@article{3752,
  keywords = {Humans, Reproducibility of Results, Surveys and Questionnaires, Morbidity, Medical Audit, Medical Records, Mortality},
  author = {Ashley Siems and Russell Banks and Richard Holubkov and Kathleen Meert and Christian Bauerfeld and David Beyda and Robert Berg and Yonca Bulut and Randall Burd and Joseph Carcillo and J Michael Dean and Eleanor Gradidge and Mark Hall and Patrick McQuillen and Peter Mourani and Christopher Newth and Daniel Notterman and Margaret Priestley and Anil Sapru and David Wessel and Andrew Yates and Athena Zuppa and Murray Pollack},
  title = {Structured Chart Review: Assessment of a Structured Chart Review Methodology.},
  abstract = { <p><b>BACKGROUND AND OBJECTIVES: </b>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.</p><p><b>METHODS: </b>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.</p><p><b>RESULTS: </b>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 ( = 41) revealed excellent percent agreement for the causes (80.5\%-100\%) and therapeutic advances (68.3\%-100\%). κ statistics were strong for the pathophysiological categories but weaker for the therapeutic categories.</p><p><b>CONCLUSIONS: </b>A structured chart review by knowledgeable primary reviewers, followed by a brief secondary review, can be valid and reliable.</p> },
  year = {2020},
  journal = {Hosp Pediatr},
  volume = {10},
  pages = {61-69},
  month = {2020 Jan},
  issn = {2154-1671},
  doi = {10.1542/hpeds.2019-0225},
  language = {eng},
}