The aim of this study was to investigate the consistency of experts' evaluation of different types of obstetric claims for compensation.Design
Inter-rater reliability study of obstetric claims for compensation.Setting
Medical experts' evaluation in The Norwegian System of Compensation to Patients, a no-blame system.Sample
The 15 most frequently used medical experts were asked to evaluate 12 obstetric claims applied for compensation.Methods
Inter-rater agreement was assessed by absolute agreement, Fleiss' kappa statistic and Gwet's AC1.Main outcome measures
Consistency in the evaluation of negligence (carelessness without intention to harm) and causality (relation between care and injury) between negligence and patient injury.Results
The experts demonstrated moderate consistency in their evaluation of negligence (Fleiss' kappa = 0.53/AC1 = 0.54) and causality (Fleiss' kappa = 0.41/AC1 = 0.54). There was a higher level of agreement in clinical scenarios with well-documented diagnostic criteria and guidelines, including shoulder dystocia and asphyxia with low Apgar score and metabolic acidosis.Conclusion
We found a moderate level of agreement in experts' evaluation of negligence and causality between the injury and provided health care, the two most important questions to be answered in obstetric claims for compensation.