THE ACCURACY OF RETROSPECTIVE CHART REVIEW IN MEASURING NOSOCOMIAL INFECTION RATES: RESULTS OF VALIDATION STUDIES IN PILOT HOSPITALS

Publisher Website
Google Scholar
Abstract
To measure the accuracy and consistency of a standardized method—retrospective chart review (RCRp)—for estimating nosocomial infection rates (NIRs) in individual hospitals, the authors performed a series of pilot studies in four hospitals of different types. in comparison with a standard based on diagnoses made by physician-epidemioioglsts supervising intensive prospective data collection teams, the RCR method was found to have an average sensttivity of 0.74 (±0.02 SE; range 0.69–0.78) and an average speclflclty of 0.964 (±0.002; 0.945–0.991). These values were comparable to those of the physician-epidemiologists' diagnoses and varied less among the hospitals. Two independent teams of chart reviewers were found to have similar levels of sensitivity and specificity, and the reliability of diagnosis at the level of the individual chart reviewer averaged 0.94. In a restudy at one of the pilot hospC tais at the midpoint of the actual Medical Records Survey (MRS), there was a substantial increase in sensttivity and a slight increase in specificity as a result of improvements made in the RCR method after the original pilot studies.