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. 2020 Nov;134(6):2319-2334.
doi: 10.1007/s00414-020-02368-z. Epub 2020 Jul 17.

Medico-legal assessment of personal damage in older people: report from a multidisciplinary consensus conference

Francesca Ingravallo  1 , Ilaria Cerquetti  2 , Luca Vignatelli  3 , Sandra Albertini  4 , Matteo Bolcato  5 , Maria Camerlingo  6 , Graziamaria Corbi  7 , Domenico De Leo  8 , Andrea De Nicolò  9 , Francesco De Stefano  10 , Alessandro Dell'Erba  11 , Paola Di Giulio  12 , Ranieri Domenici  13 , Piergiorgio Fedeli  14 , Alessandro Feola  15 , Nicola Ferrara  16 , Paola Forti  17 , Francesca Frigiolini  18 , Pasquale Gianniti  19 , Enrico Gili  20 , Primiano Iannone  21 , Alessandro Lovato  22 , Maria Lia Lunardelli  23 , Alessandra Marengoni  24 , Franco Marozzi  25 , Massimo Martelloni  26 , Patrizia Mecocci  27 , Andrea Molinelli  10 , Lorenzo Polo  28 , Margherita Portas  29 , Patrizio Rossi  30 , Carlo Scorretti  31 , Marco Trabucchi  32 , Stefano Volpato  33 , Riccardo Zoja  34 , Gloria Luigia Castellani  35
Affiliations

Medico-legal assessment of personal damage in older people: report from a multidisciplinary consensus conference

Francesca Ingravallo et al. Int J Legal Med. 2020 Nov.

Abstract

Ageing of the global population represents a challenge for national healthcare systems and healthcare professionals, including medico-legal experts, who assess personal damage in an increasing number of older people. Personal damage evaluation in older people is complex, and the scarcity of evidence is hindering the development of formal guidelines on the subject. The main objectives of the first multidisciplinary Consensus Conference on Medico-Legal Assessment of Personal Damage in Older People were to increase knowledge on the subject and establish standard procedures in this field. The conference, organized according to the guidelines issued by the Italian National Institute of Health (ISS), was held in Bologna (Italy) on June 8, 2019 with the support of national scientific societies, professional organizations, and stakeholders. The Scientific Technical Committee prepared 16 questions on 4 thematic areas: (1) differences in injury outcomes in older people compared to younger people and their relevance in personal damage assessment; (2) pre-existing status reconstruction and evaluation; (3) medico-legal examination procedures; (4) multidimensional assessment and scales. The Scientific Secretariat reviewed relevant literature and documents, rated their quality, and summarized evidence. During conference plenary public sessions, 4 pairs of experts reported on each thematic area. After the last session, a multidisciplinary Jury Panel (15 members) drafted the consensus statements. The present report describes Conference methods and results, including a summary of evidence supporting each statement, and areas requiring further investigation. The methodological recommendations issued during the Conference may be useful in several contexts of damage assessment, or to other medico-legal evaluation fields.

Keywords: Medico-legal assessment; Multidimensional assessment; Older adults; Personal damage; Personal injury; Pre-existing conditions.

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Conflict of interest statement

The following authors received an honorarium for their counselling activities from insurance and accident investigation companies: G.L Castellani (Allianz, AXA, UnipolSai, Zurich), A. Feola (Allianz, Helvetia and ITAS), A. Lovato (Società Reale Mutua Assicurazioni and UnipolSai), F. Marozzi (Allianz, CIS Infortunistica, GIESSE Infortunistica, Helvetia, and ITAS), and R. Zoja (Gruppo HDI, Global SE, and Società Reale Mutua Assicurazioni). G.L. Castellani contributed to writing the Chapter on ‘Evaluation methods in older people’ of SIMLA’s guide to medical-legal evaluation of personal damage; P. Fedeli contributed to several scientific publications on personal damage assessment. F. De Stefano is a member of the Ligurian Regional Commission for the assessment of medical malpractice damages. E. Gili is an employee of the National Association of Insurance Companies (ANIA). The remaining authors declare that they have no conflicts of interest.

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