Maurits van Tulder

Vrije Universiteit Amsterdam | VU · IHS-Institute of Health Sciences

Objectives: To develop and validate approaches for mapping Oswestry Disability Index (ODI) responses to EQ-5D-3L utility values and to evaluate the impact of using mapped utility values on cost-utility results compared to published regression models. Methods: Three response mapping approaches were developed in a random sample of 70% of 18,692 pa...

Background Physiotherapy is usually the first line of treatment for musculoskeletal disorders. If pain persists, an appointment with an orthopaedic surgeon is indicated, but many disorders for which patients are placed on orthopaedic waiting lists cannot be treated in an orthopaedic clinic. Specialised manual therapy, although not mainstream, can b...

Background Chiropractors commonly provide care to people with low-back pain (LBP). The aim of this survey was to determine the opinions and beliefs of chiropractors regarding the support and management of LBP. We also investigated whether their management is in accordance with the three most commonly recommended approaches to LBP based upon interna...

Objectives: To evaluate if adding motivational interviewing (MI) or a stratified vocational advice intervention (SVAI) to usual case management (UC), reduced sickness absence over 6 months for workers on sick leave due to musculoskeletal disorders. Methods: We conducted a three-arm parallel pragmatic randomised controlled trial including 514 emp...

In health intervention research, epidemiologists and economists are more and more interested in estimating causal effects based on observational data. However, collaboration and interaction between both disciplines are regularly clouded by differences in the terminology used. Amongst others, this is reflected in differences in labeling, handling, a...

Introduction: Surgery is not a viable treatment for all patients with hip dysplasia. Currently, usual care for these patients is limited to a consultation on self-management. We have shown that an exercise and patient education intervention is a feasible and acceptable intervention for patients not receiving surgery. Therefore, we aim to investiga...

Introduction The primary aim of this randomised controlled trial is to investigate the effectiveness of 3 months of progressive resistance training (PRT) compared to neuromuscular exercise (NEMEX) on functional performance in patients with hip osteoarthritis (OA). Secondary aims are to investigate the effectiveness of exercise booster sessions (EBS...

Objectives C-reactive protein point-of-care testing (CRP POCT) is a promising diagnostic tool to guide antibiotic prescribing for lower respiratory tract infections (LRTI) in nursing home residents. This study aimed to evaluate cost-effectiveness and return-on-investment (ROI) of CRP POCT compared with usual care for nursing home residents with sus...

The statistical quality of trial‐based economic evaluations is often suboptimal, while a comprehensive overview of available statistical methods is lacking. Therefore, this review summarized and critically appraised available statistical methods for trial‐based economic evaluations. A literature search was performed to identify studies on statistic...

Systematic reviews are necessary to synthesize available evidence and inform clinical practice and health policy decisions. There has been an explosion of evidence available in many fields; this makes it challenging to keep evidence syntheses up to date and useful. Comparative effectiveness systematic reviews are informative, however producing thes...

Statistical analysis plan published at ClinicalTrials.gov Identifier: NCT04196634

Objective This was to elucidate the experiences and perceptions of people with severe mental illness (SMI) and their health care professionals with the SMILE (Severe Mental Illness Lifestyle Evaluation) group-based lifestyle intervention. SMILE focuses primarily on promoting healthy diet, physical activity and weight loss. Method A qualitative stu...

Purpose To assess whether regression modeling can be used to predict EQ-5D-3L utility values from the Oswestry Disability Index (ODI) in low back pain (LBP) patients for use in cost-effectiveness analysis. Methods EQ-5D-3L utility values of LBP patients were estimated using their ODI scores as independent variables using regression analyses, while...

Purpose Many systematic reviews have reported on the effectiveness of spinal manipulative therapy (SMT) for low back pain (LBP) in adults. Much less is known about the older population regarding the effects of SMT. Objective To assess the effects of SMT on pain and function in older adults with chronic LBP in an individual participant data (IPD) m...

Objectives: The purpose of this study was (1) to describe diagnostic imaging in Dutch and Belgian chiropractic practice in general, (2) to estimate adherence to the diagnostic imaging guidelines for patients with low back pain (LBP) via vignettes, and (3) to evaluate factors associated with diagnostic imaging and adherence to the guidelines. Meth...

Objective: To examine validity, reliability and responsiveness of three commonly used questionnaires for assessing physical function (i.e. Oswestry Disability Questionnaire (ODI), Quebec Back Pain Disability Scale (QBPDS) and Roland-Morris Disability Questionnaire (RMDQ)) in older patients undergoing chiropractic care for low back pain (LBP). Des...

BACKGROUND: Real-world data are increasingly being used for as a complement to randomized controlled trials (RCTs) for evaluating the effectiveness and cost-effectiveness of healthcare interventions. Real-world data often are expected to have higher generalizability by including more representative patient populations and resembling daily clinical...

Background Despite the increased deployment and added value of Advanced Practitioner Physiotherapy (APP) in musculoskeletal care internationally, APP is not yet widely accepted within Dutch primary care. This may be due to specific constraints in the implementation of APP within the Dutch healthcare system. This study aimed to explore the experienc...

Background: A frequent consequence of stroke is impaired mental function, which often affects the ability to perform activities and participate in life situation. In occupational therapy practice, performance-based instruments during activity and participation are often used. However, it is important to assess if the instruments used are valid, re...

Objective To assess the costs and cost-effectiveness of percutaneous transforaminal endoscopic discectomy (PTED) compared with open microdiscectomy among patients with sciatica. Methods This economic evaluation was conducted alongside a 12-month multicentre randomised controlled trial with a non-inferiority design, in which patients were randomise...

Objective To assess whether percutaneous transforaminal endoscopic discectomy (PTED) is non-inferior to conventional open microdiscectomy in reduction of leg pain caused by lumbar disc herniation. Design Multicentre randomised controlled trial with non-inferiority design. Setting Four hospitals in the Netherlands. Participants 613 patients aged...

Shoulder disorders are very common musculoskeletal conditions. Few studies have focused on the costs associated with shoulder disorders, and the economic burden has never been established in a nationwide cost-of-illness study. We aimed to evaluate the healthcare costs and costs of productivity loss (sick leave), and to evaluate if costs were higher...

Purpose Marker-by-treatment analyses are promising new methods in internal medicine, but have not yet been implemented in orthopaedics. With this analysis, specific cut-off points may be obtained, that can potentially identify whether meniscal surgery or physical therapy is the superior intervention for an individual patient. This study aimed to in...

Purpose Multiple surgical techniques are practiced to treat sciatica caused by lumbar disk herniation. It is unknown which factors surgeons find important when offering certain surgical techniques. The objective of this study is threefold: 1) determine the relative weight surgeons place on various characteristics of sciatica treatment, 2) determine...

Background: Despite the increasing deployment and added value of Advanced Practitioner in Physiotherapy (APP) in musculoskeletal care internationally, APP is not widely accepted in Dutch primary care yet. This may be due to constraints in the implementation of APP within the Dutch health care system. The aim of this study was to explore experiences...

Background Several interventions have been developed to improve physical health and lifestyle behaviour of people with a severe mental illness (SMI). Recently, we conducted a pragmatic cluster-randomised controlled trial which evaluated the effects of the one-year Severe Mental Illness Lifestyle Evaluation (SMILE) lifestyle intervention compared wi...

Introduction One-stop surgery (OSS) allows for same-day outpatient clinic visit, preoperative assessment, and surgical repair. This study aims to determine the efficiency, (cost-)effectiveness, and family satisfaction of one-stop inguinal hernia surgery compared with usual care. Material and Methods Children (≥ 3 months) with inguinal hernia and Am...

Introduction Measurement instruments are important in clinical practice and research for assessing physical function in critically ill patients in the intensive care unit (ICU). Objective To investigate inter-rater reliability and responsiveness of the Danish version of the CPAx (CPAx-D). Method Critically ill patients from three Danish ICUs were...

Background There has been immense interest and debate regarding the effectiveness of antibiotic treatment for chronic low back pain. Two randomised controlled trials have examined the efficacy of antibiotics for chronic low back pain with disc herniation and Modic changes, but have reported conflicting results. The aim of this double-blind, randomi...

Objective: To perform the psychometric validation of the Dutch version of the Core Outcome Measures Index (COMI) for the neck. Methods: A total of 178 patients, who had an indication for surgery due to degenerative cervical spinal disease, were enrolled in the study. They filled in a baseline booklet containing the Dutch version of the COMI-neck...

Objectives This study evaluated logistics, process data, and barriers/facilitators for the implementation and use of C-reactive protein point-of-care testing (CRP POCT) for suspected lower respiratory tract infections (LRTIs) in nursing home (NH) residents. Design This process evaluation was performed alongside a cluster randomized, controlled tri...

Background The incidence of metachronous contralateral inguinal hernia (MCIH) is high in infants with an inguinal hernia (5–30%), with the highest risk in infants aged 6 months or younger. MCIH is associated with the risk of incarceration and necessitates a second operation. This might be avoided by contralateral exploration during primary surgery....

Background: Low back pain has been the leading cause of disability globally for at least the past three decades and results in enormous direct healthcare and lost productivity costs. Objectives: The primary objective of this systematic review is to assess the impact of exercise treatment on pain and functional limitations in adults with chronic...

Objective To evaluate whether C reactive protein point-of-care testing (CRP POCT) safely reduces antibiotic prescribing for lower respiratory tract infections in nursing home residents. Design Pragmatic, cluster randomised controlled trial. Setting The UPCARE study included 11 nursing home organisations in the Netherlands. Participants 84 physic...

OBJECTIVE Lumbar discectomy is a frequently performed procedure to treat sciatica caused by lumbar disc herniation. Multiple surgical techniques are available, and the popularity of minimally invasive surgical techniques is increasing worldwide. Clinical outcomes between these techniques may not show any substantial differences. As lumbar discectom...

Introduction Patient-reported outcome measures (PROMs) are the preferred outcomes measured in patients with lumbar spinal degenerative diseases. As PROMs can be lengthy and therefore pose a burden to patients and researchers, short and standardized PROMs are needed, such as the Core Outcome Measures Index (COMI). Research question Is the Dutch ver...

Background Patients with diabetes mellitus type 2 (DM2) and/or coronary heart disease (CHD) are at high risk to develop major depression. Preventing incident major depression may be an important tool in reducing the personal and societal burden of depression. The aim of the current study was to assess the cost-effectiveness of a stepped care progra...

Background: The Musculoskeletal Health Questionnaire (MSK-HQ) is a recently developed generic questionnaire that consists of 14 items assessing health status in people with musculoskeletal disorders. The objective was to translate and cross-culturally adapt the MSK-HQ into Norwegian and to examine its construct validity and reliability in people o...

Introduction Adequate responsiveness and knowledge of the minimal important change (MIC) is essential when using patient reported outcome measures to assess treatment efficacy. Objective To evaluate the responsiveness and MIC of common outcomes in patients with subacromial impingement syndrome undergoing arthroscopic subacromial decompression. Me...

Background As resources for healthcare are scarce, decision-makers increasingly rely on economic evaluations when making reimbursement decisions about new health technologies, such as drugs, procedures, devices, and equipment. Economic evaluations compare the costs and effects of two or more interventions. Musculoskeletal disorders have a high prev...

Background and aims: Currently, low back pain (LBP) is considered one of the most disabling conditions worldwide, with a growing prevalence in Brazil. LBP is associated with an increase in disability-adjusted life years (DALYs), which impacts the worker’s individual productive capacity resulting in productivity losses. A large share of the Brazilia...

Background Baseline imbalances, skewed costs, the correlation between costs and effects, and missing data are statistical challenges that are often not adequately accounted for in the analysis of cost-effectiveness data. This study aims to illustrate the impact of accounting for these statistical challenges in trial-based economic evaluations. Met...

Background Low-back pain, including facet joint pain, accounts for up to 20 % of all sick leaves in DenmarkA proposed treatment option is cryoneurolysis. This study aims to investigate the effect of cryoneurolysis in lumbar facet joint pain syndrome. Methods A single-center randomized controlled trial (RCT) is performed including 120 participants...

Objective To summarize the reporting quality of healthcare abstracts and inconsistencies between abstracts and full texts. Study design and Setting This systematic review included overviews of randomized controlled trials (RCTs) and systematic reviews (SRs) that summarized data of healthcare abstracts on reporting of abstracts and consistency of a...

Background A 2019 review concluded that spinal manipulative therapy (SMT) results in similar benefit compared to other interventions for chronic low back pain (LBP). Compared to traditional aggregate analyses individual participant data (IPD) meta-analyses allows for a more precise estimate of the treatment effect. Purpose To assess the effect of...

Purpose: To assess the impact of EQ-5D country-specific value sets on cost-utility outcomes. Methods: Data from 2 randomized controlled trials on low back pain (LBP) and depression were used. 3L value sets were identified from the EuroQol Web site. A nonparametric crosswalk was employed for each tariff to obtain the likely 5L values. Differences...

Background: Baseline imbalances, skewed costs, the correlation between costs and effects, and missing data are statistical challenges that are often not adequately accounted for in the analysis of cost-effectiveness data. This study aims to illustrate the impact of accounting for these statistical challenges in trial-based economic evaluations. Met...

Introduction: This study assesses the cost-effectiveness (CE) of a multidisciplinary pain rehabilitation program (treatment as usual [TAU]) with and without psychomotor therapy (PMT) for chronic pain patients. Methods: Chronic pain patients were assigned to TAU + PMT or TAU using cluster randomization. Clinical outcomes measured were health-relate...

Background: Low back pain is a common condition among older adults that significantly influences physical function and participation. Compared to their younger counterparts, there is limited information available about the clinical course of low back pain in older people, in particularly those presenting for chiropractic care. Improving our unders...

Like any assessment tool, hand‐held dynamometry (HHD) must be valid and reliable in order to be meaningful in clinical practice and research. To summarize the evidence of measurement properties of HHD for assessment of shoulder muscle strength. Cochrane Central Register of Controlled Trials (CENTRAL), Pubmed, EMBASE, and PEDro were searched up to F...

Objective: To evaluate the content validity of patient-reported outcome measurement (PROM) instruments used with patients with musculoskeletal complaints treated in primary care to assess satisfaction. Design: Systematic review of clinimetrical measurement. Literature search: A literature search in MEDLINE, EMBASE and CINAHL was undertaken (up...

Study design: Individual participant data (IPD) meta-analysis OBJECTIVE.: To identify which participant characteristics moderate the effect of spinal manipulative therapy (SMT) on pain and functioning in chronic LBP. Summary of background: The effects of SMT are comparable to other interventions recommended in guidelines for chronic low back pai...

Study design: Systematic review and meta-analysis. Objective: To give a systematic overview of effectiveness of percutaneous transforaminal endoscopic discectomy (PTED) compared to open microdiscectomy (OM) in the treatment of lumbar disk herniation (LDH). Summary of background data: The current standard procedure for the treatment of sciatica...

Introduction: Low back pain (LBP) is recognised globally as a prevalent, costly and disabling condition. Recurrences are common and contribute to much of the burden of LBP. Current evidence favours exercise and education for prevention of LBP recurrence, but an optimal intervention has not yet been established. Walking is a simple, widely accessib...

Introduction: Intermittent neurogenic claudication (INC) is often caused by lumbar spinal stenosis (LSS). Laminectomy is considered a frequently used surgical technique for LSS. Previous studies have shown that laminectomy can potentially cause lumbar instability. Less invasive techniques, preserving midline structures including the bilateral smal...

Background It is unknown whether the treatment effects of partial meniscectomy and physical therapy differ when focusing on activities most valued by patients with degenerative meniscal tears. Purpose To compare partial meniscectomy with physical therapy in patients with a degenerative meniscal tear, focusing on patients’ most important functional...

Background: To evaluate the cost-effectiveness of a reduction in the number of routine radiographs in the follow-up of patients with ankle fractures. Methods: We performed an economic evaluation alongside the multicentre, randomised WARRIOR trial. Participants were randomised to a reduced imaging follow-up protocol (i.e. radiographs at week 6 an...

Background: Medical practice variation in caesarean section rates is the most studied type of practice variation in the field of obstetrics and gynaecology. This has not resulted in increased homogeneity of treatment between geographic areas or healthcare providers. Our study aim was to evaluate whether current study designs on medical practice va...

Background: Acute low back pain is associated with pain and disability, but symptoms are often self-healing. The effectiveness of exercise therapy for acute low back pain remains uncertain with conflicting evidence from systematic reviews. The aim of this systematic review of systematic reviews was to assess the overall certainty of evidence for t...