Cum Laude for Robert Willemsen

He has studied the diagnostic problems of assessing chest pain in primary care. He has seen that the frequency of chest pain, presented to a general practitioner (GP) is high in the Netherlands.

He has also seen that a GP misses an infarction rarely but 70,000 patients are referred to a cardiologist immediately without eventually having an infarction or any severe disease. GP's feel comfortable with this level of over referral since few infarctions are missed this way.

A clinical decision rule (CDR) consisting of symptoms and a point of care test should lead to a reduction in referrals of patients without infarction of 40% in order to become cost neutral. Such CDRs including a point of care test were tested. However, no CDR performed better than the classic judgment by the GP without aid of a CDR.