Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
1979-11-28
pubmed:abstractText
Elective surgery second opinion programs are predicted on strict acceptance of the accuracy of the consultant's surgical judgment. The reliability and reproducibility of clinical judgment, therefore, become basic to the effectiveness of such programs. This aspect, however, has received little attention. We report a randomized and controlled survey of surgical specialists which defines agreement/disagreement patterns in surgical decision-making for seven elective surgical procedures. For each disease process, four case histories, including at least one control, were developed by specialty panels of physicians. The case summaries described fictional patients who were seeking professional consultation. The histories were mailed to a random sample of Board-certified specialists from the State of Maryland and the District of Columbia. The response rate was approximately 80% for all five specialties. The respondents were asked to indicate whether they would (Yes) or would not (No) perform the surgical procedure in question. Factual knowledge was not sought, but instead the application of that knowledge and experience to decide on the need for surgical intervention. By comparing the responses for each case history, the agreement/disagreement patterns of inter-observer surgical judgment were determined. Analysis of the data revealed a marked divergence of opinion concerning the need for surgery. The significant point of this study is that surgical judgment differs to a major degree from one surgeon to the next. In a second-opinion program the number of consultants needed to provide a reliable clinical decision probably exceeds the number who are logistically available and that the patient would be willing to visit. Surgical decision-making is a semi-exact scientific process, and it is unreasonable to expect exact answers to clinical problems.
pubmed:commentsCorrections
http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-102045, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-105162, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-1097917, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-1124505, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-1129704, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-1141757, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-12990333, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-13523008, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-13584936, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-13695033, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-13721921, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-14297767, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-269965, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-406565, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-4175411, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-4427624, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-4688484, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-4706275, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-4750608, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-4821907, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-5007750, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-5409538, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-5409541, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-5416249, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-564670, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-5812257, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-589087, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-635774, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-686898, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-713632, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-876328, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-889380, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-895790, http://linkedlifedata.com/resource/pubmed/commentcorrection/485616-956332
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:status
MEDLINE
pubmed:month
Sep
pubmed:issn
0003-4932
pubmed:author
pubmed:issnType
Print
pubmed:volume
190
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
409-19
pubmed:dateRevised
2009-11-18
pubmed:meshHeading
pubmed:year
1979
pubmed:articleTitle
Surgical decision making. The reliability of clinical judgment.
pubmed:publicationType
Journal Article, Case Reports