The reliability of medical record review for estimating adverse event rates

Abstract

BACKGROUND: The data used by the U.S. Institute of Medicine to estimate deaths from medical errors come from a study that relied on nurse and physician reviews of medical records to detect the errors. OBJECTIVE: To measure the reliability of medical record review for detecting adverse events and negligent adverse events. DESIGN: Medical record review. SETTING: Hospitalizations in Utah and Colorado in 1992. MEASUREMENTS: After three independent reviews of 500 medical records, the following were measured: reliability and the effect of varying criteria for reviewer confidence in and reviewer agreement about the presence of adverse events. RESULTS: For agreements in judgments of adverse events a..