PMID- 21642876
OWN - NLM
STAT- MEDLINE
DCOM- 20111209
LR  - 20220310
IS  - 1537-1948 (Electronic)
IS  - 0025-7079 (Linking)
VI  - 49
IP  - 10
DP  - 2011 Oct
TI  - Can we rely on patients' reports of adverse events?
PG  - 948-55
LID - 10.1097/MLR.0b013e31822047a8 [doi]
AB  - BACKGROUND: Evidence suggests that patients can report a variety of adverse 
      events (AEs) not captured by traditional methods such as a chart review. Little 
      is known, however, about whether patient reports are useful for measuring patient 
      safety. OBJECTIVES: To examine the degree to which physician reviewers agreed 
      that patient reports of "negative effects" constituted AEs, and to identify 
      questionnaire items that affected reviewers' judgments. METHODS: We surveyed 
      patients discharged from Massachusetts hospitals in 2003 to elicit information 
      about negative effects associated with hospitalization. Physician reviewers 
      judged whether patient-reported negative effects represented AEs, and classified 
      the severity of the event. Likelihood ratios were calculated to assess whether 
      patient responses to questionnaire items affected reviewers' judgments. RESULTS: 
      Of the 2582 patients surveyed, 753 patients reported 1170 negative effects, and 
      71.2% of these effects were classified as AEs by physician reviewers. Negative 
      effects most likely to be classified as AEs involved newly prescribed medications 
      and changes to previously prescribed medications. Additional information elicited 
      from follow-up survey questions modestly affected reviewers' classification of 
      serious AEs. Negative effects reported by women, younger patients, those 
      reporting better health status, and those not admitted through the emergency 
      department were more likely to be classified as AEs. CONCLUSIONS: Many patients 
      were able to identify care-related AEs. Patient responses to questions about the 
      sequelae of the events provided limited additional information for physicians to 
      use in gauging the presence and severity of the event. Patient reports complement 
      other incident-detection methods by providing information that is credible and 
      unavailable from other sources.
FAU - Zhu, Junya
AU  - Zhu J
AD  - Center for Patient Safety, Dana-Farber Cancer Institute, The Heller School for 
      Social Policy and Management, Brandeis University, Boston, MA 02215-5450, USA. 
      junya_zhu@dfci.harvard.edu
FAU - Stuver, Sherri O
AU  - Stuver SO
FAU - Epstein, Arnold M
AU  - Epstein AM
FAU - Schneider, Eric C
AU  - Schneider EC
FAU - Weissman, Joel S
AU  - Weissman JS
FAU - Weingart, Saul N
AU  - Weingart SN
LA  - eng
GR  - U18 HS11928/HS/AHRQ HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Med Care
JT  - Medical care
JID - 0230027
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Chi-Square Distribution
MH  - Data Collection/methods
MH  - Female
MH  - Humans
MH  - Likelihood Functions
MH  - Logistic Models
MH  - Male
MH  - Massachusetts
MH  - Medical Errors/*statistics & numerical data
MH  - Middle Aged
MH  - Patient Discharge
MH  - *Patients
MH  - Reproducibility of Results
MH  - *Self Disclosure
MH  - Surveys and Questionnaires
EDAT- 2011/06/07 06:00
MHDA- 2011/12/14 06:00
CRDT- 2011/06/07 06:00
PHST- 2011/06/07 06:00 [entrez]
PHST- 2011/06/07 06:00 [pubmed]
PHST- 2011/12/14 06:00 [medline]
AID - 10.1097/MLR.0b013e31822047a8 [doi]
PST - ppublish
SO  - Med Care. 2011 Oct;49(10):948-55. doi: 10.1097/MLR.0b013e31822047a8.