超越法律和科学决策过程之间的距离:基于证据的预测算法,用于评估医疗保健相关感染中的专业责任
Sara Sablone1, Andrea Nicola Cardinale1, Ettore Gorini2
1Section of Legal Medicine, Interdisciplinary Department of Medicine, Bari Policlinico Hospital, University of Bari, 70124, Bari, Italy.
Journal of forensic and legal medicine
|September 26, 2024
概括
意大利最高法院的标准有效地确定了医疗保健所获得的感染 (HAI) 和职业责任. 结合法律 ("法律") 和临床 ("传染病") 标准,为诉讼提供了一个强大的工具,确保司法调查的科学严谨性.
科学领域:
- 医疗法 法律 医疗法
- 传染性疾病 传染性疾病
- 法医医学 法医医学
背景情况:
- 医疗保健感染 (HAI) 是一个重大问题,意大利最高法院在第6386号裁决中确定了设施责任的三个标准 (时间,地形,临床).
- 设施必须证明遵守特定的预防卫生措施,以避免患病室感染的责任.
- 这项研究评估了这些"法律标准"的预测价值与传染病专家使用的临床标准.
研究的目的:
- 为了比较"法律标准"与"传染病标准"在确定医院感染和职业责任方面的有效性.
- 评估结合法律和临床标准在HAI案件中赋予责任的预测价值.
- 探索法律诉讼中的技术顾问统一评分系统的潜力.
主要方法:
- 两个队列的回顾性分析:来自意大利法院判决的51名患者和来自巴里大学医院的349名患者 (2020-2022年).
- "法律"和"传染病"两个标准都应用于分层队列 (nosocomial和non-nosocomial).
- 接收器操作特征 (ROC) 曲线和曲线下的面积 (AUC) 用于评估预测值.
主要成果:
- 确定的医院感染的发生率在"法律"队列中 (84%) 比"现实世界"系列 (46%) 高.
- 无论是"法律"标准 (AUC=0.944) 还是"传染病"标准 (AUC=0.948) 都显示出具有责任性的医院感染的强有力的预测价值.
- 综合两套标准的综合评分系统实现了最高的AUC (0.9488),至少有1个"法律"和2个"传染病"标准的预测能力很高.
结论:
- 意大利最高法院的"法律标准"有效地分配了对医院感染的责任,弥合了法律和科学决策.
- 合并的"法律"和"传染病"评分系统为技术顾问提供了有价值的工具,特别是在缺乏临床文档的情况下.
- 这种方法增强了有关全球高职院校职业责任的司法调查的科学严谨性.
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