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At least 19 recordsLinked to original sources
PubMed1991

Reviewing peer review: the NCI Clinic Alert three years later.

On May 16, 1988 the National Cancer Institute fired the opening volley in what would become two major battles--one over the treatment of node-negative breast cancer and the other over the proper protocol for disseminating vital scientific information. On this date the "Clinical Alert" was mailed to thousands of physicians in the United States. It was formulated to rapidly apprise physicians of the results of three clinical trials exploring the effects of adjuvant therapy in node-negative breast cancer. These results were perceived as scientifically compelling as well as clinically relevant. The results of the trials, the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-13 and B-14 trials and the Intergroup Study (INT) 0011, have subsequently been formally published and the results confirmed those presented in the Alert. Nevertheless, the debate over the treatment of node-negative breast cancer is far from resolved. Similarly, the debate over the vehicle employed for the dissemination of the Alert, ie, the US Mail, rages on. An unprecedented number of editorials, articles, and monographs have been published that deal with this question. At the center of this debate is the fact that the NCI elected to bypass the time honored institution of the peer reviewed journal. In effect, this debate emphasizes the need for a comprehensive review of the peer review process.

Breast Neoplasms↗
PubMed2001

Peer review.

Peer review is essential for ensuring quality medical care. In the 1980s a physician-plaintiff prevailed in lawsuit filed against peer reviewers who excluded the physician from a hospital's medical staff. The peer reviewers had acted to preserve their own economic interests. A multimillion-dollar verdict against the peer reviewers destroyed the community's only multispecialty practice and received national attention. Congress reacted by passing the Health Care Quality Improvement Act that granted sweeping, legal immunity for peer reviewers but also created the National Practitioner's Data Bank. The combination of the establishment of a public repository for physicians malpractice and medical staff privileging activity in combination with the near complete legal protection of peer reviewers has converted peer review from an evaluative to a punitive process. The peer review process and the laws that govern it should be reformed to regain its ability to improve and assure quality without being a threat to physicians.

Humans↗
PubMed1995

Peer review.

Peer review is a major component of a professional practice and shared governance model in which professional staff nurses are given responsibility for practice and patient outcomes. Careful planning is necessary for the development of a peer-review program. Components include definition of roles, responsibilities, and performance standards, as well as the development of an evaluation tool and process. Peer review affords nurses many opportunities for growth and development and allows them to develop communication, evaluation, and presentation skills. The concept of peer review may expand to meet the needs of changing health-care delivery models.

Career Mobility↗
PubMed2004

Feedback from community pharmacy users on the contribution of community pharmacy to improving the public's health: a systematic review of the peer reviewed and non-peer reviewed literature 1990-2002.

OBJECTIVE: To systematically review feedback from pharmacy users on their perceptions and experiences of health-related advice and services provided from community pharmacies. METHODS: The focus of the review was community pharmacy activities in relation to promoting health and well-being, preventing ill-health and maintaining health. Searches were conducted for peer-reviewed (international) and non-peer-reviewed (UK) research. Electronic databases searched included MEDLINE, EMBASE, Cochrane Library and International Pharmaceutical Abstracts; hand searches of key journals and conference abstracts, key informants. Key informants in the UK were contacted to identify unpublished studies. The inclusion period was 1990 onwards. Data extraction and synthesis Data were abstracted into a matrix by one author with a sample checked by a second. The Health Development Agency's Evidence Base 2000 standards and the evidence categories used by the Department of Health in the National Service Frameworks were applied to each item. MAIN RESULTS: Seven peer reviewed papers and 13 non-peer reviewed reports were identified for inclusion in the review. Consumer usage of pharmacies is almost universal with prescription supplies and purchase of over the counter medicines predominating. Evidence shows that not only is usage low for general health advice, but that pharmacists are perceived as 'drugs experts' rather than experts on health and illness. Emergency hormonal contraception and head lice management schemes have been well received. There is a need to consider privacy and confidentiality surrounding advice giving. CONCLUSIONS: Users of community pharmacy-based health development initiatives express a high level of satisfaction. If community pharmacies are to be used to their full extent, then actions to extending the public's awareness and acceptance of the pharmacist's role in giving advice will be crucial. Further research will be needed to measure any change in premises development on the public's perception of the level of privacy in pharmacies.

Confidentiality↗
PubMed1989

The professional practice climate and peer review.

Peer review, a mechanism of professional self-regulation, should not be viewed in isolation. It is one element of a professional practice climate and is interrelated to primary nursing, evaluation of patient outcomes, quality assurance, and self-governance. Much has been written about peer review but little of it describes how staff nurses and administrators can collaborate to operationalize the concept. The peer review system described represents the efforts of one unit's nursing staff at University Hospitals of Cleveland.

Humans↗
PubMed1986

Reflections of a CHAMPUS-APA peer reviewer.

Peer review is a major professional response to the problems of health insurance coverage for psychiatric services. Standard insurance programs reimburse only services that are conventional and cost-effective. The system assumes that services are skillfully documented by providers. Experience as a peer reviewer helps clinicians acquire skill in documentation.

Cost-Benefit Analysis↗
PubMed2006

Linking processes and outcomes to improve surgical performance: a new approach to morbidity and mortality peer review.

Peer review of surgical cases resulting in death or potentially avoidable complications is a longstanding tradition, but intensive reviews of individual cases rarely produces tangible improvements in clinical outcomes. The systematic comparison of care received by patients who experienced adverse outcomes to care received by patients who had uneventful surgical courses is a promising alternative to intensive case review. However, the results of these studies may be misleading because physicians often choose interventions based on their perceptions of patients' preoperative risks, and higher adverse outcome rates among patients with higher preoperative risk may distort comparisons of alternative interventions. The creation of a control sample by carefully matching each patient who experienced an adverse outcome to a patient who had a similar preoperative risk but did not experience an adverse outcome can overcome this problem and provide excellent insight into how to improve clinical performance most effectively and efficiently. By using currently available electronic data to compute each patient's risk of an adverse outcome, a series of cases with adverse outcomes can be matched to an equal number of controls. Peer review committees can then direct focused data collection and analyses of potentially critical processes of care to determine which, if any, are associated with significantly poorer clinical results. A simulated scenario is analyzed in detail to illustrate the ability of this technique to correctly determine best practices when other approaches fail to do so.

General Surgery↗
PubMed1989

A peer review of a peer review organization.

Under Medicare, one of the federally required objectives of peer review organizations is to reduce inappropriate and unnecessary admissions. We reevaluated 32 admissions approved and 32 denied by the Arizona peer review organization, Health Services Advisory Group (HSAG), in a "blind" manner to determine whether practicing physicians in the community agree with the local peer review organization. Overall, physicians at the Scottsdale Memorial Hospital (SMH) approved 72% of HSAG-approved and denied 61% of HSAG-denied admissions. Of the 64 admissions, 3 or 4 of 4 reviewers (2 physicians and 2 nurses) agreed with the HSAG decision in 38 (59%), but 2 or more reviewers disagreed in the other 26 (41%). Disagreement between the 2 physicians occurred in 48% of the cases and disagreement between the 2 nurses in 33%. Even among admissions denied by SMH physician reviewers, the physicians would have admitted 23% of those patients under similar circumstances. In 28% of the HSAG-denied admissions, the reviewing physicians thought that the patients' health care would have been compromised if the admissions had not taken place. Despite well-defined criteria for the appropriateness of hospital admissions, the review process remains subjective, with much disagreement between peer review organizations and practicing physicians.

Aged↗
PubMed2004

[Inter-university cooperation in Flanders--an academic point of view on peer review].

Peer review as a possibility for discussion among practising dentists was introduced in Belgium in 1998 in the framework of a quality ensuring program. The 'Interuniversitary Cooperation', an initiative of Flemish universities active in teaching, research and patient treatment in dentistry has been involved in this program since its beginning to set up a dialogue between academia and dental practitioners and to gather information on scientific and educational matters. In this article the principles and organisation are described and thought is given to the attitude of the participants and future possibilities.

Belgium↗
PubMed1992

Interagency psychiatric consultation liaison nursing peer review and peer board: quality assurance and empowerment.

This article describes the implementation of an interagency peer review group and formal review board for psychiatric consultation liaison nurses (PCLN) practicing in affiliated institutions. Peer group members enhance their skill levels, assure quality standards of practice, and implement system changes through peer collaboration and member feedback. The model assures quality PCLN practice, fosters member resilience, creates a counterbalance for PCLN role isolation, and provides professional empowerment. The authors also disclose the peer group members' struggle and resolution to implement the mandated task of the annual performance review through the process of the PCLN formal peer review board.

Humans↗
PubMed2002

The use of dedicated methodology and statistical reviewers for peer review: a content analysis of comments to authors made by methodology and regular reviewers.

STUDY OBJECTIVES: In 1997, Annals of Emergency Medicine initiated a protocol by which every original research article, in addition to each regular review, was concurrently evaluated by 1 of 2 methodology and statistical reviewers. We characterized and contrasted comments made by the methodology and regular peer reviewers. METHODS: After pilot testing, interrater reliability assessment, and revision, we finalized a 99-item taxonomy of reviewer comments organized in 8 categories. Two authors, uninvolved in the writing of reviews, classified each comment from a random sample of methodology reviews from 1999. For 30 of these reviews (15 for each methodology reviewer), the 2 authors also scored all (range 2 to 5) regular reviews. RESULTS: Sixty-five reviews by methodologist A, 60 by methodologist B, and 68 by regular reviewers were analyzed. Comments by methodologist A most frequently concerned the presentation of results (33% of all comments) and methods (17%). Methodologist B commented most frequently on presentation of results (28%) and statistical methods (16%). Regular reviewers most frequently made non-methodology/statistical comments (45%) and comments on presentation of results (18%). Of note, comments made by methodology and regular reviewers about methods issues were often contradictory. CONCLUSION: The distributions of comments made by the 2 methodology and statistical reviewers were similar, although reviewer A emphasized presentation and reviewer B stressed statistical issues. The regular reviewers (most of whom were unaware that a dedicated methodology and statistical reviewer would be reviewing the article) paid much less attention to methodology issues. The 2 dedicated methodology and statistical reviewers created reviews that were similarly focused and emphasized methodology issues that were distinct from the issues raised by regular reviewers.

Peer Review, Research↗