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Convergent Validity of Three Methods for Measuring Postoperative Complications
Bradley A Fritz1, Krisztina E Escallier, Arbi Ben Abdallah
1From the Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri.
Anesthesiology
|March 31, 2016
Summary
Patient surveys show poor agreement with medical records for in-hospital postoperative complications. While useful for post-discharge events, patient-reported outcomes require improved survey design and communication for accuracy.
Area of Science:
- Medical Informatics
- Patient Outcomes Research
- Surgical Complications
Background:
- Anesthesiologists require precise tools for tracking postoperative outcomes.
- The reliability of patient self-reporting for diverse surgical complications remains under-investigated.
Purpose of the Study:
- To evaluate the accuracy of patient self-reported postoperative complications compared to electronic and manual chart reviews.
- To assess the agreement between different methods of postoperative complication data collection.
Main Methods:
- A cohort study involving 1,578 adult surgical patients who completed a post-procedure survey.
- Comparison of patient survey responses with automated and manual electronic chart reviews.
- Telephone follow-up with a subset of patients to investigate discrepancies.
Main Results:
- Patient self-reports demonstrated poor-to-moderate positive agreement (0-58%) but excellent negative agreement (82-100%) with chart reviews.
- Discrepancies were often due to patients reporting events outside the in-hospital timeframe.
- Automated chart review agreement with manual chart review was also assessed.
Conclusions:
- Patient self-reporting is more reliable for subjective experiences or post-discharge events than for specific in-hospital complications.
- Improving in-hospital communication and survey design can enhance the quality of patient-reported complication data.
- Chart review remains a crucial method for verifying in-hospital postoperative complications.
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