Methodological approaches to the expert appraisal of therapeutic care quality in chronic cholecystitis

• Main Authors: Galina Ivanovna Nechaeva, Vadim Adil'evich Akhmedov, Aleksey Vasil'evich Bereznikov, Vladimir Pavlovich Konev, G I Nechayeva, V A Akhmedov, A V Bereznikov, V P Konev
• Format: Article
• Language: Russian
• Published: "Consilium Medicum" Publishing house 2010-03-01
• Series: Терапевтический архив
• Subjects: chronic noncalculous cholelithiasis; standardization; expert examination of medical care quality
• Online Access: https://ter-arkhiv.ru/0040-3660/article/view/33360

Aim: to develop a technology for assessing the quality and consequences of medical care in chronic noncalculous cholecystitis by an expert - a therapist, a gastroenterologist. Materials and methods. One hundred and ninety-three cases of expert appraisal of medical care quality in chronic noncalculous cholecystitis were analyzed. The expert appraisal of the quality of medical care was carried out by comparing with that of the reference - the standard for the diagnosis and treatment of chronic noncalculous cholecystitis. To detect the defects correlated with the negative consequences of medical care, the authors calculated statistical criteria for assessing an association between the indices of accumulated informative value and the consequences of rendered medical care. Results. According to the assessed quality of medical care, the patients were divided into two groups: 1) 163 patients with negative consequences of delivered medical care; 2) 30 patients with its positive consequences (a control group). The identified drawbacks that significantly determined negative outcomes had a certain distribution in the groups by their frequency. The analysis provided calculations of the accumulated informative value index for each case individually for the processes of diagnosis and treatment, by drawing up the boundaries of proper and improper medical care delivered to patients with chronic noncalculous cholecystitis. Conclusion. The formulated criteria of positive consequences of medical care are oriented to the differential diagnosis of biliary tract pathology, to differentiated approaches to treatment analysis, and to the likely outcomes of exposure to medical and diagnostic actions on the pathological process, which allows an expert to predict its further dynamics and consequences of rendered medical care. The algorithmized expert appraisal of cases of medical care delivery makes it possible to objectivize the opinion and conclusions of an expert.