Colorado Medicare study: A history.

Discusses a demonstration project, conducted in Colorado during 1976–1978, designed to study what effect the availability of two new benefits under Medicare, the inclusion of the services of independent psychologists and the expansion of existing mental health coverage, will have on the use and cost of total mental health services and of other medical and hospital services. Questions that express the concerns of legislators also will be evaluated: (a) Can psychology agree on the definition of a psychologist who can deliver services on an autonomous basis, and (b) can psychology assure quality service on an independent basis? Procedures to define provider status, provide peer review, and identify reimbursable services have been instituted to address these questions and should prove to be precedent setting in future national health legislation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Invited peer review: The AABT experience.

In response to the growing need to provide the independent evaluation and examination of treatment programs, the Association for Advancement of Behavioral Therapy (AABT) formed the Professional Consultation and Peer Review Committee. The present study describes the peer review process in a hierarchical manner, beginning with the least demanding type of review or consultation and progressing to a full-scale evaluation. In the past 2 yrs, this committee has developed 6 types of review services that it offers free of charge to interested consumers and behavior therapists: individual case consultation between therapists, a compilation of guidelines for behavioral treatment programs, review of written materials of particular programs, on-site review of noncontroversial and controversial programs, and professional assistance in litigation involving determination of appropriate treatment. In all cases the committee promotes reliance on the empirical literature as the justification for treatment decisions and program operation. It is concluded that the review services are designed to protect individual clients and competent therapists and to assist in assuring appropriate treatment. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The philosophical underpinnings of peer review.

The current impetus for peer review had its origin in issues of cost containment, bolstered by intentions to improve quality of service. Peer review is usually conceived of as a way to either police a profession by ridding it of the few "bad actors" or to assure that services delivered meet minimum standards. The present article argues, however, that a more useful philosophy of peer review is to assume that it is at the heart of the definition of a profession. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Successful peer review of courses: a case study

PURPOSE: In patients with early cervix carcinoma, both radiotherapy and surgery or combined modalities provide effective therapies. In the two last modalities, recommended surgery is radical hysterectomy. The purpose of this prospective study was to assess the value of a limited vaginal hysterectomy after brachytherapy in patients without any unfavorable prognostic factor. PATIENTS AND METHODS: Twenty-two patients (stage Ia2 with vascular invasion: three patients, stage Ib 1:19 patients) with 1 cm median maximal tumor size and with previous negative laparoscopic lymphadenectomy (median number of lymph nodes: 12) underwent a limited vaginal hysterectomy 6 weeks after utero-vaginal brachytherapy. RESULTS: Two mild intra-operative complications were noted. Venous hemorrhage (100 mL) occurred in one patient during lymphadenectomy and another patient presented bladder injury during hysterectomy. These two complications were successfully controlled with no need for laparotomy. Only one late complication was observed: bladder grade G2 (b). With a 29 months follow-up (20-48 months), no recurrence was reported. CONCLUSION: These results appear promising in patients with very early cervix carcinoma but remain to be confirmed on a larger scale.     

Education and peer review.

The success of a peer review system to assure quality of psychological services depends on its acceptance by psychologists, consumers, and 3rd-party agents. Educational efforts aimed at these 3 target groups are important in facilitating that acceptance. The present study outlines components of the educational program adopted by the developers of the American Psychological Association/CHAMPUS (Civilian Health and Medical Program of the Uniformed Services) peer review system. Components that, although not part of the CHAMPUS system, should be included in an ideal educational effort are also outlined. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of peer review on professional practice.

Discusses the history and impact of peer review as an in-house quality control process. It is described as similar to previous steps in that it is developed and administered by psychologists but different because it goes beyond qualifying criteria for engaging in practice to deal with performance after an individual has become a qualified provider. The effects of peer review on several aspects of professional practice are discussed. Vehicles for obtaining information for review judgments are examined in terms of criteria, theoretical orientation, and benefit decisions. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A look backward: The peer review program of the American Psychological Association.

The American Psychological Association (APA) contracted with a major insurance company to implement an experimental peer review program between 1982 and 1986. One hundred fifty mental health treatment reports (MHTRs) and 72 corresponding peer reviews were analyzed to determine criteria for review and review outcome. Longer, more intensive treatments were reviewed more often, and shorter treatments were reviewed more positively. MHTRs were less often reviewed if they estimated treatment length, stated appropriate plans and goals, responded to need for medication, and were clearly written. MHTRs were positively reviewed for the same reasons and for mentioning measurable functional impairment and how patients used treatment support and intervention. Relation of findings to past research and APA peer review as a whole are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Political aspects of peer review.

Discusses professional psychology's increasing recognition in federal health-care legislation. Whether psychology is eventually included in a national health insurance bill will be primarily determined by political considerations, including psychology's relationship with organized medicine, its credibility within the federal bureaucracy, and its performance in the development of standards for care and assurance of quality. It is concluded that psychology's success in developing a workable system of quality assurance through peer review may be the profession's most important asset in determining its role in future legislation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A model system of peer review.

Discusses issues involved in the establishment of an effective system of peer review of mental health services: selection of reviewers and cases for review, development of criteria for review, documentation, management of the review process, and management of information (including confidentiality). Decisions regarding most of these issues may be made at the local agency level. A national system of peer review that would facilitate the development of local review systems and provide the support necessary to ensure the acceptance of quality assurance efforts as routine professional activities is presented. The system would function on 4 levels. The 1st 2 levels would function locally and involve selection by trained nonpsychologists of cases for review and review of those cases by a committee of professionals. At the 3rd level, a peer review consortium would review special cases; and at the 4th level, a group supported by the American Psychological Association would assist local agencies in the development of peer review systems and would serve other policymaking functions. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Report of the committee on by-laws and constitution review.

A 1992 report from the Society of Psychologists in Addictive Behavior's Committee on By-laws and Constitution Review informs that the first set of by-laws of the Society was drawn up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An evaluation of the Aetna pilot peer review project.

Describes a 6-mo trial peer review project in which the 3rd-party payer requested treatment reports from psychologist providers, submitted 45 selected cases to reviewers designated by the American Psychological Association, and received recommendation from these reviewers. The characteristics of the patients, the type of treatment provided, and the characteristics of the reviewers are outlined. Differences in the judged adequacy of treatment were related to factors such as the reviewer's gender and theoretical orientation, the frequency of sessions, the therapeutic orientation of the provider, and the gender of the patient. Problems related to poor documentation and the potential of peer review in improving patient care are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Finding the missing science: The fate of studies submitted for review by a human subjects committee.

Publication bias, including prejudice against the null hypothesis, and other biasing filters may operate on researchers as well as journal editors and reviewers. A survey asked 33 psychology researchers to describe the fate of 159 studies approved by their departmental human subjects review committee. About two thirds of completed studies did not result in published summaries. About half of the unpublished studies fell out of the process for reasons other than methodological quality. Among these, lack of interest and aims that did not include publication were cited more often than nonsignificant results as the reasons why publication was not pursued. However, significant findings were more likely than nonsignificant findings to be submitted for meeting presentation or publication. These results indicate attention needs to be paid to improving how psychological scientists communicate, especially to the creation of prospective research registers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric peer review: a working model

The author describes a system for psychiatric peer review developed by a peer review committee in a general hospital. At the heart of the system is a form called the peer review check sheet, which requires the physician to specify diagnosis, reasons for hospitalization, and major symptom complexes, as well as laboratory work and treatment and discharge plans. Minimal criteria have been established to verify the diagnoses and to justify the need for hospitalization. Each month the check sheets are removed from the charts of patients who have been discharged and sent to committee members for evaluation. Those that are incomplete or unsatisfactory signal the need to examine the patient's chart.     

The Jungians: A Comparative and Historical Perspective: Book review.

Review of book: Thomas B. Kirsch (Au.) The Jungians: A Comparative and Historical Perspective. London: Routledge, 2000, 276pp. Reviewed by Nathan G. Hale, Jr. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists' evaluations of psychodynamic psychotherapy: A peer review analogue experiment.

Replicated a study by L. H. Cohen and D. Pizzirusso (in press) that evaluated peer review by American Psychological Association/Civilian Health and Medical Program of the Uniformed Services reviewers. In the present study, 54 National Register psychologists of either a psychodynamic or eclectic theoretical orientation evaluated 1 of 3 psychodynamic treatment reports that varied on reported patient progress levels to examine the effect of theoretical orientation on evaluations and if peer review activities can be carried out using reviewers who are more representative of the profession. The results of both studies were similar. Psychodynamic psychologists rated treatment as more satisfactory and were more generous in their future care reimbursement recommendations than eclectic psychologists. Results suggest that psychologist providers in general represent a source of competent personnel for peer review activities. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)