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Biomedical subjects

H F Crebolder

Publications and source records attributed to H F Crebolder.

7 recordsLinked to original sources
PubMed1992

The diagnostic value of symptoms for the identification of patients with an increased risk of colorectal disease. A criteria-based analysis.

In most textbooks of gastroenterology, diseases with their symptoms are discussed. The exact diagnostic value of these symptoms, however, regarding the differentiation between organic and functional disease, is not mentioned. A criteria-based meta-analysis of the few existing studies in this field was done. From the 14 identified studies, there were two that did not find any significant symptoms. In the other studies the diagnostic value of colonic symptoms showed great variability. Methodological deficiencies in these studies are probably responsible for the latter. The generalization of these results into general practice is not straightforward and needs research in general practice patients.

Colonic Diseases↗
PubMed1992

Reactions of doctors to various forms of feedback designed to improve the sampling quality of cervical smears.

Three different forms of feedback designed to improve the sampling quality of cervical smears were tested in a randomized controlled trial among 179 physicians. The reactions of the doctors to the various interventions are reported as they appeared from their answers in a questionnaire. The influence of the interventions on the employed sampling technique is described on the basis of their answers to a telephone inquiry. The inclusion in laboratory protocols of an evaluation of the sampling quality of the submitted smears was largely appreciated, as was specific advice offered on indication. Monthly overviews comparing the performance of the individual doctor to that of his peers were esteemed by three out of four. Further information, help or training was requested more frequently than average by physicians obtaining inadequately sampled smears relatively often. The number of doctors using the combined spatula and Cytobrush method as sampling technique doubled during the study period.

Feedback↗
PubMed1991

Geographical variations in the sampling quality of cervical smears.

It is generally accepted that cervical smears are adequately sampled when they contain endocervical and/or metaplastic cells. An extensive literature search via MEDLINE and FAMLI for papers on cervical smears yielded 33 articles providing explicit information both on the country where the study was executed and on the relationship between the adequate sampling of smears and the sampling method used. The correlation between the geographic origin of cervical smears and the proportion of those smears that were adequately sampled was examined. The results were controlled for the sampling method. It was found that the proportion of adequately sampled smears reported in studies in the U.K. is exceedingly low, in contrast with the proportion reported from The Netherlands. The differences between the various countries studied are stable over different sampling methods. It is suggested that, in order to ameliorate the sampling quality of cervical smears, factors associated with the working conditions in particular regions also need be considered.

Europe↗
PubMed1987

Experiences with self-assessment and peer review among general practitioners in The Netherlands.

The relation between peer review and postgraduate training proved to be complex. Involvement occurred by way of three projects (PI, PII, and PIII) involving 1,200 general practitioners by directed or self-motivated assessment. The simple assumption that the discovery by audit of knowledge, skills of attitude gaps, automatically lead to appropriate training, proved to be untrue. Experience learned that auditing itself is an educational process which links up with the individual needs of the participants. More study, research and experience is needed with regard to the interrelationship between peer review and postgraduate training, but both are essential and integral elements of the striving for excellence and quality.

Educational Measurement↗