ACOG criticized by LA court

[admin]

Kate,
I see what you are saying and I understand and agree.

Nancy,
Thank you for posting that information. That is helpful and puts the point across well about how some of the journals get their recommendations for the reviews.

Kay

[admin]

That is why we have to be careful. It seems like that journal does a much better job of providing a thorough review, but if you notice, the authors name is still provided, and they try to obtain a review from someone who has the same intrests. From what I have learned, and my experience only, is that doctors learn who reviews for what journals and tend to do the I will review you if you review me type of thing. In the description that Rich gave where the authors name is provided, that could be the case, especially in fields where there are not a large amount of well known specialists. I am not saying that is the case, just offering what I have learned while hearing the doctors perspective. Parents need to know how the review process works from both sides so they can better determine how their child's care is handled. It seems that no matter what the guidelines of reviewing are, there is always another side, and a way around them. That could be one reason that some journals ask for their own recomendations, considering that is what they basically get in some cases, and it usually forces them to provide more than one person, which gives them a different approach to gaining the review. I am speaking of articles in general, not all articles. That is the reason again, that some parents may get confused about certain treatments. The information is easy to find, but trying to figure out what is truly accepted and what really works, is much harder. Everyone knows, I am sure, that you can't trust everything you read to its full extent, especially if only one side is presented. I hope this helps other parents learn about the process.
Kay

[admin]

Just because a medical article is published does not mean that it is accpeted mainstream medicine. That is what the doctors like Dr. Gherman want the public, and juries, to believe, but that is not the reality. I don't know "Kate", but can only assume that she has never read the literature. I have. I have also argued to many courts in this country that Dr. Gherman's literature is misleading and unrealiable, and had the Court agree with me.

The Gherman article is unrealiable because it contains statements such as :

“We acknowledge that almost all of the information concerning the relationship between delivery, shoulder dystocia and brachial plexus injury has been collected retrospectively and therefore has an inherent ascertainment bias. “

The Gherman article actually bases most of it medical information upon aother misleading articles written by Dr. Jennett and Dr. Ouzounian. Those article are flawed as well. The authors seeks to support the “notion” that the etiology of permanent brachial plexus palsy associated with birth may not be related to traction based upon eight cases reviewed. The authors acknowledge, however, that in cases of Erb palsy delivered without documentation of shoulder dystocia, they recognize the possibility that the occurrence of a shoulder dystocia may have been unrecognized. Further, the authors expressly acknowledge that they are presenting nothing more than a a hypotheses as to what might have possible occurred, or what theoretically could also contribute to cause this injury.

Further, Dr. Jennett refers to the possibility of another cause and suggests without any medical basis that it must be an maladaption in the uterus. The author never states how this happens, when it happens or why it happens. Simply that it is a possibility. Of course the real basis for the article is found in the first paragraph when the author discusses medical legal issues and his desire to find another reason for brachial plexus injuries other than medical negligence. The article is nothing more than speculation.

These articles have been written with the express purpose of defending medical malpractice cases. The articles are not supported by proper medical evidence and have an admitted bias. It is for this reason they are excluded from trials, and why the Courts have called them misleading. I would be pleased to discuss these issues in more detail if people are interested.

Ken Levine
Klevine@klevinelaw.com
617-566-2700

[admin]

Whilst the peer review process can contain flaws, at least it does put the work of the doctor 'out there' so that a basis for what they are doing and their evidence for why they feel it works is public-they may choose their own reviewers but once it has been published in a journal then reveiwers they have not chosen are free to comment, and do!
In the case of bpi surgery, the International Symposium regularly held by the Narakas Club provides an additional forum for presentation of work, most of the world's foremost bpi doctors are present and can comment on presented work. Why would a doctor not want to have work he or she feels helps people with bpi more widely known if it is effective?
Whether we hold much faith in peer review or not, I for one am thankful that most doctors do publish their results, and I am not sure that the surgeries would be as advanced as the are if the pioneering doctors who went before had not published their work. I pray that doctor do keep publishing, if only to help others in the future.

[admin]

Just because a medical article is published does not mean that it is accpeted mainstream medicine. That is what the doctors like Dr. Gherman want the public, and juries, to believe, but that is not the reality. I have argued to many courts in this country that Dr. Gherman's literature is misleading and unrealiable, and had the Court agree with me.The Gherman article is unrealiable because it contains statements such as :

'We acknowledge that almost all of the information concerning the relationship between delivery, shoulder dystocia and brachial plexus injury has been collected retrospectively and therefore has an inherent ascertainment bias. '


The Gherman article actually bases most of it medical information upon another misleading articles written by Dr. Jennett and Dr. Ouzounian. Those article are flawed as well. The authors seeks to support the notion that the etiology of permanent brachial plexus palsy associated with birth may not be related to traction based upon eight cases reviewed. The authors acknowledge, however, that in cases of Erb
palsy delivered without documentation of shoulder dystocia, they recognize the possibility that the occurrence of a shoulder dystocia may have been unrecognized. Further, the authors expressly acknowledge that they are presenting nothing more than a a hypotheses as to what might have possible occurred, or what theoretically could also contribute to cause this injury.Further, Dr. Jennett refers to the possibility of another cause and suggests without any medical basis that it must be an maladaption in
the uterus. The author never states how this happens, when it happens or why it happens. Simply that it is a possibility. Of course the real basis for the article is found in the first paragraph when the author discusses medical legal issues and his desire to find another reason for brachial plexus injuries other than medical negligence. The article is nothing more than speculation.These articles have been written with the express purpose of defending medical malpractice cases. The articles are not supported by proper medical evidence and have an admitted bias. It is for this reason they
are excluded from trials, and why the Courts have called them misleading. I would be pleased to discuss these issues in more detail if people are interested.

Ken Levine
Klevine@klevinelaw.com
617-566-2700

[admin]

Well said Ken. Thanks for that input.
Kay

[admin]

Ken, those are very good points.

This article that I found about peer review on line was good also.

http://www.quackwatch.org/04ConsumerEducation/peer.html

[admin]

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