[Physicians' assessments of work capacity in patients with SHC: comparison between five European countries]. / Beoordeling van arbeidsongeschiktheid bij SOLK.

OBJECTIVE: Comparing assessments of incapacity to work in patients with subjective health complaints (SHC) by physicians from 5 different European countries. DESIGN: Cross-sectional study. METHOD: General practitioners from Norway (n=56), Sweden (n=29), Denmark (n=41), France (n=46) and occupational and insurance physicians from the Netherlands (n=93) watched and assessed incapacity to work in nine video vignettes of patients with SHC. We subsequently analysed differences between assessments (whether or not there was incapacity to work) by country, with Norway as a reference, as well as differences between general practitioners from the four countries and occupational and insurance physicians using a generalised linear mixed model. RESULTS: Assessments of incapacity to work by physicians from the 5 countries were generally very similar. However, compared to Norwegian general practitioners, Swedish general practitioners (odds ratio (OR) of 0.43 with 95% confidence interval (CI) of 0.23-0.79) and Dutch occupational and insurance physicians (OR of 0.55 with 95% CI of 0.36-0.86) concluded less often that the patients in the videos were unable to work. There were no differences between general practitioners from the other 2 European countries and those from Norway. The Dutch occupational and insurance physicians also concluded less often that there was an incapacity to work compared to all general practitioners from the other 4 European countries (OR of 0.67 with 95% CI of 0.49-0.93). CONCLUSION: There are significant differences between assessments of incapacity to work in patients with SHC between countries and professional groups, but these differences are generally small. Potential explanations for these differences could be found in occupational and insurance medicine specialist training and in the existence of professional guidelines.

["Traffic lights" in pediatrics: what do residents beginning their family residency know about them?]. / Les « feux tricolores ¼ en pédiatrie : état des lieux des connaissances en début de 3e cycle de médecine générale.

OBJECTIVES: Pediatric practice is a difficult task requiring physicians to discriminate potentially serious situations among a variety of benign situations. The goal of this study was to assess the knowledge of students beginning their residency in family medicine on these situations. METHODS: One hundred and three students were evaluated on pediatric "traffic lights" using 103 true/false questions. Pediatric and family medicine teachers of the Nantes University Hospital defined "traffic lights" as the fundamentals of pediatrics, misleading situations, and diagnosis and treatment that should not to be missed. Emergency levels were defined by colors, with "red light" corresponding to life-threatening emergencies. RESULTS: Thirty-six percent of the questions (n=103) had a correct response rate below 75%. Thirty-two percent of the questions on emergency situations ("red lights") (n=37) had a response rate below 75%. Fifteen percent of the questions (n=103) had a correct response rate below 50%, half of which were "red light" (e.g., on meningitis, diabetic acidocytosis, or shock). Questions concerning infants (n=24) had significantly fewer correct answers (correct response rate below 50%: 29% versus 10%; P=0.047). All the students answered seven questions correctly. The students' mean score (percentage of good answers) was 76% (±6%). No student had 100% or less than 50% good answers. CONCLUSIONS: Some life-threatening situations or situations concerning infants had not been mastered by most of the students. It is therefore essential to optimize the teaching of pediatrics during the second cycle of medical studies.