Keriel-Gascou M, Brami J, Chanelière M, Haeringer-Cholet A, Larrieu C, Villebrun F, Robert T, Michel P
Département de médecine générale, EA 4128 santé, individu, société, université Lyon I, 8, avenue Rockefeller, 69373 Lyon, France.
Faculté de médecine Paris-Descartes, Haute Autorité de santé, 75005 Paris, France.
Rev Epidemiol Sante Publique. 2014 Feb;62(1):41-52. doi: 10.1016/j.respe.2013.10.007. Epub 2014 Jan 15.
There is no widely accepted definition of incident for primary care doctors in France and no taxonomic classification system for epidemiological use. In preparation for a future epidemiological study on primary care incidents in France (the ESPRIT study), this work was designed to identify the definitions and taxonomic classifications used internationally along with the usual methods and results in terms of frequency in the literature. The goal was to determine a French definition and taxonomy.
Systematic review of the literature and consensus methods.
An exhaustive search of epidemiological surveys was performed. A structured grid was used. After having identified the definitions used in the literature, a definition was chosen using the focus groups method. Taxonomies identified in the literature were classified by relationship, architecture, code number, and number of studies published. Subsequently, a consensus among experts, who independently tested these taxonomies on six incidents, was reached for choosing the most appropriate for epidemiological data collection (little information on a large number of cases).
Twenty-four papers reporting 17 studies were selected among 139 articles. Five definitions and eight taxonomies were found. The chosen definition of incident was based on the WHO definition "A patient safety incident is an event or circumstance that could have resulted, or did result, in harm to a patient, and whose wish it is not repeated again". The test of incidents resulted in the choice of the TAPS version of the International Taxonomy of Medical Error in Primary Care for a reproducible and internationally recognized codification and the tempos method for its current use in French general practice.
The definitions, taxonomies, data collection characteristics and frequency of incidents results in the international literature on incidents in primary care are key components for the preparation of an epidemiological survey on incidents in primary care.
在法国，对于基层医疗医生而言，“事件”尚无被广泛接受的定义，也没有用于流行病学研究的分类系统。为筹备未来一项关于法国基层医疗事件的流行病学研究（ESPRIT研究），开展本项工作旨在确定国际上使用的定义和分类系统，以及文献中常见的方法和事件发生频率的研究结果。目标是确定法国的定义和分类法。
文献系统综述及共识方法。
对流行病学调查进行全面检索。使用结构化表格。在确定文献中使用的定义后，采用焦点小组方法选择一个定义。将文献中确定的分类法按关系、架构、编码和发表研究数量进行分类。随后，专家们针对六个事件对这些分类法进行独立测试，并达成共识，以选择最适合流行病学数据收集的分类法（大量病例的信息较少）。
从139篇文章中选出24篇报道17项研究的论文。发现了五个定义和八个分类法。所选的事件定义基于世界卫生组织的定义：“患者安全事件是指一个事件或情况，它可能已经导致或确实导致了对患者的伤害，并且希望此类事件不再重复发生”。对事件的测试结果是选择了基层医疗中医疗差错国际分类法的TAPS版本，用于可重复且国际认可的编码，并选择了节奏法用于其在法国全科医疗中的当前应用。
基层医疗事件国际文献中的定义、分类法、数据收集特征和事件发生频率结果是筹备基层医疗事件流行病学调查的关键组成部分。
