Quality-of-care review of optometric records: inter-rater reliability

As managed care organizations (MCOs) move into the realm of vision care, the issue of quality measurement has grown in relevance. This article assesses the inter-rater reliability of a medical record review instrument of a managed vision care plan. This study attempts to duplicate the continuous quality improvement initiative set forth by these MCOs. Twenty examiners, using the review instrument developed by the respective MCO, independently rated the records of 29 patients. Although the reviewers rated more than 86% of all records similarly, statistical analysis and further investigation deemed the instrument inconsistent and thus unreliable in its measurement.