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 > VIS-project
 Wat bevalt beter




The Value of Information Study

Diagnostic and screening tests in health care are predominantly evaluated for their ability to support treatment decisions. In daily clinical practice, however, medical tests may also have additional effects on patients’ health apart from the consequences of subsequent management decisions. For example, testing may provide reassurance if patients feel uncertain about their condition. Alternatively, testing may provoke anxiety as tests may reveal bad news. Or by providing information to patients about their medical condition, test may trigger patients to alter their behavior and lifestyle.


To comprehensively assess the health-related consequences of a medical test, all its relevant effects should be evaluated, thus including the additional effects of testing that arise independently of the subsequent management decisions. At present, the ranges of these additional effects of testing and its mechanisms have not been systematically documented. A clear understanding of the mechanisms underlying these additional effects may help to optimize the benefits of using tests in clinical practice. This study will explore additional effects of testing on patients’ outcomes.

Study design

The range and mechanisms of additional effects of medical testing will be explored in focus group discussions with medical professionals. The focus group discussions will be transcribed verbatim. Transcriptions will be coded inductively and analyzed by three researchers. Based on this data we will construct a framework of additional effects of medical tests and their mechanisms.


Secondly, we will investigate additional effects of medical testing from a patients’ perspective. We will conduct semi-structured interviews with different groups of patients. This data will be used to adjust the conceptual framework of additional effects of medical testing.


Finally, we will use the results from the focus groups and patient interviews to develop an instrument that assists health researchers to systematically identify potential additional effects of medical testing. This instrument will be designed as a simple checklist, accompanied with instructions and explanations of each item. The instrument will be briefly evaluated for its psychometric properties:

Time schedule
September 2008 – December 2010

Main researcher

Jolande Y. Vis, research physician, AMC.


Brent C. Opmeer, epidemiologist, KEBB, AMC.

Prof. Ben Willem J. Mol, gynecologist / epidemiologist, AMC.

Prof. Patrick M.M. Bossuyt, epidemiologist, KEBB, AMC.


Other steering board members

Prof. Carl (K.)G.M. Moons, epidemiologist, Julius Center, UMCU.

Kirsten J. McCaffery, senior research fellow, School of Public Health, University of Sydney.

Myra C. van Zwieten, ethicist and qualitative health researcher, AMC.

Marcel G.W. Dijkgraaf, epidemiologist, AMC.

ZonMw, The Netherlands Organisation for Health Research and Development.

Dossier number 80-82325-98-8011.




Jolande Y. Vis, MD, MSc.

Email: j.y.vis@amc.nl

Tel: +31(0)6-49834988