PMID- 19473812
OWN - NLM
STAT- MEDLINE
DCOM- 20100326
LR  - 20091204
IS  - 1878-5921 (Electronic)
IS  - 0895-4356 (Linking)
VI  - 63
IP  - 1
DP  - 2010 Jan
TI  - The inter-rater agreement of retrospective assessments of adverse events does not 
      improve with two reviewers per patient record.
PG  - 94-102
LID - 10.1016/j.jclinepi.2009.03.004 [doi]
AB  - OBJECTIVE: To evaluate the inter-rater agreement of the record review process of 
      the Dutch Adverse Event study, which we aimed to improve by the involvement of 
      two independent physician reviewers per record instead of one including a 
      consensus procedure in case of disagreement. METHODS: The inter-rater agreement 
      within pairs of physicians (independent review between physician A+B) and between 
      pairs of physicians (independent review between physician A+B and C+D) was 
      measured to evaluate the record review process with two physicians including a 
      consensus procedure, with 4,272 and 119 records, respectively. RESULTS: The 
      inter-rater agreement within pairs of physicians was substantial for the 
      determination of adverse events (AEs) with a kappa of 0.64 (95% confidence 
      interval [CI]: 0.61, 0.68). The inter-rater agreement between pairs of physicians 
      was fair for the determination of AEs with a kappa of 0.25 (95% CI: 0.05, 0.45). 
      CONCLUSION: A record review process with two physicians per record including a 
      consensus procedure to assess AEs is not more reliable than a record review 
      process with one physician. Retrospective estimates of incidence of AEs from 
      record review studies should be interpreted with caution. Improvement of the 
      method is necessary for monitoring incidence of AEs over time at a national 
      level.
FAU - Zegers, Marieke
AU  - Zegers M
AD  - NIVEL, Netherlands Institute for Health Services Research, P.O. box 1568, 3500 BN 
      Utrecht, The Netherlands. m.zegers@nivel.nl
FAU - de Bruijne, Martine C
AU  - de Bruijne MC
FAU - Wagner, Cordula
AU  - Wagner C
FAU - Groenewegen, Peter P
AU  - Groenewegen PP
FAU - van der Wal, Gerrit
AU  - van der Wal G
FAU - de Vet, Henrica C W
AU  - de Vet HC
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20090526
PL  - United States
TA  - J Clin Epidemiol
JT  - Journal of clinical epidemiology
JID - 8801383
SB  - IM
MH  - Consensus
MH  - Hospitalization
MH  - Humans
MH  - Medical Errors/prevention & control/*statistics & numerical data
MH  - Medical Records/*standards
MH  - Netherlands
MH  - Observer Variation
MH  - Reproducibility of Results
MH  - Safety Management/*methods
EDAT- 2009/05/29 09:00
MHDA- 2010/03/27 06:00
CRDT- 2009/05/29 09:00
PHST- 2008/04/14 00:00 [received]
PHST- 2008/12/15 00:00 [revised]
PHST- 2009/03/16 00:00 [accepted]
PHST- 2009/05/29 09:00 [entrez]
PHST- 2009/05/29 09:00 [pubmed]
PHST- 2010/03/27 06:00 [medline]
AID - S0895-4356(09)00079-1 [pii]
AID - 10.1016/j.jclinepi.2009.03.004 [doi]
PST - ppublish
SO  - J Clin Epidemiol. 2010 Jan;63(1):94-102. doi: 10.1016/j.jclinepi.2009.03.004. 
      Epub 2009 May 26.