TY - JOUR
T1 - Building Consensus for a Shared Definition of Adverse Events
T2 - A Case Study in the Profession of Dentistry
AU - Franklin, Amy
AU - Kalenderian, Elsbeth
AU - Hebballi, Nutan
AU - Delattre, Veronique
AU - Etoule, Jini
AU - White, Joel
AU - Vaderhobli, Ram
AU - Stewart, Denice
AU - Kent, Karla
AU - Yansane, Alfa
AU - Walji, Muhammad
N1 - Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022/8/1
Y1 - 2022/8/1
N2 - Background To achieve high-quality health care, adverse events (AEs) must be proactively recognized and mitigated. However, there is often ambiguity in applying guidelines and definitions. We describe the iterative calibration process needed to achieve a shared definition of AEs in dentistry. Our alignment process includes both independent and consensus building approaches. Objective We explore the process of defining dental AEs and the steps necessary to achieve alignment across different care providers. Methods Teams from 4 dental institutions across the United States iteratively reviewed patient records after identification of charts using an automated trigger tool. Calibration across teams was supported through negotiated definition of AEs and standardization of evidence provided in review. Interrater reliability was assessed using descriptive and κ statistics. Results After 5 iterative cycles of calibration, the teams (n = 8 raters) identified 118 cases. The average percent agreement for AE determination was 82.2%. Furthermore, the average, pairwise prevalence and bias-adjusted κ (PABAK) was 57.5% (κ = 0.575) for determining AE presence. The average percent agreement for categorization of the AE type was 78.5%, whereas the PABAK was 48.8%. Lastly, the average percent agreement for categorization of AE severity was 82.2% and the corresponding PABAK was 71.7%. Conclusions Successful calibration across reviewers is possible after consensus building procedures. Higher levels of agreement were found when categorizing severity (of identified events) rather than the events themselves. Our results demonstrate the need for collaborative procedures as well as training for the identification and severity rating of AEs.
AB - Background To achieve high-quality health care, adverse events (AEs) must be proactively recognized and mitigated. However, there is often ambiguity in applying guidelines and definitions. We describe the iterative calibration process needed to achieve a shared definition of AEs in dentistry. Our alignment process includes both independent and consensus building approaches. Objective We explore the process of defining dental AEs and the steps necessary to achieve alignment across different care providers. Methods Teams from 4 dental institutions across the United States iteratively reviewed patient records after identification of charts using an automated trigger tool. Calibration across teams was supported through negotiated definition of AEs and standardization of evidence provided in review. Interrater reliability was assessed using descriptive and κ statistics. Results After 5 iterative cycles of calibration, the teams (n = 8 raters) identified 118 cases. The average percent agreement for AE determination was 82.2%. Furthermore, the average, pairwise prevalence and bias-adjusted κ (PABAK) was 57.5% (κ = 0.575) for determining AE presence. The average percent agreement for categorization of the AE type was 78.5%, whereas the PABAK was 48.8%. Lastly, the average percent agreement for categorization of AE severity was 82.2% and the corresponding PABAK was 71.7%. Conclusions Successful calibration across reviewers is possible after consensus building procedures. Higher levels of agreement were found when categorizing severity (of identified events) rather than the events themselves. Our results demonstrate the need for collaborative procedures as well as training for the identification and severity rating of AEs.
KW - adverse events
KW - dentistry
KW - patient safety
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U2 - 10.1097/PTS.0000000000000959
DO - 10.1097/PTS.0000000000000959
M3 - Article
C2 - 35948296
AN - SCOPUS:85135916115
SN - 1549-8417
VL - 18
SP - 470
EP - 474
JO - Journal of patient safety
JF - Journal of patient safety
IS - 5
ER -