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目的从8401名放射学专家的执业认证资料来归纳判定出医疗事故诉讼案最常见的原因。材料与方法这一研究得到新泽西医学院机构伦理委员会批准。参与网上One-CallMedical调查的来自47个州的8401名放射科医师,对这一CT/MRI研究的劳工补偿险案例的代理,被要求提供他们的不当治疗史作为执业认证申请的部分条件。这些放射科医师中有2624名(31%)在职业生涯中至少遇到一次索赔。在每个入选者的认证档案中,如果有针对入选者的索赔,就会有关于每个医疗事故诉讼的记叙,在大多数实例中,可以据此做出初步判定。在4793个案例中,4043例(84%)可从记叙中找到被指称的原因。用Stata12(2011;Stata,CollegeStation,Tex)软件进行统计学分析。结果最为常见的一般性原因为误诊[14.83个索赔每1000人年(95%CI:14.19~15.51)]。在此类中,乳腺癌的漏诊最为频繁[3.57个索赔每1000人年(95%CI:3.26~3.91)],紧随其后的是非脊柱骨折[2.49个索赔每1000人年(95%CI:2.28~2.72)]、脊柱骨折[1.32个索赔每1000人年(95%CI:1.16~1.49)]、肺癌[1.26个索赔每1000人年(95%CI:1.11~1.42)]和血管疾病[1.08个索赔每1000人年(95%CI:0.93~1.24)]。下一个频发的类目为操作治疗并发症[1.76个索赔每1000人年(95%CI:1.58~1.96)],紧接着是与病人[0.40个索赔每1000人年(95%CI:0.32~0.50)]或陪人[0.71个索赔每1000人年(95%CI:0.60~0.84)]沟通不足。放射科医师作为次要角色被索赔的概率是0.92个索赔每1000人年(95%CI:0.77~1.10)。没能推荐额外的检查是一个罕见的原因[0.41个索赔每1000人年(95%CI:0.34~0.50)]。结论到目前为止,误诊是最常见的针对放射科医师的医疗纠纷诉讼案的原因。在这一类目中,乳腺癌被漏诊最频繁,次之为非脊柱骨折和脊柱骨折。沟通不足和未能推荐额外的检查均为引发诉讼案的不常见原因。
Objective To summarize the most common causes of medical malpractice cases from the data of 8401 radiologists’ practicing certification. Materials and Methods This study was approved by the Institutional Ethics Committee of the New Jersey School of Medicine. 8401 radiologists from 47 states who participated in the One-CallMedical Online Survey were represented on this CT / MRI study of labor compensation insurance cases and were asked to provide their history of improper treatment as part of their certification of practice. Of these radiologists, 2624 (31%) encountered at least one claim during their careers. In each enrolled’s certification file, if there is a claim against the enrolleer, there will be a narrative of each medical malpractice, and in most instances a preliminary determination can be made accordingly. Of 4793 cases, 4043 (84%) can find the reason for the allegation from the narrative. Stata12 (2011; Stata, CollegeStation, Tex) software was used for statistical analysis. The most common reason for the results was misdiagnosis [14.83 claims per 1,000 person-years (95% CI: 14.19 to 15.51)]. Of these, breast cancer missed the most frequently (3.57 claims per 1000 person-years (95% CI: 3.26-3.91)], followed by non-spinal fractures [2.49 claims per 1,000 person-years (95% CI (1.28 claims per 1,000 person-years (95% CI: 1.11 to 1.42)] and vascular disease (1.26 claims per 1,000 person-years (95% CI: 1.16 to 1.49) [1.08 claims per 1,000 person-years (95% CI: 0.93 to 1.24)]. The next most frequent category was the treatment of complications [1.76 claims per 1,000 person-years (95% CI: 1.58-1.96)], followed by [0.40 claims per 1,000 person-years of claims (95% CI: 0.32 ~ 0.50)] or escorts [0.71 claims per 1,000 person-years (95% CI: 0.60 to 0.84)]. The odds of a radiologist claiming as a secondary role were 0.92 claims per 1,000 person-years (95% CI: 0.77 to 1.10). The failure to recommend additional exams is a rare cause [0.41 claims per 1,000 person-years (95% CI: 0.34 to 0.50)]. Conclusion So far, misdiagnosis is the most common cause of medical dispute litigation against radiologists. Breast cancer is the most frequently missed in this category, followed by non-spinal fractures and spinal fractures. Insufficient communication and the failure to recommend additional examinations are unusual causes of lawsuits.