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Table 1 Characteristics of eligible studies

From: Sex differences in medico-legal action against doctors: a systematic review and meta-analysis

First author, year (country)

Study design

Description of study population

Years data collected

Data source

Outcomes assessed

Statistical test

Alam et al. [13], 2013 (Canada)

Cohort

Anaesthetists of all grades

2000–2011

Medical regulatory authority (College of Physicians and Surgeons)

Disciplinary action

Proportion

Alam et al. [14], 2011 (Canada)

Cohort

Doctors of all specialties and grades

2002–2009

Medical regulatory authority (College of Physicians and Surgeons)

Disciplinary action

Proportion

Balch et al. [23], 2011 (USA)

Cross-sectional

Surgeons of all grades

2010

Electronic questionnaire

Malpractice suit in last 2 years

χ2 P <0.01

Baldwin et al. [24], 1991 (USA)

Cohort

General practitioners and obstetricians of all grades

1982–1988

Insurance company

Malpractice experience

χ2 P >0.05

Birkeland et al. [15], 2013 (Denmark)

Cohort

General practitioners; grades of doctors not stated

2007

Medical regulatory authority (Complaint handling authority)

Disciplinary action

Multivariate analysis adjusted for complaint motives, patient characteristics, GP characteristics

Bismark et al. [38], 2013 (Australia)

Cohort

All specialties of all grades

2000–2011

Health Service Commissions

Patient complaints

Proportion

Cardarelli et al. [16], 2004 (USA)

Case–control

All specialties of all grades

1989–1998

Medical regulatory authority (State Board of Medical Examiners)

Disciplinary action

Multivariate analysis adjusted for years in practice, ethnicity, international education, specialty, method of licensure

Chauhan et al. [25], 2005 (USA)

Cross-sectional

Obstetricians and gynaecologists, excluded residents

Not reported

Postal questionnaire

Malpractice claim

Multivariate analysis adjusted for age, ethnicity, years in practice, no subspecialty

Clay et al. [17], 2003 (USA)

Case–control

Majority of specialties a of all grades

1997–1999

Medical regulatory authority (State Medical Board)

Disciplinary action

Univariate analysis with controls matched on location

Donaldson et al. [39], 2014 (England)

Cohort

All specialties of all grades

2001–2012

National Clinical Assessment Service

Referral to National Clinical Assessment Service

Univariate analysis

Elkin et al. [18], 2011 (Australia & New Zealand)

Cohort

All specialties of all grades

2000–2009

Written determinations

Disciplinary action

Rate

Ely et al. [26], 1999 (USA)

Cohort

General practitioners, excluding doctors who were unlicensed or recently licensed

1971–1994

Insurance company

Malpractice claims

Univariate and multivariate analysis adjusted for international education, board certification, physician’s recognition award, practice location

Goldenbaum et al. [36], 2008 (USA)

Cohort

All specialties of all grades

1998–2006

Online and published sources and databases

Criminal and administrative cases involving controlled substances

χ2 P <0.001

Hickson et al. [27], 2002 (USA)

Cohort

Majority of specialties b excluding residents

1992–1998

Patient Advocates Office and Office of Insurance and Risk Management

Malpractice (at least one lawsuit)

χ2 P <0.001

Khaliq et al. [19], 2005 (USA)

Cohort

All specialties of all grades

2001

Medical regulatory authority (State Medical Board)

Disciplinary action

Univariate and multivariate analysis adjusted for ethnicity, board certification, international education, specialty

Kohatsu et al. [6], 2004 (USA)

Case–control

All specialties of all grades

1998–2001

Medical regulatory authority (State Medical Board) and American Medical Association e-Physician Profiles system

Disciplinary action

Univariate and multivariate analysis adjusted for age, board certification, international education, specialty

Morrison et al. [7], 1998 (USA)

Case–control

All specialties of all grades

1995–1997

Medical regulatory authority (State Medical Board) and Directory of Physicians in the United States

Disciplinary action

Univariate analysis

Nash et al. [35], 2009 (Australia)

Cross-sectional

All specialties of all grades

2007

Postal questionnaire

Medico-legal matter

Univariate and multivariate analysis adjusted for age, marital status, specialty, international education, solo practice, hours worked per week, peer review in past 12 months, CME requirements, teaching role, AUDIT score, GHQ score

Nash et al. [34], 2009 (Australia)

Cross-sectional

General practitioners; grades of doctors not stated

2006

Postal questionnaire and insurance company

Medico-legal matter

χ2 P <0.001

Pande et al. [37], 2013 (USA)

Cohort

All specialties of all grades

2000–2011

Office of the Inspector General of the US Department of Health and Human Services

Criminal case (convicted of Medicare and Medicaid fraud)

Proportion

Papadakis et al. [8], 2004 (USA)

Case–control

All specialties of all grades

1990–2000

Medical regulatory authority (State Medical Board)

Disciplinary action

Univariate and multivariate analysis adjusted for undergraduate GPA, MCAT score, did not pass medical school course, professionalism severity ranking

Papadakis et al. [9], 2005 (USA)

Case–control

All specialties of all grades

2990–2003

Medical regulatory authorities (Federation of State Medical Boards)

Disciplinary action

Univariate and multivariate analysis adjusted for MCAT score, number of medical school courses not passed, unprofessional behaviour in medical school

Papadakis et al. [20], 2008 (USA)

Cohort

Internal medicine residents

2000–2006

American Board of Internal Medicine

Disciplinary action

Univariate and multivariate analysis adjusted for performance during residency, international education, no subspecialty certification

St George [32], 2003 (New Zealand)

Cohort

All specialties of all grades

1996–2002

Medical regulatory authority (Medical Council)

Referral to medical regulatory body

Proportion

Tamblyn et al. [33], 2007 (Canada)

Cohort

All specialties of all grades

1993–1996

Medical regulatory authorities

Referral to medical regulatory body

Univariate and multivariate analysis adjusted for examination score, international education, specialty, practice location

Taragin et al. [28], 1992 (USA)

Cohort

All specialties, excluding <2 years of observations

1977–1987

Insurance company

Malpractice claims

Multivariate analysis adjusted for medical degree type, international education, board certification

Unwin et al. [5], 2014 (UK)

Cross-sectional

All specialties of all grades

2013

Medical regulatory authority (Medical Council)

Disciplinary action

Univariate and multivariate analysis adjusted for years since qualification, international education, specialty

Wakeford [21], 2011 (UK)

Cross-sectional

All specialties of all grades

2011

Medical regulatory authority (Medical Council)

Disciplinary action

χ2 P <0.001

Weisman et al. [29], 1988 (USA)

Cross-sectional

Obstetricians and gynaecologists excluding residents

1984

Postal questionnaire and telephone survey

Malpractice litigation

Multivariate analysis adjusted for practice type and location, years since residency, board certification, work type, patient demographics, international education

Weycker et al. [30], 2000 (USA)

Cohort

All specialties of all grades

1980–1989

Insurance company and American Medical Association Physician Masterfiles

Malpractice claims

Multivariate analysis adjusted for prior claims, educational characteristics, demographic characteristics, practice characteristics

Wu et al. [31], 2009 (Taiwan)

Cross-sectional

All specialties of all grades

1991and 2005

Postal questionnaire

Malpractice claims

Multivariate analysis adjusted for age, specialty

Yates et al. [22], 2010 (UK)

Case–control

All specialties of all grades

1999–2004

Medical regulatory authority (Medical Council)

Disciplinary action

Univariate and multivariate analysis adjusted for social class, failed exams in early/preclinical course

  1. a Excluded dermatologists and physical medicine doctors
  2. b Excluded pathologists, radiologists, anaesthesiologists, emergency medicine doctors, and those doctors in administrative and research positions