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2. Experimental studies to improve the reliability and validity of regulatory judgments on health care in the Netherlands: a randomized controlled trial and before and after case study

Author

van den Bergh, Huub, Tuijn, S., Robben, P.B.M., F, Janssen, LS OZ vakdidactiek Nederlands, LS taalbeheersing van het Nederlands, and ILS L&E

Subjects
evaluation, health services research
Abstract

Rationale, aims and objectives We examined the effect of two interventions on both the reliability and validity of regulatory judgments: adjusting the regulatory instrument and attending a consensus meeting. Method We adjusted the regulatory instrument. With a randomized controlled trial (RCT) we examined the effect of the adjustments we made to the instrument. In the consensus meeting inspectors discussed cases and had to reach consensus about the order of the cases. We used a before and after case study to assess the effect of the consensus meeting. We compared the judgments assigned in the RCT with the unadjusted instrument with the judgments assigned with the unadjusted instrument after the consensus meeting. Moreover we explored the effect of increasing the number of inspectors per regulatory visit based on the estimates of the two interventions. Results The consensus meeting improved the agreement between inspectors; the variance between inspectors was smallest (0.03) and the reliability coefficient was highest (0.59). Validity is assessed by examining the relation between the assigned judgments and the corporate standard and expressed by a correlation coefficient. This coefficient was highest after the consensus meeting (0.48). Adjustment of the instrument did not increase reliability and validity coefficients. Conclusions Participating in a consensus meeting improved reliability and validity. Increasing the number of inspectors resulted in both higher reliability and validity values. Organizing consensus meetings and increasing the number of inspectors per regulatory visit seem to be valuable interventions for improving regulatory judgments.

Published
2014

4. Het sondeproject: een nieuwe dimensie in medicatiebegeleiding door de medicatieveiligheid

Author

van den Bemt, P.M.L.A., Wagner, C., van der Wal, G., Tuijn, S., Population-based studies of drug treatment: from molecule to patient outcomes, Universiteit Utrecht, and Dep Farmaceutische wetenschappen

Subjects
Farmacie/Biofarmaceutische wetenschappen (FARM), Ziekenhuisstructuur en organisatie van de gezondheidszorg, Epidemiology, Farmacie(FARM), Public Health, Biomedische technologie en medicijnen
Published
2005

6. Het sturend effect van vragen met voorbeeldantwoorden in een face-to-face setting

Author

Tuijn, S., van den Bergh, H., Holleman, B.C., Language use, Universiteit Utrecht, and Afd Taalwetenschap

Subjects
Taverne
Abstract

In de prescriptieve literatuur worden vragen met voorbeeldantwoorden sturende vragen genoemd. Bevindingen hierover vanuit een conversatieanalytisch perspectief, spreken deze sturing tegen terwijl resultaten van experimenteel onderzoek op dit gebied deze sturing bevestigen. Om deze controverse op te lossen is middels een experiment nagegaan of vragen met voorbeeldantwoorden sturend zijn in een face-to-face-setting, waarbij betrokkenheid van respondenten bij de thema’s van de vragen een essentiële rol speelt. De vragen zijn geformuleerd in twee varianten met voorbeeldantwoorden (gesloten-complete en gesloten-incomplete variant) en een controlevariant zonder voorbeeldantwoorden (open variant). Uit dit onderzoek blijkt dat de gesloten-incomplete variant van de betrokken vragen wordt opgevat als een open vraag en niet sturend is.Tevens leveren de plaats van afname (wachtkamer versus behandelkamer) en bekendheid met de interviewer significante effecten op. In de behandelkamer wordt vaker een toelichting gegeven en respondenten lichten hun antwoord vaker toe als zij door een onbekende interviewer worden ondervraagd.

Published
2004

8. Het sondeproject: een nieuwe dimensie in medicatiebegeleiding door de medicatieveiligheid

Author

Population-based studies of drug treatment: from molecule to patient outcomes, Universiteit Utrecht, Dep Farmaceutische wetenschappen, van den Bemt, P.M.L.A., Wagner, C., van der Wal, G., Tuijn, S., Population-based studies of drug treatment: from molecule to patient outcomes, Universiteit Utrecht, Dep Farmaceutische wetenschappen, van den Bemt, P.M.L.A., Wagner, C., van der Wal, G., and Tuijn, S.

Published
2005

10. Reducing interrater variability and improving health care: a meta-analytical review.

Author

Tuijn S, Janssens F, Robben P, and van den Bergh H

Subjects
Health Personnel, Humans, Linear Models, Observer Variation, Quality Assurance, Health Care, Research standards
Abstract

Objectives: In the scientific literature about reliability, the main approach to increasing reliability seems to involve increasing the number of observers and improving the instrument used. Other aspects for improving reliability - like the training of raters - seem to receive less notice. It is worth asking whether this technical approach could be complemented by training the user of the instrument. A systematic meta-analytical review of the research literature was performed to answer this question and examine the effectiveness of planned interventions for improving interrater reliability of health care professionals., Method: The databases of PubMed (MEDLINE), Embase, Omega and PsycINFO were searched. The inclusion criteria were met by 57 studies. Details extracted from the studies included the study design, the number of observers and the number of observed cases, the intervention, the type of instrument (whether or not it was highly technical), and statistical information about the agreement before and after the intervention. Interventions were categorized into three groups: training of professionals, improving the diagnostic instrument and a combination of training and improving the instrument. A meta-analysis was performed by means of linear regression., Results: The interventions were arranged according to their effectiveness in improving the diagnostic instrument (mean change: β = 0.13), training combined with improving the instrument (mean change: β = 0.10) and training (mean change: β = 0.09)., Conclusion: On average, although all types of interventions are effective, improving the diagnostic instrument seems to be the most effective. Especially when highly technical instruments were concerned, improvement proved to be very effective (β = 0.52). Because instrumental variables constitute a major source of error, improving the instrument is an important approach. However, this review offers solid arguments that can complement the literature and practice, with a focus on training the user of the instrument., (© 2011 Blackwell Publishing Ltd.)

Published
2012
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