Evidence map›Paper›PMID 32651589›Full record

ArticleAmerican journal of clinical pathology2020

Malpractice and Patient Safety Concerns.

Lisa M Reisch, Martiniano J Flores, Andrea C Radick, Hannah L Shucard, Kathleen F Kerr, Michael W Piepkorn, Raymond L Barnhill, David E Elder, Stevan R Knezevich, Joann G Elmore

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of clinical pathology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Defensive medicine in dermatological practice - Dermatopathology as a mirror of structural challenges.Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG · 2026
    Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Lisa M ReischDepartment of Biostatistics, University of Washington, Seattle.
Martiniano J FloresEdwards Lifesciences, Irvine, CA.
Andrea C RadickDepartment of Biostatistics, University of Washington, Seattle.
Hannah L ShucardDepartment of Biostatistics, University of Washington, Seattle.
Kathleen F KerrDepartment of Biostatistics, University of Washington, Seattle.
Michael W PiepkornDivision of Dermatology, Department of Medicine, University of Washington School of Medicine, Seattle.
Raymond L BarnhillDepartments of Pathology and Translational Research, Institut Curie, Paris Sciences and Lettres Research University, and Faculty of Medicine, University of Paris Descartes, Paris, France.
David E ElderDepartment of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia.
Stevan R KnezevichPathology Associates, Clovis, CA.
Joann G ElmoreDepartment of Medicine, David Geffen School of Medicine, University of California, Los Angeles.

Funding

Reducing Errors in the Diagnosis of Melanoma and Melanocytic LesionsR01CA201376 · NCI · UNIVERSITY OF WASHINGTON · PI ELMORE, JOANN G, KERR, KATHLEEN F. · 2016 to 2020
$3.2M
NCI NIH HHS R01 CA201376
6 · The paper itself

Abstract

objectives"Assurance behaviors," a type of defensive medicine, involve physicians' utilization of additional patient services to avoid adverse legal outcomes. We aim to compare the use of clinical behaviors (such as ordering additional tests, services, and consultations) due to malpractice concerns with the same behaviors due to patient safety concerns.

methodsA national sample of dermatopathologists (n = 160) completed an online survey.

resultsParticipants reported using one or more of five clinical behaviors due to concerns about medical malpractice (95%) and patient safety (99%). Self-reported use of clinical behaviors due to malpractice concerns and patient safety concerns was compared, including ordering additional immunohistochemistry/molecular tests (71% vs 90%, respectively, P < .0001), recommending additional surgical sampling (78% vs 91%, P < .0001), requesting additional slides (81% vs 95%, P < .0001), obtaining second reviews (78% vs 91%, P < .0001), and adding caveats into reports regarding lesion difficulty (85% vs 89%, P > .05).

conclusionsDermatopathologists use many clinical behaviors both as assurance behaviors and due to patient safety concerns, with a higher proportion reporting patient safety concerns as a motivation for specific behaviors.

Indexed as

Defensive MedicineMalpracticePatient SafetyPractice Patterns, Physicians'Attitude of Health PersonnelHealth Care SurveysHumansPathologistsSkinSkin DiseasesAssurance behaviorsDefensive medicineDermatopathologyMedical malpracticeMelanocytic skin lesionsPatient harmPatient safety

Identifiers

PMID32651589
PMCPMC7553247

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.