3 results on '"Veldhoven, Carel"'
Search Results
2. An online international comparison of palliative care identification in primary care using the Surprise Question.
- Author
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White, Nicola, Oostendorp, Linda JM, Vickerstaff, Victoria, Gerlach, Christina, Engels, Yvonne, Maessen, Maud, Tomlinson, Christopher, Wens, Johan, Leysen, Bert, Biasco, Guido, Zambrano, Sofia, Eychmüller, Steffen, Avgerinou, Christina, Chattat, Rabih, Ottoboni, Giovanni, Veldhoven, Carel, and Stone, Patrick
- Subjects
SURVIVAL ,STATISTICS ,LIFE expectancy ,CROSS-sectional method ,MULTIVARIATE analysis ,PHYSICIANS' attitudes ,REGRESSION analysis ,PRIMARY health care ,COMPARATIVE studies ,CASE studies ,PALLIATIVE treatment - Abstract
Background: The Surprise Question ('Would I be surprised if this patient died within 12 months?') identifies patients in the last year of life. It is unclear if 'surprised' means the same for each clinician, and whether their responses are internally consistent. Aim: To determine the consistency with which the Surprise Question is used. Design: A cross-sectional online study of participants located in Belgium, Germany, Italy, The Netherlands, Switzerland and UK. Participants completed 20 hypothetical patient summaries ('vignettes'). Primary outcome measure: continuous estimate of probability of death within 12 months (0% [certain survival]–100% [certain death]). A threshold (probability estimate above which Surprise Question responses were consistently 'no') and an inconsistency range (range of probability estimates where respondents vacillated between responses) were calculated. Univariable and multivariable linear regression explored differences in consistency. Trial registration: NCT03697213. Setting/participants: Registered General Practitioners (GPs). Of the 307 GPs who started the study, 250 completed 15 or more vignettes. Results: Participants had a consistency threshold of 49.8% (SD 22.7) and inconsistency range of 17% (SD 22.4). Italy had a significantly higher threshold than other countries (p = 0.002). There was also a difference in threshold levels depending on age of clinician, for every yearly increase, participants had a higher threshold. There was no difference in inconsistency between countries (p = 0.53). Conclusions: There is variation between clinicians regarding the use of the Surprise Question. Over half of GPs were not internally consistent in their responses to the Surprise Question. Future research with standardised terms and real patients is warranted. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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3. An online international comparison of thresholds for triggering a negative response to the 'Surprise Question': a study protocol
- Author
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Yvonne Engels, Johan Wens, Linda J. M. Oostendorp, Maud Maessen, Patrick Stone, Christina Gerlach, Bert Leysen, Nicola White, Carel Veldhoven, Christina Avgerinou, Guido Biasco, Steffen Eychmüller, Rabih Chattat, Giovanni Ottoboni, Christopher Tomlinson, Sofia C. Zambrano, Victoria Vickerstaff, White, Nicola, Oostendorp, Linda, Vickerstaff, Victoria, Gerlach, Christina, Engels, Yvonne, Maessen, Maud, Tomlinson, Christopher, Wens, Johan, Leysen, Bert, Biasco, Guido, Zambrano, Sofia, Eychmüller, Steffen, Avgerinou, Christina, Chattat, Rabih, Ottoboni, Giovanni, Veldhoven, Carel, and Stone, Patrick
- Subjects
Palliative care ,Survival ,Study Protocol ,0302 clinical medicine ,Belgium ,Germany ,Surveys and Questionnaires ,610 Medicine & health ,Netherlands ,Multiple choice ,media_common ,lcsh:RC952-1245 ,General Medicine ,Prognosis ,Death ,Surprise ,Italy ,Negative response ,030220 oncology & carcinogenesis ,0305 other medical science ,Psychology ,Switzerland ,medicine.medical_specialty ,Attitude to Death ,Attitude of Health Personnel ,Prognosi ,media_common.quotation_subject ,education ,lcsh:Special situations and conditions ,1117 Public Health and Health Services ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,03 medical and health sciences ,Surprise question ,All institutes and research themes of the Radboud University Medical Center ,General Practitioners ,030502 gerontology ,medicine ,Humans ,National level ,Protocol (science) ,Internet ,Correction ,Certificate ,United Kingdom ,Vignette ,Family medicine ,Human medicine ,Gerontology - Abstract
Background The Surprise Question (SQ) “would I be surprised if this patient were to die in the next 12 months?” has been suggested to help clinicians, and especially General Practitioners (GPs), identify people who might benefit from palliative care. The prognostic accuracy of this approach is unclear and little is known about how GPs use this tool in practice. Are GPs consistent, individually and as a group? Are there international differences in the use of the tool? Does including the alternative Surprise Question (“Would I be surprised if the patient were still alive after 12 months?”) alter the response? What is the impact on the treatment plan in response to the SQ? This study aims to address these questions. Methods An online study will be completed by 600 (100 per country) registered GPs. They will be asked to review 20 hypothetical patient vignettes. For each vignette they will be asked to provide a response to the following four questions: (1) the SQ [Yes/No]; (2) the alternative SQ [Yes/No]; (3) the percentage probability of dying [0% no chance – 100% certain death]; and (4) the proposed treatment plan [multiple choice]. A “surprise threshold” for each participant will be calculated by comparing the responses to the SQ with the probability estimates of death. We will use linear regression to explore any differences in thresholds between countries and other clinician-related factors, such as years of experience. We will describe the actions taken by the clinicians and explore the differences between groups. We will also investigate the relationship between the alternative SQ and the other responses. Participants will receive a certificate of completion and the option to receive feedback on their performance. Discussion This study explores the extent to which the SQ is consistently used at an individual, group, and national level. The findings of this study will help to understand the clinical value of using the SQ in routine practice. Trial registration Clinicaltrials.gov NCT03697213 (05/10/2018). Prospectively registered. Electronic supplementary material The online version of this article (10.1186/s12904-019-0413-x) contains supplementary material, which is available to authorized users.
- Published
- 2019
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