Evidence map›Paper›PMID 36100273›Full record

ArticleCMAJ open

Patterns and trends among physicians-in-training named in civil legal cases: a retrospective analysis of Canadian Medical Protective Association data from 1993 to 2017.

Allan McDougall, Cathy Zhang, Qian Yang, Taryn Taylor, Heather K Neilson, Janet Nuth, Ellen Tsai, Shirley Lee, Guylaine Lefebvre, Lisa A Calder

Abstract read
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. 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.

Allan McDougallThe Canadian Medical Protective Association (McDougall, Zhang, Yang, Neilson, Nuth, Tsai, Lee, Lefebvre, Calder); Faculty of Education (McDougall), University of Ottawa, Ottawa, Ont.; Department of Obstetrics & Gynecology (Taylor), Schulich School of Medicine & Dentistry, Centre for Education Research & Innovation, London, Ont.; Clinical Epidemiology Program (Calder), Ottawa Hospital Research Institute, Ottawa, Ont.
Cathy ZhangThe Canadian Medical Protective Association (McDougall, Zhang, Yang, Neilson, Nuth, Tsai, Lee, Lefebvre, Calder); Faculty of Education (McDougall), University of Ottawa, Ottawa, Ont.; Department of Obstetrics & Gynecology (Taylor), Schulich School of Medicine & Dentistry, Centre for Education Research & Innovation, London, Ont.; Clinical Epidemiology Program (Calder), Ottawa Hospital Research Institute, Ottawa, Ont.
Qian YangThe Canadian Medical Protective Association (McDougall, Zhang, Yang, Neilson, Nuth, Tsai, Lee, Lefebvre, Calder); Faculty of Education (McDougall), University of Ottawa, Ottawa, Ont.; Department of Obstetrics & Gynecology (Taylor), Schulich School of Medicine & Dentistry, Centre for Education Research & Innovation, London, Ont.; Clinical Epidemiology Program (Calder), Ottawa Hospital Research Institute, Ottawa, Ont.
Taryn TaylorThe Canadian Medical Protective Association (McDougall, Zhang, Yang, Neilson, Nuth, Tsai, Lee, Lefebvre, Calder); Faculty of Education (McDougall), University of Ottawa, Ottawa, Ont.; Department of Obstetrics & Gynecology (Taylor), Schulich School of Medicine & Dentistry, Centre for Education Research & Innovation, London, Ont.; Clinical Epidemiology Program (Calder), Ottawa Hospital Research Institute, Ottawa, Ont.
Heather K NeilsonThe Canadian Medical Protective Association (McDougall, Zhang, Yang, Neilson, Nuth, Tsai, Lee, Lefebvre, Calder); Faculty of Education (McDougall), University of Ottawa, Ottawa, Ont.; Department of Obstetrics & Gynecology (Taylor), Schulich School of Medicine & Dentistry, Centre for Education Research & Innovation, London, Ont.; Clinical Epidemiology Program (Calder), Ottawa Hospital Research Institute, Ottawa, Ont.
Janet NuthThe Canadian Medical Protective Association (McDougall, Zhang, Yang, Neilson, Nuth, Tsai, Lee, Lefebvre, Calder); Faculty of Education (McDougall), University of Ottawa, Ottawa, Ont.; Department of Obstetrics & Gynecology (Taylor), Schulich School of Medicine & Dentistry, Centre for Education Research & Innovation, London, Ont.; Clinical Epidemiology Program (Calder), Ottawa Hospital Research Institute, Ottawa, Ont.
Ellen TsaiThe Canadian Medical Protective Association (McDougall, Zhang, Yang, Neilson, Nuth, Tsai, Lee, Lefebvre, Calder); Faculty of Education (McDougall), University of Ottawa, Ottawa, Ont.; Department of Obstetrics & Gynecology (Taylor), Schulich School of Medicine & Dentistry, Centre for Education Research & Innovation, London, Ont.; Clinical Epidemiology Program (Calder), Ottawa Hospital Research Institute, Ottawa, Ont.
Shirley LeeThe Canadian Medical Protective Association (McDougall, Zhang, Yang, Neilson, Nuth, Tsai, Lee, Lefebvre, Calder); Faculty of Education (McDougall), University of Ottawa, Ottawa, Ont.; Department of Obstetrics & Gynecology (Taylor), Schulich School of Medicine & Dentistry, Centre for Education Research & Innovation, London, Ont.; Clinical Epidemiology Program (Calder), Ottawa Hospital Research Institute, Ottawa, Ont.
Guylaine LefebvreThe Canadian Medical Protective Association (McDougall, Zhang, Yang, Neilson, Nuth, Tsai, Lee, Lefebvre, Calder); Faculty of Education (McDougall), University of Ottawa, Ottawa, Ont.; Department of Obstetrics & Gynecology (Taylor), Schulich School of Medicine & Dentistry, Centre for Education Research & Innovation, London, Ont.; Clinical Epidemiology Program (Calder), Ottawa Hospital Research Institute, Ottawa, Ont.
Lisa A CalderThe Canadian Medical Protective Association (McDougall, Zhang, Yang, Neilson, Nuth, Tsai, Lee, Lefebvre, Calder); Faculty of Education (McDougall), University of Ottawa, Ottawa, Ont.; Department of Obstetrics & Gynecology (Taylor), Schulich School of Medicine & Dentistry, Centre for Education Research & Innovation, London, Ont.; Clinical Epidemiology Program (Calder), Ottawa Hospital Research Institute, Ottawa, Ont. research@cmpa.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMedico-legal data show opportunities to improve safe medical care; little is published on the experience of physicians-in-training with medical malpractice. The purpose of this study was to examine closed civil legal cases involving physicians-in-training over time and provide novel insights on case and physicians characteristics.

methodsWe conducted a retrospective descriptive study of closed civil legal cases at the Canadian Medical Protective Association (CMPA), a mutual medico-legal defence organization for more than 105 000 physicians, representing an estimated 95% of physicians in Canada. Eligible cases involved at least 1 physician-in-training and were closed between 1993 and 2017 (for time trends) or 2008 and 2017 (for descriptive analyses). We analyzed case rates over time using Poisson regression and the annualized change rate. Descriptive analyses addressed case duration, medico-legal outcome and patient harm. We explored physician specialties and practice characteristics in a subset of cases.

resultsOver a 25-year period (1993-2017), 4921 physicians-in-training were named in 2951 closed civil legal cases, and case rates decreased significantly (β = -0.04, 95% confidence interval -0.05 to -0.03, where β was the 1-year difference in log case rates). The annualized change rate was -1.1% per year. Between 2008 and 2017, 1901 (4.1%) of 45 967 physicians-in-training were named in 1107 civil legal cases. Cases with physicians-in-training generally involved more severe patient harm than cases without physicians-in-training. In a subgroup with available information (

interpretationThe rate of civil legal cases involving physicians-in-training has diminished over time, but more recent cases featured severe patient harm and death. Efforts to promote patient safety may enhance medical care and reduce the frequency and severity of malpractice issues for physicians-in-training.

Indexed as

MalpracticePhysiciansCanadaHumansPatient SafetyRetrospective Studies

Identifiers

PMID36100273
PMCPMC9477539

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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.