TY - JOUR
T1 - Structured chart review
T2 - Assessment of a structured chart review methodology
AU - Siems, Ashley
AU - Banks, Russell
AU - Holubkov, Richard
AU - Meert, Kathleen L.
AU - Bauerfeld, Christian
AU - Beyda, David
AU - Berg, Robert A.
AU - Bulut, Yonca
AU - Burd, Randall S.
AU - Carcillo, Joseph
AU - Dean, J. Michael
AU - Gradidge, Eleanor
AU - Hall, Mark W.
AU - McQuillen, Patrick S.
AU - Mourani, Peter M.
AU - Newth, Christopher J.L.
AU - Notterman, Daniel A.
AU - Priestley, Margaret A.
AU - Sapru, Anil
AU - Wessel, David L.
AU - Yates, Andrew R.
AU - Zuppa, Athena F.
AU - Pollack, Murray M.
N1 - Publisher Copyright:
Copyright © 2020 by the American Academy of Pediatrics
PY - 2020/1/1
Y1 - 2020/1/1
N2 - BACKGROUND AND OBJECTIVES: Chart reviews are frequently used for research, care assessments, and quality improvement activities despite an absence of data on reliability and validity. We aim to describe a structured chart review methodology and to establish its validity and reliability. METHODS: A generalizable structured chart review methodology was designed to evaluate causes of morbidity or mortality and to identify potential therapeutic advances. The review process consisted of a 2-tiered approach with a primary review completed by a site physician and a short secondary review completed by a central physician. A total of 327 randomly selected cases of known mortality or new morbidities were reviewed. Validity was assessed by using postreview surveys with a Likert scale. Reliability was assessed by percent agreement and interrater reliability. RESULTS: The primary reviewers agreed or strongly agreed in 94.9% of reviews that the information to form a conclusion about pathophysiological processes and therapeutic advances could be adequately found. They agreed or strongly agreed in 93.2% of the reviews that conclusions were easy to make, and confidence in the process was 94.2%. Secondary reviewers made modifications to 36.6% of cases. Duplicate reviews (n 5 41) revealed excellent percent agreement for the causes (80.5%–100%) and therapeutic advances (68.3%–100%). k statistics were strong for the pathophysiological categories but weaker for the therapeutic categories. CONCLUSIONS: A structured chart review by knowledgeable primary reviewers, followed by a brief secondary review, can be valid and reliable.
AB - BACKGROUND AND OBJECTIVES: Chart reviews are frequently used for research, care assessments, and quality improvement activities despite an absence of data on reliability and validity. We aim to describe a structured chart review methodology and to establish its validity and reliability. METHODS: A generalizable structured chart review methodology was designed to evaluate causes of morbidity or mortality and to identify potential therapeutic advances. The review process consisted of a 2-tiered approach with a primary review completed by a site physician and a short secondary review completed by a central physician. A total of 327 randomly selected cases of known mortality or new morbidities were reviewed. Validity was assessed by using postreview surveys with a Likert scale. Reliability was assessed by percent agreement and interrater reliability. RESULTS: The primary reviewers agreed or strongly agreed in 94.9% of reviews that the information to form a conclusion about pathophysiological processes and therapeutic advances could be adequately found. They agreed or strongly agreed in 93.2% of the reviews that conclusions were easy to make, and confidence in the process was 94.2%. Secondary reviewers made modifications to 36.6% of cases. Duplicate reviews (n 5 41) revealed excellent percent agreement for the causes (80.5%–100%) and therapeutic advances (68.3%–100%). k statistics were strong for the pathophysiological categories but weaker for the therapeutic categories. CONCLUSIONS: A structured chart review by knowledgeable primary reviewers, followed by a brief secondary review, can be valid and reliable.
UR - http://www.scopus.com/inward/record.url?scp=85085164057&partnerID=8YFLogxK
U2 - 10.1542/hpeds.2019-0225
DO - 10.1542/hpeds.2019-0225
M3 - Article
C2 - 31879317
AN - SCOPUS:85085164057
SN - 2154-1663
VL - 10
SP - 61
EP - 69
JO - Hospital pediatrics
JF - Hospital pediatrics
IS - 1
ER -