30, 2020 to identify articles including pat...
Een melanoom is potentieel gevaarlijk en wordt bij voorkeur met spoed verwijderd (excisie met marge). Soms wil de huisarts echter eerst meer informatie hebben over een verdachte huidafwijking, bijvoorbeeld bij een patiënt die niet (meer) naar het ziekenhuis wil of omdat de huidafwijking op een zichtbare plek zit. Een biopt kan dan uitkomst bieden,...
Objectives
To study the test-retest reliability and measurement error, construct validity, responsiveness, interpretability, and floor/ceiling effects of a Patient-Reported Outcomes Measurement Information System (PROMIS) short form designed to measure physical function in geriatric rehabilitation patients (PROMIS-PF-GR).
Design
Prospective cohort...
Introduction
The adolescent years represent a key period for the development of musculoskeletal complaints (MSC) and the differences between boys and girls. We evaluated the prevalence and course of MSC and factors associated with MSC while growing up from age 11 to age 20.
Methods
Questionnaire‐based data at age 11 (n=2638), age 14 (n=2517), age...
Ouderen met duizeligheid door een perifere vestibulaire aandoening leven langer dan ouderen met duizeligheid door een cardiovasculaire aandoening. Bijna de helft van de ouderen met duizeligheidsklachten ondervindt na 10 jaar nog steeds of opnieuw ernstige beperkingen door de duizeligheid. Beschouw duizeligheid bij ouderen in de huisartsenpraktijk d...
The striking difference between men and women in headache prevalence is suggested to develop in adolescence. Although headaches are common and affect quality of life and daily functioning, the evidence needed to develop effective counselling and preventive approaches is still limited.Using data collected at age 11, 14, 17 and 20 years in the Dutch...
Background
Internet-based vestibular rehabilitation (VR) with physiotherapy support, known as blended VR, was effective in reducing vestibular symptoms in a recent randomised controlled trial. Blended VR is a complex intervention comprised of physiotherapeutic visits, the vertigo training website, and VR exercises. Because of these interacting comp...
Objectives
To develop and internally validate prediction models to assess treatment success of both stand-alone and blended online vestibular rehabilitation (VR) in patients with chronic vestibular syndrome.
Design
Secondary analysis of a randomised controlled trial.
Setting
59 general practices in The Netherlands.
Participants
202 adults, aged...
Objectives
To evaluate the cost-effectiveness of stand-alone and blended internet-based vestibular rehabilitation (VR) in comparison with usual care (UC) for chronic vestibular syndromes in general practice.
Design
Economic evaluation alongside a three-armed, individually randomised controlled trial.
Setting
59 Dutch general practices.
Participa...
Background:
Antibiotic overprescribing for suspected urinary tract infection (UTI) in nursing homes (NHs) is common. Typical clinical scenarios in which antibiotics are inappropriately prescribed include response to nonspecific signs and symptoms and/or a positive urine test in the absence of symptoms referable to the urinary tract. These and othe...
PurposeTo develop and test the validity of a Patient-Reported Outcomes Measurement Information System (PROMIS®) short form for measuring physical function of geriatric rehabilitation patients.Methods
Experts selected items from the Dutch-Flemish PROMIS v1.2 Physical Function (PROMIS-PF) item bank and proposed new items to develop the PROMIS-PF shor...
Objective: To assess the cost-effectiveness of a brief cognitive behavioural intervention for patients with medically unexplained physical symptoms (MUPS) provided by a mental health nurse practitioner (MHNP) in primary care in comparison with usual care.
Methods: We performed an economic evaluation from a societal perspective alongside a cluster r...
Objectives
To explore patients’ experiences with fluctuations in persistent physical symptoms (PPS) and to understand which factors—from their viewpoint—play a role in these fluctuations.
Design
Qualitative study using semistructured interviews and thematic content analysis.
Setting
This qualitative study is part of a multicentre prospective coho...
Objective
The 25-item Dizziness Handicap Inventory (DHI) is the most used questionnaire to assess vestibular symptoms. However, the abbreviated 10-item DHI-S is more suitable for daily practice. The objective of this study was to assess validity, reliability, responsiveness, optimal cut-off point for substantial impairment and minimally important c...
In steeds meer huisartspraktijken hebben praktijkondersteuners een rol in de begeleiding van vrouwen met een verhoogd risico op fracturen. Meestal zijn dit vrouwen die eerder een fractuur hebben meegemaakt. Het is nog niet duidelijk of screening van de bevolking effectief is. In dit artikel lees je de resultaten van een groot onderzoek in ons land.
Objective
The somatosensory amplification theory considers symptom focusing and somatosensory amplification as important perpetuating factors of persistent physical symptoms. We investigated whether symptom focusing and somatosensory amplification were associated with symptom severity and mental and physical functioning over a three-year period in...
Objective
This study introduces a new method to establish clinical thresholds for multi-item tests, based on item response theory (IRT), as an alternative to receiver operating characteristic (ROC) analysis. The performance of the IRT method was examined and compared with the ROC method across multiple simulated datasets and in a real dataset.
Stu...
Huisartsen zien veel patiënten met somatisch onvoldoende verklaarde lichamelijke klachten (SOLK). We onderzochten de effectiviteit van cognitieve gedragstherapie uitgevoerd door de praktijkondersteuner ggz bij patiënten met SOLK die minstens een half jaar klachten hadden met een clustergerandomiseerde gecontroleerde trial in 85 huisartsenpraktijken...
Poster Manual therapy as a prophylactic treatment for migraine: design of a randomized controlled trial
Background:
People with migraine often experience disability with serious consequences for their social life and work productivity. The pharmacological prophylactic management of migraine is effective in reducing migraine attacks. However, many people are reluctant to use daily prophylactic medication, leading to a demand for non-pharmacological t...
Purpose: The prognosis of dizzy older patients in primary care is unknown. Our objective was to determine the prognosis and survival of patients with different subtypes and causes of dizziness.
Methods: In a primary care prospective cohort study, 417 older adults with dizziness (mean age 75.5 years) received a full diagnostic workup in 2006-2008....
Observatie is de kurk waar de empirische wetenschap op drijft, maar op observationeel onderzoek wordt nogal eens neergekeken. Toch zijn er veel wetenschappelijke ontdekkingen gedaan die louter gebaseerd waren op dergelijk onderzoek. In deze bijdrage enige recente voorbeelden uit H&W die de voors en tegens van observationeel onderzoek illustreren.
Background:
Medically unexplained symptoms (MUS) are highly prevalent and pose a burden both on patients and on health care. In a pilot study psychosomatic therapy delivered by specialised therapists for patients with MUS showed promising results with regard to patient's acceptability, feasibility and effects on symptoms. The aim of this study is...
Background: People with migraine often experience disability with serious consequences for social life and work productivity. The pharmacological prophylactic management of migraine is effective in reducing migraine attacks. However, many people are reluctant to use daily prophylactic medication, leading to a demand for non-pharmacological treatmen...
Objective
To investigate the clinical effectiveness and safety of stand alone and blended internet based vestibular rehabilitation (VR) in the management of chronic vestibular syndromes in general practice.
Design
Pragmatic, three armed, parallel group, individually randomised controlled trial.
Setting
59 general practices in the Netherlands.
Pa...
SPIN (hoge SPecificiteit rules IN) en SNOUT (hoge SeNsitiviteit rules OUT) zijn bekende ezelsbruggetjes voor de eigenschappen van een diagnostische test, maar hun waarde is afhankelijk van de prevalentie. Bovendien zijn ze maar beperkt geldig wanneer de sensitiviteit of specificiteit van een test wat lager is. Ik illustreer dit aan de hand van een...
Background: People with migraine often experience disability with serious consequences for social life and work productivity. The pharmacological prophylactic management of migraine is effective in reducing migraine attacks. However, many people are reluctant to use daily prophylactic medication, leading to a demand for non-pharmacological treatmen...
Inleiding Bij ouderen is duizeligheid vaak een aspecifieke klacht die allerlei oorzaken kan hebben. Wij ontwikkelden en valideerden een voorspellend model om ouderen met een hoog risico op een ongunstig beloop van duizeligheid te kunnen identificeren. Methode Wij gebruikten de gegevens van twee prospectieve cohorten. Het ‘ontwikkelcohort’ telde 203...
The Four-Dimensional Symptom Questionnaire (4DSQ) is a self-report instrument measuring distress, depression, anxiety and somatization. The questionnaire has been developed and validated in adult samples. It is unknown whether adolescents and emerging adults respond to the 4DSQ items in the same way as adults do. The objective of the study was to e...
Background: People with migraine often experience disability with serious consequences for social life and work productivity. The effectiveness of pharmacological prophylactic management of migraine is limited, leading to a demand for non-pharmacological treatment options. We present the design and discuss the feasibility of a pragmatic, randomized...
Background:
This study aimed to identify subgroups for whom supported self-help preventive cognitive therapy (S-PCT) is more (cost)effective than treatment as usual (TAU) in preventing relapse and recurrence of major depression.
Methods:
We conducted a randomized controlled trial in which 248 remitted, recurrently depressed participants were ran...
Objective:
To examine the effectiveness of a cognitive behavioural intervention delivered by mental health nurse practitioners (MHNPs) to patients with undifferentiated somatoform disorder (USD), compared to usual care.
Methods:
We conducted a cluster randomized trial among primary care patients with USD comparing the intervention to usual care....
Objective Central sensitization (CS), a mechanism explaining the persistence of symptoms, has been the focus of many research projects. Explanations given to patients with chronic pain are often based on this mechanism. It is hypothesized that CS also plays an important role in the persistence of medically unexplained symptoms (MUS). However, defin...
Background:
As the population ages, the number of people with chronic diseases increases. Frequently, older people suffer from joint pain together with other chronic diseases, which can lead to decreased physical functioning.
Aims:
To investigate the associations of the changes in cognitive appraisals, coping strategies and pain with the change...
Supplemental_Material – Supplemental material for Goal-setting in geriatric rehabilitation: a systematic review and meta-analysis
Objective
To explore the effect of goal-setting on physical functioning, quality of life and duration of rehabilitation in geriatric rehabilitation compared to care as usual.
Data sources
Medline, Embase, CINAHL, PsycINFO and the Cochrane Library were searched from initiation to October 2018.
Methods
We included randomized controlled trials (RCTs...
Background:
In clinical practice, oxygen is generally administered to patients with the intention of increasing oxygen delivery. Supplemental oxygen may, however, cause arterial hyperoxia, which is associated with hemodynamic alterations. We performed a systematic review and meta-analysis of the literature to determine the effect of hyperoxia on c...
Answer to the comment on Castien et al.(2018) pressure pain thresholds over thecranio-cervical region in headache - asystematic review and meta-analysis
(15) Answer to the comment on Castien et al. (2018) pressure pain thresholds over the cranio-cervical region in headache - a systematic review and meta-analysis. Available from: https://www.resea...
Background: Several funding organizations using different agendas support research in general practice. Topic selection and prioritization are often not coordinated, which may lead to duplication and research waste.
Objectives: To develop systematically a national research agenda for general practice involving general practitioners, researchers, pa...
Objective:
The Barthel index (BI) is a widely used observer-based instrument to measure physical function. Our objective is to assess the structural validity, reliability, and interpretability of the BI in the geriatric rehabilitation setting.
Design:
Two studies were performed. First, a prospective cohort study was performed in which the attend...
Background
In primary and secondary care medically unexplained symptoms (MUS) or functional somatic syndromes (FSS) constitute a major burden for patients and society with high healthcare costs and societal costs. Objectives were to provide an overview of the evidence regarding the cost-effectiveness of interventions for MUS or FSS, and to assess t...
CHEC extended scoring instruction.
(DOCX)
Studies excluded on full-text level.
(DOCX)
Protocol of the study, PROSPERO.
(PDF)
Objectives
Dizziness is common in older people. Physicians are often unable to identify a specific cause for dizziness in older people, even after an extensive diagnostic work-up. A prognosis-oriented approach, i.e. treating modifiable risk factors for an unfavourable course of dizziness, may reduce dizziness-related impairment in older people in p...
Consort checklist.
(DOCX)
Translated summary of the guideline ‘Dizziness’ of the Dutch College of General Practitioners (treatment section).
(DOCX)
Background:
The number of people with dementia and natural dentition is growing. As dementia progresses, the degree of self-care decreases and the risk of oral health problems and orofacial pain increases.
Objectives:
To examine and compare the presence of orofacial pain and its potential causes in older people with Mild Cognitive Impairment (MC...
Iedere praktijkondersteuner wordt weleens geconfronteerd met een vraag in een patiëntencontact waarop zij het antwoord niet weet. Evidence-based medicine leert ons dat zij dan op zoek moet gaan naar zo sterk mogelijk actueel bewijs. Als je naar onderzoek gaat zoeken, welk type bewijs heb je dan nodig bij welke vraag?
Purpose:
Because dizziness in older people is often chronic and can substantially affect daily functioning, it is important to identify those at risk for an unfavorable course of dizziness to optimize their care. We aimed to develop and externally validate a prediction model for an unfavorable course of dizziness in older patients in primary care,...
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The aim of this review is to assess the benefit and safety of TNF-α inhibitors in JIA.
Background:
Dementia is a clinical syndrome with a number of different causes which is characterised by deterioration in cognitive, behavioural, social and emotional functions. Pharmacological interventions are available but have limited effect to treat many of the syndrome's features. Less research has been directed towards non-pharmacological tr...
Background:
In 2013 the Dutch guideline for management of medically unexplained symptoms (MUS) was published. The aim of this study is to assess medical care for patients with persistent MUS as recorded in their electronic medical records, to investigate if this is in line with the national guideline for persistent MUS and whether there are change...
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: to compare the effectiveness of interventions for the treatment of pediculosis capitis; to compare the effectiveness of different formulations (of lotion, shampoo, creme rinse, mousse or systemic treatments) of the same insecticide against pediculosis capitis; t...
Een Cochrane-review laat zien dat een behandeling met corticosteroïden in het ziekenhuis de mortaliteit en morbiditeit bij patiënten met pneumonie verlaagt. Of dit ook bij huisartspatiënten zo is, is weliswaar niet bewezen, maar de mogelijke waarde van systemische corticosteroïden naast antibiotica bij pneumonie verdient vermelding in de NHG-Standa...
