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Research Electronic Data Capture (REDCap®) used as an audit tool with a built-in database.

Signe H Kragelund1, Mona Kjærsgaard1, Søren Jensen-Fangel2

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Summary

This study developed a REDCap audit tool for antimicrobial stewardship, finding significant inter-expert differences in case evaluations. Discussion improved agreement, highlighting the need to consider observer variability in expert-based projects.

Keywords:
Antimicrobial stewardship programAudit toolDatabaseExpert evaluationResearch Electronic Data Capture (REDCap®)

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Area of Science:

  • Health Informatics
  • Clinical Pharmacy
  • Infectious Diseases

Background:

  • Antimicrobial stewardship programs are crucial for optimizing antibiotic use.
  • Electronic data capture systems can enhance audit processes.
  • Expert consensus is often required for evaluating antimicrobial treatment protocols.

Purpose of the Study:

  • To develop and implement a REDCap-based audit tool for antimicrobial stewardship.
  • To assess the necessity of multiple expert reviewers for antimicrobial treatment evaluations.
  • To determine the level of agreement among experts in case assessments.

Main Methods:

  • Development of a custom audit tool using REDCap (Research Electronic Data Capture).
  • Retrospective data collection and manual entry for 722 patient cases over one year.
  • Utilized seven predefined flowcharts covering antimicrobial treatment initiation, infection, prescription, discontinuation, reassessment, and microbiological sampling.
  • Employed a two-expert initial assessment with a third expert consulted for disagreements.

Main Results:

  • The REDCap audit tool facilitated independent expert evaluation.
  • Initial agreement between two experts was 31.9%; discussion resolved disagreements in 66.2% of cases.
  • A third expert was involved in only 1.9% of cases.
  • Overall agreement across 3406 assessed flowcharts was 75.8% after discussions.

Conclusions:

  • A REDCap-integrated audit tool can effectively support antimicrobial stewardship evaluations.
  • Significant inter-observer variability exists, necessitating careful consideration in expert-driven research.
  • Expert discussion is effective in achieving consensus, with minimal need for a third reviewer.