Search Results (62)

Objective: To investigate the occurrence trends, distribution characteristics, and contributing factors of medical damage liability disputes in Chongqing from 2012 to 2024, thereby providing data support for risk prevention and control in regional medical institutions and for health policy formulation. Methods: A retrospective study design was employed. Adjudication documents pertaining to medical damage liability disputes in Chongqing, spanning from January 2012 to December 2024, were retrieved from the China Judgments Online database. A total of 1761 eligible cases were selected based on standardized criteria. Statistical analysis was conducted on core case variables. Results: The number of cases exhibited a fluctuating upward trend from 2012 to 2024, peaking in 2019 (276 cases) before subsequently declining. The average actual compensation amount demonstrated a steady increase, reaching its highest level in 2023 (259,200 ± 53,900 CNY). Deficiencies in diagnostic and therapeutic procedures constituted the predominant cause of disputes (50.37%). Surgical departments (46.05%) and orthopedics departments (22.60%) were identified as high-risk specialties. Tertiary public hospitals accounted for the highest proportion of disputes (48.89%) and the highest average actual compensation (216,100 ± 10,600 CNY). Regarding the apportionment of liability, secondary liability attributed to the medical provider was the most frequent (29.59%). Patient death was the most common adverse outcome (37.14%). The highest average compensation amount was associated with persistent vegetative state outcomes (777,500 ± 157,200 CNY). Statistically significant differences in actual compensation amounts were observed across all outcome categories (all p < 0.05). Conclusions: The situation concerning medical damage disputes in Chongqing remains severe. The etiologies of disputes are predominantly attributable to medical technical factors—particularly deficiencies in diagnostic and therapeutic procedures—and failure to fulfill a duty of care, both of which are associated with elevated compensation amounts. Given that this study employed a retrospective descriptive design, the aforementioned findings reflect associations among variables rather than causal relationships. Based on the identified risk hierarchy, it is recommended that priority be given to strengthening perioperative safety verification and re-certification of critical procedural skills in high-incidence departments, such as surgery and obstetrics and gynecology, enhancing informed consent and medical record quality management, and advancing the tiered healthcare delivery system, with a view to reducing medical risks and mitigating doctor–patient conflicts. Full article

Medical mediation (MM) is a collaborative tool for resolving ethically complex disputes in healthcare. Background/Objectives: Though widely recognized in international clinical ethics, it has only been recently introduced in Greece. The objective of this study was (i) to quantify agreement with MM across three clinical scenarios, (ii) to estimate the proportion of professionals that support mediation and institutional training, and (iii) to identify distinct attitudinal profiles using latent class analysis (LCA). Methods: A structured, cross-sectional online questionnaire was completed by 431 healthcare professionals across Greece. The survey included three clinical vignettes (on (1) end-of-life care, (2) religious refusal of treatment, and (3) medical error disclosure), Likert-scale items on attitudes toward mediation, and demographic information. LCA was used to identify patterns of response across the scenarios and differentiate between strongly supportive, moderately supportive, and cautiously positive professional profiles. Results: Participants expressed strong support for mediation across all scenarios (median scores ≥ 9), with the highest support for medical error disclosure (mean 8.67 ± 2.10 and a median of 10). Most participants (97.2%, n = 419) considered mediation at least sometimes effective, and 80.7% (n = 348) endorsed institutional training. However, only 3.0% (n = 13) reported formal training and 1.9% (n = 8) reported being very familiar with MM. LCA revealed three distinct respondent profiles: strongly supportive (73.3%, n = 316), moderately supportive (14.6%, n = 63), and cautiously positive (12.1%, n = 52). Significant trends were observed across profiles for the perceived effectiveness of mediation and support for institutional training (p < 0.01). However, formal training and familiarity with mediation among the participants were low (<5%). Conclusions: Despite limited training and formal implementation, Greek healthcare professionals show high support for MM. The demand and need for structured mediation training and integration into the Greek healthcare system is strong. The identification of distinct attitudinal profiles provides insight into potential variation in organizational readiness for implementing structured mediation training Full article

In this article, we have reviewed the literature on severe myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). ME/CFS is a clinical diagnosis in the absence of a diagnostic test. However, in research settings and disability disputes, 2-day cardiopulmonary exercise testing can be used to diagnose and document the abnormal response to exercise. Biomedical research into this disease has been scarce and underfunded for decades. Consequently, there are no effective treatments. In its most severe form, it is more disabling than many other diseases, and patients are bedbound 24/7, dependent on carers, and spend their days in dark and quiet rooms. Even the soft sound of a human voice can lead to further deterioration. Some of the very severely ill suffer from life-threatening malnutrition and need to be tube-fed. The COVID-19 pandemic has led to a sharp increase in the number of patients with post-infectious diseases, and many of them fulfill ME/CFS criteria. Dedicated, focused research using advanced medical technologies is needed to gain further understanding of the underlying disease mechanism. This will enable us to find effective pharmacological treatments and address the unmet medical needs of these very ill people. Full article

Background: Medical mediation offers a patient-centered, collaborative alternative to traditional resolution methods for healthcare conflicts that is gaining international traction in an increasingly complex environment of advancing technology and diverse patient populations. This systematic review aims to synthesize the literature on medical mediation and analyze its clinical applications, conflict typologies, involved actors, mediation methodologies, legal frameworks, and theoretical underpinnings. Methods: A systematic search was conducted in PubMed and Scopus for English-language articles published between 1984 and 2025. Results: Of 656 initial records, 152 studies met the inclusion criteria and were categorized across six domains: clinical context, actors involved, conflict type, mediation framework, legal/policy structure, and theoretical foundations. Most studies originated from high-income countries, particularly the U.S. and U.K., with notable expansion after 2010. Medical mediation was most frequently applied in bedside care, end-of-life decision-making, and managed-care disputes. While ethics consultants were the primary mediators, increasing involvement of trained clinicians and institutional actors was also observed. Most studies emphasized generic bioethical mediation frameworks, with some focused on formalized models and training. Legal frameworks varied, and an increasing number of countries have been adopting institutional or national programs to support mediation. Conclusions: Medical mediation is an efficient tool for resolving complex clinical conflicts, enhancing communication, and preserving therapeutic relationships. Its institutionalization, through law and training, is key to the promotion of justice, transparency, and ethical integrity in modern healthcare systems. Full article

Undetected, rare diversities scattered among medically important emerging yeast, both in historical literature and recent AI research, are questioned and proffered for rapid and variable niche adaptations. These variable stresses may appear most notable among the medical sciences concerned with emerging yeast infections. Misidentified species, questionable therapies, and possible disease functions and retractions or rejections of manuscripts are identified in part, with the C. haemulonii Complex, C. auris, and C. lusitaniae. Analysis of the Commentary below, including a thorough definition of the disputed details among the references, implies that further researches on EVs and sRNA are needed by multi-sciences. Full article

Introduction: Burnout syndrome, long described as an “occupational phenomenon”, now affects 15–20% of the general workforce and more than 50% of clinicians, teachers, social-care staff and first responders. Its precise nosological standing remains disputed. We conducted a mechanistic review of electroencephalography (EEG) studies to determine whether burnout is accompanied by reproducible brain-function alterations that justify disease-level classification. Methods: Following PRISMA-adapted guidelines, two independent reviewers searched PubMed/MEDLINE, Scopus, Google Scholar, Cochrane Library and reference lists (January 1980–May 2025) using combinations of “burnout,” “EEG”, “electroencephalography” and “event-related potential.” Only English-language clinical investigations were eligible. Eighteen studies (n = 2194 participants) met the inclusion criteria. Data were synthesised across three domains: resting-state spectra/connectivity, event-related potentials (ERPs) and longitudinal change. Results: Resting EEG consistently showed (i) a 0.4–0.6 Hz slowing of individual-alpha frequency, (ii) 20–35% global alpha-power reduction and (iii) fragmentation of high-alpha (11–13 Hz) fronto-parietal coherence, with stage- and sex-dependent modulation. ERP paradigms revealed a distinctive “alarm-heavy/evaluation-poor” profile; enlarged N2 and ERN components signalled hyper-reactive conflict and error detection, whereas P3b, Pe, reward-P3 and late CNV amplitudes were attenuated by 25–50%, indicating depleted evaluative and preparatory resources. Feedback processing showed intact or heightened FRN but blunted FRP, and affective tasks demonstrated threat-biassed P3a latency shifts alongside dampened VPP/EPN to positive cues. These alterations persisted in longitudinal cohorts yet normalised after recovery, supporting trait-plus-state dynamics. The electrophysiological fingerprint differed from major depression (no frontal-alpha asymmetry, opposite connectivity pattern). Conclusions: Across paradigms, burnout exhibits a coherent neurophysiological signature comparable in magnitude to established psychiatric disorders, refuting its current classification as a non-disease. Objective EEG markers can complement symptom scales for earlier diagnosis, treatment monitoring and public-health surveillance. Recognising burnout as a clinical disorder—and funding prevention and care accordingly—is medically justified and economically imperative. Full article

While many continuous distributions are known, the list of discrete ones (usually derived from counting) often reported is relatively short. This list becomes even shorter when dealing with dichotomous observables: binomial, hypergeometric, negative binomial, and uniform. Binomial distribution is important for medical studies, since a finite sample from a population included in a medical study with yes/no outcome resembles a series of independent Bernoulli trials. The problem of calculating the confidence interval (CI, with conventional risk of 5% or otherwise) is revealed to be a problem of combinatorics. Several algorithms dispute the exact calculation, each according to a formal definition of its exactness. For two algorithms, four previously proposed case studies are provided, for sample sizes of 30, 50, 100, 150, and 300. In these cases, at 1% significance level, ordered sequences defining the confidence bounds were generated for two formal definitions. Images of the error’s alternation are provided and discussed. Both algorithms propose symmetric solutions in terms of both CIs and actual coverage probabilities. The CIs are not symmetric relative to the observed variable, but are mirrored symmetric relative to the middle of the observed variable domain. When comparing the solutions proposed by the algorithms, with the increase in the sample size, the ratio of identical confidence levels is increased and the difference between actual and imposed coverage is shrunk. Full article

This article explores the persistent issue of assaults on medical staff in China that are unrelated to malpractice, which exacerbate tensions in doctor–patient relationships. These conflicts are primarily fueled by factors such as the disparity between doctors and patients, unequal distribution of medical resources, and inadequacies in the legal protection system. Drawing on Foucault’s micro-power theory, this research proposes a tripartite governance model that includes reconfiguring medical resources through public–private partnerships, implementing proactive legal mechanisms such as hospital-embedded policing systems, and establishing mandatory protocols for treatment explanations to reduce information asymmetry. The article also highlights the importance of medical conflict mediation systems to effectively resolve disputes and ensure satisfaction for all parties involved. Full article

The medical industry has made significant advancements in recent years. However, the lack of accountability in medical management has resulted in systemic deficiencies, which have adversely affected patient trust and contributed to an increase in medical disputes. As a result, there is a growing emphasis on managing the quality of medical services, particularly in enhancing patient experience. To address these challenges, we propose a new system for evaluating health services. This system will allow patients to anonymously rate the services they receive while also providing doctors the opportunity to appeal specific reviews. The hospital handles the evaluations and appeals through the management of the cloud platform. We propose a new scheme to assist the work of the platform, which is a lattice-based group signature with verifier-local revocation (VLR-GS). Most of the work on VLR-GS has focused on the random oracle model (ROM) or using non-interactive zero-knowledge proofs (NIZKs). Our construction is anonymous and traceable in the standard model under the hardness of the learning with errors problem and short integer solution problem. Furthermore, theoretically analyzing it has practical significance in both security and efficiency. In conclusion, the proposed scheme establishes a secure and privacy-oriented platform for an anonymous medical service evaluation system, with the goal of fostering patient trust and improving hospital service quality within the healthcare sector. Full article

Medicine is struggling with the constantly rising incidence of breast cancer. The key to this fight is to be able to speed up diagnosis, as rapid diagnosis reduces the number of aggressive or advanced cases. For this process to be effective, it is necessary to have the right attitude toward diagnosis as a research practice. Our critical analysis of diagnosis, as a methodology of medical science, reflects on it as a research practice that is regulated in a socio-subjective way by a methodological culture. This position allows us to contrast critical methodological culture with the habitual–practical, or methodical, culture of practicing diagnosis. We point to the interpretative status of medical analyses performed by medical historians by referring to Italian Renaissance paintings and historical–artistic interpretations. In this field, analyzing disputes between researchers as a clash of methodologies in the ways interpretation transforms signs into meaning is a critical methodological reflection. Medicine is a diverse scientific discourse with a paradigmatic structure in which new ways of conducting diagnostic tests may appear. It is only possible to see this from the methodological level. In addition, passive respect for existing patterns of conduct hinders an exchange of views between researchers, which limits the possibility of correcting research procedures. The ultimate consequence of such passivity is an inability to improve diagnosis, which, in turn, harms the interests of patients. In this regard, it is worth remembering that the paramount objective of diagnosis is not the disease, but the patient. Full article

Background/Objectives: ACE (angiotensin-converting enzyme) is considered a serological marker of sarcoidosis as elevated levels have been reported in 30–80% of patients. However, elevated ACE levels are also encountered in other medical conditions, and the clinical correlation between ACE levels and disease activity in sarcoidosis is disputable as well. To determine the significance of elevated ACE levels in the diagnosis and follow-up of sarcoidosis patients. Methods: All electronic patient records in which an ACE level was recorded in a large tertiary hospital were identified using a computerized algorithm. Medical diagnoses, ACE numerical values, and clinical data were also automatically extracted. Furthermore, all records with a diagnosis of sarcoidosis were manually reviewed for ascertainment of the diagnosis and searched for additional clinical manifestations and treatment responses. Results: A total of 1416 records with a documented ACE level were found in the database, and 146 of the records had a diagnosis of sarcoidosis in the medical record. However, the diagnosis was excluded in 27 of these cases after a manual review of the records. Elevated ACE levels were most commonly encountered among patients with sarcoidosis, non-Hodgkin’s lymphoma, cirrhosis, and interstitial lung disease. Elevated ACE levels had a positive predictive value of 12.76% and a negative predictive value of 94.6% for the diagnosis of sarcoidosis in our cohort, with a sensitivity of 63.5% and a specificity of 59.5%. Among patients with sarcoidosis, ACE levels around the time of diagnosis were higher than ACE levels in remission. However, a paired analysis did not find a statistically significant difference in ACE levels between the two timepoints. A positive correlation between lack of cardiac involvement and elevated ACE levels was found on multivariate analysis. Conclusions: ACE levels are a non-specific serological marker with low specificity and sensitivity for sarcoidosis and a poor positive predictive value, but with a negative predictive value of 94.6%. Furthermore, elevated ACE levels correlated poorly with disease activity in our cohort. Full article

Major global public health emergencies face unprecedented challenges, such as an infodemic and scientific disputes, and governments especially need to implement fast and effective crisis communication. Firstly, this paper takes the Elaboration Likelihood Model as a framework and constructs a crisis communication persuasion effect evaluation method with emotion analysis. Secondly, this paper takes the crisis communication at the beginning of the COVID-19 outbreak in China as an example and examines the persuasive effects of the peripheral route, represented by medical experts, and the central route, represented by mainstream media. This study finds that the peripheral route of persuasive communication can quickly establish communication trust and quickly change the public’s peripheral attitude, but the persuasive effect is unstable. The central route of persuasive communication demonstrates a significantly positive, stable, and anti-interference persuasive effect. Dual-subject persuasion is an important strategy for controlling an outbreak by rapidly establishing communication trust, combating an infodemic, boosting public confidence, and popularizing medical knowledge. This study evaluates the persuasive effects of crisis communication in the early stages of the COVID-19 outbreak in China, hoping to provide valuable practical references for crisis communication during the outbreak in future global public health emergencies. Full article

Background: Alternative Disputes Resolution (ADR) systems are becoming increasingly important tools in recent years for the management and resolution of health responsibility cases, but their dissemination and efficiency are still poorly described. The purpose of this paper is to present an ADR system in the autonomous province of Bolzano: the Conciliation Commission. Methods: systematic collection of all claims of the South Tyrol Sanitary Service that were dealt with in the Conciliation Commission from 1 January 2012 to 31 December 2022. Results: closing times of the applications received turn out to be less than a year in 63.8% of the cases, with a number of cases managed rather stably in the time, even if minimal if compared to the number of complaints received to the South Tirol Health Service. Only 5.3% of the application continued the legal process before a civil court. Conclusions: the Conciliation Commission of South Tirol appears to be an excellent instrument for the resolution of disputes in the healthcare field, with rapid resolution times and little to zero costs for the healthcare company, a public health institution. Despite its effectiveness, it seems to be a tool that is still little-known in South Tyrol. Full article

The doctor–patient relationship has received widespread attention as a significant global issue affecting people’s livelihoods. In clinical practice within the medical field, applying existing artificial intelligence (AI) technology presents issues such as uncontrollability, inconsistency, and lack of self-explanation capabilities, even raising concerns about ethics and morality. To address the problem of doctor–patient interaction differences arising from the doctor–patient diagnosis and treatment, we collected the textual content of doctor–patient dialogues in outpatient clinics of local first-class hospitals. We utilized case scenario analysis, starting from two specific cases: multi-patient visits with the same doctor and multi-doctor interaction differences with the same patient. By capturing the external interactions and the internal thought processes, we unify the external expressions and internal subjective cognition in doctor–patient interactions into interactions between data, information, knowledge, wisdom, and purpose (DIKWP) models. We propose a DIKWP semantic model for the doctor–patient interactions on both sides, including a DIKWP content model and a DIKWP cognitive model, to achieve transparency throughout the entire doctor–patient interaction process. We semantically–bidirectionally map the diagnostic discrepancy space to DIKWP uncertainty and utilize a purpose-driven DIKWP semantic fusion transformation technique to disambiguate the uncertainty problem. Finally, we select four traditional methods for qualitative and quantitative comparison with our proposed method. The results show that our method performs better in content and uncertainty handling. Overall, our proposed DIKWP semantic model for doctor–patient interaction processing breaks through the uncertainty limitations of natural language semantics in terms of interpretability, enhancing the transparency and interpretability of the medical process. It will help bridge the cognitive gap between doctors and patients, easing medical disputes. Full article

Background: Understanding the concept and dynamic process of the evolution of professional identity and roles of market access (MA) in the pharmaceutical industry (pharma) is critical to personal, interpersonal, and professional levels of development and impact. Objective: The aim was to carry out a scoping review of the conceptualisation of MA within pharma. Data Sources: BioMed Central, WorldCat.org, and Directory of Open Access Journals were searched from 2003 to 2023. Study Selection: All articles on concepts or definitions and other surrogate terms on MA in pharma were selected. Data Extraction: Keywords generated from an initial cursory literature search on MA in pharma were used in conjunction with AND/OR as search terms. Using the data charting method, key findings were mapped and summarised descriptively. inductive analysis was performed, allowing codes/themes that are relevant to the concept to emerge. Data Synthesis: Arskey and O’Malley’s six-stage framework and the PRISMA extension for scoping reviews extension checklist were used as the review and reporting templates. The databases search yielded 222 results. Following title and abstract screening, a total of 146 papers were screened, and 127 of them were excluded. Full-text review was conducted for 19 papers that were deemed by two reviewers to meet the eligibility criteria. One of the authors arbitrated on disputed papers for inclusion. Only 14 of the included papers were found to meet the criteria for the final analysis. Five conceptual dimensions of MA in pharma were identified as “right products”, “right patient”, “right price”, “right point” (time), and “right place” (setting). Conclusions: Market access in pharma is a process that commences with the development and availability of the right products that are proven to be efficacious and disease/condition-specific (including medications, medical devices, and vaccines); specifically produced for the right patients or end users who will maximise best clinical outcomes and economic value; delivered at the right point in a timely, sustained, and efficient manner, given at the right price (commercially viable or reimbursed price that represents good value); and conducted within the economic, policy, societal, and technological contexts, with the overarching goal of achieving the best patient outcomes and ensuring product profitability. Full article