Lessons from a decade of technical–scientific opinions in obstetrical litigation

Domingues, Ana Patrícia; Moura, Paulo; Vieira, Duarte Nuno

doi:10.1016/j.jflm.2014.04.012

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…On the contrary, because of the increase in the demand for evidence-based medicine and increase in litigation encountered in medical practice, we may advocate that confirmatory test for syphilis is introduced in routine antenatal testing to reduce the problem of false positives. 29 The adverse effect of the use of benzathine penicillin has been reported. Such adverse effects are of special interest to health care administrators and World Health Organization.…”

Section: Discussionmentioning

confidence: 99%

Is routine antenatal venereal disease research laboratory test still justified? Nigerian experience

Nwosu¹,

Eleje²,

Obi-Nwosu

et al. 2015

IJWH

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ObjectiveTo determine the seroreactivity of pregnant women to syphilis in order to justify the need for routine antenatal syphilis screening.MethodsA multicenter retrospective analysis of routine antenatal venereal disease research laboratory (VDRL) test results between 1 September 2010 and 31 August 2012 at three specialist care hospitals in south-east Nigeria was done. A reactive VDRL result is subjected for confirmation using Treponema pallidum hemagglutination assay test. Analysis was by Epi Info 2008 version 3.5.1 and Stata/IC version 10.ResultsAdequate records were available regarding 2,156 patients and were thus reviewed. The mean age of the women was 27.4 years (±3.34), and mean gestational age was 26.4 weeks (±6.36). Only 15 cases (0.70%) were seropositive to VDRL. Confirmatory T. pallidum hemagglutination assay was positive in 4 of the 15 cases, giving an overall prevalence of 0.19% and a false-positive rate of 73.3%. There was no significant difference in the prevalence of syphilis in relation to maternal age and parity (P>0.05).ConclusionWhile the prevalence of syphilis is extremely low in the antenatal care population at the three specialist care hospitals in south-east Nigeria, false-positive rate is high and prevalence did not significantly vary with maternal age or parity. Because syphilis is still a serious but preventable and curable disease, screening with VDRL alone, without confirmatory tests may not be justified. Because of the increase in the demand for evidence-based medicine and litigation encountered in medical practice, we may advocate that confirmatory test for syphilis is introduced in routine antenatal testing to reduce the problem of false positives. The government should increase the health budget that will include free routine antenatal testing including the T. pallidum hemagglutination assay.

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Section: Discussionmentioning

confidence: 99%

Is routine antenatal venereal disease research laboratory test still justified? Nigerian experience

Nwosu¹,

Eleje²,

Obi-Nwosu

et al. 2015

IJWH

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“…The studies were published during 1972–2021. Among those, the 50 European studies included in this systematic review2 3 5–8 16–20 22–25 34–68 were published during 1995–2020 with a steep increase in publications during the recent years (table 1, figure 2).…”

Section: Resultsmentioning

confidence: 99%

How defensive medicine is defined in European medical literature: a systematic review

et al. 2022

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ObjectivesDefensive medicine has originally been defined as motivated by fear of malpractice litigation. However, the term is frequently used in Europe where most countries have a no-fault malpractice system. The objectives of this systematic review were to explore the definition of the term ‘defensive medicine’ in European original medical literature and to identify the motives stated therein.DesignSystematic review.Data sourcesPubMed, Embase and Cochrane, 3 February 2020, with an updated search on 6 March 2021.MethodsFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we reviewed all European original peer-reviewed studies fully or partially investigating ‘defensive medicine’.ResultsWe identified a total of 50 studies. First, we divided these into two categories: the first category consisting of studies defining defensive medicine by using a narrow definition and the second category comprising studies in which defensive medicine was defined using a broad definition. In 23 of the studies(46%), defensive medicine was defined narrowly as: health professionals’ deviation from sound medical practice motivated by a wish to reduce exposure to malpractice litigation. In 27 studies (54%), a broad definition was applied adding … or other self-protective motives. These self-protective motives, different from fear of malpractice litigation, were grouped into four categories: fear of patient dissatisfaction, fear of overlooking a severe diagnosis, fear of negative publicity and unconscious defensive medicine. Studies applying the narrow and broad definitions of defensive medicine did not differ regarding publication year, country, medical specialty, research quality or number of citations.ConclusionsIn European research, the narrow definition of defensive medicine as exclusively motivated by fear of litigation is often broadened to include other self-protective motives. In order to compare results pertaining to defensive medicine across countries, future studies are recommended to specify whether they are using the narrow or broad definition of defensive medicine.PROSPERO registration numberCRD42020167215.

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“…The technical-scientific opinions emitted by the Council regarding each case and the influence of the clinical files quality on these conclusions was reported and commented elsewhere 20,21 .…”

Section: Discussionmentioning

confidence: 99%

Medico-legal litigation in Obstetrics: a characterization analysis of a decade in Portugal

Domingues¹,

Belo²,

Moura³

et al. 2015

Rev. Bras. Ginecol. Obstet.

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Lessons from a decade of technical–scientific opinions in obstetrical litigation

Cited by 6 publications

References 19 publications

Is routine antenatal venereal disease research laboratory test still justified? Nigerian experience

Is routine antenatal venereal disease research laboratory test still justified? Nigerian experience

How defensive medicine is defined in European medical literature: a systematic review

Medico-legal litigation in Obstetrics: a characterization analysis of a decade in Portugal

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