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The consistency of experts' evaluation of obstetric claims for compensation
Author(s) -
Andreasen S,
Backe B,
Lydersen S,
Øvrebø K,
Øian P
Publication year - 2015
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.12979
Subject(s) - shoulder dystocia , carelessness , consistency (knowledge bases) , medicine , cohen's kappa , compensation (psychology) , kappa , choking , harm , asphyxia , psychology , pediatrics , statistics , pregnancy , social psychology , psychiatry , linguistics , genetics , geometry , mathematics , philosophy , anatomy , biology
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 AC 1. 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/ AC 1 = 0.54) and causality (Fleiss' kappa = 0.41/ AC 1 = 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.