Qualitätssicherung in der Sozialmedizinischen Begutachtung durch Peer Review – ein Pilotprojekt der Deutschen Rentenversicherung

Strahl, André; Gerlich, C.; Wolf, Hans-Dieter; Gehrke, J; Müller-Garnn, Annette; Vogel, Heiner

doi:10.1055/s-0034-1390450

Cited by 5 publications

(10 citation statements)

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“…Preliminary studies [ 17 ] and experience in peer-review procedure [ 20 ] indicate that an interactive training approach seems to be most appropriate to produce the skills required for peer review. The literature describes that learning in interactive small groups, as part of an active, collaborative, problem-based learning process, promotes an intense information processing, a deeper understanding of learning content and the possibility to check and clarify the accuracy of the understanding of learning content [ 21 – 23 ].…”

Section: Methodsmentioning

confidence: 99%

“…The non-standardized peer-training (CG) took place earlier, during evaluation of the item catalogue of the peer review programme (see [ 17 ]). Nineteen social medical physicians from 12 German Pension Insurances departments were part of the CG.…”

Section: Methodsmentioning

confidence: 99%

“…Twenty reports were reviewed by all peers, while two peers reviewed 240 medical reports each. Reliability for the main target criterion (confirmability) was found to be 0.37 [ 9 , 17 ]. The generally applicable standard of evaluation, 0.7, was not met.…”

Section: Introductionmentioning

confidence: 99%

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Development and evaluation of a standardized peer-training in the context of peer review for quality assurance in work capacity evaluation

et al. 2018

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BackgroundThe German quality assurance programme for evaluating work capacity is based on peer review that evaluates the quality of medical experts’ reports. Low reliability is thought to be due to systematic differences among peers. For this purpose, we developed a curriculum for a standardized peer-training (SPT). This study investigates, whether the SPT increases the inter-rater reliability of social medical physicians participating in a cross-institutional peer review.MethodsForty physicians from 16 regional German Pension Insurances were subjected to SPT. The three-day training course consist of nine educational objectives recorded in a training manual. The SPT is split into a basic module providing basic information about the peer review and an advanced module for small groups of up to 12 peers training peer review using medical reports. Feasibility was tested by assessing selection, comprehensibility and subjective use of contents delivered, the trainers’ delivery and design of training materials. The effectiveness of SPT was determined by evaluating peer concordance using three anonymised medical reports assessed by each peer. Percentage agreement and Fleiss’ kappa (κm) were calculated. Concordance was compared with review results from a previous unstructured, non-standardized peer-training programme (control condition) performed by 19 peers from 12 German Pension Insurances departments. The control condition focused exclusively on the application of peer review in small groups. No specifically training materials, methods and trainer instructions were used.ResultsPeer-training was shown to be feasible. The level of subjective confidence in handling the peer review instrument varied between 70 and 90%. Average percentage agreement for the main outcome criterion was 60.2%, resulting in a κm of 0.39. By comparison, the average percentage concordance was 40.2% and the κm was 0.12 for the control condition.ConclusionConcordance with the main criterion was relevant but not significant (p = 0.2) higher for SPT than for the control condition. Fleiss’ kappa coefficient showed that peer concordance was higher for SPT than randomly expected. Nevertheless, a score of 0.39 for the main criterion indicated only fair inter-rater reliability, considerably lower than the conventional standard of 0.7 for adequate reliability.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Development and evaluation of a standardized peer-training in the context of peer review for quality assurance in work capacity evaluation

et al. 2018

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“…In der Fokusgruppenarbeit wurden von den Experten wahrgenommene Probleme (n = 45) im Gutachterwesen angesprochen. Diese lassen sich in 10…”

Section: Problemfelder Im Gutachterwesenunclassified

“…Der anfänglich noch lineare Charakter zur Verbesserung des Gutachterwesens wurde aufgebrochen und mehr Reflexivität ins Gutachterverfahren implementiert [8]. In eine ähnliche Richtung geht der zur Weiterentwicklung der Sozialmedizin in der gesetzlichen Rentenversicherung entwickelte förderliche Ansatz der Peer Review-Verfahren in der sozialmedizinischen Begutachtung [10].…”

Section: Diskussionunclassified