PMID- 15977591
OWN - NLM
STAT- MEDLINE
DCOM- 20050819
LR  - 20110727
IS  - 0546-1766 (Print)
IS  - 0546-1766 (Linking)
VI  - 52
IP  - 5
DP  - 2005 May
TI  - [Methodology of retrospective chart review to detect adverse events: the 
      reliability of physician judgment].
PG  - 422-32
AB  - PURPOSE: To establish a scientific basis for promoting patient safety, basic 
      information related to the incidence of adverse events (AEs) is needed. In 
      studies in several other countries, trained nurses screened for potential AEs 
      using explicit criteria in the first stage, and physicians reviewed selected 
      charts in the second stage. To assure the accuracy of retrospective chart review, 
      it is important to verify the reliability of AE judgments by physician reviewers. 
      The purpose of this study was to test this reliability of judgment of AEs (their 
      presence, causation of healthcare management and preventability) by three 
      physician reviewers. METHODS: This study used 100 selected charts of 
      non-psychiatric inpatients in an acute care hospital. Three physicians 
      independently assessed AEs and discussed their judgments with the physician who 
      created the manual for judging AEs. We considered judgments of the AEs agreed on 
      by the four physicians to be final AE judgments and compared the reliability of 
      each measure related to AE judgments among the physician reviewers using the 
      kappa statistic. RESULTS: The number of AE cases each physician reviewer judged 
      ranged from 18 to 27. Agreement on the presence of an AE ranged from 83.0% to 
      90.0% (kappa=0.52-0.70). Ultimately, AEs were judged to have occurred in 16 cases 
      while 7 cases were deferred. The agreement on the presence of an AE between the 
      physician's and the final judgment ranged from 86.0% to 96.8% (kappa = 
      0.56-0.88). However, agreement on the causation of healthcare management and 
      preventability between the physician's and the final judgment was not in the 
      acceptable range. CONCLUSION: The reliability of each physician's judgments 
      regarding the presence of an AE was satisfactory. However, the reliability of 
      judgments related to the causation of health care management and preventability 
      was not necessarily satisfactory. Therefore, it is considered important to judge 
      causation and preventability based on discussion with clinical experts in the 
      relevant field.
FAU - Ikeda, Shunya
AU  - Ikeda S
AD  - Department of Health Policy and Management, Keio University School of Medicine.
FAU - Kobayashi, Mia
AU  - Kobayashi M
FAU - Sakaguchi, Misa
AU  - Sakaguchi M
FAU - Kaneko, Toshihiro
AU  - Kaneko T
FAU - Hirose, Masahiro
AU  - Hirose M
FAU - Sakai, Hideto
AU  - Sakai H
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - Nihon Koshu Eisei Zasshi
JT  - [Nihon koshu eisei zasshi] Japanese journal of public health
JID - 19130150R
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Japan
MH  - Male
MH  - *Malpractice
MH  - Medical Records
MH  - Middle Aged
MH  - Physicians/*psychology
MH  - Retrospective Studies
EDAT- 2005/06/28 09:00
MHDA- 2005/08/20 09:00
CRDT- 2005/06/28 09:00
PHST- 2005/06/28 09:00 [pubmed]
PHST- 2005/08/20 09:00 [medline]
PHST- 2005/06/28 09:00 [entrez]
PST - ppublish
SO  - Nihon Koshu Eisei Zasshi. 2005 May;52(5):422-32.