Biomedical subjects

E Griep

Publications and source records attributed to E Griep.

3 recordsLinked to original sources

PubMed2001

Rhemulatologists' performance in dailiy practice.

OBJECTIVE: To assess rheumatologists' performance for 8 rheumatologic conditions and to explore possible explanatory factors. METHODS: After written informed consent was obtained, 27 rheumatologists (21% of all Dutch rheumatologists) practicing in 16 outpatient departments were each visited by 8 incognito "standardized patients" (SPs). The diagnoses of these 8 cases account for about 23% of all new referred patients in the Netherlands. Results for ordered lab tests as well as real radiographs with corresponding results from a radiologist were simulated. Information from the visits was obtained from the SPs, who completed predefined case-specific checklists, and by collecting data on resource utilization. Feedback was provided. RESULTS: Altogether 254 encounters took place, of which 201 were first visits and 53 were followup visits. SPs were unmasked twice during a visit. There was considerable variation in resource utilization (lab tests and imaging) between cases and between rheumatologists. Mean costs per rheumatologist ranged from US $ 4.67 to $ 65.36 per visit for lab tests and from US $ 33.15 to $ 226.84 per visit for imaging tests. No significant correlations were seen between resource utilization costs and number of years of clinical experience or performance on checklist scores. Rheumatologists with longer experience had lower total item checklist scores (r = -0.47; P < 0.05). CONCLUSION: A considerable variation in resource utilization was found among 27 Dutch rheumatologists. The information obtained is an excellent source for discussion on the appropriateness of care.

Adult↗

PubMed1983

Cognitive and personality function in myotonic muscular dystrophy.

Twenty-nine patients with myotonic dystrophy from 14 families were tested with the Wechsler and Shipley measures of cognitive function. Forty-one per cent of the subjects had little or no physical handicap. Approximately one-third had low Wechsler scores, whereas 7% had relatively high scores. There was a trend for affected females to have poorer cognitive function than males. Limited cognitive ability correlated with maternal inheritance of the gene and severe physical handicap, but there were individual exceptions. Strongest cognitive abilities were verbal and informational, whereas the weakest were immediate recall, abstraction and spatial manipulation and orientation. There was no evidence of intellectual decline with time. Signs of cerebral atrophy on CT scans were uncommon, occurring for certain in only one of 19 subjects. Personality profiles were also constructed for 25 myotonic subjects using interview and MMPI techniques. Forty-four per cent of the subjects had unremarkable personality profiles, 24% had mild personality difficulties and 32% had prominent personality abnormalities. Serious personality difficulty was most common in patients with low cognitive ability and advanced physical handicap. There was no "typical" personality pattern representative of the entire group. It is likely that many personality problems were the result of individuals with limited resources attempting to cope with their physically deforming and debilitating neuromuscular disorder.

Adolescent↗

PubMed1981

Pattern reversal visual evoked potentials. Studies in Charcot-Marie-Tooth hereditary neuropathy.

Pattern reversal visual evoked potentials (PRVEP) were studied in 25 patients from 17 separate families with Charcot-Marie-Tooth (CMT) syndrome. Twenty patients had classic CMT with depressed tendon reflexes, slow motor nerve conduction velocities, and autosomal dominant inheritance. Four patients demonstrated typical findings of CMT, but there was no documented family history. One patient had the axonal form of hereditary motor sensory neuropathy. Abnormally delayed latencies of the PRVEP were found in four patients (16% of the total), including the only patient with clinical optic atrophy. There was no consistent correlation, of PRVEP with severity of disease. These results confirm earlier clinical reports of occasional optic nerve involvement in CMT and represent additional evidence that central pathways may be involved in this primarily peripheral nervous system disorder.

Adolescent↗