Nederlands tijdschrift voor geneeskunde
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In medical literature, both 'gold standard' and 'golden standard' are employed to describe a reference test used for comparison with a novel method. The term 'gold standard' in its current sense in medical research was coined by Rudd in 1979, in reference to the monetary gold standard. ⋯ Whereas the gold standard was never regarded as infallible, the incorrect term 'golden standard' implies a level of perfection that is unattainable in medical science. Consequently, the correct term should be 'gold standard'.
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Ned Tijdschr Geneeskd · Dec 2005
[Evaluation of a programme for the prenatal screening for Down's syndrome by ultrasonographic nuchal translucency measurement and serum determinations in the first trimester of pregnancy].
To determine the diagnostic value of the combination screening test for Down's syndrome in women in the first trimester of pregnancy. ⋯ The diagnostic value of the first-trimester combination test was greater than that of only nuchal translucency measurement. Moreover, the diagnostic value was greater if the chances were calculated on the basis of the median values of the VU Medial Centre population than when other median values were used.
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There has been considerable change in the field of assessment of medical competence. At the moment, competency-orientated assessment, 'mini-CEX' (brief clinical evaluation exercises) and portfolios are quite popular. ⋯ Using a portfolio, information on the student's competence can be collated and evaluated from various sources, including mini-CEX. As such, a portfolio has much in common with a patient chart.
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Ned Tijdschr Geneeskd · Dec 2005
[Performance indicators as a measure of the quality of medical care: rhetoric and reality].
Performance indicators may provide an indication of insufficient quality of medical care but they do not identify the cause of the problem. The political context for performance indicators is based on market ideology, where quality improvement is the goal and consumer pressure is the means. It is usually difficult to compare performance indicators among hospitals given the differences in definitions, methods of assessment, case mix, preclinical factors and data quality. ⋯ At this time, the presence and degree of consumer pressure is unclear, and the ultimate effects of making performance factors publicly available on the quality of care is unknown. The question is whether mandatory reporting of a set of performance indicators by hospitals can provide sufficient insight into the quality of care; the measure appears to be too rough and too many factors influence the outcome. Procedure assessment is a good alternative to the use of performance indicators.