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临床同行评审:一个急需改革、存在潜在固有偏见的强制性过程。

Clinical peer Review; A mandatory process with potential inherent bias in desperate need of reform.

作者信息

Bader Husam, Abdulelah Mohammad, Maghnam Rama, Chin David

机构信息

Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ, USA.

Department of Internal Medicine, University of Jordan, Amman, Jordan.

出版信息

J Community Hosp Intern Med Perspect. 2021 Nov 15;11(6):817-820. doi: 10.1080/20009666.2021.1965704. eCollection 2021.

Abstract

Clinical peer review, a process mandated across all hospitals in the USA, originated as a measure to protect patients by ensuring a standardized level of medical service that is provided by all practicing physicians. The process involves retrospective chart reviewing to assess the quality of patients' care provided by physicians as well as adherence to the most appropriate guidelines. The process of clinical peer review almost entirely serves its ultimate purpose in quality preservation; However, certain laws gave immunity to reviewers resulting in abuse and using the clinical peer review process for secondary gain. Some notable cases of abuse were discussed in the article, we also shed light on two forms of bias that can potentially interfere with the review process and the dreaded outcomes that come along a negative peer review. We also propose methods to overcome these biases to further standardize and improve this crucial process.

摘要

临床同行评审是美国所有医院都必须执行的一项程序,最初是作为一种措施,通过确保所有执业医师提供标准化的医疗服务水平来保护患者。该程序包括回顾性病历审查,以评估医师提供的患者护理质量以及对最适当指南的遵守情况。临床同行评审程序几乎完全实现了其在质量保障方面的最终目的;然而,某些法律给予评审人员豁免权,导致出现滥用情况,并将临床同行评审程序用于次要目的。文章讨论了一些著名的滥用案例,我们还揭示了两种可能干扰评审过程的偏见形式以及负面同行评审带来的可怕后果。我们还提出了克服这些偏见的方法,以进一步规范和改进这一关键程序。

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本文引用的文献

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Clinical peer review program self-evaluation for US hospitals.美国医院临床同行评审计划自我评估
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