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Record W2104188193 · doi:10.1136/qshc.2002.003905

HARVARD MEDICAL PRACTICE STUDY

2004· article· en· W2104188193 on OpenAlexaff
G. Ross Baker

Bibliographic record

VenueBMJ Quality & Safety · 2004
Typearticle
Languageen
FieldHealth Professions
TopicMedical Malpractice and Liability Issues
Canadian institutionsUniversity of Toronto
Fundersnot available
KeywordsMedicineAdverse effectHealth careTortSample (material)Incidence (geometry)Medical practicePublic healthActuarial scienceMedical emergencyFamily medicineBusinessNursingPolitical scienceLawAccounting

Abstract

fetched live from OpenAlex

Background: As part of an interdisciplinary study of medical injury and malpractice litigation, we estimated the incidence of adverse events, defined as injuries caused by medical management, and of the subgroup of such injuries that resulted from negligent or substandard care.Methods: We reviewed 30 121 randomly selected records from 51 randomly selected acute care, nonpsychiatric hospitals in New York State in 1984.We then developed population estimates of injuries and computed rates according to the age and sex of the patients as well as the specialties of the physicians.Results: Adverse events occurred in 3.7% of the hospitalizations (95% confidence interval 3.2 to 4.2), and 27.6% of the adverse events were due to negligence (95% confidence interval 22.5 to 32.6).Although 70.5% of the adverse events gave rise to disability lasting less than 6 months, 2.6% caused permanently disabling injuries and 13.6% led to death.The percentage of adverse events attributable to negligence increased in the categories of more severe injuries (Wald test x 2 = 21.04,p,0.0001).Using weighted totals we estimated that among the 2 671 863 patients discharged from New York hospitals in 1984 there were 98 609 adverse events and 27 179 adverse events involving negligence.Rates of adverse events rose with age (p,0.0001).The percentage of adverse events due to negligence was markedly higher among the elderly (p,0.01).There were significant differences in rates of adverse events among categories of clinical specialties (p,0.0001),but no differences in the percentage due to negligence.Conclusions: There is a substantial amount of injury to patients from medical management, and many injuries are the result of substandard care.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.009
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.125
Threshold uncertainty score0.419

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.009
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0020.005
Science and technology studies0.0020.001
Scholarly communication0.0020.002
Open science0.0010.001
Research integrity0.0010.002
Insufficient payload (model declined to judge)0.1250.021

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.157
GPT teacher head0.587
Teacher spread0.431 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations61
Published2004
Admission routes1
Has abstractyes

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