This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Ronald L. Goldman, PhD, MPH

JAMA. 1992;267(7):958-960.

Abstract
Objective.
—To critically examine the literature regarding the interreviewer reliability of the standard practice of peer assessment of quality of care.

Data Sources.
—Computerized searches of the English-language literature from 1966 through 1990 using MEDLINE, HEALTHLINE, and SCISEARCH databases were performed to identify studies reporting data on interreviewer agreement of implicit evaluations of patient care episodes.

Study Selection.
—Seventeen studies were identified. Five studies were excluded from this review because of deficiencies in the methods or lack of data on chance-corrected indexes of agreement.

Data Extraction Synthesis.
—The degree of agreement beyond chance was compared with accepted standards in the 12 remaining studies. Most of these studies found agreement corrected for chance to be in the range regarded as poor, indicating that physician agreement regarding quality of care is only slightly better than the level expected by chance.

Conclusions.
—Given the magnitude of the resources devoted to quality assurance and the centrality of peer assessment to these efforts, there is a need for a global reexamination of the peer review process. A number of proposals appear to have potential for improving the peer review process including more objective assessment procedures, multiple reviewers, higher standards for reviewers, elimination of systematic reviewer bias, use of outcome judgments, and adoption of practice guidelines.

(JAMA. 1992;267:958-960)

Author Affiliations
From the Quality Management Office, Department of Veterans Affairs Central Office, Washington, DC.

Footnotes
Reprint requests to Quality Management Office (15), VA Central Office, 810 Vermont Ave NW, Washington, DC 20420 (Dr Goldman).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

An epistemology of patient safety research: a framework for study design and interpretation. Part 3. End points and measurement
Brown et al.
Qual Saf Health Care 2008;17:170-177.
ABSTRACT | FULL TEXT  

Integrating Incident Reporting into an Electronic Patient Record System
Haller et al.
J. Am. Med. Inform. Assoc. 2007;14:175-181.
ABSTRACT | FULL TEXT  

Inter- and intra-rater reliability for classification of medication related events in paediatric inpatients.
Kunac et al.
Qual Saf Health Care 2006;15:196-201.
ABSTRACT | FULL TEXT  

The measurement of active errors: methodological issues
Lilford et al.
Qual Saf Health Care 2003;12:ii8-12.
ABSTRACT | FULL TEXT  

Quality Assessment of a Collaborative Approach for Decreasing Drug-Related Morbidity and Achieving Therapeutic Goals
Isetts et al.
Arch Intern Med 2003;163:1813-1820.
ABSTRACT | FULL TEXT  

Estimating Hospital Deaths Due to Medical Errors: Preventability Is in the Eye of the Reviewer
Hayward and Hofer
JAMA 2001;286:415-420.
ABSTRACT | FULL TEXT  

Bioethics for clinicians: 23. Disclosure of medical error
Hebert et al.
CMAJ 2001;164:509-513.
ABSTRACT | FULL TEXT  

Comparison of Vignettes, Standardized Patients, and Chart Abstraction: A Prospective Validation Study of 3 Methods for Measuring Quality
Peabody et al.
JAMA 2000;283:1715-1722.
ABSTRACT | FULL TEXT  

Adverse events in health care: issues in measurement
Walshe
Qual Saf Health Care 2000;9:47-52.
FULL TEXT  

Hospital Peer Review and the National Practitioner Data Bank: Clinical Privileges Action Reports
Baldwin et al.
JAMA 1999;282:349-355.
ABSTRACT | FULL TEXT  

Economic Grand Rounds: Equitable Peer Review
Lazarus
Psychiatr. Serv. 1998;49:1535-1539.
FULL TEXT  

Research Evidence on the Validity of Risk-Adjusted Mortality Rate as a Measure of Hospital Quality of Care
Thomas and Hofer
Med Care Res Rev 1998;55:371-404.
ABSTRACT  

Peer Review of the Quality of Care: Reliability and Sources of Variability for Outcome and Process Assessments
Smith et al.
JAMA 1997;278:1573-1578.
ABSTRACT  

Chart Review: A Need for Reappraisal
Wu and Ashton
Eval Health Prof 1997;20:146-163.
ABSTRACT  

Effectiveness of Care and Improvement in Quality of Life in Patients With Panic Disorder
Owen et al.
Eval Rev 1997;21:405-416.
ABSTRACT  

The Electronic House Call: Consequences of Telemedicine Consultations for Physicians, Patients, and Society
&stbye and Hurlen
Arch Fam Med 1997;6:266-271.
ABSTRACT  

Secondary Diagnoses as Predictive Factors for Survival or Mortality in Medicare Patients with Acute Pneumonia
White et al.
American Journal of Medical Quality 1996;11:186-192.
ABSTRACT  

Improving Participation and Interrater Agreement in Scoring Ambulatory Pediatric Association Abstracts: How Well Have We Succeeded?
Kemper et al.
Arch Pediatr Adolesc Med 1996;150:380-383.
ABSTRACT  

Physicians' Mistakes: Will Your Colleagues Offer Support?
Ely
Arch Fam Med 1996;5:76-77.
ABSTRACT  

Linking Process and Outcome of Care in a Continuous Quality Improvement Program for Anesthesia Services
Posner et al.
American Journal of Medical Quality 1994;9:129-137.
ABSTRACT  

Quality Health Care
Laffel and Berwick
JAMA 1993;270:254-255.
ABSTRACT  

PROs and the Health Care Quality Improvement Initiative: Insights from 50 Cases of Serious Medical Mistakes
Feldman and Rundall
Med Care Res Rev 1993;50:123-152.
 

The {kappa} Statistic
Berry
JAMA 1992;268:2513-2513.
ABSTRACT  

Clinical Competence of Family Physicians: The Patient Perspective
Mainous and David
Arch Fam Med 1992;1:65-68.
ABSTRACT  

The Health Care Quality Improvement Initiative: A New Approach to Quality Assurance in Medicare
Jencks and Wilensky
JAMA 1992;268:900-903.
ABSTRACT  

Watching the Doctor-Watchers: How Well Do Peer Review Organization Methods Detect Hospital Care Quality Problems?
Rubin et al.
JAMA 1992;267:2349-2354.
ABSTRACT