Structured chart review: Assessment of a structured chart review methodology

Ashley Siems; Russell Banks; Richard Holubkov; Kathleen L. Meert; Christian Bauerfeld; David Beyda; Robert A. Berg; Yonca Bulut; Randall S. Burd; Joseph Carcillo; J. Michael Dean; Eleanor Gradidge; Mark W. Hall; Patrick S. McQuillen; Peter M. Mourani; Christopher J.L. Newth; Daniel A. Notterman; Margaret A. Priestley; Anil Sapru; David L. Wessel; Andrew R. Yates; Athena F. Zuppa; Murray M. Pollack

doi:10.1542/hpeds.2019-0225

Structured chart review: Assessment of a structured chart review methodology

Ashley Siems, Russell Banks, Richard Holubkov, Kathleen L. Meert, Christian Bauerfeld, David Beyda, Robert A. Berg, Yonca Bulut, Randall S. Burd, Joseph Carcillo, J. Michael Dean, Eleanor Gradidge, Mark W. Hall, Patrick S. McQuillen, Peter M. Mourani, Christopher J.L. Newth, Daniel A. Notterman, Margaret A. Priestley, Anil Sapru, David L. WesselAndrew R. Yates, Athena F. Zuppa, Murray M. Pollack

Molecular Biology

Research output: Contribution to journal › Article › peer-review

15 Scopus citations

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 (n 5 41) revealed excellent percent agreement for the causes (80.5%–100%) and therapeutic advances (68.3%–100%). k 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.

Original language	English (US)
Pages (from-to)	61-69
Number of pages	9
Journal	Hospital pediatrics
Volume	10
Issue number	1
DOIs	https://doi.org/10.1542/hpeds.2019-0225
State	Published - Jan 1 2020

All Science Journal Classification (ASJC) codes

Pediatrics
Pediatrics, Perinatology, and Child Health

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10.1542/hpeds.2019-0225

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Siems, A., Banks, R., Holubkov, R., Meert, K. L., Bauerfeld, C., Beyda, D., Berg, R. A., Bulut, Y., Burd, R. S., Carcillo, J., Dean, J. M., Gradidge, E., Hall, M. W., McQuillen, P. S., Mourani, P. M., Newth, C. J. L., Notterman, D. A., Priestley, M. A., Sapru, A., ... Pollack, M. M. (2020). Structured chart review: Assessment of a structured chart review methodology. Hospital pediatrics, 10(1), 61-69. https://doi.org/10.1542/hpeds.2019-0225

@article{a052ec23766046f9a788778bed1ca1d5,

title = "Structured chart review: Assessment of a structured chart review methodology",

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 (n 5 41) revealed excellent percent agreement for the causes (80.5%–100%) and therapeutic advances (68.3%–100%). k 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.",

author = "Ashley Siems and Russell Banks and Richard Holubkov and Meert, {Kathleen L.} and Christian Bauerfeld and David Beyda and Berg, {Robert A.} and Yonca Bulut and Burd, {Randall S.} and Joseph Carcillo and Dean, {J. Michael} and Eleanor Gradidge and Hall, {Mark W.} and McQuillen, {Patrick S.} and Mourani, {Peter M.} and Newth, {Christopher J.L.} and Notterman, {Daniel A.} and Priestley, {Margaret A.} and Anil Sapru and Wessel, {David L.} and Yates, {Andrew R.} and Zuppa, {Athena F.} and Pollack, {Murray M.}",

note = "Publisher Copyright: Copyright {\textcopyright} 2020 by the American Academy of Pediatrics",

year = "2020",

month = jan,

day = "1",

doi = "10.1542/hpeds.2019-0225",

language = "English (US)",

volume = "10",

pages = "61--69",

journal = "Hospital pediatrics",

issn = "2154-1663",

publisher = "American Academy of Pediatrics",

number = "1",

}

Siems, A, Banks, R, Holubkov, R, Meert, KL, Bauerfeld, C, Beyda, D, Berg, RA, Bulut, Y, Burd, RS, Carcillo, J, Dean, JM, Gradidge, E, Hall, MW, McQuillen, PS, Mourani, PM, Newth, CJL, Notterman, DA, Priestley, MA, Sapru, A, Wessel, DL, Yates, AR, Zuppa, AF & Pollack, MM 2020, 'Structured chart review: Assessment of a structured chart review methodology', Hospital pediatrics, vol. 10, no. 1, pp. 61-69. https://doi.org/10.1542/hpeds.2019-0225

TY - JOUR

T1 - Structured chart review

T2 - Assessment of a structured chart review methodology

AU - Siems, Ashley

AU - Banks, Russell

AU - Holubkov, Richard

AU - Meert, Kathleen L.

AU - Bauerfeld, Christian

AU - Beyda, David

AU - Berg, Robert A.

AU - Bulut, Yonca

AU - Burd, Randall S.

AU - Carcillo, Joseph

AU - Dean, J. Michael

AU - Gradidge, Eleanor

AU - Hall, Mark W.

AU - McQuillen, Patrick S.

AU - Mourani, Peter M.

AU - Newth, Christopher J.L.

AU - Notterman, Daniel A.

AU - Priestley, Margaret A.

AU - Sapru, Anil

AU - Wessel, David L.

AU - Yates, Andrew R.

AU - Zuppa, Athena F.

AU - Pollack, Murray M.

PY - 2020/1/1

Y1 - 2020/1/1

N2 - 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 (n 5 41) revealed excellent percent agreement for the causes (80.5%–100%) and therapeutic advances (68.3%–100%). k 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.

AB - 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 (n 5 41) revealed excellent percent agreement for the causes (80.5%–100%) and therapeutic advances (68.3%–100%). k 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.

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U2 - 10.1542/hpeds.2019-0225

DO - 10.1542/hpeds.2019-0225

M3 - Article

C2 - 31879317

AN - SCOPUS:85085164057

SN - 2154-1663

VL - 10

SP - 61

EP - 69

JO - Hospital pediatrics

JF - Hospital pediatrics

IS - 1

ER -

Structured chart review: Assessment of a structured chart review methodology

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