Medisch specialisten erg omgevingsgevoelig

Specialisten, die geraadpleegd worden bij letselschade zaken voor het gerecht, blijken opvallend vaak in het voordeel van het beweerde slachtoffer te oordelen.

Tijdens een onderzoek waarin men aan zes onafhankelijke radiologisch specialisten longfoto’s voorlegde die gebruikt waren in asbestrechtszaken tegen werkgevers, bleek in het allergrootste deel van de gevallen de uitspraak van de onafhankelijke specialisten af te wijken van die van de artsen die bij de rechtszaken betrokken waren.

Uitspraken van medisch specialisten zijn heel vaak bepalend voor de meningvorming rond bepaalde onderwerpen. Dit onderzoek toont aan dat je ook medisch specialisten lang niet altijd kunt vertrouwen.

Independent consultants interpreting chest radiographs of individuals exposed to asbestos found significantly fewer serious cases than physicians hired by plaintiff lawyers to examine the same individuals’ films, according to a study.

The study, to be published today in the scientific journal Academic Radiology, states that six radiologists and pulmonologists who reinterpreted chest X-rays initially screened by plaintiff lawyers’ readers “failed to confirm the conclusions in the majority of the cases.”

The study’s consultants reread each of 492 reports and found possible exposure to asbestos on a significant level in only 4.5% of the cases. The plaintiffs’ physicians found that 95.9% of the chest X-rays were positive for parenchymal abnormalities, a sign of asbestos exposure.

Co-author Dr. Joseph Gitlin, a public- health physician who researches medical imaging at Johns Hopkins University School of Medicine in Baltimore, said “differences between two honest well-trained experts often occur but the differences are rarely large.” In this study, he said, “the magnitude of difference in the interpretation is far beyond” the normal range. He declined to speculate on what caused the vast differences.

Chest X-rays are at the heart of thousands of asbestos lawsuits. Individuals who claim occupational injury from asbestos must show a certain degree of exposure on chest X-rays to get compensation.

The films used in the study were evidence in litigation on behalf of individuals exposed to asbestos. The consultants hired to conduct a second reading of the X-ray films weren’t told the source of the films or that they had been used in litigation, according to the authors.

Write to Kathryn Kranhold at


Not X-Ray Vision
The Wall Street Journal (Thursday, August 5, 2004)

These columns have been describing the ways in which asbestos litigation is corrupting our courts. Now comes a major new study showing how some physicians have also put their ethics on hold in order to share in the lucre from this legal scandal.
The study appears in Academic Radiology, one of the top peer-reviewed radiology journals. Led by Joseph Gitlin, an associate professor at Johns Hopkins, the study delves into the tawdry world of asbestos X-rays. A crucial part of any asbestos lawsuit are the “expert witness” physicians who make a living interpreting chest X-rays and telling juries that plaintiffs have suffered asbestos-related injuries. But as the new study shows, “expert” doesn’t mean what it used to.
Mr. Gitlin obtained 492 X-rays that had been examined by doctors retained by plaintiffs’ lawyers and entered as evidence in asbestos lawsuits. These X-ray readers had claimed to find evidence of possible asbestos-related lung damage in 96% of the cases. The researchers then had the same X-rays reinterpreted by six independent radiologists who didn’t know either the original findings or that the X-rays were part of court cases. The independent radiologists found abnormalities in a mere 4.5% of the cases. So, 96% vs. 4.5% — this would seem to be outside the margin of scientific error.
The obvious implication is that the asbestos blob has been compromising the ethics not just of lawyers but of doctors too. Some radiologists have clearly been willing to betray their profession’s scientific and ethical standards in pursuit of large expert-witness paydays.
An accompanying editorial in Academic Radiology by two noted radiologists — including the former chairman of the ethics committee for the American College of Radiology — notes that the “radiologic community itself clearly has an obligation to conduct further investigations” and if necessary to take steps to “restore integrity” to its profession. That’s for sure, but then again the asbestos blob seems to corrupt everything it touches.

Bron: Wall Street Journal

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