Introduction Routine assessment of patient-reported outcomes (PROs) in oncology has shown to improve the quality of the delivered care and to prolong survival. However, for successful... Show moreIntroduction Routine assessment of patient-reported outcomes (PROs) in oncology has shown to improve the quality of the delivered care and to prolong survival. However, for successful implementation of routine assessment of PROs, more knowledge on their usability in clinical practice is needed. Objective This study aimed to cross-sectionally assess the perspective of patients and clinicians on the practicality of routinely measuring PROs in clinical practice for glioma patients. Methods Semistructured interviews were conducted evaluating the role of healthcare professionals (HCP) in discussing results of PRO measures (PROMs), and the preferred topics, methods and frequency of PRO assessment. Glioma patients, their proxies and HCPs involved in the treatment of glioma patients from eight centres in the Netherlands were included. Results Twenty-four patients, 16 proxies and 35 HCPs were interviewed. The majority of patients, proxies and HCPs (92%, 81% and 80%, respectively) were willing to discuss PRO results during consultations. Although HCPs prefer that results are discussed with the nurse specialist, only one-third of patients/proxies agreed. Functioning of daily life was considered important in all three groups. Most participants indicated that discussion of PROM results should take place during standard follow-up visits, and completed at home about 1 week in advance. On group level, there was no preference for administration of questionnaires on paper or digitally. Lastly, all centres had staff available to send questionnaires on paper. Conclusion This study shows that routine assessment of PROs is desired by patients, proxies and HCP's in neuro-oncological care in Dutch hospitals. Show less
Fakkel, M.; Peeters, M.; Lugtig, P.; Zondervan-Zwijnenburg, M.A.J.; Blok, E.; White, T.; ... ; Vollebergh, W.A.M. 2020
In 5 of the 6 large Dutch developmental cohorts investigated here, lower SES adolescents are underrepresented and higher SES adolescents overrepresented. With former studies clearly revealing... Show moreIn 5 of the 6 large Dutch developmental cohorts investigated here, lower SES adolescents are underrepresented and higher SES adolescents overrepresented. With former studies clearly revealing differences between SES strata in adolescent social competence and behavioral control, this misrepresentation may contribute to an overestimation of normative adolescent competence. Using a raking procedure, we used national census statistics to weigh the cohorts to be more representative of the Dutch population. Contrary to our expectations, in all cohorts, little to no differences between SES strata were found in the two outcomes. Accordingly, no differences between weighted and unweighted mean scores were observed across all cohorts. Furthermore, no clear change in correlations between social competence and behavioral control was found. These findings are most probably explained by the fact that measures of SES in the samples were quite limited, and the low SES participants in the cohorts could not be considered as representative of the low SES groups in the general population. Developmental outcomes associated with SES may be affected by a raking procedure in other cohorts that have a sufficient number and sufficient variation of low SES adolescents. Show less
Peeters, M.; Zwinkels, H.; Koekkoek, J.; Vos, M.; Dirven, L.; Taphoorn, M. 2020
Background: The aim of this study was to explore the impact of the timing of Health-Related Quality of Life (HRQoL) measurements in clinical care on the obtained HRQoL scores in glioma patients,... Show moreBackground: The aim of this study was to explore the impact of the timing of Health-Related Quality of Life (HRQoL) measurements in clinical care on the obtained HRQoL scores in glioma patients, and the association with feelings of anxiety or depression. Methods: Patients completed the European Organisation for Research and Treatment of Cancer (EORTC)'s Quality of Life Questionnaires (QLQ-C30 and QLQ-BN20), and the Hospital Anxiety and Depression Scale (HADS) twice. All patients completed the first measurement on the day of the Magnetic Resonance Imaging (MRI) scan (t= 0), but the second measurement (t= 1) depended on randomization; Group 1 (n= 49) completed the questionnaires before and Group 2 (n= 51) after the consultation with the physician. Results: median HRQoL scale scores on t0/t1 and change scores were comparable between the two groups. Between 8-58% of patients changed to a clinically relevant extent (i.e., >= 10 points) on the evaluated HRQoL scales in about one-week time, in both directions, with only 3% of patients remaining stable in all scales. Patients with a stable role functioning had a lower HADS anxiety change score. The HADS depression score was not associated with a change in HRQoL. Conclusions: Measuring HRQoL before or after the consultation did not impact HRQoL scores on a group level. However, most patients reported a clinically relevant difference in at least one HRQoL scale between the two time points. These findings highlight the importance of standardized moments of HRQoL assessments, or patient-reported outcomes in general, during treatment and follow-up in clinical trials. Show less
Wiering, E.; Kluin, M.; Peeters, M.; Blokland, A.; Huisman, W. 2020
Voor risicogerichte handhaving van regelnaleving door bedrijven is het niet alleen van belang inzicht te verkrijgen in hoe vaak een bedrijf de regels overtreedt, maar ook welke regels worden... Show moreVoor risicogerichte handhaving van regelnaleving door bedrijven is het niet alleen van belang inzicht te verkrijgen in hoe vaak een bedrijf de regels overtreedt, maar ook welke regels worden overtreden. Patronen in de aard van regelovertreding kunnen indicatief zijn voor de achterliggende oorzaak van regelovertreding en daarmee nuttige kennis opleveren voor het vormgeven van effectieve handhavingsstrategieën. In deze studie brengen we patronen in de aard van regelovertreding in kaart voor 494 Nederlandse Brzo-bedrijven die vallen onder de Europese Seveso III-richtlijn. We maken hiervoor gebruik van zowel de diversiteitsindex als latenteklasseanalyse. Onze resultaten laten zien dat diversiteit in regelovertreding sterk samenhangt met de frequentie waarmee bedrijven regels overtreden. Regelovertredende bedrijven blijken doorgaans geen specialisten, maar generalisten. Implicaties voor toezicht en handhaving worden besproken. Show less
