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Ingravallo F, Cerquetti I, Vignatelli L, Albertini S, Bolcato M, Camerlingo M, Corbi G, De Leo D, De Nicolò A, De Stefano F, Dell'Erba A, Di Giulio P, Domenici R, Fedeli P, Feola A, Ferrara N, Forti P, Frigiolini F, Gianniti P, Gili E, Iannone P, Lovato A, Lunardelli ML, Marengoni A, Marozzi F, Martelloni M, Mecocci P, Molinelli A, Polo L, Portas M, Rossi P, Scorretti C, Trabucchi M, Volpato S, Zoja R, Castellani GL. Medico-legal assessment of personal damage in older people: report from a multidisciplinary consensus conference. Int J Legal Med 2020; 134:2319-2334. [PMID: 32681208 PMCID: PMC7578136 DOI: 10.1007/s00414-020-02368-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 06/22/2020] [Indexed: 12/19/2022]
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.
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Affiliation(s)
- Francesca Ingravallo
- Ageing Research Centre, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via Irnerio 49, 40126, Bologna, Italy.
| | | | - Luca Vignatelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Matteo Bolcato
- National Board of Young Medico-legal Experts, Legal Medicine, University of Padua, Padua, Italy
| | | | - Graziamaria Corbi
- Department of Medicine and Health Sciences "V. Tiberio" and Italian Society of Gerontology and Geriatrics, University of Molise, Campobasso, Italy
| | - Domenico De Leo
- College of Italian Professors of Legal Medicine, Department of Diagnostics and Public Health, Unit of Forensic Medicine, University of Verona, Verona, Italy
| | | | - Francesco De Stefano
- Italian Society of Legal and Insurance Medicine (SIMLA), Department of Science of Health (DISSAL), University of Genoa, Genoa, Italy
| | - Alessandro Dell'Erba
- Federation of the Italian Associations of Medico-Legal Experts (FAMLI), Department of Interdisciplinary Medicine (DIM), Section of Legal and Forensic Medicine, University of Bari, Bari, Italy
| | - Paola Di Giulio
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | | | - Piergiorgio Fedeli
- Italian Research Group on Personal Injury (GISDAP), University of Camerino, Camerino, Italy
| | - Alessandro Feola
- National Board of Young Medico-legal Experts, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Nicola Ferrara
- Department of Translational Medical Sciences and Italian Society of Gerontology and Geriatrics, Federico II University of Naples, Naples, Italy
| | - Paola Forti
- Ageing Research Centre, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via Irnerio 49, 40126, Bologna, Italy
| | | | | | - Enrico Gili
- National Association of Insurance Companies (ANIA), Rome, Italy
| | - Primiano Iannone
- National Center for Clinical Excellence, Quality and Safety of Care (CNEC), Rome, Italy
| | - Alessandro Lovato
- The Surveillance and Cooperation Body on Civil Justice, Bologna, Italy
| | - Maria Lia Lunardelli
- Geriatric Unit, Orthogeriatric Ward, University Hospital Policlinico S. Orsola Malpighi, Bologna, Italy
| | - Alessandra Marengoni
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Franco Marozzi
- Federation of the Italian Associations of Medico-Legal Experts (FAMLI), Milan, Italy
| | - Massimo Martelloni
- Department of Legal Medicine, Local Health Trust Toscana Nordovest, Scientific Society of Forensic Medicine of Italian National Health Service Hospitals (COMLAS), Lucca, Italy
| | - Patrizia Mecocci
- Department of Medicine, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Andrea Molinelli
- Italian Society of Legal and Insurance Medicine (SIMLA), Department of Science of Health (DISSAL), University of Genoa, Genoa, Italy
| | | | | | - Patrizio Rossi
- National Institute for Insurance against Accidents at Work (INAIL), Rome, Italy
| | | | - Marco Trabucchi
- Italian Association of Psychogeriatrics (AIP), University of Tor Vergata, Rome, Italy
| | - Stefano Volpato
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Riccardo Zoja
- Department of Health and Biomedical Sciences, Section of Legal Medicine, University of Milan, Milan, Italy
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