Devitt J E
Can Med Assoc J. 1973 May 19;108(10):1279-81.
A peer review of breast operation statistics was conducted. Standards for the proportion of biopsies positive for cancer, and for length of postoperative stay following operation for benign and malignant conditions were developed and each surgeon was informed of his performance and how it compared with that of his colleagues. The same parameters of care were reviewed one year later to study changes in performance. Low volume of clinical material, failure of two surgeons to change, and a steady general improvement in all parameters in the years prior to the presentation of the peer review, confused the demonstration of improvement in the year after the educational effort. There was a statistically significant improvement in the proportion of biopsies positive for cancer, reflecting reduction in unnecessary biopsies, but the pre-existing annual improvement in reducing postoperative stays was not accelerated. Does continuing medical education by peer review really work? Probably.
开展了一项针对乳房手术统计数据的同行评议。制定了癌症活检阳性比例以及良性和恶性疾病手术后住院时间的标准，并告知每位外科医生其表现以及与同事表现的对比情况。一年后对相同的医疗参数进行了复查，以研究表现的变化。临床资料数量少、两名外科医生未做出改变，以及在同行评议前几年所有参数都稳步普遍改善，使得在教育努力后的一年里难以证明有所改善。癌症活检阳性比例有统计学意义的提高，这反映了不必要活检的减少，但在缩短术后住院时间方面先前存在的年度改善并未加速。同行评议式的继续医学教育真的有效吗？可能是有效的。
