Structured Chart Review: Assessment of a Structured Chart Review Methodology. Author Ashley Siems, Russell Banks, Richard Holubkov, Kathleen Meert, Christian Bauerfeld, David Beyda, Robert Berg, Yonca Bulut, Randall Burd, Joseph Carcillo, J Michael Dean, Eleanor Gradidge, Mark Hall, Patrick McQuillen, Peter Mourani, Christopher Newth, Daniel Notterman, Margaret Priestley, Anil Sapru, David Wessel, Andrew Yates, Athena Zuppa, Murray Pollack Publication Year 2020 Type Journal Article Abstract 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 ( = 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.CONCLUSIONS: A structured chart review by knowledgeable primary reviewers, followed by a brief secondary review, can be valid and reliable. Keywords Humans, Reproducibility of Results, Surveys and Questionnaires, Morbidity, Medical Audit, Medical Records, Mortality Journal Hosp Pediatr Volume 10 Issue 1 Pages 61-69 Date Published 2020 Jan ISSN Number 2154-1671 DOI 10.1542/hpeds.2019-0225 Alternate Journal Hosp Pediatr PMCID PMC6931034 PMID 31879317 PubMedPubMed CentralGoogle ScholarBibTeXEndNote X3 XML