Maier-Riehle B, Gerdes N, Protz W, Jäckel W H
Department für Epidemiologie und Sozialmedizin, Bad Säckingen.
Gesundheitswesen. 1998 May;60(5):290-6.
In Germany the statutory pension insurance institutions have started a quality assurance programme. Our institute developed a peer review procedure for screening the process quality of rehabilitation care. The peer review was tested in a pilot study. Our article refers to the examination of interrater reliability, intrarater reliability and reviewer bias. First of all, experienced doctors were trained in reviewing reports routinely written by rehabilitation doctors at discharge of their patients. The peers had to judge on 56 process criteria belonging to six categories (e.g. case history). The reliability coefficients were calculated for the overall judgement of each category and the overall judgement of the process quality of rehabilitation care. The coefficients of interrater reliability and the coefficients of average intrarater reliability range from sufficient to good. Only few reviewers showed a general tendency to harsh or lenient rating. The objectivity of the tested peer review procedure seems definitely higher than in American studies of peer review of hospital charts.
在德国，法定养老保险机构已启动一项质量保证计划。我们的研究所制定了一项同行评审程序，用于筛查康复护理的过程质量。该同行评审在一项试点研究中进行了测试。我们的文章涉及对评分者间信度、评分者内信度和评审者偏差的检验。首先，对经验丰富的医生进行培训，让他们对康复医生在患者出院时常规撰写的报告进行评审。同行们必须根据属于六个类别的56项过程标准进行评判（例如病史）。计算了每个类别的总体评判以及康复护理过程质量的总体评判的信度系数。评分者间信度系数和平均评分者内信度系数范围从足够到良好。只有少数评审者表现出普遍的严厉或宽松评分倾向。所测试的同行评审程序的客观性似乎肯定高于美国对医院病历同行评审的研究。
