Ennis M, Clark A, Grudzinskas J G
Department of Psychology, University College London, UK.
Lancet. 1991 Sep 7;338(8767):616-8. doi: 10.1016/0140-6736(91)90616-w.
The increased number of medical negligence claims against obstetricians and gynaecologists has led to concerns about a trend towards defensive medical practice in the UK. The attitudes of obstetricians in the British Isles to tests of fetal and maternal wellbeing, which may influence decisions about patient care, were investigated in 3194 Fellows and Members of the Royal College of Obstetricians and Gynaecologists. Perceived accuracy of tests ranged from 86.3% for fetal blood sampling to 25.9% for biochemical tests. Despite some tests being perceived as having poor accuracy, all were widely used even by those who deemed them inaccurate. The most frequent explanations given for this paradoxical finding were that such tests were an aid to clinical judgement and were necessary for medicolegal reasons. Our data indicate that tests deemed to be inaccurate are used in clinical practice because some obstetricians fear litigation. Our findings were not influenced by age, gender, grade of doctor, or site of practice.
针对产科医生和妇科医生的医疗过失索赔数量不断增加，这引发了人们对英国防御性医疗行为趋势的担忧。对3194名皇家妇产科学院院士和成员进行了调查，了解英伦诸岛产科医生对胎儿和产妇健康检查的态度，这些检查可能会影响患者护理的决策。检查的感知准确率从胎儿血样采集的86.3%到生化检查的25.9%不等。尽管有些检查被认为准确率较低，但所有检查仍被广泛使用，即使是那些认为它们不准确的人。对这一矛盾发现最常见的解释是，此类检查有助于临床判断，并且出于法医学原因是必要的。我们的数据表明，一些被认为不准确的检查仍在临床实践中使用，因为一些产科医生害怕诉讼。我们的研究结果不受年龄、性别、医生级别或执业地点的影响。
