Punching Back: Hospital System Sued Again Over Alleged Peer Review Misconduct.

Hospital system sued again over alleged peer review misconduct.

Peer review in forensic science.

Peer review features prominently in the forensic sciences. Drawing on recent research and studies, this article examines different types of peer review, specifically: editorial peer review; peer review by the scientific community; technical and administrative review; and verification (and replication). The article reviews the different meanings of these quite disparate activities and their utility in relation to enhancing performance and reducing error. It explains how forensic practitioners should approach and use peer review, as well as how it should be described in expert reports and oral testimony. While peer review has considerable potential, and is a key component of modern quality management systems, its actual value in most forensic science settings has yet to be determined. In consequence, forensic practitioners should reflect on why they use specific review procedures and endeavour to make their actual practices and their potential value transparent to consumers; whether investigators, lawyers, jurors or judges. Claims that review increases the validity of a scientific technique or accuracy of opinions within a particular case should be avoided until empirical evidence is available to support such assertions.

Evaluating the Pros and Cons of Different Peer Review Policies via Simulation.

In the academic world, peer review is one of the major processes in evaluating a scholars contribution. In this study, we are interested in quantifying the merits of different policies in a peer review process, such as single-blind review, double-blind review, and obtaining authors feedback. Currently, insufficient work has been undertaken to evaluate the benefits of different peer review policies. One of the major reasons for this situation is the inability to conduct any empirical study because data are presently unavailable. In this case, a computer simulation is one of the best ways to conduct a study. We perform a series of simulations to study the effects of different policies on a peer review process. In this study, we focus on the peer review process of a typical computer science conference. Our results point to the crucial role of program chairs in determining the quality and diversity of the articles to be accepted for publication. We demonstrate the importance of discussion among reviewers, suggest circumstances in which the double-blind review policy should be adopted, and question the credibility of the authors feedback mechanism. Finally, we stress that randomness plays an important role in the peer review process, and this role cannot be eliminated. Although our model may not capture every component of a peer review process, it covers some of the most essential elements. Thus, even the simulation results clearly cannot be taken as literal descriptions of an actual peer review process. However, we can at least still use them to identify alternative directions for future study.

Recent Developments in Medicine and the Law.

This article discusses recent developments in three areas, all of which relate to discovery in medical malpractice cases. The first topic is claims of spoliation in the context of medical malpractice. The second topic is the evolving peer review privilege and its limitation or expansion by state courts. Finally, we discuss two important cases in which state courts have interpreted HIPAA's privacy rules and applied them in the context of ex parte communications with treating physicians and pre-suit discovery of a plaintiff's medical information.

International central adjudication committee in the PLATO trial: independent body of experts or friendly family picnic?

The International Central Adjudication Committee (ICAC) is responsible for blinded independent assessment of complex clinical events in randomized trials. In this study, we analyze the constituence and impact of the ICAC in the PLATO trial. The PLATO ICAC was entirely governed by two academic institutions, Duke Clinical Research Institute (DCRI) and Uppsala Clinical Research Center (UCRC). Both co-chairman, all coordinators and half of the adjudicators in the PLATO ICAC belonged to either DCRI or UCRC. Among the other adjudicators representing USA, Canada and Australia, majority had DCRI ties, including at least five former Duke cardiology fellows. Furthermore, both co-chairmen are listed as adjudicators, representing obvious conflict. In the PLATO trial, the sponsor representatives were involved in selecting the ICAC members. Finally, 21 out of the 50 adjudicators represented Sweden, the homeland of the PLATO sponsor and primary investigator. Heavy selection bias in the ICAC constituence, lack of independence and potential control of the ICAC by the study sponsor may influence PLATO outcomes, and should be avoided in the future.

Clinical peer review in the United States: history, legal development and subsequent abuse.

The Joint Commission on Accreditation requires hospitals to conduct peer review to retain accreditation. Despite the intended purpose of improving quality medical care, the peer review process has suffered several setbacks throughout its tenure. In the 1980s, abuse of peer review for personal economic interest led to a highly publicized multimillion-dollar verdict by the United States Supreme Court against the perpetrating physicians and hospital. The verdict led to decreased physician participation for fear of possible litigation. Believing that peer review was critical to quality medical care, Congress subsequently enacted the Health Care Quality Improvement Act (HCQIA) granting comprehensive legal immunity for peer reviewers to increase participation. While serving its intended goal, HCQIA has also granted peer reviewers significant immunity likely emboldening abuses resulting in Sham Peer Reviews. While legal reform of HCQIA is necessary to reduce sham peer reviews, further measures including the need for standardization of the peer review process alongside external organizational monitoring are critical to improving peer review and reducing the prevalence of sham peer reviews.