Chart reviews in emergency medicine research: Where are the methods?
Chart reviews in emergency medicine research: Where are the methods?
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DOI：
10.1016/s0196-0644(96)70264-0
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发表时间：
1996-03-01
影响因子：
6.2
通讯作者：
Steiner, J
中科院分区：
文献类型：
--
作者：
Gilbert, EH;Lowenstein, SR;Steiner, J
研究目的：病历回顾经常用于急诊医学研究。然而，很少严格审查图表审查所提取的数据的可靠性。本调查的目的是确定使用图表审查数据的急诊医学研究文章的比例，以及报告病例选择方法、提取者培训、监测和盲法以及评价者间一致性的比例。从1989年1月至1993年12月发表在三个急诊医学期刊的研究文章进行了鉴定。结果：在识别出的986篇原始研究文章中，244篇（25%; 95%置信区间[CI]，22%至28%）依赖于图表评论。入选标准描述为98%（95% CI，96%至99%），73%（95% CI，67%至79%）定义了分析的变量。很少提及其他方法：提取者培训，18%（95% CI，13%-23%）;标准化提取表格，11%（95% CI，7%-15%）;定期提取者监测，4%（95% CI，2%-7%）;提取者对研究假设设盲，3%（95% CI，1%-6%）。在5%（95% CI，3%-9%）中提到了评估者间可靠性，并在0.4%（95% CI，0%-2%）中进行了统计学检验。15%的随机样本的文章进行了重新评估，由第二个调查员; interrater协议是高的所有八个critics.Conclusion：图表审查是一种常见的方法，在急诊医学研究的数据收集。然而，通常缺乏关于数据质量的信息。图表审查应坚持更高的方法标准，否则这些研究的结论可能是错误的。
Study objective: Medical chart reviews are often used in emergency medicine research. However, the reliability of data abstracted by chart reviews is seldom examined critically The objective of this investigation was to determine the proportion of emergency medicine research articles that use data from chart reviews and the proportions that report methods of case selection, abstractor training, monitoring and blinding, and interrater agreement.Methods: Research articles published in three emergency medicine journals from January 1989 through December 1993 were identified. The articles that used chart reviews were analyzed.Results: Of 986 original research articles that were identified, 244 (25%; 95% confidence interval [CI], 22% to 28%) relied on chart reviews. Inclusion criteria were described in 98% (95% Cl, 96% to 99%), and 73% (95% Cl, 67% to 79%) defined the variables being analyzed. Other methods were seldom mentioned: abstractor training, 18% (95% Cl, 13% to 23%); standardized abstraction forms, 11% (95% Cl, 7% to 15%); periodic abstractor monitoring, 4% (95% Cl, 2% to 7%); and abstractor blinding to study hypotheses, 3% (95% Cl, 1% to 6%). Interrater reliability was mentioned in 5% (95% Cl, 3% to 9%) and tested statistically in .4% (95% Cl, 0% to 2%). A 15% random sample of articles was reassessed by a second investigator; interrater agreement was high for all eight criteria.Conclusion: Chart review is a common method of data collection in emergency medicine research. Yet, information about the quality of the data is usually lacking. Chart reviews should be held to higher methodologic standards, or the conclusions of these studies may be in error.