The consistency of experts' evaluation of obstetric claims for compensation

Objective The aim of this study was to investigate the consistency of experts' evaluation of different types of obstetric claims for compensation. Design Inter‐rater reliability study of obstetric claims for compensation. Setting Medical experts' evaluation in The Norwegian System of Compe...

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Bibliographic Details
Published in:BJOG : an international journal of obstetrics and gynaecology 2015-06, Vol.122 (7), p.948-953
Main Authors: Andreasen, S, Backe, B, Lydersen, S, Øvrebø, K, Øian, P
Format: Article
Language:English
Subjects:
Agreement
Compensation and Redress
consistency
Female
guidelines
Humans
inter‐rater reliability
Malpractice - statistics & numerical data
Medical Errors - statistics & numerical data
medical experts
negligence
Norway - epidemiology
Observer Variation
obstetrics
Obstetrics - statistics & numerical data
Pregnancy
Surveys and Questionnaires
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Summary:Objective The aim of this study was to investigate the consistency of experts' evaluation of different types of obstetric claims for compensation. Design Inter‐rater reliability study of obstetric claims for compensation. Setting Medical experts' evaluation in The Norwegian System of Compensation to Patients, a no‐blame system. Sample The 15 most frequently used medical experts were asked to evaluate 12 obstetric claims applied for compensation. Methods Inter‐rater agreement was assessed by absolute agreement, Fleiss' kappa statistic and Gwet's AC1. Main outcome measures Consistency in the evaluation of negligence (carelessness without intention to harm) and causality (relation between care and injury) between negligence and patient injury. Results The experts demonstrated moderate consistency in their evaluation of negligence (Fleiss' kappa = 0.53/AC1 = 0.54) and causality (Fleiss' kappa = 0.41/AC1 = 0.54). There was a higher level of agreement in clinical scenarios with well‐documented diagnostic criteria and guidelines, including shoulder dystocia and asphyxia with low Apgar score and metabolic acidosis. Conclusion We found a moderate level of agreement in experts' evaluation of negligence and causality between the injury and provided health care, the two most important questions to be answered in obstetric claims for compensation.
ISSN:1470-0328
1471-0528
DOI:10.1111/1471-0528.12979