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      Black Robes and White Coats: Daubert Standard and Medical and Legal Considerations for Medical Expert Witnesses

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      Cureus
      Cureus
      daubert standard, frye standard, lawsuits, legal medical case, medical expert witness

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          Abstract

          Expert testimony can play a pivotal role in a legal case involving a medical issue, but it is crucial that this testimony be scientifically sound. In the United States, the Frye Standard demanded that such expert medical testimony be “generally accepted,” but it has been superseded by the more demanding Daubert Standard. Under Daubert, judges became “gatekeepers” as to what scientific material was admissible in court and what might be dismissed as junk science. While a vast improvement over Frye, the Daubert Standard still faces its own problems. Judges usually lack scientific and medical expertise and sometimes have to do their own medical research to be able to evaluate the experts and their testimony. Expert witnesses can be subjected to an adversarial Daubert challenge, even during trial, to establish their credentials and the evidence they are reporting. About half of all judges have had no formal education in handling scientific evidence, but 91% felt comfortable in their gatekeeper role. Considerations for expert witnesses include training or coaching, familiarity with the entire case and courtroom procedures, and an ability to not just know the evidence but to be able to communicate it effectively to a lay audience (jury). Some countries have pioneered a concurrent testimony approach in complex cases, whereby experts argue the evidence of the case under oath before a judge in advance of the trial to determine where there are points of agreement and where the main areas of contention reside. This process, colorfully called “hot tubbing,” is aimed at a more conciliatory approach to reaching compromises. Nevertheless, bias still can result even in hot-tubbing cases, and more research is needed to better understand the nature of jury bias and how it can affect jury decisions in complex medical cases.

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          How Experts’ Use of Medical Technical Jargon in Different Types of Online Health Forums Affects Perceived Information Credibility: Randomized Experiment With Laypersons

          Background Online health forums are widely used, but the quality of advice differs as much as the knowledge backgrounds of the audience members who receive the advice. It is important to understand how people judge the information given online. In line with the communication accommodation theory (CAT), online forums represent specific social contexts of communication which can present either accommodative or nonaccommodative language to an audience. Accordingly, use of accommodative or nonaccommodative language might affect people’s perceived trust in the communicator. Objective The objective of this study was to investigate how experts who use accommodative (vs nonaccommodative) language are evaluated by passive users of an online forum. Methods Participants (n=98) took part in an online experiment and read experts’ posts about 10 nutrition myths. Following a 2 x 2 mixed design, experts’ posts were written using either low or high amounts of medical technical jargon (MTJ) (within factor) and were directed at different audiences (mainly other medical experts [in a professional forum] vs a user group mainly comprising laypersons [in an advisory forum]) (between factor). Accommodation occurred where experts used high amounts of MTJ to address other medical experts in the professional forum; it also occurred when experts used low amounts of MTJ to address laypersons in the advisory forum. Conversely, nonaccommodation occurred when experts used high amounts of MTJ in the advisory forum and low amounts of MTJ in the professional forum. In each condition, participants evaluated the credibility of the information, the trustworthiness of the experts, and the accommodation by the experts. Results Overall, participants judged the credibility of information to be higher when experts used MTJ that was accommodative to the designated audience, F 1,95=3.10, P=.04, ηp 2=.031. In addition, participants judged the experts in professional forums to be more trustworthy than experts in advisory forums (all F 1,96≥3.54, P ≤.03, ηp 2≥.036). Moreover, participants rated experts who used high amounts of MTJ to have higher competence (F 1,96=37.54, P<.001, ηp 2=.28], lower integrity (F 1,96=10.77, P=.001, ηp 2=.101), and lower benevolence (F 1,96=9.75, P=.002, ηp 2=.092), as well as to have lower perceived accommodation to the audience (all F 1,96≥72.17, P<.001, ηp 2≥.43) compared with experts who used low MTJ. Conclusions To provide health information online that is perceived as credible, experts should consider using similar language as the language used by the addressed audience. As it is often impossible to determine the exact makeup of an online audience, further research might investigate whether having experts explicitly declare which audience they intend to address can help people to more reliably assess an expert’s trustworthiness. Furthermore, as people assess information differently depending on the context of online communication, it would be valuable for research to consider other aspects of the context beyond those of the audience.
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            The Error in “Error Rate”: Why Error Rates Are So Needed, Yet So Elusive

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              Asking the gatekeepers: A national survey of judges on judging expert evidence in a post-Daubert world.

              Drawing on the responses provided by a survey of state court judges (N = 400), empirical evidence is presented with respect to judges' opinions about the Daubert criteria, their utility as decision-making guidelines, the level to which judges understand their scientific meaning, and how they might apply them when evaluating the admissibility of expert evidence. Proportionate stratified random sampling was used to obtain a representative sample of state court judges. Part I of the survey was a structured telephone interview (response rate of 71%) and in Part II, respondents had an option of completing the survey by telephone or receiving a questionnaire in the mail (response rate of 81%). Survey results demonstrate that judges overwhelmingly support the "gatekeeping" role as defined by Daubert, irrespective of the admissibility standard followed in their state. However, many of the judges surveyed lacked the scientific literacy seemingly necessitated by Daubert. Judges had the most difficulty operationalizing falsifiability and error rate, with only 5% of the respondents demonstrating a clear understanding of falsifiability and only 4% demonstrating a clear understanding of error rate. Although there was little consensus about the relative importance of the guidelines, judges attributed more weight to general acceptance as an admissibility criterion. Although most judges agreed that a distinction could be made between "scientific" and "technical or otherwise specialized" knowledge, the ability to apply the Daubert guidelines appeared to have little bearing on whether specific types of expert evidence were designated as "science" or "nonscience." Moreover, judges' "bench philosophy of science" seemed to reflect the rhetoric, rather than the substance, of Daubert. Implications of these results for the evolving relationship between science and law and the ongoing debates about Frye, Daubert, Joiner, and Kumho are discussed.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                13 September 2024
                September 2024
                : 16
                : 9
                : e69346
                Affiliations
                [1 ] Pain Medicine, NEMA Research, Inc., Naples, USA
                [2 ] Scientific Communications, NEMA Research, Inc., Naples, USA
                Author notes
                Article
                10.7759/cureus.69346
                11471272
                39398691
                4590969c-9907-4b10-b9df-39cabfbcd68f
                Copyright © 2024, Pergolizzi et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 14 June 2024
                : 2 September 2024
                Categories
                Other
                Forensic Medicine
                Medical Education

                daubert standard,frye standard,lawsuits,legal medical case,medical expert witness

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