Peer Review


Journal Article

  1. Posner KL, Caplan RA, Cheney FW: Variation in expert opinion in medical malpractice review. Anesthesiology 85:1049-54, 1996.  |  NLM PubMed Link  |  Subjects: Malpractice System, Peer Review
    Medical experts in malpractice claim review rely on implicit (personal,unstated) rather than explicit (stated prior to review) criteria in assessing whether the standard of care was met. The data collection process of the ASA Closed Claims Program was used to investigate the role of this implicit assessment process in expert opinion. Reviewing original documents, anesthesiologists agreed on 62% of claims and disagreed on 38%, suggesting that divergent opinions may be easily found in seeking opinions from multiple experts.
  2. Caplan RA, Posner K, Cheney FW: Effect of outcome on physician judgments of appropriateness of care. JAMA 265:1957-1960, 1991.  |  NLM PubMed Link  |  Subjects: Peer Review, Quality of Care
    Twenty-one cases which involved adverse anesthetic outcome were reviewed by 112 practicing anesthesiologists who were asked to judge the standard of care. Matched sets of cases were judged which differed only in outcome. A significant inverse relationship was noted between severity of outcome and appropriateness of care. For the same clinical scenario, as the severity of patient injury increased care was more apt to be judged substandard.
  3. Posner KL, Sampson PD, Caplan RA, Ward RJ, Cheney FW: Measuring interrater reliability among multiple raters: An example of methods for nominal data. Statistics in Medicine 9:1103-1115, 1990.  |  NLM PubMed Link  |  Subjects: Peer Review
    This paper describes some of the statistical refinements utilized to measure interrater reliability in the ASA Closed Claims Program.
  4. Caplan RA, Posner K, Ward RJ, Cheney FW: Peer reviewer agreement for major anesthetic mishaps. Quality Review Bulletin 14:363-368, 1988.  |  NLM PubMed Link  |  Subjects: Peer Review, Quality of Care
    A study of the reliability of closed claims reviewer judgments about standard of care, presence or absence of human error, and the role of better monitoring in the prevention of anesthetic mishaps. Forty-two anesthesiologists reviewed 48 closed claim abstracts of anesthetic mishaps. The data demonstrated that anesthesiologists from widely different backgrounds can produce a cohesive set of judgments about anesthetic mishaps.

Closed Claims Bibliography

To access a complete bibliography of peer-reviewed journal articles from the Closed Claims Program, click here; Closed Claims Program Bibliography . You may also request delivery of the bibliography via e-mail, fax or postal mail.

Note to Patients

These studies are primarily designed to aid physicians in improving their clinical practice. We are sorry we cannot address individual patient questions or give medical or legal advice or provide data analysis.