Wim A M Lucassen

Wim A M Lucassen
Academisch Medisch Centrum Universiteit van Amsterdam | AMC · Department of General Practice

MD, PhD

About

59
Publications
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778
Citations
Introduction
Additional affiliations
April 2013 - present
University of Amsterdam
Position
  • PostDoc Position

Publications

Publications (59)
Article
Full-text available
Background Advancing age is the primary selection criterion for community screening for atrial fibrillation (AF), with selection often restricted to those aged ≥65 years. If multivariable models were shown to have considerable additional value over age alone in predicting AF risk among younger individuals, AF screening could be expanded to patients...
Article
Full-text available
Background/Introduction Guidelines recommend screening for atrial fibrillation (AF). Currently screening is not considered standard care among general practitioners (GPs). Aim To explore the experiences of primary care workers with different methods of screening for AF and with implementation in daily practice. Design & setting A qualitative stud...
Article
Full-text available
Objective To evaluate the diagnostic performance of the Marburg Heart Score (MHS), INTERCHEST, Gencer rule, Bruins Slot rule and compare these with unaided clinical judgement in patients with chest pain in urgent primary care. Design Retrospective, cohort study. Setting Regional primary care facility responsible for out-of-hours primary care for...
Article
Tijdige behandeling van atriumfibrilleren (AF) kan het risico op ernstige complicaties zoals een herseninfarct aanzienlijk verlagen. Die behandeling wordt echter bemoeilijkt door het paroxysmaal en asymptomatisch voorkomen van AF. Daarom gaan we in een nieuw onderzoek na of screening op AF met een jaarlijkse, 7-daagse, continue ecg-monitoring de op...
Article
Objective: To determine the accuracy of QT measurement in a smartphone-operated, single-lead ECG (1L-ECG) device (AliveCor KardiaMobile 1L). Design: Cross-sectional, within-patient diagnostic validation study. Setting/participants: Patients underwent a 12-lead ECG (12L-ECG) for any non-acute indication in primary care, April 2017-July 2018. I...
Article
Full-text available
Background: Timely detection of atrial fibrillation (AF) is important because of its increased risk of thrombo-embolic events. Single time point screening interventions fall short in detection of paroxysmal AF, which requires prolonged electrocardiographic monitoring, usually using a Holter. However, traditional 24-48 h Holter monitoring is less a...
Article
Full-text available
Aim To validate the Roth score as a triage tool for detecting hypoxaemia. Backgrounds The virtual assessment of patients has become increasingly important during the corona virus disease (COVID-19) pandemic, but has limitations as to the evaluation of deteriorating respiratory function. This study presents data on the validity of the Roth score as...
Article
Background Timely detection of atrial fibrillation (AF) is important because of its increased risk of thrombo-embolic events. Single time point screening interventions for AF are hindered because of AF's often paroxysmal nature. Community based prevalence of paroxysmal AF (pAF), however, is scarcely investigated. To detect pAF, often a Holter for p...
Article
Full-text available
Objectives To evaluate the performance of direct-to-consumer pulse oximeters under clinical conditions, with arterial blood gas measurement (SaO 2 ) as reference standard. Design Cross-sectional, validation study. Setting Intensive care. Participants Adult patients requiring SaO 2 -monitoring. Interventions The studied oximeters are top-selling...
Preprint
Full-text available
Background: The demand for pulse oximeters is high in the current COVID-19 pandemic. Despite their popularity, clinical studies to evaluate the reliability in obtaining information on a patient's oxygenation status, are lacking. Aim: To evaluate the performance of pulse oximeters under clinical conditions, with arterial blood gas measurement (SaO2)...
Article
Full-text available
Background and purpose Hypertension is common in patients with atrial fibrillation (AF) and carries an additional risk for complications, most notably stroke and bleeding. We assessed the history of hypertension, level of blood pressure control, and an interaction with the choice of oral anticoagulants on clinical outcomes Methods We performed a s...
Article
Full-text available
Single‑lead electrocardiograms (1 L-ECGs) are increasingly used in (pre)clinical settings for the detection and monitoring of a range of rhythm and conduction disorders. In this short communication paper, we aim to provide an overview of the usefulness and potential pitfalls when implementing 1 L-ECGs into everyday clinical practice. Moreover, we p...
Article
Full-text available
Background Chest pain is a common symptom in urgent primary care. The distinction between urgent and non-urgent causes can be challenging. A modified version of the HEART score, in which troponin is omitted (‘simplified HEART’) or replaced by the so-called ‘sense of alarm’ (HEART-GP), may aid in risk stratification. Method This study involved a re...
Article
Full-text available
Aims To validate a multivariable risk prediction model (Cohorts for Heart and Aging Research in Genomic Epidemiology model for atrial fibrillation (CHARGE-AF)) for 5-year risk of atrial fibrillation (AF) in routinely collected primary care data and to assess CHARGE-AF’s potential for automated, low-cost selection of patients at high risk for AF bas...
Article
Full-text available
Objective: To investigate whether opportunistic screening in primary care increases the detection of atrial fibrillation compared with usual care. Design: Cluster randomised controlled trial. Setting: 47 intention-to-screen and 49 usual care primary care practices in the Netherlands, not blinded for allocation; the study was carried out from S...
Article
Full-text available
Background: Handheld single-lead electrocardiograms (1L-ECG) present a welcome addition to the diagnostic arsenal of general practitioners (GPs). However, little is known about GPs' 1L-ECG interpretation skills, and thus its reliability in real-world practice. Objective: To determine the diagnostic accuracy of GPs in diagnosing atrial fibrillati...
Article
Full-text available
The aims of this study are (1) to evaluate the performance of current triage for chest pain; (2) to describe the case mix of patients undergoing triage for chest pain; and (3) to identify opportunities to improve performance of current Dutch triage system for chest pain. Chest pain is a common symptom, and identifying patients with chest pain that...
Article
Artsen gebruiken verschillende predictiemodellen om het risico op hart- en vaatziekten (HVZ) in te schatten bij mensen met cardiovasculaire risicofactoren zonder HVZ. Deze modellen zijn echter niet zo nauwkeurig in het schatten van het cardiovasculair risico. Biomarkers bieden hierbij mogelijk uitkomst. Zo zou behandeling op geleide van de hoogte v...
Article
Full-text available
Background: For the improvement of AF care, it is important to gain insight into current anticoagulation prescription practices and guideline adherence. This report focuses on the largest Dutch subset of AF-patients, derived from the GARFIELD-AF registry. Methods: Across 35 countries worldwide, patients with newly diagnosed 'non-valvular' atrial...
Article
Full-text available
Aims: Atrial fibrillation (AF) is a common arrhythmia associated with an increased stroke risk. The use of multivariable prediction models could result in more efficient primary AF screening by selecting at-risk individuals. We aimed to determine which model may be best suitable for increasing efficiency of future primary AF screening efforts. Me...
Article
Full-text available
Purpose To study whether polypharmacy or drug–drug interactions have differential effect on safety and efficacy in patients treated with direct oral anticoagulants (DOACs) versus warfarin. Methods We performed a systematic review and meta-analysis of studies that randomized patients with atrial fibrillation to DOACs or warfarin stratified by the n...
Article
Background Hypertension is common in patients with atrial fibrillation (AF) and carries an additional risk for complications, most notably stroke and bleeding. We assessed the history of hypertension, level of blood pressure control, and an interaction with the choice of oral anticoagulants on clinical outcomes. Purpose To gain insights into the r...
Article
Background Atrial fibrillation (AF) presents a considerable burden on our health care systems. Early detection of AF may prevent AF-associated complications, such as stroke and heart failure. Given our aging populations, the number of new AF cases is expected to double over the next decades. As such, there is renewed interest to screen for AF in th...
Article
Purpose: To validate a smartphone-operated, single-lead electrocardiography (1L-ECG) device (AliveCor KardiaMobile) with an integrated algorithm for atrial fibrillation (AF) against 12-lead ECG (12L-ECG) in a primary care population. Methods: We recruited consecutive patients who underwent 12L-ECG for any nonacute indication. Patients held a sma...
Article
A significant proportion of elderly patients are not properly treated with anticoagulants. Here we describe the pros and cons of anticoagulant treatment in elderly patients with atrial fibrillation, illustrated by two cases. We discuss the sometimes difficult treatment decisions to be made in frail elderly patients, especially after they have suffe...
Article
Full-text available
Objective To identify and assess the performance of clinical decision rules (CDR) for chest pain in general practice. Design Systematic review of diagnostic studies. Data sources Medline/Pubmed, Embase/Ovid, CINAHL/EBSCO and Google Scholar up to October 2018. Study selection Studies that assessed CDRs for intermittent-type chest pain and for rul...
Article
Aim: Premature atrial contractions (PACs) are a common cardiac phenomenon, traditionally considered to be of little clinical significance. Recent studies, however, suggest that PACs are associated with atrial fibrillation (AF), as well as ischaemic stroke, transient ischaemic attack, and mortality. This systematic review aims to investigate the ass...
Article
Full-text available
Background GPs are frequently confronted with patients with acute onset chest pain. Although usually benign, approximately 5% is due to acute coronary syndrome (ACS). Unfortunately, ACS is not always recognised, leading to a missed diagnosis in 2–5% of presentations. Aim The authors set out to study the level of risk GPs are willing to accept with...
Article
Aims Atrial fibrillation (AF) patients have increased risk of stroke. In paroxysmal AF, the combination of duration and frequency of episodes defines AF burden. In patients with cardiac implantable electronic devices (CIEDs), atrial high-rate episodes (AHREs) can be monitored continuously and are considered as a proxy for AF. This systematic review...
Article
Samenvatting Hendriksen JM, Lucassen WA, Erkens PM, Stoffers HE, Van Weert HC, Büller HR, Hoes AW, Moons KG, Geersing GJ. Klinische blik versus beslisregel bij longembolie. Huisarts Wet 2017;60(4):152-4. Achtergrond Om de diagnose ‘longembolie’ uit te sluiten adviseert de NHG-Standaard een diagnostisch predictiemodel te gebruiken, zoals de Wells-b...
Article
Full-text available
Purpose: Diagnostic prediction models such as the Wells rule can be used for safely ruling out pulmonary embolism (PE) when it is suspected. A physician's own probability estimate ("gestalt"), however, is commonly used instead. We evaluated the diagnostic performance of both approaches in primary care. Methods: Family physicians estimated the pr...
Article
Samenvatting Hendriksen JM, Geersing GJ, Lucassen WA, Erkens PM, Stoffers HE, vanWeert HC, Büller HR, Hoes AW, Moons KG. Een bruikbare klinische beslisregelvoor longembolie. Huisarts Wet 2016;59(5):200-3. Doel Om overdiagnostiek te voorkomen, is in de huisartsenpraktijk behoefte aan een bruikbare, efficiënte en veilige beslisregel om longembolie bi...
Article
Full-text available
Guidelines provide recommendations for antithrombotic treatment to prevent stroke in people with atrial fibrillation, but oral anticoagulant prescriptions in Dutch primary care are often discordant with these recommendations. Suboptimal guideline features (i.e. format and content) have been suggested as a potential explanatory factor for this type...
Article
Full-text available
Background: Atrial fibrillation is a common cause of stroke and other morbidity. Adequate treatment with anticoagulants reduces the risk of stroke by 60 %. Early detection and treatment of atrial fibrillation could prevent strokes. Atrial fibrillation is often asymptomatic and/or paroxysmal. Case-finding with pulse palpation is an effective screen...
Article
Full-text available
Objective To validate all diagnostic prediction models for ruling out pulmonary embolism that are easily applicable in primary care. Design Systematic review followed by independent external validation study to assess transportability of retrieved models to primary care medicine. Setting 300 general practices in the Netherlands. Participants Indivi...
Article
Background General practitioners (GP) can safely exclude pulmonary embolism (PE) using the Wells PE-rule combined with D-dimer testing.Objective To compare the accuracy of a strategy using the Wells rule combined with either a qualitative point of care (POC) D-dimer test performed in primary care or a quantitative laboratory based D-dimer test.Meth...
Article
- The revised Dutch College of General Practitioners (Nederlands Huisartsen Genootschap [NHG]) guideline 'Deep-vein thrombosis and pulmonary embolus' includes recommendations for the treatment of patients with deep-vein thrombosis (DVT) and thrombophlebitis, and for the exclusion of pulmonary embolism (PE).- The general practitioner (GP) can exclud...
Article
To provide insight into the current use, future needs, and attitudes towards point-of-care testing among Dutch family practitioners. Cross-sectional online survey. We performed a survey among 2129 Dutch family practitioners. We asked respondents to report on the current and desired use of point-of-care tests, frequency of use, their opinions on asp...
Article
Full-text available
Doel: Het huidige gebruik, de toekomstige behoeften en houding ten aanzien van sneltesten onder Nederlandse huisartsen in kaart brengen. Opzet: Dwarsdoorsnede-onderzoek met online-vragenlijsten. Methode: Wij verrichtten een vragenlijstonderzoek onder 2129 Nederlandse huisartsen, waarbij we keken naar het huidige en gewenste gebruik van sneltesten...
Article
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Met stijgende verbazing heb ik het journaaltje gelezen over het niet-pluisgevoel van de huisarts.
Article
Introduction: Pulmonary embolism (PE) often presents with nonspecific symptoms and may be an easily missed diagnosis. When the differential diagnosis includes PE, an empirical list of frequently occurring alternative diagnoses could support the GP in diagnostic decision making. Objectives: To identify common alternative diagnoses in patients in...
Article
Full-text available
Du Perron LJ, Op de Coul ME, Lucassen WAM. De ziekte van Kawasaki: tijdige diagnose essentieel. Huisarts Wet 2014;57(7):370-2. Koorts bij kinderen is meestal zelflimiterend en kan in verreweg de meeste gevallen in de eerste lijn afgewacht of behandeld worden. Soms maakt het kind een ernstig zieke indruk of zijn er andere (alarm)symptomen die verwi...
Article
Lucassen WAM, Kuijs-Augustijn M, Van Weert HCPM. The value of CRP testing after exclusion of lung embolism. Huisarts Wet 2014;57(2):92-4. If a general practitioner sees a patient with chest pain associated with breathing or unexplainable symptoms of dyspnoea, he or she can safely exclude lung embolism if the Wells decision rule for lung embolism is...
Article
Atriumfibrilleren is een frequent voorkomende ritmestoornis. Ook zonder aanwezigheid van klachten is het belangrijk atriumfibrilleren te herkennen, omdat het tot ernstige complicaties kan leiden, in het bijzonder een ischemisch CVA. Screening in de huisartsenpraktijk van hoogrisicopatiënten zou daarom weleens nuttig kunnen zijn. Om het risico op ee...
Article
Lucassen WAM, Erkens PMG, Geersing GJ. Diagnostiek van longembolie. Huisarts Wet 2013;56(6):264-8. Wanneer de huisarts bij een patiënt longembolie vermoedt, kan hij eigenlijk niets anders doen dan verwijzen naar de tweede lijn. Dit is vaak nogal onbevredigend, omdat uiteindelijk slechts 10- 20% van de verwezen patiënten de diagnose longembolie krij...
Article
Full-text available
Background: After excluding pulmonary embolism (PE) with an unlikely Wells-decision rule and a negative D-dimer test, the general practitioner still has to differentiate between clinically relevant and clinically non-relevant diseases accounting for the presented symptoms. A negative D-dimer test makes clinically relevant disease less likely. The...
Article
Introduction: Multi-detector computed tomography (MDCT) is considered to be the reference standard in diagnosing pulmonary embolism (PE). However, two concerns remain. Firstly, with the introduction of MDCT the prevalence of (sub)segmental emboli increased but the clinical implications of these small clots are uncertain. Secondly, we are not well...
Article
Full-text available
To validate the use of the Wells clinical decision rule combined with a point of care D-dimer test to safely exclude pulmonary embolism in primary care. Prospective cohort study. Primary care across three different regions of the Netherlands (Amsterdam, Maastricht, and Utrecht). 598 adults with suspected pulmonary embolism in primary care. Doctors...
Article
Longembolie is nog steeds een van de meest gemiste diagnoses, in het bijzonder omdat deze diagnose vaak niet eens wordt overwogen. In dit artikel worden eerst de anamnese en het lichamelijk onderzoek besproken. Dyspneu is de meest voorkomende klacht bij patiënten met een longembolie (73%): dyspneu in rust, dyspnée d’effort en orthopneu. Op de tweed...
Article
Clinical probability assessment is combined with d-dimer testing to exclude pulmonary embolism (PE). To compare the test characteristics of gestalt (a physician's unstructured estimate) and clinical decision rules for evaluating adults with suspected PE and assess the failure rate of gestalt and rules when used in combination with d-dimer testing....
Article
Full-text available
In secondary care the Wells clinical decision rule (CDR) combined with a quantitative D-dimer test can exclude pulmonary embolism (PE) safely. The introduction of point-of-care (POC) D-dimer tests facilitates a similar diagnostic strategy in primary care.We estimated failure-rate and efficiency of a diagnostic strategy using the Wells-CDR combined...
Article
Full-text available
Goudswaard AN, In ’t Veld CJ, Kramer WLM. Handboek verrichtingen in de huisartsenpraktijk. Houten: Prelum Uitgevers, 2009. 404 pagina’s, € 125,-. ISBN 978 90 8562 037 2.
Article
Putative cross-reactions between anti-DNA and anticardiolipin activities were studied using sera of different patients and a panel of monoclonal antibodies to DNA. Sera were obtained from patients with systemic lupus erythematosus, from patients with syphilis, and from heroin addicts who showed a biologic false-positive result on the serologic test...

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Project
D2AF stands for Detecting and Diagnosing Atrial Fibrillation. This is a multicenter cluster randomized trial. The objective of the D2AF study is to detect atrial fibrillation in an early stage, i.e. before a serious event has occurred. www.d2af.nl