Population-based health information systems, such as cancer registries, have been in use for decades [85] and are becoming increasingly common [76, 77]. To ensure that the results of studies based on information from forensic databases are translated in a useful and reliable manner, policymakers should be aware of their strengths and limitations, such as the potential underestimation of suicides. It is important to note that datasets such as NCIS were not designed exclusively for academic research or for specific research questions [76]. Therefore, the variability in the content and details of the information it contains is a function of the variability within and between coroners and corona jurisdictions. NCIS has been described as a useful tool for investigating deaths and conducting research on public health and safety. In particular, access to coroners` recommendations has been noted as particularly useful [42]. The choice of data source can significantly influence the results of studies and sometimes leads to contradictory conclusions. Using NCIS as an example, this study identifies the main strengths and limitations of a national forensic database used by public health researchers and peer-reviewed. This information allows researchers, policy makers and practitioners to be better prepared when determining whether a research question is being addressed by a particular line of evidence and the validity of the study result. Hopefully, this will reduce the waste of valuable resources and lead to better public health initiatives. To our knowledge, this is the first study to determine the strengths and limitations of NCIS as determined by researchers and their fellow scientists. Overall, studies have been published in a wide range of journals in terms of country of origin, field and skill level, contributing to the generalizability of the results. In addition, a broad and systematic search strategy was used to identify appropriate studies, and a search of NCIS`s own database ensured that published studies were not overlooked.
Studies published in peer-reviewed journals have been included on the basis that their results have undergone the flawed but indispensable peer review process, giving them legitimacy [78, 79]. The authors thank Ms. Natalie Johnson (Director of NCIS) and Ms. Jessica Jackson (Deputy Director of NCIS) for their assistance in identifying appropriate publications and reviewing the manuscript. This research did not receive specific grants from any public, commercial or not-for-profit funding organization. There are cases where test results are not received by the prescribing physician. In other cases, patients do not perform the tests as directed or the results are filed before the doctor examines them and the patient is not informed of the results. It is important that physicians and their staff are able to track the status of these prescriptions to ensure that none are overlooked or forgotten. Another aspect of care that requires better follow-up is referral to specialists.
Each step must be documented, not only to avoid medico-legal problems, but also for good patient care. [11] Prior to the advent of forensic databases, investigations of unexpected and non-natural deaths consisted primarily of traditional surveillance programs run by government agencies focused on public health or safety, which generally investigated specific types of deaths, such as deaths in custody. However, their conclusions were limited by incomplete data obtained from voluntary reports by local agencies or by approximate information from national statistics such as the National Vital Statistics System in the United States or the Australian Bureau of Statistics in Australia [84]. Ioannidis JPA. Why most published research is wrong. PLoS Med. 2005;2(8):696–701. Medical law and bioethics will no longer consider meta-analyses for publication.
Of the 106 publications included, 30 reported strengths and limitations, only 37 reported limitations, only seven were strengths, and 32 were neither of them. The effects of NCIS reported forces were described in 14 publications, while 46 publications examined the effects of constraints. NCIS has been flagged as a reliable source of detailed, high-quality information with comprehensive coverage of deaths of interest, making it a powerful injury surveillance tool. Despite these strengths, the researchers reported that open-label cases and lack of information created potential selection and reporting biases and could exclude the identification and control of confounders. Nevertheless, concerns remain about the possible shortcomings of this dataset format and its impact on research results [22]. While electronic access reduces the cost and time required for case identification and data collection, discussion of methodological limitations and strengths of this data for public health research remains rudimentary. The published research literature is rich in studies that use different lines of evidence and reach conflicting conclusions [23]. Therefore, failure to assess the presence and impact of limitations and strengths of forensic death investigation data on research findings can lead to suboptimal public health intervention policies and programs. In some cases, this may have important clinical implications, as evidenced by the paradigm shift in hormone replacement therapy and cardiovascular disease risk [24]. A descriptive statistical analysis was performed to describe the frequency of the original published research, the topic of the research conducted, and studies that included a discussion of the strengths and limitations of NCIS as a data source and implications for its results. Authors 1, 4 and 3 independently conducted an analysis of the content of this information to identify the nature, impact of NCIS`s strengths and limitations, as reported by the researchers. For physicians, it is essential to develop an asset protection plan in addition to professional liability insurance.
A malpractice lawsuit not only reduces a physician`s ability to make a living in medicine, but can also harm or destroy assets earned and invested. There are two categories of professional liability, such as personal or individual liability: This bears the liability risk of the doctor and his qualified assistant. Errors and Omissions Policy: This policy applies to an institution, nursing home or hospital and its staff. If a physician owns a hospital or facility, it is recommended to establish both an individual policy and an error policy, as the hospital or facility is a separate legal entity and can often be a party to a medico-legal matter. [7] To ensure that research findings are valid and inform health policy, it is important to consider the limitations of data sources that may influence outcomes. Adverse outcomes occur in health care, regardless of the intent and quality of care provided. Patients may suffer harm or receive inadequate treatment or be dissatisfied, leading them to seek redress through medico-legal proceedings against the doctor. In Australia, there are formal complaint resolution mechanisms in all Australian states and territories, and a complaint to one of these complaints bodies is common. Patients are also seeking damages for medical negligence. A minority of patients seek compensation if no illegal treatment has taken place or if there is no reason to complain. Poor outcomes cause stress for everyone involved, not only the patient and family, but also the doctor and the doctor`s family. The medico-legal processes of complaints, claims and inquiries that may ensue can be stressful for the physician, regardless of the cause or outcome.