Mevik Kjersti, Griffin Frances A, Hansen Tonje Elisabeth, Deilkås Ellen, Vonen Barthold
Fran Griffin & Associates, LLC, 318 Sea Spray Lane Neptune, NJ USA 07753.
Akershus University Hospital, Post box 1000, 1478 Lørenskog, Norway.
Int J Qual Health Care. 2016 Sep;28(4):492-6. doi: 10.1093/intqhc/mzw054. Epub 2016 Jun 9.
To evaluate the inter-rater reliability of results from Global Trigger Tool (GTT) reviews when one of the three reviewers remains consistent, while one or two reviewers rotate.
Comparison of results from retrospective record review performed as a cross-sectional study with three review teams each consisting of two non-physicians and one physician; Team I (three consistent reviewers), Team II (one of the two non-physician reviewers or/and the physician from Team I are replaced for different review periods) and Team III (three consistent reviewers different from reviewers in Team I and Team II).
Medium-sized hospital trust in Northern Norway.
A total of 120 records were selected as biweekly samples of 10 from discharge lists between 1 July and 31 December 2010 for a 3-fold review.
Replacement of review team members was tested to assess impact on inter-rater reliability and adverse events measurment.
Inter-rater reliability assessed with the Cohen kappa coefficient between different teams regarding the presence and severity level of adverse events.
Substantial inter-rater reliability regarding the presence and severity level of adverse events was obtained between Teams I and II, while moderate inter-rater reliability was obtained between Teams I and III.
Replacement of reviewers did not influence the results provided that one of the non-physician reviewers remains consistent. The experience of the consistent reviewer can result in continued consistency in interpretation with the new reviewer through discussion of events. These findings could encourage more hospital to rotate reviewers in order to optimize resources when using the GTT.
当三位审阅者中有一位保持不变，而另外一两位审阅者轮流更换时，评估全球触发工具（GTT）评审结果的评分者间信度。
作为横断面研究进行回顾性记录评审，比较三个评审团队的结果，每个团队由两名非医生和一名医生组成；第一组（三位固定审阅者），第二组（在不同评审期更换第一组中的两名非医生审阅者之一或/和医生），第三组（与第一组和第二组的审阅者不同的三位固定审阅者）。
挪威北部的中型医院信托机构。
从2010年7月1日至12月31日的出院清单中，每两周抽取10份记录，共抽取120份记录进行三轮评审。
测试评审团队成员的更换，以评估对评分者间信度和不良事件测量的影响。
用科恩kappa系数评估不同团队之间关于不良事件的存在和严重程度水平的评分者间信度。
第一组和第二组之间在不良事件的存在和严重程度水平方面获得了较高的评分者间信度，而第一组和第三组之间获得了中等程度的评分者间信度。
只要非医生审阅者之一保持不变，审阅者的更换不会影响结果。通过对事件的讨论，固定审阅者的经验可以使新审阅者在解释上保持持续一致。这些发现可能会鼓励更多医院在使用GTT时轮换审阅者，以优化资源。
