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Medical examiner variability

Published online by Cambridge University Press:  29 June 2007

R. Hinchcliffe
R. Hinchcliffe*
Affiliation:
Division of Audiological Medicine, Institute of Laryngology and Otology, University College London Medical School. London, UK.
*
Address for correspondence: R. Hinchcliffe, Division of Audiological Medicine, Institute of Laryngology and Otology, University College London Medical School, London WC1X 8EE.
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Abstract

There are undoubtedly many factors that contribute to inter-examiner variability relevant to the use of medical practitioners in justiciable matters. One source of variability with regard to claims relating to hearing disorders could well be the training and ‘calibration’ of medical examiners. A tentative analysis of the examination papers and of the declared roles of the specialties that provide these examiners lends support to such a thesis. One solution would be to train special specialists for medicolegal work, as envisaged by Boyarsky for forensic urology (Boyarsky, 1996). At the same time there is the need to change the role-perception of many examiners. There is also the need for medical examiners to express honest, unbiased opinions. There are also problems inherent in the litigation process which does not promote the interactive and adaptive processes between experts that characterise scientific discussions and enquiry.

Keywords

JurisprudenceObserver variationEducationHearing lossnoise-induced
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 1 , January 1997 , pp. 8 - 14
Copyright
Copyright © JLO (1984) Limited 1997

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Footnotes

A review based upon a paper presented at the 11th World Congress of Medical Law, Sun City, Northwest Province, South Africa. 28 July–1 August, 1996.

References

Alberti, P. W. (1987) Noise and the ear. In Scott-Brown's Otolaryngology. 5th Edition. Vol 2, Ch 18. Adult audiology. Butterworths, London, pp 594–641.Google Scholar
Aswapokee, N. (1996) What is evidence-based medicine? Proceedings of the Siriraj Scientific Congress, 4–8 March, Chuan Printing, Bangkok, p 136.Google Scholar
Bentham, J. (1825) Treatise on Judicial Evidence, Payne, London, p 41.Google Scholar
Boyarsky, S. (1996) Forensic urology: A practical vision. Proceedings of 11th World Congress on Medical Law, Sun City, Northwest Province, South Africa. International Centre of Medicine and Law, Buhrmannsdrif, South Africa, 1: 75–80.Google Scholar
Brewin, T. B. (1992) Excessive fear of dilute radiation. Journal of the Royal Society of Medicine 85: 311–313.Google ScholarPubMed
Chadwick, D. L. (1971) Occupational hearing loss and the otologist. In Occupational Hearing Loss. (Robinson, D. W., Ed). Academic Press, London, pp 217–223.Google Scholar
Cochrane, A. L., Chapman, P. J., Oldham, P. D. (1951) Observers' errors in taking medical histories. Lancet 1: 1007.CrossRefGoogle ScholarPubMed
Coles, R. R. A. (1975) Medico-legal aspects of noise hazards to hearing. Medico-Legal Journal 43: 3–19.CrossRefGoogle ScholarPubMed
Cornes, P., Aitken, R. C. B. (1992) Medical reports on persons claiming compensation for personal injury. Journal of the Royal Society of Medicine 85: 329–333.Google ScholarPubMed
DHSS (1973) Occupational Deafness. Report by the Industrial Injuries Advisory Council in accordance with Section 62 of the National Insurance (Industrial Injuries) Act 1965 on the question whether there are degrees of hearing loss due to noise which satisfy the conditions for prescription under the Act. Cmnd. 5461, HMSO, London.Google Scholar
DHSS (1982) Occupational Deafness. Cmnd 8749, HMSO, London, para. 39.Google Scholar
Editorial (1984) Counsel, Nov/Dec8Google Scholar
Hadfield, P. (1995) How to judge the performance of an ENT surgeon. ENT News 4: 9–10.Google Scholar
Hand, D. J. (1996) Statistics and the theory of measurement. Journal of the Royal Statistical Society A 159: 445–492.CrossRefGoogle Scholar
Hinchcliffe, R. (1996a) Who train the trainers? A broad perspective. Proceedings of VIII International Symposium on Audiological Medicine, Chiang Rai, Thailand.Google Scholar
Hinchcliffe, R. (1996b) Inter-examiner variability. Proceedings of 11th World Congress on Medical Law, Sun City, Northwest Province, South Africa. International Centre of Medicine and Law, Buhrmannsdrif, South Africa. 1: 389–402.Google Scholar
MacDermott, J. (1996) A judicial point of view with regard to the testimony of medical experts. Presented at 11th World Congress on Medical Law, Sun City, Northwest Province, South Africa. International Centre of Medicine and Law, Buhrmannsdrif, South Africa (Session 3 on 29 July).Google Scholar
MacNaughton-Jones, H., Stewart, W. R. H., Milligan, W., Tilley, H., Birmingham, A., Joyce, R. D. (1902) The Practitioner's Handbook of Diseases of the Ear and Nasopharynx. 6th Edition. Baillière, Tindall and Cox, London.Google Scholar
Medicolegal (1979) Medical reports not to the lawyers' liking. British Medical Journal ii, 1376.Google Scholar
Montaigne, M. de (1580) Essais 2: De La Ressemblance des Enfants aux Pères (Of the Resemblance of Children to their Fathers). Chapitre XXXVII. Reprinted by Librairie Générale Française, Paris, 1972. p 540.Google Scholar
Morrison, M. C. T. (1993) Medico-legal Reports. Journal of the Royal Society of Medicine 86: 247.Google ScholarPubMed
Popper, K. R. (1972) Conjectures and Refutations: The Growth of Scientific Knowledge. 4th Edition. Routledge and Kegan Paul, London, p 35.Google Scholar
Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., Richardson, W. S. (1996) Evidence based medicine: what it is and what it isn't. British Medical Journal 312: 71–72.CrossRefGoogle ScholarPubMed
Smith, A. F. M. (1996) Mad cows and ecstasy: chance and choice in an evidence-based society. Journal of the Royal Statistical Society A. 159: 367–383.CrossRefGoogle Scholar
Wilbush, J. (1992) The Sherlock Holmes paradigm - detectives and diagnosis. Journal of the Royal Society of Medicine 85: 342–345.Google ScholarPubMed
Woolf, The Right Honourable the Lord (1995) Access to Justice: Interim Report to the Lord Chancellor on the civil justice system in England and Wales.Google Scholar