title: The consistency of experts' evaluation of obstetric claims for compensation.
abstract: OBJECTIVE
  The aim of this study was to investigate the consistency of experts' evaluation of different types of obstetric claims for compensation.
  
  
  METHODS
  Inter-rater reliability study of obstetric claims for compensation.
  
  
  METHODS
  Medical experts' evaluation in The Norwegian System of Compensation to Patients, a no-blame system.
  
  
  METHODS
  The 15 most frequently used medical experts were asked to evaluate 12 obstetric claims applied for compensation.
  
  
  METHODS
  Inter-rater agreement was assessed by absolute agreement, Fleiss' kappa statistic and Gwet's AC1.
  
  
  METHODS
  Consistency in the evaluation of negligence (carelessness without intention to harm) and causality (relation between care and injury) between negligence and patient injury.
  
  
  RESULTS
  The experts demonstrated moderate consistency in their evaluation of negligence (Fleiss' kappa = 0.53/AC1 = 0.54) and causality (Fleiss' kappa = 0.41/AC1 = 0.54). There was a higher level of agreement in clinical scenarios with well-documented diagnostic criteria and guidelines, including shoulder dystocia and asphyxia with low Apgar score and metabolic acidosis.
  
  
  CONCLUSIONS
  We found a moderate level of agreement in experts' evaluation of negligence and causality between the injury and provided health care, the two most important questions to be answered in obstetric claims for compensation.
authors.affiliation: Department of Obstetrics and Gynaecology, Nordlandssykehuset, Bodø, Norway.|Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.
authors.forename: S
authors.initials: S
authors.lastname: Andreasen
authors.affiliation: Institute for Laboratory Medicine, Women's and Children's Health, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: B
authors.initials: B
authors.lastname: Backe
authors.affiliation: Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: S
authors.initials: S
authors.lastname: Lydersen
authors.affiliation: Department of Surgery, Haukeland University Hospital, Bergen, Norway.
authors.forename: K
authors.initials: K
authors.lastname: Øvrebø
authors.affiliation: Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.|Department of Obstetrics and Gynaecology, University Hospital of North Norway, Tromsø, Norway.
authors.forename: P
authors.initials: P
authors.lastname: Øian
mesh_terms: D035881:Compensation and Redress; D005260:Female; D006801:Humans; D008318:Malpractice / Q000706:statistics & numerical data*; D019300:Medical Errors / Q000706:statistics & numerical data*; D009664:Norway / Q000453:epidemiology; D015588:Observer Variation; D009774:Obstetrics / Q000706:statistics & numerical data*; D011247:Pregnancy; D011795:Surveys and Questionnaires
keywords: Agreement; consistency; guidelines; inter-rater reliability; medical experts; negligence; obstetrics