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Record W2158460691 · doi:10.1136/qshc.2007.023564

The egocentric surgeon or the roots of wrong side surgery

2008· letter· en· W2158460691 on OpenAlexaff
J. W Senders, R. Kanzki

Bibliographic record

VenueBMJ Quality & Safety · 2008
Typeletter
Languageen
FieldHealth Professions
TopicMedical Malpractice and Liability Issues
Canadian institutionsUniversity of Toronto
Fundersnot available
KeywordsMedicineSurgeryGeneral surgery

Abstract

fetched live from OpenAlex

> “Oh wad some power the giftie gie us > > To see the world as our patient sees it! > > It wad frae monie a blunder free us, And foolish notion.” > > (With apologies to R Burns) A wrong site procedure is an event in which any medical (frequently surgical) procedure is executed on the wrong body part, or on the correctly named body part but on the wrong side of a patient’s body. If the procedure is surgery then the event is a wrong site surgery or a wrong side surgery. Wrong side surgery is generally considered to be a subset of wrong site surgery. The Joint Commission on the Accreditation of Health Care Organizations (JCAHO) reviewed 15 reported cases of wrong side surgery in a “Sentinel Event Alert” of August 1988. The problem has gained more attention since that time. In 2003, JCAHO promulgated a “Universal protocol for eliminating wrong site, wrong procedure, wrong person surgery”. Our own interest arose (see Acknowledgement) from a chance event. There are no reliable probabilities of various kinds of wrong side and wrong site surgery, because of both poor numerators (number of events) and poor denominators (opportunities for events). JCAHO classifies wrong side surgery as “sentinel events” and accumulates statistics. From 2000 to 2005 there were 3044 sentinel events (categorised in table 1). Wrong site surgery events are near the top of the list and we may assume that about 80% of them were wrong side surgery events (see tables 2 and 3). View this table: Table 1 Classification of 3044 sentinel events reviewed by JCAHO, January 1995 through March 20051 View this table: Table 2 Types of wrong surgery* View this table: Table 3 Surgery error rates in the Veterans Administration system3 As both JCAHO and the Veterans Administration (VA) system show, most wrong site surgery events are wrong side surgeries. The statistics offered are similar. JCAHO reports a wrong side/wrong site surgery ratio of 0.76 (0.59/(0.59+0.19)), and the VA ratio is 0.86 (0.44/(0.44+0.07)). Ericson4 of Washington University in St Louis estimates that …

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)0.002
metaresearch head score (Gemma)0.013
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.022
Threshold uncertainty score0.074

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0020.013
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0010.001
Science and technology studies0.0030.013
Scholarly communication0.0030.005
Open science0.0010.003
Research integrity0.0040.006
Insufficient payload (model declined to judge)0.0220.003

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 head0.209
GPT teacher head0.490
Teacher spread0.281 · 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 designNot applicable
Domainnot available
GenreCommentary

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

Citations8
Published2008
Admission routes1
Has abstractyes

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