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Introduction: Assessment of physicians' performance focuses on the quality of their work. The aim of this study was to develop a valid, usable and acceptable multisource feedback assessment tool (MFAT) for hospital consultants., Material and Methods: Statements were produced on consultant competencies within non-medical areas like collaboration, professionalism, communication, health promotion, academics and administration. The statements were validated by physicians and later by non-physician professionals after adjustments had been made. In a pilot test, a group of consultants was assessed using the final collection of statements of the MFAT. They received a report with their personal results and subsequently evaluated the assessment method., Results: In total, 66 statements were developed and after validation they were reduced and reformulated to 35. Mean scores for relevance and "easy to understand" of the statements were in the range between "very high degree" and "high degree". In the pilot test, 18 consultants were assessed by themselves, by 141 other physicians and by 125 other professionals in the hospital. About two thirds greatly benefited of the assessment report and half identified areas for personal development. About a third did not want the head of their department to know the assessment results directly; however, two thirds found a potential value in discussing the results with the head., Conclusion: We developed an MFAT for consultants with relevant and understandable statements. A pilot test confirmed that most of the consultants gained from the assessment, but some did not like to share their results with their heads. For these specialists other methods should be used.

Between July 1988 and July 1990, 42 patients with low-grade gliomas of the cerebrum were treated in our department. Their age ranged from six to 72, there were 27 males and 15 females. Seventy-nine percent of the patients had suffered from epileptic fits, in 69% it was the presenting symptom. Thirty-one percent had normal neurological examination. On CT-scanning most tumours were hypodense, one-third demonstrated enhancement after intravenous contrast. Midline shift suggested a grade two tumour, but otherwise it was not possible to distinguish between grade one and grade two tumours on CT or MR. There was an unaccountable overweight of tumours on the left side of the brain. Forty patients underwent surgery, in one-third a radical extirpation was undertaken. In six patients a biopsy was nondiagnostic. Twenty-five percent had postoperative radiation. Adult patients who suffer an epileptic seizure without any other obvious aetiology should have a CT or MR scan even in cases when the neurological examination is normal.