Nederlands tijdschrift voor geneeskunde
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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.
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Ned Tijdschr Geneeskd · Nov 2005
Review[Preventive surgical prcedures for inherited risk of breast cancer].
Preventive surgical procedures for inherited risk of breast cancer Forwomen with a demonstrated BRCA1 or BRCA2 mutation, the cumulative risk of developing invasive breast cancer before the age of 70 years is about 50-85% and the risk of developing invasive epithelial ovarian cancer is 20-60%. Regular surveillance including physical examination and imaging is offered to mutation carriers and the options for risk-reducing surgery are discussed. ⋯ Prophylactic bi- or contralateral mastectomy after previous treatment for unilateral breast cancer reduces the incidence of contralateral breast cancer, but has no impact on survival. The complexity of the problem demands a multidisciplinary approach within the context of a family cancer clinic.
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Ned Tijdschr Geneeskd · Nov 2005
[Dutch authors in international medical journals are also authors of publications in the Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine)].
To determine whether Dutch medical scientists who frequently publish in international journals with high impact factors also publish in Dutch in the Nederlands Tijdschrit voor Geneeskunde (NTvG). ⋯ Authors that publish many articles in frequently cited international journals also write articles for the NTvG and, vice versa, the authors of articles in the NTvG also publish in international journals.