我们可以知道什么时候错误是错误吗? 评估利克尔特尺度在测量误差时的可靠性
Elianna S Grossman1, Jonathan L Burstein1, Jorge Fradinho1
1Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America.
The American journal of emergency medicine
|October 17, 2025
概括
医生对急诊室医疗错误的审查显示,对错误的存在有中度的同意,但对其严重程度有分歧. 对于可靠的质量审查,需要标准化的框架.
科学领域:
- 紧急医疗 紧急医疗
- 医疗质量保证 医疗质量保证
- 患者安全 患者安全
背景情况:
- 定义和检测医疗错误是一项挑战.
- 质量审查对于识别急诊室 (ED) 潜在的患者安全问题至关重要.
研究的目的:
- 为了确定紧急医疗 (EM) 医生质量审查在检测医疗错误时的可靠性.
- 评估对错误识别和严重程度的评级者间协议.
主要方法:
- 从一个学术ED (11/2012-11/2024) 的19200个案例的回顾性审查.
- 这些病例包括返回急救室,快速转移到重症监护室,意外死亡,以及患者/医疗服务提供者的投诉.
- 病例被随机分配给经过质量保证培训的EM医生,使用8-点利克特级别;科恩的卡帕评估一致.
主要成果:
- 使用加权的利克特和分组尺度 (卡帕 = 0.43-0.44) 发现了适度的协议.
- 在评估错误可能性时,协议减少了.
- 审稿人同意存在错误,但不同意其严重程度.
结论:
- 虽然EM医生可以就错误的存在达成一致,但关于其分类和严重程度存在重大分歧.
- 调查结果强调了需要标准化错误分类框架,以提高质量保证审查的可靠性.
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