Y D van Leeuwen

Publications (12)5.42 Total impact

• Article: Hippocrates

  Y. D. van Leeuwen, J. L. Baggen
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  ABSTRACT: Een recensie schrijven dwingt tot zorgvuldig lezen. Het is een genoegen om dit boekje bladzijde na bladzijde om te slaan en het stof van zo’n 2500 najaarsstormen te zien verdwijnen onder de pen van deskundige auteurs. Ook de afbeeldingen zijn een lust voor het oog. Het onderwerp is de Eed van Hippocrates. Met scalpel en pincet wordt de eed ontleed, om te ontdekken dat de inhoud en de vorm ervan in de loop der eeuwen drastisch zijn gewijzigd en toegepast te eigen bate. boekbespreking-huisartsgeneeskunde
  Huisarts en wetenschap 05/2012; 47(11):240-240.
• Article: Huisarts en ziekte of huisarts en patiënt?

  Y D van Leeuwen, J L Baggen
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  ABSTRACT: Denkbeelden over taken en functies van de huisarts, ‘achter een bureau bedacht’, hebben grote invloed op wat zich in de spreekkamer afspeelt. Ook de filosofie komt om de hoek kijken als men een antwoord zoekt op de vraag: moet de huisarts van de toekomst ziekte- of patiëntgericht werken? Dit of-of-denken zelf staat echter ter discussie. De geschiedenis van dit denken wordt in dit artikel gepresenteerd en de lijn wordt doorgetrokken naar de toekomst. Conclusie is dat het gewogen oordeel vertaald in een advies op maat het ‘eindpunt’ zou moeten zijn en niet de gezondheid of het welzijn van de patiënt. De patiënt neemt dit laatste voor eigen rekening. De bedoeling is dat de huisarts niet langer wordt opgezadeld met onhaalbare doelen die tot burnout kunnen leiden. arts-patiënt relatie-huisarts-huisartsgeneeskunde-taakopvatting-Woudschoten-ziekte
  Huisarts en wetenschap 05/2012; 44(13):31-34.
• Article: De medische beslissing: juist én zinnig?besliskundediagnostiekmethodologiesensitiviteitspecificiteit

  Y D van Leeuwen, J L Baggen
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  ABSTRACT: In dit artikel wordt een methode gepresenteerd om de factoren die de medische beslissing bepalen in kaart en beeld te brengen. Hoewel de klassieke medische besliskunde hier al een succesvolle poging toe heeft gedaan, ontbreekt als het ware ‘de helft’ van de argumentatie, namelijk die welke betrekking heeft op het individuele geval en diens verhaal. Bovendien slagen artsen er zelden in de Bayesiaanse rekenwijze in de praktijk van alledag toe te passen. De wijze van verbeelden maakt duidelijk hoe wetenschap en praktijk, evidence en experience, juistheid en zinnigheid op elkaar ingrijpen.
  Huisarts en wetenschap 04/2012; 45(2):780-783.
• Article: [A woman with anginal symptoms and normal coronary arteries].

  F I Guldemond, P F H M Höppener, J A Kragten, Y D van Leeuwen, J Siebenga
  Nederlands tijdschrift voor geneeskunde 01/2009; 152(50):2750; author reply 2750.
• Article: [Cardiac symptoms due to pectus excavatum in a man over the age of 55].

  F I Guldemond, P F H M Höppener, J A Kragten, Y D van Leeuwen, J Siebenga
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  ABSTRACT: A healthy 59-year-old man, a retired general practitioner, suffered from increasing palpitations, fatigue and postural dyspnoea: bending over led to a significant increase in his shortness of breath. Cardiological and pulmonological examination, performed at regular intervals, showed occasional supraventricular arrhythmia and nodal tachycardia but did not yield a satisfactory explanation for the symptoms. In the years that followed, the physical impairment became a considerable handicap. Finally, the patient himself suggested a possible explanation on the basis of an Internet search: his pectus excavatum. A literature search confirmed this hypothesis. A lateral chest X-ray in bending position and a CT-scan of the chest revealed compression of the heart by the sternum. Ten years after the onset of symptoms, a modified Ravitch operation finally brought nearly complete recovery.
  Nederlands tijdschrift voor geneeskunde 03/2008; 152(6):337-41.
• Article: [Screening for diabetic retinopathy].

  L W den Ouden, Y D van Leeuwen, J L Baggen
  Nederlands tijdschrift voor geneeskunde 07/2007; 151(23):1312-3; author reply 1313.
• Article: [Pleural mesothelioma in family practice; complicated pain problems].

  Y D van Leeuwen
  Nederlands tijdschrift voor geneeskunde 08/1997; 141(32):1582-3.
• Source

  Available from: nih.gov

  Article: Selection for postgraduate training for general practice: the role of knowledge tests.

  Y D van Leeuwen, S S Mol, M C Pollemans, C P van der Vleuten, R Grol, M J Drop
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  ABSTRACT: Postgraduate training for general practice is a legal requirement in most countries of the European Community, and includes posts in general practice as well as in hospitals. The effectiveness of the training has not been fully evaluated, and it is largely unknown whether the results are satisfactory or what the impact of the separate training components is--nor is it known which characteristics or prior achievements of the trainee influence the end-of-training performance. To determine the value of knowledge tests in the context of entry selection for postgraduate training in general practice. Three (equated) knowledge tests were administered during the two years' postgraduate training of 85 Dutch trainees. The first test was taken at entrance, the second eight months later, and the third shortly before the end of the entire training period. Complete data for 57 trainees were available for analysis. A multiple regression analysis was performed to estimate the predictive values of test 1 and test 2 scores, separately and in combination, for test 3 scores. Since the knowledge test may be used for selection purposes, the analysis was repeated using logistic regression with two pass/fail criteria: a 'minimum criterion' and an 'excellence criterion'. Neither of the two analyses yielded a predictive value of test 1 that was high enough to warrant the use of knowledge tests in the context of entry selection. A 'below minimum' score on test 2 correlated 100% with a 'below minimum' score on test 3. However, the positive predictive value of an above minimum score on test 2 was only 86%. The knowledge tests used in this study are not suitable in the context of entry selection. However, trainees that score 'below minimum' after eight months of training may be regarded as 'at risk' in that they will probably score 'below minimum' at the end of training.
  British Journal of General Practice 07/1997; 47(419):359-62. · 1.83 Impact Factor
• Source

  Available from: unimaas.nl

  Article: Factors influencing the growth in knowledge of trainees in general practice.

  Y D Van Leeuwen, H Düsman, S S Mol, M C Pollemans, M J Drop, R P Grol, C P Van Der Vleuten
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  ABSTRACT: The relation between the content of postgraduate training for general practice and the outcome in terms of the growth in knowledge of trainees was investigated. The training variables included were: (1) the number of patients seen per day, (2) the trainer, (3) the practice and (4) the theoretical curriculum. Subjects were 58 trainee-trainer pairs. Growth in knowledge was assessed by two written tests administered with eight months interval. Training variables were evaluated by means of questionnaires and logbook-registration. The correlation was explored between each of the training variables and the knowledge tests scores. To correct for interactional effects, a step-wise multiple regression analysis was performed with the second test as dependent variable and the first test as well as the training variables as independent variables. Significant growth in knowledge was demonstrated. Non of all training variables investigated explained the variance in scores on the second test equally good or better than the scores on the entry test. The impact of the separate training-components on the growth in knowledge, remains unclear. We may speculate, that the sort of knowledge assessed with the written literature based true/false test is different from the sort of knowledge transferred during every day training: evidence based knowledge versus experience based knowledge. Equally valid is the conclusion that these findings fit into the theory that in adult learning the outcome is more learner than teacher dependent.
  Advances in Health Sciences Education 02/1997; 2(1):61-70. · 2.09 Impact Factor
• Source

  Available from: ru.nl

  Article: Change in knowledge of general practitioners during their professional careers.

  Y D van Leeuwen, S S Mol, M C Pollemans, M J Drop, R Grol, C P van der Vleuten
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  ABSTRACT: In this study the level of knowledge of general practitioners (GPs) in different stages of their career, from the undergraduate level onwards to more than 20 years after certification, has been investigated. The total body of knowledge as well as the knowledge about different aspects of care was established. Participants were 108 medical students, 445 postgraduate trainees in six different stages of their training and 351 GPs with 5 to more than 20 years of experience. They all took the same written test, designed to assess knowledge closely related to patient care. An increase in test score was found from the start of postgraduate training onwards followed by a decrease starting 5-10 years after certification. The curves for the different aspects of care varied. It is concluded that the body of knowledge of GP-trainees increases during postgraduate training and reaches the level of knowledge of GPs who are less than 10 years certified. From 10 years after certification onwards the knowledge decreases as well as changes over time. The latter had also been found in two American studies relating to the knowledge of certified GPs and internists. The results seem important for the organization and content of postgraduate training and continuous medical education.
  Family Practice 10/1995; 12(3):313-7. · 1.50 Impact Factor
• Article: [Farsightedness; diagnosis by the family physician].

  Y D van Leeuwen, J L Baggen
  Nederlands tijdschrift voor geneeskunde 09/1994; 138(32):1601-3.
• Article: [The test diagram, a visual aid in the interpretation of tests results].

  J L Baggen, P Leffers, Y D van Leeuwen
  Nederlands tijdschrift voor geneeskunde 10/1984; 128(35):1656-9.