University of Groningen Diagnostic strategies in children with chronic gastrointestinal symptoms in primary care Holtman, Geeske IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below. Document Version Publisher's PDF, also known as Version of record Publication date: 2016 Link to publication in University of Groningen/UMCG research database Citation for published version (APA): Holtman, G. A. (2016). Diagnostic strategies in children with chronic gastrointestinal symptoms in primary care [Groningen]: Rijksuniversiteit Groningen Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons). Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date: 11-02-2018
Gea Holtman
Diagnostic strategies in children with chronic gastrointestinal symptoms in primary care The study described in this thesis was funded by a grant from the Fonds NutsOhra and a grant from the University Medical Centre Groningen doelmatigheidsonderzoek. Proefschrift Publication of this thesis was financially supported by Research Institute SHARE (School of HeAlth REsearch), University of Groningen, University Medical Centre Groningen, and Stichting Kleine Kwalen in Huisartsgeneeskunde. ter verkrijging van de graad van doctor aan de Rijksuniversiteit Groningen op gezag van de rector magnificus prof. dr. E. Sterken en volgens besluit van het College voor Promoties. De openbare verdediging zal plaatsvinden op Diagnostic strategies in children with chronic gastrointestinal symptoms in primary care maandag 31 oktober 2016 om 14.30 uur ISBN 978-90-367-9057-4 (printed version) ISBN 978-90-367-9056-7 (electronic version) Graphic design Teuntje van de Wouw Printed by GVO drukkers & vormgevers B.V. Copyright 2016 G.A. Holtman, Groningen, The Netherlands All rights reserved. No part of this thesis may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the written permission of the author or, when appropriate, of the publishers of the publications. door Geeske Atje Holtman geboren op 10 september 1985 te Groningen Cover image is copyrighted, used with permission. Permission granted by publishing house Peter Hammer Verlag and the author Prof. Werner Holzwarth. Original book: Vom kleinen Maulwurf, der wissen wollte, wer ihm auf den kopf gemacht hat.
Promotor Prof. dr. M.Y. Berger Copromotores Dr. Y. Lisman-van Leeuwen Dr. P.F. van Rheenen Beoordelingscommissie Prof. dr. G.J. Dinant Prof. dr. H.J. Verkade Prof. dr. P.M.M. Bossuyt In memory of my mother
CONTENTS CHAPTER 1 General introduction 9 CHAPTER 2 Non-invasive tests for inflammatory bowel disease: a meta-analysis 21 CHAPTER 3 Added value of laboratory markers to symptoms for inflammatory bowel disease, an individual patient data meta-analysis of 1120 paediatric patients 65 CHAPTER 4 Challenges in diagnostic accuracy studies in primary care: the faecal calprotectin example 85 CHAPTER 5 Diagnostic accuracy of faecal calprotectin for paediatric inflammatory bowel disease in primary care, a prospective cohort study 99 CHAPTER 6 Diagnostic test strategies for inflammatory bowel disease in children presenting at primary care level 117 CHAPTER 7 Evaluation of point-of-care test calprotectin and lactoferrin for inflammatory bowel disease among children with chronic gastrointestinal symptoms 135 CHAPTER 8 Summary and general discussion 151 Nederlandse samenvatting Dankwoord Lijst van deelnemende huisartsenpraktijken Curriculum Vitae List of publications 165 173 179 185 189