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PubMed1988

The effects of peer review in general practice.

This paper describes the effects of an intensive, structured programme of peer review on the behaviour of general practitioners. Trained assessors evaluated 43 doctors before and after participating in the programme. Both the medical and non-medical performance of the general practitioners was assessed using a previously tested measuring instrument. In addition, the prescribing behaviour of the participants was compared with that of a control group. After taking part in the programme, the work of the general practitioners conformed more closely to a number of criteria for good general practice care. This was particularly true for clarifying the questions and expectations of the patients, active stimulation of patient involvement, history taking and providing information and advice to patients. The greatest change occurred among general practitioners who had previously conformed least with the established criteria. During peer review participants in the project prescribed fewer drugs, such as analgesics, tranquillizers and antibiotics, than before peer review while non-participants prescribed more. The value of these changes is discussed.

Family Practice↗

PubMed2006

Scientific peer review to inform regulatory decision making: leadership responsibilities and cautions.

The article offers insights on the peer-review process as it relates to scientific and technical reports used to inform regulatory decisions. Used effectively, peer review is a powerful tool for advising organizational leaders whether the scientific foundations of their decisions can be expected to withstand scrutiny as rule-making products move through interagency reviews, public comment and stakeholder processes, congressional oversight, and judicial review. The emphasis is "heads up" rather than "how to." That is, without delving into myriad technical and administrative details, the discussion highlights nine fundamental "leadership responsibilities" that determine the nature and course of peer review.

Conflict of Interest↗

PubMed1992

Evaluation of TRISS as a means of selecting trauma deaths for clinical peer review.

This study was carried out to evaluate the predictive power of a mathematical model called TRISS in identifying avoidable trauma deaths when compared with peer review (PR). The subjects studied comprised the 24 deaths that occurred among 81 severely injured patients (Injury Severity Score greater than or equal to 16) admitted to a trauma unit over a 1 year period. Sixteen patients who had a greater than 50% probability of survival (Ps) calculated by TRISS died. Peer review concluded that five of those were potentially avoidable deaths. Eight deaths occurred in patients with a Ps less than 50%. Peer review regarded those eight as inevitable deaths. The data, when analysed, showed TRISS to have a 100% sensitivity, 42% specificity, 31% positive predictive value and a negative predictive value of 100% when compared with peer review. It is concluded that TRISS tends to over-estimate potentially avoidable death, especially in patients with severe head injury. However it is a good audit filter as it reliably excludes inevitable death.

Age Factors↗

PubMed1999

Peer review committee is learning laboratory.

The peer review process benefits dentists, their patients and the volunteers who conduct the process and learn its most valuable lessons. These lessons are to keep impeccable records, charge reasonable fees while maintaining high standards, make sure treatment plans are appropriate, refrain from disparaging the work of colleagues, and be an effective communicator.

Communication↗

PubMed1988

The impact of Patrick v. Burget on peer review.

In analyzing the effect of Patrick v. Burget upon peer review, the authors conclude that the decision was not "an atom bomb" and that physicians who wish to work for changes in state law to ensure the availability of the state action exemption for peer review actions will find substantial guidance in the decision.

Economic Competition↗

PubMed2003

Evaluating an instrument for the peer review of inpatient teaching.

The purpose of this study was to assess an instrument for the peer review of inpatient teaching at Mayo. The Mayo Teaching Evaluation Form (MTEF) is an instrument, based on the Stanford seven-category educational framework, which was developed for the peer review of inpatient teaching. The MTEF has 28 Likert-scaled items derived from the Stanford Faculty Development Program form (SFDP-26), the Mayo electronic evaluation form and three additional items. In this study three physician-evaluators used the MTEF to evaluate 10 attending physicians on the Mayo general internal medicine hospital services. Cronbach's alphas were used to assess the internal consistency of the MTEF, and Kendall's coefficient of concordance was used to summarize the inter-rater reliability. Results of this study reveal that the MTEF is internally consistent, based on average ratings across all evaluators (Cronbach's alpha=0.894). Stanford categories with the highest alphas are Self-Directed Learning, Learning Climate, Communication of Goals, and Evaluation. Categories with lower alphas are Feedback, Understanding and Retention, and Control of Teaching Session. Additionally, the majority of items on the MTEF show significant agreement across all evaluators, and teacher enthusiasm was among the most reliable items. In conclusion, the MTEF is overall internally consistent for the peer review of inpatient teaching at Mayo. Hence, the MTEF may be a useful element in the peer evaluation of teaching at our institution.

Education, Medical↗

PubMed1994

Special report on medical staff relationships. Ninth Circuit buttresses peer review immunities.

Following on the heels of Austin, the Fobbs and Smith decisions may result in a significant reduction in the number of federal antitrust claims filed by aggrieved physicians in the context of peer review actions. However, by permitting claims of discrimination and conspiracy to go forward in the Fobbs case, the Ninth Circuit may have encouraged the filing of more suits against peer reviewers based on these types of claims, rather than on antitrust theories. In order to benefit from HCQIA's immunities, medical staffs are once again admonished to review, and revise when necessary their medical staff bylaws and peer review policies to provide for adequate notice and hearing, and to assure that peer review participants are well informed about and carefully comply with all of HCQIA's requirements.

Antitrust Laws↗

PubMed2004

Educational interventions to improve practice of nonspecialty physicians who are identified in need by peer review.

This article reports on the peer review process of the College of Physicians and Surgeons of Ontario, the licensing and regulatory authority, and the effect of educational interventions on physicians identified to be in need. Since 1980, the college has assessed more than 175 random and targeted nonspecialist physicians each year. A structured remediation process has been employed for those in need. Extensive data files have been maintained by the college. A majority of physicians identified as needing improvement improved and maintained their improved performance. The simple structured interventions employed by the college demonstrate an educational intervention that produces practice improvement.

Age Factors↗

PubMedDate not supplied

Peer Review as a QA Tool in Environmental Applications.

Peer Review is commonly applied during the final stage of a project and is used in the science community to determine the soundness of a conclusion and if the quality of information meets the standards of the scientific and technical community. Quality Assurance and Quality Control procedures are most effective when applied to planning, then during the process stage of a project, and during the review of a product. The gold standard for validating the quality of a study's results is comparison with a referenced data set, model, or result (Azouzi, 1999). However, costs can severely limits this approach for many applications. This article proposes an additional means for quality assessment using peer review as a quality assessment tool during the planning, process, and review of a project.

Journal Article↗

PubMed1990