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Peer Review
Journal Articles
- Caplan RA, Posner K, Ward RJ, Cheney FW: Peer reviewer agreement
for major anesthetic mishaps. Quality Review Bulletin 14:363-368,
1988. [NLM PubMed Link] See also: Quality of
Care.
- A study of the reliability of closed claims reviewer judgments
about standard of care, presence or absence of human error,
and the role of better monitoring in the prevention of anesthetic
mishaps.
Forty-two anesthesiologists reviewed 48 closed claim abstracts
of anesthetic mishaps. The data demonstrated that anesthesiologists
from widely different backgrounds can produce a cohesive set
of judgments about anesthetic mishaps.
- Posner KL, Sampson PD, Caplan RA, Ward RJ, Cheney FW: Measuring
interrater reliability among multiple raters: An example of methods
for nominal data. Statistics in Medicine 9:1103-1115, 1990.
- This paper describes some of the statistical refinements
utilized to measure interrater reliability in the ASA Closed
Claims Project.
- Caplan RA, Posner K, Cheney FW: Effect of outcome on physician
judgments of appropriateness of care. JAMA 265:1957-1960,
1991. [NLM PubMed Link] See also: Quality of Care.
Order this article from: ASA Closed Claims
Project.
- Twenty-one cases which involved adverse anesthetic outcome
were reviewed by 112 practicing anesthesiologists who were asked
to judge the standard of care. Matched sets of cases were judged
which differed only in outcome. A significant inverse relationship
was noted between severity of outcome and appropriateness of
care. For the same clinical scenario, as the severity of patient
injury increased care was more apt to be judged substandard.
- Posner KL, Caplan RA, Cheney FW: Variation in expert opinion
in medical malpractice review. Anesthesiology 85:1049-54,
1996. [Abstract, NLM PubMed Link] See also: Malpractice System.
- Medical experts in malpractice claim review rely on implicit (personal,unstated)
rather than explicit (stated prior to review) criteria in assessing
whether the standard of care was met. The data collection process
of the ASA Closed Claims Project was used to investigate the role
of this implicit assessment process in expert opinion. Reviewing
original documents, anesthesiologists agreed on 62% of claims
and disagreed on 38%, suggesting that divergent opinions may be
easily found in seeking opinions from multiple experts.
Newsletter Articles
- Caplan, RA: Is peer review biased? ASA Newsletter 55(6):5-7,
1991.
- Caplan RA, Posner KL: The expert witness: Insights from the
Closed Claims Project. ASA Newsletter 61(6):9-10, 1997.
[Full Text] See also: Malpractice System
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