Clinical decision making about late malformation in pregnancy


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Title Clinical decision making about late malformation in pregnancy
Period 07 / 2002 - 05 / 2007
Status Completed
Dissertation Yes
Research number OND1286244


- Project summary: This multidisciplinary prospective study aims at collecting data about the clinical decision making process for unborn infants with structural abnormalities, detected by ultrasonography. The role and opinions of all medical professionals participating in the decision making process are being studied, as well as the outcome of the decision making process and its implementation. Furthermore the role, feelings and concerns of parents will be assessed. The results of this study will provide an empirical background for the scientific and societal discussion on clinical decision making concerning seriously ill unborn infants and to the establishment of guidelines for good clinical practice in this field. Both qualitative and quantitative methods are used to assess the decision making process. Parental decision making and its outcome are assessed by interviews with 150 women during and after pregnancy and a validated questionnaire after pregnancy. Decision making by physicians is examined by measurement of the multidisciplinary perinatal meeting. Opinions of the members of this team before and after discussing a case are being assessed in 75 cases. The decision making process during this meeting is observed systematically by means of a checklist. Furthermore a study regarding the outcome and determinants of the decision making process of all cases of the last five years is being performed. - Progress: A detailed research plan has been developed and collaboration from the physicians involved in decision making has been gained. Furthermore several instruments assessing the decision making process were developed and tested. Data of decision making in 80 women and their partners have been collected, as well as data of 60 cases discussed in the multidisciplinary perinatal team. The determinants, outcome and implementation of decision making in the multidisciplinary perinatal team in 318 cases, discussed in the last five years, have been analysed.

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Supervisor Prof.dr. P.J. van der Maas
Supervisor Prof.dr. J.W. Wladimiroff
Doctoral/PhD student Dr. H.H. Bijma


D23220 Internal medicine
D23350 Psychiatry, clinical psychology
D23361 Neonatology

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