Table 1.
Characteristics of eligible studies
| 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 |
a Excluded dermatologists and physical medicine doctors
b Excluded pathologists, radiologists, anaesthesiologists, emergency medicine doctors, and those doctors in administrative and research positions