Knepper S
Ned Tijdschr Geneeskd. 2005 Dec 3;149(49):2712-4.
As requested by the Minister for Social Services and Employment, the Health Council of The Netherlands reviewed existing medical guidelines on the assessment, treatment and counselling of patients claiming sick leave and disability. These guidelines were developed separately by physicians concerned with their own specific fields. The Health Council recommends the development of more encompassing guidelines, based on scientific evidence whenever possible, starting with 10 diagnoses that frequently lead to long-term industrial disability. The assessment of long-term disability is complex and varies for each individual. The contribution of scientific 'evidence' remains modest. It is not possible to predict permanent disability with lists of diseases and corresponding medical prognoses. It may be possible to support the assessment by 'mediprudence', cases of example. The recommendation of the Health Council offers perspective toward qualitatively improved assessment of the effects of diseases on patient functioning.
应社会服务与就业部长的要求，荷兰卫生委员会审查了关于对申请病假和残疾补助的患者进行评估、治疗及咨询的现有医学指南。这些指南是由各相关特定领域的医生分别制定的。卫生委员会建议制定更具综合性的指南，尽可能以科学证据为基础，先从10种经常导致长期工伤残疾的诊断入手。长期残疾的评估很复杂，因人而异。科学“证据”的作用仍很有限。根据疾病清单和相应的医学预后无法预测永久性残疾。或许可以通过“医疗审慎”（实例）来辅助评估。卫生委员会的建议为定性改善对疾病对患者功能影响的评估提供了方向。
