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In view of the Department of Health's recommendations that Peer Review be accepted as an integral part of the medical system, local members of the college volunteered to take part in a pilot study. Those involved were divided into three groups and were left to devise their own system. Following subsequent discussion and assessment, a workable scheme evolved as described. This system employs a 'rolling' or an ongoing technique in which a group of four psychiatrists form the peer review group. Following each assessment a new member joins the team and the longest serving person is assessed before leaving. The problems and difficulties of peer review are discussed and the importance of the link between peer review and continuing education is stressed.
Peer review is an integral part of professional nursing practice that traditionally involves licensed personnel evaluating one another. Peer review councils can structure the environment further, enhancing the consistency and meaningfulness of the evaluation process. A highly structured, inclusive process of peer review can help develop unit cultures of professionalism, involvement, and excellence. The formation, implementation, and outcomes of two unique peer review councils consisting of licensed and unlicensed personnel are described.
Peer Review Committees (PRCs) that aid insurance companies in evaluating chiropractic treatments and fees have been the focus of recent court challenges. Some practitioners have argued that PRC activities constitute price fixing in violation of the Sherman Antitrust Act. PRCs have been successful thus far in claiming an exemption from antitrust scrutiny as a "business of insurance" within the meaning of the McCarran-Ferguson Act. This Note contends that PRCs are not exempt from antitrust regulation; since PRCs do not spread risks and are involved in inter- rather than intra-industry agreements, their activities do not fall within the narrowly defined "business of insurance" exemption. The Note then analyzes the merits of the price fixing allegations under both the "per se" standard and the " rule of reason." First, the Note concludes that the unique nature of the health care market and the legitimate functions served by peer review make the application of a per se standard inappropriate. Second, under the rule of reason, the Note indicates that peer review encourages efficient and innovative health care practices while it deters the escalation of health care costs. The Note concludes that the net effect of peer review is not anticompetitive, especially since PRCs lack the coercive power to compel compliance with the recommendations.
CytoJournal organized its first Peer-Reviewer's Retreat of 2006 during the United States and Canadian Academy of Pathology Annual Meeting at Atlanta on Feb 12, 2006. The major topics discussed were open access, peer review, and impact factors. Representative participants volunteered to join the task force to prepare an instructional guide for peer-reviewing cytopathology manuscripts. Concern about the impact factor for CytoJournal was discussed. A feedback to its readers and authors was recommended. Impact factor calculation needs at least three years of journal statistics. It is only possible after two years from the time a journal is first accepted by Thomson-ISI for citation tracking. CytoJournal is still too new for an impact factor to be calculated. However, general progress of CytoJournal suggests an encouraging pattern for high impact factor.
This proposal would implement portions of the Peer Review Improvement Act of 1982 (Title I, Subtitle C of the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA), Pub. L. 97-248) and the Social Security Act Amendments of 1983 (Pub. L 98-21) by establishing the review functions to be performed by a Utilization and Quality Control Peer Review Organization (PRO). The 1983 amendments to the Social Security Act amended TEFRA by requiring that effective October 1, 1983, hospitals receiving payment under the Medicare prospective payment system (PPS) are required to maintain an agreement with a PRO if there is one for the area. Effective October 1, 1984, hospitals are required to have an agreement with a PRO in order to receive Medicare payments. These proposed regulations outline the relationships among PROs, Medicare fiscal intermediaries and carriers, providers, practitioners, and beneficiaries upon the PRO's assumption of conduct of review for those hospitals under PPS and for all other facilities. The proposal would also describe the relationship between PROs and State Medicaid agencies that contract with PROs to perform review.
Nursing peer review is presented as an important quality assurance method which is widely misunderstood and not yet extensively practiced. A survey of nurses working on inhouse units at a USAF medical center was conducted. Of 78 eligible nurses, 60 responded representing each in-house unit. Military grades of 2nd Lt. through Lt. Col. and educational preparations from 2, 3, and 4 year programs provided a heterogeneous sample. Only six respondents had ever participated in peer review and those had been in educational, rather than in practice, settings. The survey results are presented and an effort to initiate nursing peer review in the medical center is described.
OBJECTIVE: This paper aims to evaluate the use and development of external peer review models and to identify where the main models are used in European Union member states and countries with reciprocal research agreements with the European Union. DESIGN: The ExPeRT (external peer review techniques) project research team conducted a series of fact-finding missions to all participating European nations. Study participants. I. Blomberg, Sweden; L. Bohigas, Spain; S. Cucic, The Netherlands; P. Morosini, Italy. The Project is led by C. Shaw, UK and is managed by C. Heaton, CASPE Research. RESULTS: We identified four main external peer review models aimed at measuring the quality of service management and delivery: health care accreditation, the International Organization for Standardization ISO 9000 standards, the European Foundation for Quality Management Excellence Model and visitatie, which is Dutch for 'visitation' or peer review-based schemes. DISCUSSION: ExPeRT has demonstrated that in principle, convergence of the four main models in order to gain from each model's key strengths is feasible. Whether convergence is practical, depends upon the willingness of governments, health service providers, health care quality professionals and organizations to come together and adopt the recommendations of the ExPeRT project.
The peer review system does not always detect fraud, plagiarism, poor quality or gross error and there is editorial reluctance to correct errors or to publish criticisms of sacred cows or 'controversial' or nonconformist views of sceptics and dissident minorities. Mediocrity is thereby perpetuated, with highly innovative science stifled by the conflict of interest and reviewer shortcomings underlying the review system. The effective court of appeal should be the editor. Self-correction of review procedures is recommended by: (i) improving the editorial quality control of peer reviews; (ii) abolition of the cloak of secrecy and anonymity of reviewers; and (iii) active encouragement of critical debate of unorthodox submissions.
Drawing on experiences as a Physician Advisor to the Office of Quality Assurance of the American Psychiatric Association, the author discusses process interactions endemic to peer review and presents recommendations for facilitating this necessary professional activity.
OBJECTIVE: In order to learn more about peer review's acceptability, efficiency, and reliability, we performed structured implicit review with and without use of a structured case review form on a random selection of peer review organization cases. METHODS: We compared the results between methods and with previously obtained review results. Twenty-five charts with physician review completed during the Health Care Financing Administration's Third Scope of Work were randomly selected for rereview. Eight physician advisors, none of whom had seen any of these charts previously, were divided into two groups. Both groups received identical formal instruction in the structured implicit review method. Half of the physicians used a structured review form when performing chart review. The other half did not use this form but completed their reviews using the previously used reporting form. Participating physicians were instructed in the structured review method as described by Rand Corporation. The review process was examined regarding acceptability and efficiency. Review results were analyzed for reliability regarding identification of adverse and potential adverse effects and identification of the source of quality concerns. RESULTS: Instructions regarding structured implicit review methods were understood easily and accepted by physician advisors. Use of the structured review form was less efficient, averaging 50% longer per review. There was no difference in the rate at which adverse events were detected. Potentially serious adverse events were found less often using structured review than in the original review. There was greater agreement among reviewers using the structured form than among those using the historic worksheet, but structured review using the Rand form identified fewer potentially significant adverse events than did the reviewers using the historic worksheets. CONCLUSIONS: Application of structured implicit review methods is clearly feasible for peer review organization case review. Use of a simple worksheet was more time efficient than use of a highly structured form. There was not only less variation in review results but also identification of fewer potentially significant adverse events when the highly structured form was used. Teaching the structured approach to chart review may be more important to obtaining good results than using a structured review form.
The peer review process is a quality control for scientific publication. Well done, it helps editors to improve their journals and protects readers from wasting time on ill-conceived, redundant, irrelevant or erroneous literature. Badly done it can act as an obstacle to innovation. This article tells you how to be a first rate peer reviewer.
CONTEXT: To compare the quality, presentation, readability, and clinical relevance of review articles published in peer-reviewed and "throwaway" journals. METHODS: We reviewed articles that focused on the diagnosis or treatment of a medical condition published between January 1 and December 31, 1998, in the 5 leading peer-reviewed general medical journals and high-circulation throwaway journals. Reviewers independently assessed the methodologic and reporting quality, and evaluated each article's presentation and readability. Clinical relevance was evaluated independently by 6 physicians. RESULTS: Of the 394 articles in our sample, 16 (4.1%) were peer-reviewed systematic reviews, 135 (34.3%) were peer-reviewed nonsystematic reviews, and 243 (61.7%) were nonsystematic reviews published in throwaway journals. The mean (SD) quality scores were highest for peer-reviewed articles (0.94 [0.09] for systematic reviews and 0.30 [0.19] for nonsystematic reviews) compared with throwaway journal articles (0.23 [0.03], F(2,391) = 280.8, P<.001). Throwaway journal articles used more tables (P =.02), figures (P =.01), photographs (P<.001), color (P<.001), and larger font sizes (P<.001) compared with peer-reviewed articles. Readability scores were more often in the college or higher range for peer-reviewed journals compared with the throwaway journal articles (104 [77.0%] vs 156 [64.2%]; P =.01). Peer-reviewed article titles were judged less relevant to clinical practice than throwaway journal article titles (P<.001). CONCLUSIONS: Although lower in methodologic and reporting quality, review articles published in throwaway journals have characteristics that appeal to physician readers.
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This notice describes new requirements for the third Scope of Work for Utilization and Quality Control Peer Review Organizations (PROs) for fiscal year 1989, beginning October 1, 1988. This notice implements section 4091(b)(1) of the Omnibus Budget Reconciliation Act of 1987 (Pub. L. 100-203), which requires us to publish a new policy or procedure adopted by the Secretary that affects substantially the performance of contract obligations at least 30 days before the date the policy or procedure is to be used. It also implements other provisions of Pub. L. 100-203, as well as requirements of the Omnibus Budget Reconciliation Act of 1986.
The peer review process in medical sciences is much debated. The method is not yet evidence based. Who are the reviewers and how do they perform? They are "independent" experts. As such they are bound to be involved in research similar to that outlined in the manuscript. Very often they are contestant in the same race. That is why the author consider the double blind method, where the author is blinded and the reviewer masked from each other's identity, the best choice. Nevertheless in very many scientific journals of high quality and envied impact factors do not blind the identity of the authors. Science is a race for fame, self accomplishment and also a means to get grants for pursuing the scientific research. Only success is able to provide resources for expensive scientific research. There is no fail-safe method against bias in grant giving and editorial process. In the tidal wave of electronic information it is mandatory to help in differentiating between signal and noise in science. Peer review is the best method to protect readers from the trash of uncontrolled publications in medical science.
This notice describes new requirements for the third Scope of Work for Utilization and Quality Control Peer Review Organizations (PROs) for fiscal year 1989, beginning October 1, 1988. This notice implements section 4091(b)(1) of the Omnibus Budget Reconciliation Act of 1987 (Pub. L. 100-203), which requires us to publish a new policy or procedure adopted by the Secretary that affects substantially the performance of contract obligations at least 30 days before the date the policy or procedure is to be used. It also implements other provisions of Pub. L. 100-203, as well as requirements of the Omnibus Budget Reconciliation Act of 1986.
Several major, national forces have created the mandate of the Peer Review Organizations (PROs) for the evaluation of the quality of care received by Medicare patients. The shift of the Medicare Program to prospective payment to hospitals has caused concern that this change in financial incentives may have adverse effects on quality. An analysis and review of the experience of the California PRO (California Medical Review, Inc.)--including the application of sanctions--suggests that corrective actions have been successful in addressing quality deficiencies. However, the relationship between those deficiencies and the prospective payment mechanism remains unclear.