Elder A G, Symington I S, Symington E H
Occupational Health Service, Greater Glasgow Health Board, UK.
Occup Med (Lond). 1994 Dec;44(5):231-5. doi: 10.1093/occmed/44.5.231.
A questionnaire survey on simulated ill-health retirement decisions was performed at a scientific conference for local authority medical advisers. Respondents were asked to make decisions based on ten case scenarios drawn from real life. The overall agreement amongst 35 physicians was low, with a kappa statistic of 0.241. There were wide variations amongst respondents, with two physicians accepting all ten cases for retirement while another accepted only one. The survey suggests that there is great potential for inconsistency and inequity in such decisions. An improvement in agreement between physicians might be achieved by training, consensus guidelines and audit. This issue should be addressed by occupational physicians and trustees of superannuation schemes.
在一次面向地方当局医学顾问的科学会议上，针对模拟的病退决策进行了问卷调查。要求受访者根据十个来自现实生活的病例情况做出决策。35位医生之间的总体一致性较低，kappa统计值为0.241。受访者之间存在很大差异，有两位医生接受了所有十个退休病例，而另一位只接受了一个。该调查表明，此类决策中存在不一致和不公平的巨大可能性。通过培训、共识指南和审计，或许可以提高医生之间的一致性。职业医生和养老金计划受托人应解决这个问题。
