A Medical Causation Analysis is an Evidence-Based Medicine (EBM) causation analysis—whether in a hospital or in a courtroom—is the systematic method capable of distinguishing expert pronouncements about medical or scientific questions of causation as either (1) authority-based opinions (derived from expert intuition or reasoning, principles of pathophysiology, or inference based on experimental or observational data of insufficient quality) or (2) evidence-based conclusions (objective knowledge arising from the availability of sufficient, high-quality evidence).
TD&P Consulting and its Physician Medical Causation Experts hold the position that the evidence-based medicine methodology ought to govern all medical causation analyses to (1) accurately distinguish medical knowledge from mere expert opinion and (2) thereby assist the court in its effort to accurately adjudicate disputed medical matters.
Sometimes, medical causation experts first formulate an opinion and then selectively cite scientific data in support. Evidence-Based Medicine is the reverse. TD&P’s experts work first to conduct a complete and transparent standard-based analysis of all available published evidence and then formulate an evidence-based conclusion, one that is reproducible by others familiar with the method.
When you identify a testifying expert to represent your client, it is essential to ask them whether they are offering an evidence-based conclusion. If the expert admits to not applying an evidence-based method, then the answer by itself indicates that the expert is merely offering an authority-based opinion. If the expert is offering an evidence-based conclusion, then their testimony is backed by their investigation into whether there is existing evidence about the matter that has been derived from the best available, methodologically sound, and statistically significant studies.
Most causation evidence does not qualify as evidence-based. Rather, it is authority based opinions that rely on speculation, anecdote, individual, or collective personal clinical experience, or evidence of insufficient quality and/or amount. And while many healthcare practitioners report that they treat hundreds of patients and that they have formed their opinion based on years of experience, supplemented by training, reading, and (anecdotal or incomplete) scientific study. Such expert opinions are merely opinions. They may be right, but they may be wrong. Causation requires facts and valid scientific proof as practiced by TD&P Consulting.
Our expert Dr. Vera Dvorak, MD, leads our Medical Causation Analysis department. She is an authority on standards of care in the healthcare industry, transitions of care, long term planning in the inpatient and outpatient setting, and medical necessity in the group practice setting.
Dr. Dvorak is a board-certified internist and geriatrician with more than 40 years of professional experience. Over this period, she has led her profession as a (1) practitioner, (2) health insurance executive, (3) hospital system professional, and (4) medical consultant. Dr. Dvorak is well-read and maintains continuous medical education at 100 hours per year. She has devoted her professional career to individual patient care and ensuring that all patients are treated with dignity and respect receiving medically necessary at the right level and the right time. A critical focus of Vera Dr. Dvorak’s career has been to help patients and caregivers clearly understand their medical diagnosis and its impact on the quality of life. Read More on Dr. Dvoark
 Davidson, T., & Guzelian, C. (2012). EVIDENCE-BASED MEDICINE (EBM): THE (ONLY) MEANS FOR DISTINGUISHING KNOWLEDGE OF MEDICAL CAUSATION FROM EXPERT OPINION IN THE COURTROOM. Tort Trial & Insurance Practice Law Journal, 47(2), 741-779. Retrieved February 19, 2020, from www.jstor.org/stable/24374298