EXAMPLE SWISS NUMBER PROFESSIONAL
However to date no systematic investigation on the professional quality of medical expertises assessed by an independent review team using a validated test instrument could be found. More guidelines could be located in specialized books and institute’s publications. A search analysis in the archives of the "Schweizerische Ärztezeitung" (SAeZ) and in the juridical literature produced only guidelines for rheumatology, neurology and psychiatry, as well as juridical requirements for expertises. In particular, it was not possible to identify a validated instrument for testing the quality of expertises (questionnaire) by which the expertises could be systematically evaluated. Surprisingly, our literature search (Medline/PubMed) has resulted in a very limited number of studies concerning the quality per se or the assessment of the quality of expertises, either in German or in the Anglo-Saxon speaking area. Considering the increasing number of assessments based on these expertises and the consequences for both insured persons and insurers, there is an urgent need for analysis and improvement. According to a recently published pilot study of the SUVA on the mainly formal quality of accident insurance expertises and the ensuing reactions in the press, it would seem that expertises show a considerable lack of quality. It is true that the Swiss Federal Court for Insurances (Eidgenössisches Versicherungsgericht, EVG) has defined the minimal requirements for medical expertises (decision of the Federal Court, BGE 125 V 351, EVG, ), but the content related quality requirements remain less well defined. disability insurance, SUVA) as well as private insurance companies (accident insurance, loss of income protection insurance or liability insurance).īesides the formal requirements the validity of expertises depends on their professional quality and the comprehensibility of the conclusions for clients and other interested parties such as lawyers and courts. In Switzerland medical expertises are commissioned either to medical specialists practicing in Switzerland or to specialised institutions such as MEDAS (Medizinische Abklärungsstation) or asim (Academy of Swiss Insurance Medicine) by both social insurances (e.g. Quality assurance, disability evaluation, reproducibility of results, legal liability, causality There is an obvious need for further research using larger samples and for educational programmes on all levels. This is hardly acceptable in face of the financial and personal consequences. In addition, expertises in the French and Italian languages were rated superior to those in German.ĬONCLUSION: Our results confirm recent criticisms that the professional quality of expertises does not suffice. The quality was inversely related to the number of involved medical disciplines, the time relapsed since injury and positively related to the difficulty of the expertise. RESULTS: Overall 19.6% (95% confidence interval: 13.1% 28.3%) of the expertises were rated to be of insufficient quality. For analysis and interpretation the grades were divided into sufficient (grades >= 4) and insufficient (grades <4). The main outcome was the overall quality rating of the expertise that was graded from 1 (very poor) to 6 (excellent) in analogy to the Swiss school grading system. Data were then tested for plausibility (obvious errors and misunderstandings). Each expertise was independently evaluated by two experts. METHODS: A sample of 97 anonymised expertises randomly chosen from a total of 3165, collected in the MGS study over a period of 3 months, were evaluated by an international board of medical experts and reviewers, using a stepwise developed questionnaire. The study was part of a market analysis of medical expertises (MGS study). The present investigation was therefore undertaken to assess the professional quality of Swiss medical expertises. Please find the affiliations for this article in the PDF.īACKGROUND: Considerable criticism has lately been raised by the media regarding the quality of Swiss medical expertises.