@article{RN467,
   author = {Velek, P. and Splinter, M. J. and Ikram, M. K. and Ikram, M. A. and Leening, M. J. G. and van der Lei, J. and Olde Hartman, T. and Peters, L. L. and Tange, H. and Rutten, F. H. and van Weert, H. and Wolters, F. J. and Bindels, P. J. E. and Licher, S. and de Schepper, E. I. T.},
   title = {Changes in the Diagnosis of Stroke and Cardiovascular Conditions in Primary Care During the First 2 COVID-19 Waves in the Netherlands},
   journal = {Neurology},
   volume = {98},
   number = {6},
   pages = {e564-e572},
   note = {1526-632x Velek, Premysl Splinter, Marije J Ikram, M Kamran Ikram, M Arfan Leening, Maarten J G Orcid: 0000-0002-4143-4839 van der Lei, Johan Olde Hartman, Tim Peters, Lilian L Tange, Huibert Rutten, Frans H van Weert, Henk Orcid: 0000-0001-6370-4724 Wolters, Frank J Orcid: 0000-0003-2226-4050 Bindels, Patrick J E Licher, Silvan de Schepper, Evelien I T Journal Article Research Support, Non-U.S. Gov't United States 2021/12/31 Neurology. 2022 Feb 8;98(6):e564-e572. doi: 10.1212/WNL.0000000000013145. Epub 2021 Dec 29.},
   abstract = {BACKGROUND AND OBJECTIVES: Although there is evidence of disruption in acute cerebrovascular and cardiovascular care during the coronavirus disease 2019 (COVID-19) pandemic, its downstream effect in primary care is less clear. We investigated how the pandemic affected utilization of cerebrovascular and cardiovascular care in general practices (GPs) and determined changes in GP-recorded diagnoses of selected cerebrovascular and cardiovascular outcomes. METHODS: From electronic health records of 166,929 primary care patients aged 30 or over within the Rotterdam region, the Netherlands, we extracted the number of consultations related to cerebrovascular and cardiovascular care, and first diagnoses of selected cerebrovascular and cardiovascular risk factors (hypertension, diabetes, lipid disorders), conditions, and events (angina, atrial fibrillation, TIA, myocardial infarction, stroke). We quantified changes in those outcomes during the first COVID-19 wave (March-May 2020) and thereafter (June-December 2020) by comparing them to the same period in 2016-2019. We also estimated the number of potentially missed diagnoses for each outcome. RESULTS: The number of GP consultations related to cerebrovascular and cardiovascular care declined by 38% (0.62, 95% confidence interval 0.56-0.68) during the first wave, as compared to expected counts based on prepandemic levels. Substantial declines in the number of new diagnoses were observed for cerebrovascular events: 37% for TIA (0.63, 0.41-0.96) and 29% for stroke (0.71, 0.59-0.84), while no significant changes were observed for cardiovascular events (myocardial infarction [0.91, 0.74-1.14], angina [0.77, 0.48-1.25]). The counts across individual diagnoses recovered following June 2020, but the number of GP consultations related to cerebrovascular and cardiovascular care remained lower than expected throughout the June to December period (0.93, 0.88-0.98). DISCUSSION: While new diagnoses of acute cardiovascular events remained stable during the COVID-19 pandemic, diagnoses of cerebrovascular events declined substantially compared to prepandemic levels, possibly due to incorrect perception of risk by patients. These findings emphasize the need to improve symptom recognition of cerebrovascular events among the general public and to encourage urgent presentation despite any physical distancing measures.},
   keywords = {Adult
*COVID-19/epidemiology
*Cardiovascular Diseases/diagnosis
Humans
Netherlands/epidemiology
Pandemics
*Primary Health Care/statistics & numerical data
*Stroke/diagnosis ,
ISSN = 0028-3878 (Print) 0028-3878 ,
DOI = 10.1212/wnl.0000000000013145},
   year = {2022},
   type = {Journal Article}
}

{"_id":"RxEByHMKph68ZQg9A","bibbaseid":"velek-splinter-ikram-ikram-leening-vanderlei-oldehartman-peters-etal-changesinthediagnosisofstrokeandcardiovascularconditionsinprimarycareduringthefirst2covid19wavesinthenetherlands-2022","author_short":["Velek, P.","Splinter, M. J.","Ikram, M. K.","Ikram, M. A.","Leening, M. J. G.","van der Lei, J.","Olde Hartman, T.","Peters, L. L.","Tange, H.","Rutten, F. H.","van Weert, H.","Wolters, F. J.","Bindels, P. J. E.","Licher, S.","de Schepper, E. I. T."],"bibdata":{"bibtype":"article","type":"Journal Article","author":[{"propositions":[],"lastnames":["Velek"],"firstnames":["P."],"suffixes":[]},{"propositions":[],"lastnames":["Splinter"],"firstnames":["M.","J."],"suffixes":[]},{"propositions":[],"lastnames":["Ikram"],"firstnames":["M.","K."],"suffixes":[]},{"propositions":[],"lastnames":["Ikram"],"firstnames":["M.","A."],"suffixes":[]},{"propositions":[],"lastnames":["Leening"],"firstnames":["M.","J.","G."],"suffixes":[]},{"propositions":["van","der"],"lastnames":["Lei"],"firstnames":["J."],"suffixes":[]},{"propositions":[],"lastnames":["Olde","Hartman"],"firstnames":["T."],"suffixes":[]},{"propositions":[],"lastnames":["Peters"],"firstnames":["L.","L."],"suffixes":[]},{"propositions":[],"lastnames":["Tange"],"firstnames":["H."],"suffixes":[]},{"propositions":[],"lastnames":["Rutten"],"firstnames":["F.","H."],"suffixes":[]},{"propositions":["van"],"lastnames":["Weert"],"firstnames":["H."],"suffixes":[]},{"propositions":[],"lastnames":["Wolters"],"firstnames":["F.","J."],"suffixes":[]},{"propositions":[],"lastnames":["Bindels"],"firstnames":["P.","J.","E."],"suffixes":[]},{"propositions":[],"lastnames":["Licher"],"firstnames":["S."],"suffixes":[]},{"propositions":["de"],"lastnames":["Schepper"],"firstnames":["E.","I.","T."],"suffixes":[]}],"title":"Changes in the Diagnosis of Stroke and Cardiovascular Conditions in Primary Care During the First 2 COVID-19 Waves in the Netherlands","journal":"Neurology","volume":"98","number":"6","pages":"e564-e572","note":"1526-632x Velek, Premysl Splinter, Marije J Ikram, M Kamran Ikram, M Arfan Leening, Maarten J G Orcid: 0000-0002-4143-4839 van der Lei, Johan Olde Hartman, Tim Peters, Lilian L Tange, Huibert Rutten, Frans H van Weert, Henk Orcid: 0000-0001-6370-4724 Wolters, Frank J Orcid: 0000-0003-2226-4050 Bindels, Patrick J E Licher, Silvan de Schepper, Evelien I T Journal Article Research Support, Non-U.S. Gov't United States 2021/12/31 Neurology. 2022 Feb 8;98(6):e564-e572. doi: 10.1212/WNL.0000000000013145. Epub 2021 Dec 29.","abstract":"BACKGROUND AND OBJECTIVES: Although there is evidence of disruption in acute cerebrovascular and cardiovascular care during the coronavirus disease 2019 (COVID-19) pandemic, its downstream effect in primary care is less clear. We investigated how the pandemic affected utilization of cerebrovascular and cardiovascular care in general practices (GPs) and determined changes in GP-recorded diagnoses of selected cerebrovascular and cardiovascular outcomes. METHODS: From electronic health records of 166,929 primary care patients aged 30 or over within the Rotterdam region, the Netherlands, we extracted the number of consultations related to cerebrovascular and cardiovascular care, and first diagnoses of selected cerebrovascular and cardiovascular risk factors (hypertension, diabetes, lipid disorders), conditions, and events (angina, atrial fibrillation, TIA, myocardial infarction, stroke). We quantified changes in those outcomes during the first COVID-19 wave (March-May 2020) and thereafter (June-December 2020) by comparing them to the same period in 2016-2019. We also estimated the number of potentially missed diagnoses for each outcome. RESULTS: The number of GP consultations related to cerebrovascular and cardiovascular care declined by 38% (0.62, 95% confidence interval 0.56-0.68) during the first wave, as compared to expected counts based on prepandemic levels. Substantial declines in the number of new diagnoses were observed for cerebrovascular events: 37% for TIA (0.63, 0.41-0.96) and 29% for stroke (0.71, 0.59-0.84), while no significant changes were observed for cardiovascular events (myocardial infarction [0.91, 0.74-1.14], angina [0.77, 0.48-1.25]). The counts across individual diagnoses recovered following June 2020, but the number of GP consultations related to cerebrovascular and cardiovascular care remained lower than expected throughout the June to December period (0.93, 0.88-0.98). DISCUSSION: While new diagnoses of acute cardiovascular events remained stable during the COVID-19 pandemic, diagnoses of cerebrovascular events declined substantially compared to prepandemic levels, possibly due to incorrect perception of risk by patients. These findings emphasize the need to improve symptom recognition of cerebrovascular events among the general public and to encourage urgent presentation despite any physical distancing measures.","keywords":"Adult *COVID-19/epidemiology *Cardiovascular Diseases/diagnosis Humans Netherlands/epidemiology Pandemics *Primary Health Care/statistics & numerical data *Stroke/diagnosis , ISSN = 0028-3878 (Print) 0028-3878 , DOI = 10.1212/wnl.0000000000013145","year":"2022","bibtex":"@article{RN467,\r\n author = {Velek, P. and Splinter, M. J. and Ikram, M. K. and Ikram, M. A. and Leening, M. J. G. and van der Lei, J. and Olde Hartman, T. and Peters, L. L. and Tange, H. and Rutten, F. H. and van Weert, H. and Wolters, F. J. and Bindels, P. J. E. and Licher, S. and de Schepper, E. I. T.},\r\n title = {Changes in the Diagnosis of Stroke and Cardiovascular Conditions in Primary Care During the First 2 COVID-19 Waves in the Netherlands},\r\n journal = {Neurology},\r\n volume = {98},\r\n number = {6},\r\n pages = {e564-e572},\r\n note = {1526-632x Velek, Premysl Splinter, Marije J Ikram, M Kamran Ikram, M Arfan Leening, Maarten J G Orcid: 0000-0002-4143-4839 van der Lei, Johan Olde Hartman, Tim Peters, Lilian L Tange, Huibert Rutten, Frans H van Weert, Henk Orcid: 0000-0001-6370-4724 Wolters, Frank J Orcid: 0000-0003-2226-4050 Bindels, Patrick J E Licher, Silvan de Schepper, Evelien I T Journal Article Research Support, Non-U.S. Gov't United States 2021/12/31 Neurology. 2022 Feb 8;98(6):e564-e572. doi: 10.1212/WNL.0000000000013145. Epub 2021 Dec 29.},\r\n abstract = {BACKGROUND AND OBJECTIVES: Although there is evidence of disruption in acute cerebrovascular and cardiovascular care during the coronavirus disease 2019 (COVID-19) pandemic, its downstream effect in primary care is less clear. We investigated how the pandemic affected utilization of cerebrovascular and cardiovascular care in general practices (GPs) and determined changes in GP-recorded diagnoses of selected cerebrovascular and cardiovascular outcomes. METHODS: From electronic health records of 166,929 primary care patients aged 30 or over within the Rotterdam region, the Netherlands, we extracted the number of consultations related to cerebrovascular and cardiovascular care, and first diagnoses of selected cerebrovascular and cardiovascular risk factors (hypertension, diabetes, lipid disorders), conditions, and events (angina, atrial fibrillation, TIA, myocardial infarction, stroke). We quantified changes in those outcomes during the first COVID-19 wave (March-May 2020) and thereafter (June-December 2020) by comparing them to the same period in 2016-2019. We also estimated the number of potentially missed diagnoses for each outcome. RESULTS: The number of GP consultations related to cerebrovascular and cardiovascular care declined by 38% (0.62, 95% confidence interval 0.56-0.68) during the first wave, as compared to expected counts based on prepandemic levels. Substantial declines in the number of new diagnoses were observed for cerebrovascular events: 37% for TIA (0.63, 0.41-0.96) and 29% for stroke (0.71, 0.59-0.84), while no significant changes were observed for cardiovascular events (myocardial infarction [0.91, 0.74-1.14], angina [0.77, 0.48-1.25]). The counts across individual diagnoses recovered following June 2020, but the number of GP consultations related to cerebrovascular and cardiovascular care remained lower than expected throughout the June to December period (0.93, 0.88-0.98). DISCUSSION: While new diagnoses of acute cardiovascular events remained stable during the COVID-19 pandemic, diagnoses of cerebrovascular events declined substantially compared to prepandemic levels, possibly due to incorrect perception of risk by patients. These findings emphasize the need to improve symptom recognition of cerebrovascular events among the general public and to encourage urgent presentation despite any physical distancing measures.},\r\n keywords = {Adult\r\n*COVID-19/epidemiology\r\n*Cardiovascular Diseases/diagnosis\r\nHumans\r\nNetherlands/epidemiology\r\nPandemics\r\n*Primary Health Care/statistics & numerical data\r\n*Stroke/diagnosis ,\r\nISSN = 0028-3878 (Print) 0028-3878 ,\r\nDOI = 10.1212/wnl.0000000000013145},\r\n year = {2022},\r\n type = {Journal Article}\r\n}\r\n\r\n","author_short":["Velek, P.","Splinter, M. J.","Ikram, M. K.","Ikram, M. A.","Leening, M. J. G.","van der Lei, J.","Olde Hartman, T.","Peters, L. L.","Tange, H.","Rutten, F. H.","van Weert, H.","Wolters, F. J.","Bindels, P. J. E.","Licher, S.","de Schepper, E. I. T."],"key":"RN467","id":"RN467","bibbaseid":"velek-splinter-ikram-ikram-leening-vanderlei-oldehartman-peters-etal-changesinthediagnosisofstrokeandcardiovascularconditionsinprimarycareduringthefirst2covid19wavesinthenetherlands-2022","role":"author","urls":{},"keyword":["Adult *COVID-19/epidemiology *Cardiovascular Diseases/diagnosis Humans Netherlands/epidemiology Pandemics *Primary Health Care/statistics & numerical data *Stroke/diagnosis","ISSN = 0028-3878 (Print) 0028-3878","DOI = 10.1212/wnl.0000000000013145"],"metadata":{"authorlinks":{}},"html":""},"bibtype":"article","biburl":"https://bibbase.org/network/files/qwipow2DJsAxqNp83","dataSources":["PJSqX8FMpCPRdw3CQ","qLDnCcKM9omXNrRY8","TB9sD3avjy7bNxfgS","vDmJPYmHEKAT3tMNL","PcZMFHooKwpboi2he","jZMXEeHTfokmisJDv"],"keywords":["adult *covid-19/epidemiology *cardiovascular diseases/diagnosis humans netherlands/epidemiology pandemics *primary health care/statistics & numerical data *stroke/diagnosis","issn = 0028-3878 (print) 0028-3878","doi = 10.1212/wnl.0000000000013145"],"search_terms":["changes","diagnosis","stroke","cardiovascular","conditions","primary","care","during","first","covid","waves","netherlands","velek","splinter","ikram","ikram","leening","van der lei","olde hartman","peters","tange","rutten","van weert","wolters","bindels","licher","de schepper"],"title":"Changes in the Diagnosis of Stroke and Cardiovascular Conditions in Primary Care During the First 2 COVID-19 Waves in the Netherlands","year":2022}