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186 results on '"Briggs, T."'

1. The impact of low-mode symmetry on inertial fusion energy output in the burning plasma state

Author

Ralph, J. E., Ross, J. S., Zylstra, A. B., Kritcher, A. L., Robey, H. F., Young, C. V., Hurricane, O. A., Pak, A., Callahan, D. A., Baker, K. L., Casey, D. T., Döppner, T., Divol, L., Hohenberger, M., Pape, S. Le, Patel, P. K., Tommasini, R., Ali, S. J., Amendt, P. A., Atherton, L. J., Bachmann, B., Bailey, D., Benedetti, L. R., Berzak Hopkins, L., Betti, R., Bhandarkar, S. D., Biener, J., Bionta, R. M., Birge, N. W., Bond, E. J., Bradley, D. K., Braun, T., Briggs, T. M., Bruhn, M. W., Celliers, P. M., Chang, B., Chapman, T., Chen, H., Choate, C., Christopherson, A. R., Clark, D. S., Crippen, J. W., Dewald, E. L., Dittrich, T. R., Edwards, M. J., Farmer, W. A., Field, J. E., Fittinghoff, D., Frenje, J., Gaffney, J., Gatu Johnson, M., Glenzer, S. H., Grim, G. P., Haan, S., Hahn, K. D., Hall, G. N., Hammel, B. A., Harte, J., Hartouni, E., Heebner, J. E., Hernandez, V. J., Herrmann, H. W., Herrmann, M. C., Hinkel, D. E., Ho, D. D., Holder, J. P., Hsing, W. W., Huang, H., Humbird, K. D., Izumi, N., Jarrott, L. C., Jeet, J., Jones, O., Kerbel, G. D., Kerr, S. M., Khan, S. F., Kilkenny, J., Kim, Y., Geppert-Kleinrath, H., Geppert-Kleinrath, V., Kong, C., Koning, J. M., Kroll, J. J., Kruse, M. K. G., Kustowski, B., Landen, O. L., Langer, S., Larson, D., Lemos, N. C., Lindl, J. D., Ma, T., MacDonald, M. J., MacGowan, B. J., Mackinnon, A. J., MacLaren, S. A., MacPhee, A. G., Marinak, M. M., Mariscal, D. A., Marley, E. V., Masse, L., Meaney, K. D., Meezan, N. B., Michel, P. A., Millot, M., Milovich, J. L., Moody, J. D., Moore, A. S., Morton, J. W., Murphy, T. J., Newman, K., Di Nicola, J.-M. G., Nikroo, A., Nora, R., Patel, M. V., Pelz, L. J., Peterson, J. L., Ping, Y., Pollock, B. B., Ratledge, M., Rice, N. G., Rinderknecht, H. G., Rosen, M., Rubery, M. S., Salmonson, J. D., Sater, J., Schiaffino, S., Schlossberg, D. J., Schneider, M. B., Schroeder, C. R., Scott, H. A., Sepke, S. M., Sequoia, K., Sherlock, M. W., Shin, S., Smalyuk, V. A., Spears, B. K., Springer, P. T., Stadermann, M., Stoupin, S., Strozzi, D. J., Suter, L. J., Thomas, C. A., Town, R. P. J., Trosseille, C., Tubman, E. R., Volegov, P. L., Weber, C. R., Widmann, K., Wild, C., Wilde, C. H., Van Wonterghem, B. M., Woods, D. T., Woodworth, B. N., Yamaguchi, M., Yang, S. T., and Zimmerman, G. B.

Published
2024
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4. Design of inertial fusion implosions reaching the burning plasma regime

Author

Kritcher, A. L., Young, C. V., Robey, H. F., Weber, C. R., Zylstra, A. B., Hurricane, O. A., Callahan, D. A., Ralph, J. E., Ross, J. S., Baker, K. L., Casey, D. T., Clark, D. S., Döppner, T., Divol, L., Hohenberger, M., Hopkins, L. Berzak, Le Pape, S., Meezan, N. B., Pak, A., Patel, P. K., Tommasini, R., Ali, S. J., Amendt, P. A., Atherton, L. J., Bachmann, B., Bailey, D., Benedetti, L. R., Betti, R., Bhandarkar, S. D., Biener, J., Bionta, R. M., Birge, N. W., Bond, E. J., Bradley, D. K., Braun, T., Briggs, T. M., Bruhn, M. W., Celliers, P. M., Chang, B., Chapman, T., Chen, H., Choate, C., Christopherson, A. R., Crippen, J. W., Dewald, E. L., Dittrich, T. R., Edwards, M. J., Farmer, W. A., Field, J. E., Fittinghoff, D., Frenje, J. A., Gaffney, J. A., Johnson, M. Gatu, Glenzer, S. H., Grim, G. P., Haan, S., Hahn, K. D., Hall, G. N., Hammel, B. A., Harte, J., Hartouni, E., Heebner, J. E., Hernandez, V. J., Herrmann, H., Herrmann, M. C., Hinkel, D. E., Ho, D. D., Holder, J. P., Hsing, W. W., Huang, H., Humbird, K. D., Izumi, N., Jarrott, L. C., Jeet, J., Jones, O., Kerbel, G. D., Kerr, S. M., Khan, S. F., Kilkenny, J., Kim, Y., Geppert-Kleinrath, H., Geppert-Kleinrath, V., Kong, C., Koning, J. M., Kruse, M. K. G., Kroll, J. J., Kustowski, B., Landen, O. L., Langer, S., Larson, D., Lemos, N. C., Lindl, J. D., Ma, T., MacDonald, M. J., MacGowan, B. J., Mackinnon, A. J., MacLaren, S. A., MacPhee, A. G., Marinak, M. M., Mariscal, D. A., Marley, E. V., Masse, L., Meaney, K., Michel, P. A., Millot, M., Milovich, J. L., Moody, J. D., Moore, A. S., Morton, J. W., Murphy, T., Newman, K., Di Nicola, J.-M. G., Nikroo, A., Nora, R., Patel, M. V., Pelz, L. J., Peterson, J. L., Ping, Y., Pollock, B. B., Ratledge, M., Rice, N. G., Rinderknecht, H., Rosen, M., Rubery, M. S., Salmonson, J. D., Sater, J., Schiaffino, S., Schlossberg, D. J., Schneider, M. B., Schroeder, C. R., Scott, H. A., Sepke, S. M., Sequoia, K., Sherlock, M. W., Shin, S., Smalyuk, V. A., Spears, B. K., Springer, P. T., Stadermann, M., Stoupin, S., Strozzi, D. J., Suter, L. J., Thomas, C. A., Town, R. P. J., Trosseille, C., Tubman, E. R., Volegov, P. L., Widmann, K., Wild, C., Wilde, C. H., Van Wonterghem, B. M., Woods, D. T., Woodworth, B. N., Yamaguchi, M., Yang, S. T., and Zimmerman, G. B.

Published
2022
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5. Burning plasma achieved in inertial fusion

Author

Zylstra, A. B., Hurricane, O. A., Callahan, D. A., Kritcher, A. L., Ralph, J. E., Robey, H. F., Ross, J. S., Young, C. V., Baker, K. L., Casey, D. T., Döppner, T., Divol, L., Hohenberger, M., Le Pape, S., Pak, A., Patel, P. K., Tommasini, R., Ali, S. J., Amendt, P. A., Atherton, L. J., Bachmann, B., Bailey, D., Benedetti, L. R., Berzak Hopkins, L., Betti, R., Bhandarkar, S. D., Biener, J., Bionta, R. M., Birge, N. W., Bond, E. J., Bradley, D. K., Braun, T., Briggs, T. M., Bruhn, M. W., Celliers, P. M., Chang, B., Chapman, T., Chen, H., Choate, C., Christopherson, A. R., Clark, D. S., Crippen, J. W., Dewald, E. L., Dittrich, T. R., Edwards, M. J., Farmer, W. A., Field, J. E., Fittinghoff, D., Frenje, J., Gaffney, J., Gatu Johnson, M., Glenzer, S. H., Grim, G. P., Haan, S., Hahn, K. D., Hall, G. N., Hammel, B. A., Harte, J., Hartouni, E., Heebner, J. E., Hernandez, V. J., Herrmann, H., Herrmann, M. C., Hinkel, D. E., Ho, D. D., Holder, J. P., Hsing, W. W., Huang, H., Humbird, K. D., Izumi, N., Jarrott, L. C., Jeet, J., Jones, O., Kerbel, G. D., Kerr, S. M., Khan, S. F., Kilkenny, J., Kim, Y., Geppert Kleinrath, H., Geppert Kleinrath, V., Kong, C., Koning, J. M., Kroll, J. J., Kruse, M. K. G., Kustowski, B., Landen, O. L., Langer, S., Larson, D., Lemos, N. C., Lindl, J. D., Ma, T., MacDonald, M. J., MacGowan, B. J., Mackinnon, A. J., MacLaren, S. A., MacPhee, A. G., Marinak, M. M., Mariscal, D. A., Marley, E. V., Masse, L., Meaney, K., Meezan, N. B., Michel, P. A., Millot, M., Milovich, J. L., Moody, J. D., Moore, A. S., Morton, J. W., Murphy, T., Newman, K., Di Nicola, J.-M. G., Nikroo, A., Nora, R., Patel, M. V., Pelz, L. J., Peterson, J. L., Ping, Y., Pollock, B. B., Ratledge, M., Rice, N. G., Rinderknecht, H., Rosen, M., Rubery, M. S., Salmonson, J. D., Sater, J., Schiaffino, S., Schlossberg, D. J., Schneider, M. B., Schroeder, C. R., Scott, H. A., Sepke, S. M., Sequoia, K., Sherlock, M. W., Shin, S., Smalyuk, V. A., Spears, B. K., Springer, P. T., Stadermann, M., Stoupin, S., Strozzi, D. J., Suter, L. J., Thomas, C. A., Town, R. P. J., Tubman, E. R., Trosseille, C., Volegov, P. L., Weber, C. R., Widmann, K., Wild, C., Wilde, C. H., Van Wonterghem, B. M., Woods, D. T., Woodworth, B. N., Yamaguchi, M., Yang, S. T., and Zimmerman, G. B.

Published
2022
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9. A Randomized Trial of Autologous Chondrocyte Implantation Versus Alternative Forms of Surgical Cartilage Management in Patients With a Failed Primary Treatment for Chondral or Osteochondral Defects in the Knee

Author

Snow, M, Middleton, L, Mehta, S, Roberts, A, Gray, R, Richardson, J, Kuiper, JH, Price, A, Smith, A, White, S, Roberts, S, Griffiths, D, Mohammed, A, Moholkar, K, Ashraf, T, Green, M, Hutchinson, J, Bhullar, T, Chitnis, S, Shaw, A, van Niekerk, L, Hui, A, Drogset, JO, Knutsen, G, McNicholas, M, Bowditch, M, Johnson, D, Turner, P, Chugh, S, Hunt, N, Ali, S, Palmer, S, Perry, A, Davidson, A, Hill, P, Deo, S, Satish, V, Radford, M, Langstaff, R, Houlihan-Burne, D, Spicer, D, Phaltankar, P, Hegab, A, Marsh, D, Cannon, S, Briggs, T, Pollock, R, Carrington, R, Skinner, J, Bentley, G, and Consortium, ACTIVE

Subjects
Physical Therapy, Sports Therapy and Rehabilitation, Orthopedics and Sports Medicine
Abstract

Background: There are limited randomized controlled trials with long-term outcomes comparing autologous chondrocyte implantation (ACI) versus alternative forms of surgical cartilage management within the knee. Purpose: To determine at 5 years after surgery whether ACI was superior to alternative forms of cartilage management in patients after a failed previous treatment for chondral or osteochondral defects in the knee. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: In total, 390 participants were randomly assigned to receive either ACI or alternative management. Patients aged 18 to 55 years with one or two symptomatic cartilage defects who had failed 1 previous therapeutic surgical procedure in excess of 6 months prior were included. Dual primary outcome measures were used: (1) patient-completed Lysholm knee score and (2) time from surgery to cessation of treatment benefit. Secondary outcome measures included International Knee Documentation Committee and Cincinnati Knee Rating System scores, as well as number of serious adverse events. Analysis was performed on an intention-to-treat basis. Results: Lysholm scores were improved by 1 year in both groups (15.4 points [95% CI, 11.9 to 18.8] and 15.2 points [95% CI, 11.6 to 18.9]) for ACI and alternative, with this improvement sustained over the duration of the trial. However, no evidence of a difference was found between the groups at 5 years (2.9 points; 95% CI, −1.8 to 7.5; P = .46). Approximately half of the participants (55%; 95% CI, 47% to 64% with ACI) were still experiencing benefit at 5 years, with time to cessation of treatment benefit similar in both groups (hazard ratio, 0.97; 95% CI, 0.72 to 1.32; P > .99). There was a differential effect on Lysholm scores in patients without previous marrow stimulation compared with those with marrow stimulation ( P = .03; 6.4 points in favor of ACI; 95% CI, −0.4 to 13.1). More participants experienced a serious adverse event with ACI ( P = .02). Conclusion: Over 5 years, there was no evidence of a difference in Lysholm scores between ACI and alternative management in patients who had previously failed treatment. Previous marrow stimulation had a detrimental effect on the outcome of ACI. Registration: International Standard Randomised Controlled Trial Number: 48911177

Published
2023
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11. Unwarranted variation and the goal of net zero for the NHS in England: exploring the link between efficiency working, patient outcomes and carbon footprint.

Author

van Hove, M., John, J. B., Ojelade, E., Ayyaz, F., Koris, J., Frame, J., Swart, M., Snowden, C., Briggs, T. W. R., and Gray, W. K.

Subjects
ECOLOGICAL impact, PHYSICIAN practice patterns, CARBON emissions, DESFLURANE, PATIENT care
Abstract

Summary: In 2020 the NHS in England set a target of reaching net zero carbon emissions by 2040. Progress has already been made towards this goal, with substantial reductions in the use of environmentally harmful anaesthetic gases, such as desflurane, in recent years. Where an effective replacement already exists, changing practice to use low carbon alternatives is relatively easy to achieve, but much greater challenges lie ahead. The Getting It Right First Time (GIRFT) programme is a clinically‐led, data‐driven clinical improvement initiative with a focus on reducing unwarranted variation in clinical practice and patient outcomes. Reducing unwarranted variation can improve patient care and service efficiency, and can also support the drive to net zero. In this article we set out what the GIRFT programme is doing to support sustainable healthcare in England, why it is uniquely positioned to support this goal and what the future challenges, barriers, enablers and opportunities are likely to be in the drive to net zero. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Advancing healthcare through innovation and transformation.

Author

Koris, J, Burke, J, Mills, E, Wallace, P, and Briggs, T

Subjects
TECHNOLOGICAL innovations, MEDICAL care
Abstract

How do we ensure that technological advancement addresses the existing gaps in healthcare and improves delivery? [ABSTRACT FROM AUTHOR]

Published
2024

13. Measurements of improved stability to achieve higher fuel compression in ICF.

Author

Do, A., Casey, D. T., Clark, D. S., Bachmann, B., Baker, K. L., Braun, T., Briggs, T. M., Chapman, T. D, Celliers, P. M., Chen, H., Choate, C., Dewald, E. L., Divol, L., Fathi, G., Fittinghoff, D. N., Hall, G. N., Hartouni, E., Holunga, D. M., Khan, S. F., and Kritcher, A. L.

Subjects
INERTIAL confinement fusion, NUCLEAR fusion, IMPLOSIONS, LASER pulses, BACKSCATTERING, FUSION reactors
Abstract

While nuclear fusion ignition has been achieved at the National Ignition Facility in inertial confinement fusion (ICF) experiments, obtaining higher gain and more efficient burn is still desired. In that regard, increasing the compression of the fuel is an important factor. In recent indirect-drive capsule implosions, the SQ-n campaign is testing the hypothesis that reducing the hydrodynamic growth of perturbations is key to achieving higher compression of high-density carbon based-ablators for ICF. SQ-n uses a design at lower adiabat with a ramped foot laser pulse shape to minimize early-time hydrodynamic instability growth, predicted to be reduced by a factor of 10, and an optimized ablator dopant distribution. Subsets of experiments were conducted within the SQ-n campaign to study the implosion symmetry, laser backscatter, stability, and compression. Only the latter two will be reviewed here. Shock timing experiments using the velocity interferometer system for any reflector diagnostic enabled the development of a gently accelerating shock velocity. The ice–ablator interface acceleration, important for managing the Richtmyer–Meshkov phase growth, was observed with refraction enhanced radiography and the ablation front growth was measured using radiography of pre-imposed modulations. Finally, layered tritium-hydrogen-deuterium (∼75% H, ∼25% T, ∼2–10% D) and deuterium–tritium implosions demonstrate that between 15% ± 3% and 30% ± 6% improved compression has been achieved. [ABSTRACT FROM AUTHOR]

Published
2023
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16. Measuring and simulating ice–ablator mix in inertial confinement fusion.

Author

Bachmann, B., MacLaren, S. A., Masse, L., Bhandarkar, S., Briggs, T., Casey, D., Divol, L., Döppner, T., Fittinghoff, D., Freeman, M., Haan, S., Hall, G. N., Hammel, B., Hartouni, E., Izumi, N., Geppert-Kleinrath, V., Khan, S., Kozioziemski, B., Krauland, C., and Landen, O.

Subjects
INERTIAL confinement fusion, EXPERIMENTAL design
Abstract

Fuel–ablator mix has been established as a major performance degrading effect in the burning plasma regime of recent inertial confinement fusion (ICF) experiments. As such, the study of fuel–ablator mix with experiments and simulations can provide valuable insight for our understanding of these experiments and establish a path for even higher yields and increased robustness. We present a novel high-yield experimental ICF design that is motivated by recent experiments measuring ice–ablator mix with a CH ablator instead of a high-density carbon (HDC) ablator [B. Bachmann et al., Phys. Rev. Lett. 129, 275001 (2022)]. We review these experiments in more detail and describe the modeling assumptions and parameters used to obtain agreement with the data from implosion and burn simulations with mix. Using this mix model calibrated a posteriori to the experimental data, we design an implosion that uses a CH ablator that is predicted to achieve better performance than a recent experiment that achieved net target gain of 1.5 in HDC. Because hydrodynamic instabilities are greatly reduced with this new design, we also expect a high reproducibility at the same implosion adiabat as current record yield experiments. [ABSTRACT FROM AUTHOR]

Published
2023
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20. Lessons from rhinology and facial plastic surgery clinical negligence claims in England 2013–2018.

Author

Navaratnam, A V, Pendolino, A L, Kaura, A, Nijim, J, Machin, J T, Briggs, T W R, Marshall, A, Randhawa, P S, and Andrews, P J

Subjects
MAXILLOFACIAL surgery, PLASTIC surgery, NATIONAL health services, MEDICAL errors, HEALTH insurance reimbursement, DECISION making, PATIENT education, ECONOMICS
Abstract

Objective: This study reviewed all rhinology clinical negligence claims in the National Health Service in England between 2013 and 2018. Method: All clinical negligence claims held by National Health Service Resolution relating to rhinology in England between 1 April 2013 and 1 April 2018 were reviewed. Results: There were 171 rhinology related claims with a total estimated potential cost of £13.6 million. There were 119 closed claims (70 per cent) with a total cost of £2.3 million, of which 55 claims resulted in payment of damages. Over three quarters of all rhinology claims were associated with surgery (n = 132). Claims associated with endoscopic sinus surgery had the highest mean cost per claim (£172 978). Unnecessary pain (33.9 per cent) and unnecessary operation (28.1 per cent) were the most commonly cited patient injuries. Conclusion: Patient education and consent have been highlighted as key areas for improvement from this review of rhinology related clinical negligence claims. A shift in clinical practice towards shared decision making could reduce litigation in rhinology. [ABSTRACT FROM AUTHOR]

Published
2022
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30. Safety of day‐case paediatric tonsillectomy in England: an analysis of administrative data for the Getting It Right First Time programme.

Author

Gray, W. K., Takhar, A. S., Navaratnam, A. V., Day, J., Swart, M., Snowden, C., Briggs, T. W. R., and Marshall, A.

Subjects
TONSILLECTOMY, TONSILLITIS, PEDIATRICS, DATA analysis, NUMERIC databases, HOSPITAL statistics, TREATMENT effectiveness
Abstract

Summary: We used the Hospital Episodes Statistics database to investigate unwarranted variation in the rates Trusts discharged children the same day after scheduled tonsillectomy and associations with adverse postoperative outcomes. We included children aged 2–18 years who underwent tonsillectomy between 1 April 2014 and 31 March 2019. We stratified analyses by category of Trust, non‐specialist or specialist, defined as without or with paediatric critical care facilities, respectively. We adjusted analyses for age, sex, year of surgery and aspects of presentation and procedure type. Of 101,180 children who underwent tonsillectomy at non‐specialist Trusts, 62,926 (62%) were discharged the same day, compared with 24,138/48,755 (50%) at specialist Trusts. The adjusted proportion of children discharged the same day as tonsillectomy ranged from 5% to 100% at non‐specialist Trusts and 9% to 88% at specialist Trusts. Same‐day discharge was not independently associated with an increased rate of 30‐day emergency re‐admission at non‐specialist Trusts but was associated with a modest rate increase at specialist Trusts; adjusted probability 8.0% vs 7.7%, odds ratio (95%CI) 1.14 (1.05–1.24). Rates of adverse postoperative outcomes were similar for Trusts that discharged >70% children the same day as tonsillectomy compared with Trusts that discharged <50% children the same day, for both non‐specialist and specialist Trust categories. We found no consistent evidence that day‐case tonsillectomy is associated with poorer outcomes. All Trusts, but particularly specialist centres, should explore reasons for low day‐case rates and should aim for rates >70%. [ABSTRACT FROM AUTHOR]

Published
2022
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45. Volume-outcome relationship for adrenalectomy: analysis of an administrative dataset for the Getting It Right First Time Programme.

Author

Gray, W. K., Day, J., Briggs, T. W. R., Wass, J. A. H., and Lansdown, M.

Subjects
MINIMALLY invasive procedures, ADRENALECTOMY, NUMERIC databases, HOSPITAL statistics, MULTILEVEL models
Abstract

Background: A minimum volume threshold of at least six procedures per annum per surgeon has been set in UK and European guidelines for adrenal surgery. The aim of this study was to investigate outcomes for adrenal surgery in England relative to annual surgeon and hospital trust volume. Methods: Data were extracted from the Hospital Episodes Statistics database for England. A 6-year period (January 2013 to December 2018 inclusive) for all adult admissions for unilateral adrenal surgery was used. The primary outcome measure was an emergency readmission within 30 days of discharge following surgery. Procedures were categorized as open or minimally invasive surgery for analysis. Multilevel modelling was used to adjust for hierarchy and potential confounders. Results: Data for 4189 adrenalectomies were identified. Only one third of surgeons (who operated on just over a half of all patients) performed at least six procedures in the year prior to the index procedure. For open surgery, emergency readmission rates fell significantly from 15.2 to 6.4 per cent for surgeons and from 13.2 to 6.1 per cent for trusts between the lowest- and highest-volume categories. Significant, but less dramatic falls were also seen for minimally invasive surgery. Conclusion: A volume-outcome effect was identified for adrenal surgery in England. Minimum volume thresholds should be set, although these may need to be more ambitious than the current threshold if outcomes are to be optimized. [ABSTRACT FROM AUTHOR]

Published
2021
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46. Biomechanics of two external fixator devices used in rat femoral fractures

Author

Osagie-Clouard, L, Kaufmann, J, Blunn, G, Coathup, M, Pendegrass, C, Meeson, R L, Briggs, T, and Moazen, M

Subjects
Biomedical Sciences
Abstract

The use of external fixators allows for the direct investigation of newly formed interfragmentary bone, and the radiographic evaluation of the fracture. We validated the results of a finite element model with the in vitro stiffness' of two widely used external fixator devices used for in vivo analysis of fracture healing in rat femoral fractures with differing construction (Ti alloy ExFix1 and PEEK ExFix2). Rat femoral fracture fixation was modelled using two external fixators. For both constructs an osteotomy of 2.75 mm was used, and offset maintained at 5 mm. Tufnol, served as standardized substitutes for rat femora. Constructs were loaded under axial compression and torsion. Overall axial and torsional stiffness were compared between the in vitro models and FE results. FE models were also used to compare the fracture movement and overall pattern of von Mises stress across the external fixators. In vitro axial stiffness of ExFix1 was 29.26 N/mm ± 3.83 compared to ExFix2 6.31 N/mm ± 0.67 (p*

Published
2019
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49. What can be learned from litigation in otology? A review of clinical negligence claims in England 2013–2018.

Author

McClenaghan, F, Ho, C, Machin, J T, Briggs, T W R, Marshall, A, and Navaratnam, A V

Subjects
NATIONAL health services, ECONOMICS, EAR surgery, DELAYED diagnosis, ACQUISITION of data methodology, EAR diseases, MEDICAL care costs, RETROSPECTIVE studies, SURGICAL complications, TREATMENT failure, TREATMENT delay (Medicine), INFORMED consent (Medical law), NEGLIGENCE, MALPRACTICE, MEDICAL records, DESCRIPTIVE statistics, HEARING disorders, LEGAL procedure, DAMAGES (Law), OTOLARYNGOLOGY, FACIAL nerve
Abstract

Background: Litigation in the National Health Service continues to rise with a 9.4 per cent increase in clinical negligence claims from the period 2018 and 2019 to the period 2019 and 2020. The cost of these claims now accounts for 1.8 per cent of the National Health Service 2019 to 2020 budget. This study aimed to identify the characteristics of clinical negligence claims in the subspecialty of otology. Methods: This study was a retrospective review of all clinical negligence claims in otology in England held by National Health Service Resolution between April 2013 and April 2018. Results: There were 171 claims in otology, 24 per cent of all otolaryngology claims, with a potential cost of £24.5 million. Over half of these were associated with hearing loss. Stapedectomy was the highest mean cost per claim operation at £769 438. The most common reasons for litigation were failure or delay in treatment (23 per cent), failure or delay in diagnosis (20 per cent), intra-operative complications (15 per cent) and inadequate consent (13 per cent). Conclusion: There is a risk of high-cost claims in otology, especially with objective injuries such as hearing loss and facial nerve injury. [ABSTRACT FROM AUTHOR]

Published
2021
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