Kees van Montfort

Life Cycle Characteristics of Small Professional Service Firms

Our study of professional services firms clearly revealed that firms change over the course of their life cycles. During the first three stages, diversification in sales, the differentiation in labor force, and the level of labor productivity increase. In the last stage, diversification in sales, the differentiation in labor force, and the level of labor productivity decrease. Development effects can be treated as interdependent. Our findings show that the effects of growth can be predicted to a certain extent. In efforts towards development, these predictions are important to business strategy, as well as to consultation with and education of SME entrepreneurs.

Addition of bevacizumab to chemotherapy in acute myeloid leukemia at older age: a randomized phase 2 trial of the Dutch-Belgian Cooperative Trial Group for Hemato-Oncology (HOVON) and the Swiss Group for Clinical Cancer Research (SAKK)

An urgent need for new treatment modalities is emerging in elderly patients with acute myeloid leukemia (AML). We hypothesized that targeting VEGF might furnish an effective treatment modality in this population. Elderly patients with AML were randomly assigned in this phase 2 study (n = 171) to receive standard chemotherapy (3 + 7) with or without bevacizumab at a dose of 10 mg/kg intravenously at days 1 and 15. In the second cycle, patients received cytarabine 1000 mg/m(2) twice daily on days 1-6 with or without bevacizumab. The complete remission rates in the 2 arms were not different (65%). Event-free survival at 12 months was 33% for the standard arm versus 30% for the bevacizumab arm; at 24 months, it was 22% and 16%, respectively (P = .42). The frequencies of severe adverse events (SAEs) were higher in the bevacizumab arm (n = 63) compared with the control arm (n = 28; P = .043), but the percentages of death or life-threatening SAEs were lower in the bevacizumab arm (60% vs 75% of SAEs). The results of the present study show that the addition of bevacizumab to standard chemotherapy does not improve the therapeutic outcome of older AML patients. This trial is registered as number NTR904 in The Nederlands Trial Register (www.trialregister.nl).

Screening for obstructive sleep apnea in treacher-collins syndrome

This study evaluated the accuracy of established obstructive sleep apnea syndrome (OSAS) questionnaires based on presenting symptoms and complaints as screening tools for OSAS in Treacher‐Collins syndrome (TCS).

The Development and Validation of a Decision-Analytic Model Representing the Full Disease Course of Acute Myeloid Leukemia

BackgroundThe treatment of acute myeloid leukemia (AML) is moving towards personalized medicine. However, due to the low incidence of AML, it is not always feasible to evaluate the cost-effectiveness of personalized medicine using clinical trials. Decision analytic models provide an alternative data source.ObjectiveThe aim of this study was to develop and validate a decision analytic model that represents the full disease course of AML.MethodsWe used a micro simulation with discrete event components to incorporate both patient and disease heterogeneity. Input parameters were calculated from patient-level data. Two hematologists critically evaluated the model to ensure face validity. Internal and external validity was tested by comparing complete remission (CR) rates and survival outcomes of the model with original data, other clinical trials and a population-based study.ResultsNo significant differences in patient and treatment characteristics, CR rate, 5-year overall and disease-free survival were found between the simulated and original data. External validation showed no significant differences in survival between simulated data and other clinical trials. However, differences existed between the simulated data and a population-based study.ConclusionsThe model developed in this study is proved to be valid for analysis of an AML population participating in a clinical trial. The generalizability of the model to a broader patient population has not been proven yet. Further research is needed to identify differences between the clinical trial population and other AML patients and to incorporate these differences in the model.

Owner-manager motives and the growth of SMEs in developing countries: Evidence from the furniture industry in Tanzania

Purpose – This paper aims to contribute to the understanding of the motives of individuals in Tanzania to start their own businesses on the one hand and the growth of their firms on the other hand. Design/methodology/approach – A survey method was used to gather data from 300 small business owners and managers located in selected cities in Tanzania. Multiple regression analysis was conducted to analyse the relationship between the motivation to start an own business on the one hand and firm growth on the other hand. Three indicators for growth, namely, employment, sales and assets, were used to measure growth. Findings – The results suggest that that pull factors are more important to start the businesses than push factors. This contradicts the common opinion and previous research that push factors are more important than pull factors in developing countries. Furthermore, the study found that pull factors are positively related to firm, whereas push factors are negatively related to firm growth. Research ...

Fifteen years of external quality assessment in leukemia/lymphoma immunophenotyping in the Netherlands and Belgium: A way forward

In 1985, external quality assurance was initiated in the Netherlands to reduce the between‐laboratory variability of leukemia/lymphoma immunophenotyping and to improve diagnostic conclusions. This program consisted of regular distributions of test samples followed by biannual plenary participant meetings in which results were presented and discussed. A scoring system was developed in which the quality of results was rated by systematically reviewing the pre‐analytical, analytical, and post‐analytical assay stages using three scores, i.e., correct (A), minor fault (B), and major fault (C). Here, we report on 90 consecutive samples distributed to 40–61 participating laboratories between 1998 and 2012. Most samples contained >20% aberrant cells, mainly selected from mature lymphoid malignancies (B or T cell) and acute leukemias (myeloid or lymphoblastic). In 2002, minimally required monoclonal antibody (mAb) panels were introduced, whilst methodological guidelines for all three assay stages were implemented.

Competing risks and survival analysis

The analysis of time-to-event data in the presence of competing risks is part of many studies today. However, the impact of the interrelationship between the competing risks on the interpretation of the results seems to be unclear to many researchers, however. We try to provide a guide to researchers interested in analysing competing risks data. Estimation of the cause-specific hazard function, the cumulative incidence function, the Gray test statistic, and the multi-stage models for analysing competing risks data are explained. Furthermore, we apply the theoretical methodology and illustrate the fundamental problems of interpreting the results of competing risk analyses by using empirical data in the field of outcome research in orthopaedics.

Addition of bevacizumab to chemotherapy in acute myeloid leukemia at older age: a randomized phase II trial of HOVON/SAKK

An urgent need for new treatment modalities is emerging in elderly patients with acute myeloid leukemia (AML). We hypothesized that targeting VEGF might furnish an effective treatment modality in this population. Elderly patients with AML were randomly assigned in this phase 2 study (n = 171) to receive standard chemotherapy (3 + 7) with or without bevacizumab at a dose of 10 mg/kg intravenously at days 1 and 15. In the second cycle, patients received cytarabine 1000 mg/m(2) twice daily on days 1-6 with or without bevacizumab. The complete remission rates in the 2 arms were not different (65%). Event-free survival at 12 months was 33% for the standard arm versus 30% for the bevacizumab arm; at 24 months, it was 22% and 16%, respectively (P = .42). The frequencies of severe adverse events (SAEs) were higher in the bevacizumab arm (n = 63) compared with the control arm (n = 28; P = .043), but the percentages of death or life-threatening SAEs were lower in the bevacizumab arm (60% vs 75% of SAEs). The results of the present study show that the addition of bevacizumab to standard chemotherapy does not improve the therapeutic outcome of older AML patients. This trial is registered as number NTR904 in The Nederlands Trial Register (www.trialregister.nl).

Emergency situations in SMEs: are entrepreneurs prepared?

Acute emergency situations in the personal life of the entrepreneurs in small and medium-sized enterprises (SMEs) can play an important role in the premature, involuntary cessation of businesses. In this paper, it is empirically investigated how entrepreneurs prepare for these emergency situations (disablement, death, prolonged illness, and divorce). Only a small minority of the entrepreneurs in our sample had prepared well for all four emergency situations. The age of the entrepreneur and firm size both influence this preparation. Furthermore, previous experience of a certain emergency situation leads to better preparation for such an emergency situation in the future.

Addition of bevacizumab to chemotherapy in acute myeloid leukemia at older age

An urgent need for new treatment modalities is emerging in elderly patients with acute myeloid leukemia (AML). We hypothesized that targeting VEGF might furnish an effective treatment modality in this population. Elderly patients with AML were randomly assigned in this phase 2 study (n = 171) to receive standard chemotherapy (3 + 7) with or without bevacizumab at a dose of 10 mg/kg intravenously at days 1 and 15. In the second cycle, patients received cytarabine 1000 mg/m(2) twice daily on days 1-6 with or without bevacizumab. The complete remission rates in the 2 arms were not different (65%). Event-free survival at 12 months was 33% for the standard arm versus 30% for the bevacizumab arm; at 24 months, it was 22% and 16%, respectively (P = .42). The frequencies of severe adverse events (SAEs) were higher in the bevacizumab arm (n = 63) compared with the control arm (n = 28; P = .043), but the percentages of death or life-threatening SAEs were lower in the bevacizumab arm (60% vs 75% of SAEs). The results of the present study show that the addition of bevacizumab to standard chemotherapy does not improve the therapeutic outcome of older AML patients. This trial is registered as number NTR904 in The Nederlands Trial Register (www.trialregister.nl).