This thesis aimed to lay the foundation for a new set of Dutch mental health instruments to measure depression and anxiety in an efficient, reliable, valid, and responsive manner. More specifically... Show moreThis thesis aimed to lay the foundation for a new set of Dutch mental health instruments to measure depression and anxiety in an efficient, reliable, valid, and responsive manner. More specifically, the Dutch-Flemish PROMIS adult v1.0 item banks for Depression and Anxiety were psychometrically evaluated for computerized adaptive test (CAT) administration in the Dutch clinical and general population. CAT is a modern methodology that can be used to develop instruments that measure both efficiently and reliably as only the most appropriate questions are administered, and assessment terminates as soon as sufficient reliability is achieved. For the PROMIS CAT instruments, this was demonstrated in the thesis: measuring depression and anxiety in Dutch persons was highly efficient and reliable. Moreover, the CAT instruments were shown to measure depression and anxiety sufficiently responsive and valid as well. This even includes longitudinal validity, which has barely been studied for other Dutch mental health instruments. Overall, it was concluded that the new instruments are an improvement over available instruments. Therefore, using the PROMIS CAT instruments in clinical practice may lead to more efficient and reliable measurement that supports professionals and patients in evaluating patients' treatment. Show less
This thesis describes the cost-effictiveness study and several substudies, using the same patient population. In chapter 2 we assessed the effectiveness of MR imaging in selecting patients with... Show moreThis thesis describes the cost-effictiveness study and several substudies, using the same patient population. In chapter 2 we assessed the effectiveness of MR imaging in selecting patients with nonacute knee symptoms for arthroscopy of the knee. In chapter 3 we discuss effectiveness and costs of MR imaging triaging these patients. In chapter 4 we determine in patients with nonacute knee symptoms and normal standardized physical examination the fraction of MR imaging studies showing arthroscopically treatable intraarticular pathology, thus evaluating whether one safely can refrain from MR imaging. In chapter 5 we discuss whether radiographs are needed when MR imaging is performed for nonacute knee symptoms anyway. The impact of bone bruise on presentation and short term course of knee complaints and the relation between bone bruise and (peri-)articular derangement is assessed in chapter 6. Show less
