Chapter 8 188 were actually about end-of-life care. They felt that end-of-life care, if taught, seemed to be intertwined with other topics. This may have biased the results in both positive and negative directions. To minimise this effect, all respondents were interviewed about their answers in the questionnaire. Data were provided of 15 out of 16 bachelor and master curricula in the Netherlands. Unfortunately, data from one master curriculum were not provided despite repeated reminders. Since data from the 15 other curricula were collected and analysed, this study still provides a reliable overview of end-of-life care in Dutch undergraduate medical curricula in 2015-2016. All elective courses were assessed by the researchers using the checklist. Any electives that were not found in study brochures were therefore not included, but it seems unlikely any electives were missed. In Chapter 3 and Chapter 4, we performed a mortality follow-back study in patients with advanced cancer or a haematological malignancy visiting the Emergency Department (ED) in the last three months of their lives in 2011-2013. A follow-back timeframe of three months was chosen because a life-expectancy of three months or less is an indication for referral to palliative-terminal care in the Netherlands. Including patients who died up to three months after their ED-visit gives pragmatic insight into the end-of-life trajectories of these patients, and into the intensity of care provided to them. Because we collected data retrospectively, there is a risk of registration bias and unmeasured confounding. Our study design choice for a mortality follow-up back study instead of a retrospective cohort study including all visiting the ED in 2011-2013 has important consequences. Since those who did not die within 3 months were not included, analysis of risk factors for approaching death after the ED-visit are only representative for those who will eventually die within three months. In Chapter 5, the performance of the Surprise Question (SQ) in patients with advanced cancer visiting the ED is evaluated using a prospective observational design. E-questionnaires including the SQ were sent to attending physicians within one working day from the patient’s ED-visit. Although e-questionnaires were sent as soon as possible, there might be some recall bias from attending physicians particularly remembering patients who were sicker than other patients. Patient data were retrospectively collected from their charts, which may have introduced bias by under-registration of characteristics and symptoms. Under-registration of symptoms that are prevalent in the palliative phase is possible because these symptoms are not routinely screened in our ED. Chapter 6 describes an observational study on symptom burden and information needs of patients referred to a hospital palliative care consultation team between 2013 and 2018 and who had used the Leiden Guide on Palliative care (LGP). In the LGP, the Utrecht
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