Claims filed after perceived malpractice in management of acute appendicitis: An observational nationwide cohort study
Bibliographic record
Abstract
BACKGROUND AND AIMS: Acute appendicitis is the most common surgical emergency worldwide. Obtaining a correct diagnosis and timely management can be challenging even in modern medicine. Hence, appendicitis is still considered a "high-risk" diagnosis for litigation and claims of malpractice. Few studies have investigated the pattern and outcome of claims for appendicitis in a contemporary universal health care system. The aim of this study is to analyze compensation claims related to the investigation and treatment of appendicitis in Norway. METHODS: An observational study based on claims from the Norwegian System of Patient Injury Compensation (NPE) from 2005 to 2023. Population rates of appendicitis treatment were obtained from the Norwegian Patient Registry (NPR; data from 2016 to 2023) and Statistics Norway (SSB). RESULTS: Altogether 207 compensation claims were filed for appendicitis and 56 (27%) received compensation. The probability of receiving compensation was not influenced by age, gender, or geographical location. The most common reasons for compensation granted were delayed diagnosis (n = 25, 45%) and delayed treatment (n = 5, 9%). The most common reasons for the 151 (73%) denied claims were predictable complication (n = 48, 32%) and condition caused by an unrelated disease (n = 40, 26%). Out of the 59,450 appendectomies performed, 96 claims were filed to NPE, giving a claim rate of 0.16% or 1 claim for every 620 appendectomies. For the entire study period, there was a total payout of 27.2 mill NOK (approximately 2.4 mill EUR) with a mean of 460,000 NOK (approximately 40,000 EUR) and a median of 75,000 NOK (approximately 6,600 EUR) per claim. CONCLUSION: In acute appendicitis, about a quarter of claims are compensated due to malpractice. More than half of the approved claims involved delays in diagnosis or treatment, which can be related to the clinical challenges of diagnosing appendicitis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot 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.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
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".