Orphan Data and the Unclosed Loop: A Dilemma in PSRO and Medical Audit

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Abstract
Peer review and continuing medical education have been traditionally regarded as forming a "loop" in which review of patient care identifies topics for continuing education, and continuing education is evaluated through follow-up review.1 This very logical theory has usually been tested in a relatively controlled setting: a specialty department in a moderate-sized hospital. In this setting, particularly when enthusiastic leadership was available, physicians subject to the peer-review process participated in (or at least endorsed) the generative process that developed the criteria. Because they were actively engaged in setting the criteria and standards for their professional performance, they were equally receptive . . .

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