The reliability of peer assessments of quality of care
Article Abstract:
Doctors may disagree on the quality of care patients receive, and this could affect the reliability of peer assessment in hospital quality assurance programs. A review of 12 studies of the agreement between two or more doctors reviewing patient care found that most reported a high degree of disagreement. Several doctors should be assigned to review a patient's medical care, and they should discuss the care as a group if they disagree about its quality. Doctors should be given more structured assessment tools, and only doctors who are experts in the patient's condition should review their colleague's care. Statistical techniques can be used to eliminate the tendency of some doctors to consistently judge medical care harshly or leniently. Objective practice guidelines could be used to eliminate subjectivity. Peer review in medical practice is likely to remain important; improving its reliability seems equally important.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1992
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Are Guidelines Following Guidelines? The Methodological Quality of Clinical Practice Guidelines in the Peer-Reviewed Medical Literature
Article Abstract:
Many groups that develop practice guidelines do not follow standards proposed for creating such guidelines. Practice guidelines are documents written for doctors that cover the best ways to diagnose or treat a disease. Most are based on evidence in the scientific literature and are therefore a component of evidence-based medicine. Researchers analyzed how well 279 practice guidelines produced by 69 different groups adhered to standards established by various professional societies. Overall, the guidelines only followed 43% of the standards. The biggest deficiency occurred in the identification and evaluation of scientific evidence.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1999
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