The Consistency of Experts’ Evaluation of Obstetric Claims for Compensation

Andreasen, Stine; Backe, Bjørn; Lydersen, Stian; Øvrebø, Kjell; Øian, Pål

doi:10.1097/01.aoa.0000482605.72173.4f

Cited by 4 publications

(4 citation statements)

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“…The absolute agreement value provides a sensible value of unity when all experts agree; however, absolute agreement does not adjust for agreement by chance. 23 Of 42 cases, 2 were excluded from the regression analysis due to lack of time estimates. In 2 other cases, the time component for quality assurance was missing, and we imputed this component based on all of the other time components of all of the other cases.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Time Consumption and Quality of Responses to Drug-related Queries: A Study From Seven Drug Information Centers in Scandinavia

Reppe

Lydersen

Schjøtt

et al. 2016

Clinical Therapeutics

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Section: Discussionmentioning

confidence: 99%

Relationship Between Time Consumption and Quality of Responses to Drug-related Queries: A Study From Seven Drug Information Centers in Scandinavia

Reppe

Lydersen

Schjøtt

et al. 2016

Clinical Therapeutics

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“…The Norwegian System of Patient Injury Compensation evaluates all claims for patient compensation in Norway. Whereas previous studies reviewing claims for compensation to the NPE have been published, no investigation of treatment failure connected to gynecological conditions has been carried out.…”

Section: Introductionmentioning

confidence: 99%

Approved claims for compensation from gynecological patients in Norway—What characterizes the cases? A 14‐year nationwide study

Ravlo

Lieng

Bukholm

et al. 2019

Acta Obstet Gynecol Scand

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Introduction The Norwegian System of Patient Injury Compensation (NPE) evaluates all patient‐reported claims in Norway. Our aim was to study the cases from gynecological patients approved by NPE in order to identify the main reasons for the injuries, the consequences of the treatment failure for the women, and the time course when the treatment failure occurred. Material and methods A retrospective, descriptive study of approved gynecological compensation claims during a 14‐year period, based on patient files from NPE. Results In all, 1454 women claimed compensation for injury related to gynecological treatment in Norway from 2000 to 2013. Compensation was approved for 438 (30.1%) women. Eleven women declined participation in the study and 16 cases were excluded, leaving 411 cases for further analyses. Consent to participate was given by 211 (51.3%) women, who gave full access to all their NPE files. Anonymized resumes and expert statements were used for the 138 (33.6%) women who did not respond and the 62 (15.1%) women who were deceased. Guidelines or good clinical practice were not followed in 40.5% of the cases. The most common reasons for injury were surgical complications (67.6%), delayed (22.4%) and incorrect (17.0%) diagnoses, and failure of communication (11.7%). The main consequences of injuries were need for extensive treatment (64.2%), permanent injury (55.2%) and impaired physical ability (41.9%). Worsening of cancer prognosis occurred in 58 women (14.1%) and death due to treatment failure in 29 (7.1%) women. Most failures occurred during the treatment period (75.2%). Conclusions We found that the main reason for injuries in gynecological patients was non‐adherence to guidelines or good clinical practice. Surgery‐related injuries were most common. Increased focus on adherence to guidelines and surgical skills might improve patient safety for gynecological patients in Norway.

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“…To overcome the kappa paradox, which occurs when high raters' agreement can be translated into misleading smaller kappa values, we also determined Gwet's AC1 analysis. [14][15][16] We interpreted Gwet's AC1 analysis using the same parameters as those used for Fleiss' kappa. 15 Analyses were completed using SPSS version 17.0 (IBM, Armonk, NY) and STATA version 12 (StataCorp, College Station, TX).…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Physicians in Differentiating Type 1 and Type 2 Myocardial Infarction Based on Clinical Information

et al. 2020

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Background Physicians commonly judge whether a myocardial infarction (MI) is type 1 (thrombotic) vs type 2 (supply/demand mismatch) based on clinical information. Little is known about the accuracy of physicians’ clinical judgement in this regard. We aimed to determine the accuracy of physicians’ judgement in the classification of type 1 vs type 2 MI in perioperative and nonoperative settings. Methods We performed an online survey using cases from the Op tical Coherence T omographic Im aging of Thromb us (OPTIMUS) Study, which investigated the prevalence of a culprit lesion thrombus based on intracoronary optical coherence tomography (OCT) in patients experiencing MI. Four MI cases, 2 perioperative and 2 nonoperative, were selected randomly, stratified by etiology. Physicians were provided with the patient’s medical history, laboratory parameters, and electrocardiograms. Physicians did not have access to intracoronary OCT results. The primary outcome was the accuracy of physicians' judgement of MI etiology, measured as raw agreement between physicians and intracoronary OCT findings. Fleiss’ kappa and Gwet’s AC1 were calculated to correct for chance. Results The response rate was 57% (308 of 536). Respondents were 62% male; median age was 45 years (standard deviation ± 11); 45% had been in practice for > 15 years. Respondents’ overall accuracy for MI etiology was 60% (95% confidence interval [CI] 57%-63%), including 63% (95% CI 60%-68%) for nonoperative cases, and 56% (95% CI 52%-60%) for perioperative cases. Overall chance-corrected agreement was poor (kappa = 0.05), consistent across specialties and clinical scenarios. Conclusions Physician accuracy in determining MI etiology based on clinical information is poor. Physicians should consider results from other testing, such as invasive coronary angiography, when determining MI etiology.

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The Consistency of Experts’ Evaluation of Obstetric Claims for Compensation

Cited by 4 publications

References 0 publications

Relationship Between Time Consumption and Quality of Responses to Drug-related Queries: A Study From Seven Drug Information Centers in Scandinavia

Relationship Between Time Consumption and Quality of Responses to Drug-related Queries: A Study From Seven Drug Information Centers in Scandinavia

Approved claims for compensation from gynecological patients in Norway—What characterizes the cases? A 14‐year nationwide study

Accuracy of Physicians in Differentiating Type 1 and Type 2 Myocardial Infarction Based on Clinical Information

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