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PhD defence

Promoting early recognition of persistent somatic symptoms in primary care

  • W.M. Kitselaar
Tuesday 27 June 2023
Academy Building
Rapenburg 73
2311 GJ Leiden

Short Summary

This dissertation investigates the early recognition of persistent somatic symptoms (PSS) in primary care. A stepwise approach was used mapping the optimal methods for re-using primary care records for predictive modeling of PSS. This is important since up to 10% of the general population experiences PSS. Moreover, general practitioners (GPs) often encounter difficulties in recognizing PSS, which may delay adequate intervention, subsequently resulting in unnecessary high burden on the patient and health care system.

The findings from this dissertation show that a complex interplay between factors from all biopsychosocial domains contribute to PSS-onset. Survey results show that GPs differ in their methods of PSS-registration. Many GPs indicate missing an unambiguous classification and registration scheme and report needing more support, tools, and/or education for PSS-related consultations. Predictive modeling of different PSS-syndromes shows both overlapping and syndrome-specific predictors. Early predictive modeling of the broad spectrum of PSS shows moderate predictive accuracy based on seven approaches for candidate-predictor selection, including theory-driven and temporal and non-temporal data-driven approaches.

In conclusion, this dissertation provides comprehensive evidence of the complexity of identification of PSS and the need for additional support for GPs regarding PSS. Furthermore, results indicate that simple data-driven approaches re-using routine care data could support recognition of PSS in primary care, although this should be combined with a multidisciplinary care approach.


  • Prof.dr. A.W.M. Evers
  • Prof.dr. M.E. Numans
  • dr. R. van der Vaart

PhD dissertations

Approximately one week after the defence, PhD dissertations by Leiden PhD students are available digitally through the Leiden Repository, that offers free access to these PhD dissertations. Please note that in some cases a dissertation may be under embargo temporarily and access to its full-text version will only be granted later.

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