The Experts below are selected from a list of 11361 Experts worldwide ranked by ideXlab platform
David W Bates - One of the best experts on this subject based on the ideXlab platform.
-
reliability evaluation of the adapted national coordinating council Medication Error reporting and prevention ncc merp index
Pharmacoepidemiology and Drug Safety, 2007Co-Authors: Rita Snyder, Jacob Abarca, Jane L Meza, Jeffrey M Rothschild, Albert Rizos, David W BatesAbstract:Purpose Adapted National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Index criteria were used in a study undertaken to evaluate commercial computerized provider order entry (CPOE) system impact on community hospital Medication Errors. This article describes: (1) adaptation of the Index, (2) classification criteria and processes used to assess the adapted Index, and (3) inter-rater reliability results. Methods A random sample of 130 (17%) of 2251 Medication safety events (MSEs) were classified based on event type, that is, adverse drug event (ADE) or potential ADE (PADE); preventability, that is, ‘yes’ or ‘no,’ and outcome severity. Event outcome severity was categorized using adapted Index categories E–I (ADEs) and B–D (PADEs). Decision rules were used for rule-based classification, while an MSE Case Review Panel used judgment-based classification when decision rules did not apply. Inter-rater reliability for both classification approaches was assessed with kappa coefficients, percentage agreement, and confidence intervals (CI). Results Level of agreement was substantial for both rule-based and judgment-based MSE classification for event type (6 = 0.70–0.90), preventability (6 = 0.67–0.82), and decision rule application (6 = 0.79). Rule-based agreement for ADE and PADE severity was almost perfect for discrete (6 = 0.83–0.84) and combined (6 = 0.87–0.90) Index categories. Judgment-based agreement was substantial for discrete (6 = 0.63–0.67) and combined (6 = 0.66–0.84) Index categories. Conclusions The adapted Index yielded substantial agreement for event type, preventability, and severity. Adaptation of the Index to support classification of non-preventable ADEs was an important improvement. Copyright © 2007 John Wiley & Sons, Ltd.
-
reliability evaluation of the adapted national coordinating council Medication Error reporting and prevention ncc merp index
Pharmacoepidemiology and Drug Safety, 2007Co-Authors: Rita Snyder, Jacob Abarca, Jane L Meza, Jeffrey M Rothschild, Albert Rizos, David W BatesAbstract:PURPOSE: Adapted National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Index criteria were used in a study undertaken to evaluate commercial computerized provider order entry (CPOE) system impact on community hospital Medication Errors. This article describes: (1) adaptation of the Index, (2) classification criteria and processes used to assess the adapted Index, and (3) inter-rater reliability results. METHODS: A random sample of 130 (17%) of 2251 Medication safety events (MSEs) were classified based on event type, that is, adverse drug event (ADE) or potential ADE (PADE); preventability, that is, 'yes' or 'no,' and outcome severity. Event outcome severity was categorized using adapted Index categories E-I (ADEs) and B-D (PADEs). Decision rules were used for rule-based classification, while an MSE Case Review Panel used judgment-based classification when decision rules did not apply. Inter-rater reliability for both classification approaches was assessed with kappa coefficients, percentage agreement, and confidence intervals (CI). RESULTS: Level of agreement was substantial for both rule-based and judgment-based MSE classification for event type (6 = 0.70-0.90), preventability (6 = 0.67-0.82), and decision rule application (6 = 0.79). Rule-based agreement for ADE and PADE severity was almost perfect for discrete (6 = 0.83-0.84) and combined (6 = 0.87-0.90) Index categories. Judgment-based agreement was substantial for discrete (6 = 0.63-0.67) and combined (6 = 0.66-0.84) Index categories. CONCLUSIONS: The adapted Index yielded substantial agreement for event type, preventability, and severity. Adaptation of the Index to support classification of non-preventable ADEs was an important improvement.
-
a 40 year old woman who noticed a Medication Error
JAMA, 2001Co-Authors: David W BatesAbstract:Ms K is a 40-year-old woman who found an er-rorwithherprescribedMedications.ShewasdiagnosedwithHIV infection in 1996 and has taken several different drugregimens. Despite the complexity of her drug program, MsK has been able to manage it well. She has taken an activerole in understanding the benefits of her Medications andhas not had major adverse effects.MsKhadaskedthatrefillsforherprescriptionsbecalledin to her pharmacy. When the time came to take her newlyfilled prescriptions, she noted that 2 of the drugs were un-familiar to her, and that 2 of her HIV drugs were missing.Ms K immediately called her primary care physician,DrT,toreportthisfactandhavetheErrorrectified.ShewasconcernedaboutcontinuingherplannedHIVregimenwith-out interruption. The Error was confirmed: Stelazine (tri-fluoperazine) and ranitidine had been dispensed to herinstead of stavudine and lamivudine.Thecorrectprescriptionswerethencalledintothephar-macy.Fortunately,MsKwasabletocontinueherdrugregi-men uninterrupted and did not experience any harm fromthis event.Overthepast4yearsMsKhasdoneremarkablywell.Sherecentlymarriedandchangedhercareerdirection.Shedoesnot smoke or abuse alcohol or illicit drugs. Her medica-tionsincludelamivudine,150mgtwicedaily;stavudine,40mgtwicedaily;efavirenz,600mgatbedtime;abacavir,300mg twice daily; pentamidine, 300 mg monthly via nebu-lizer; ethambutol, 1000 mg/d; and clarithromycin, 500 mgtwice daily.MS K: HER VIEWSI have a regular Medication regimen, a big one, because I’mHIV-positive. So I rely on my Medications and have to getprescriptions every month. I picked up the Medication. Ididn’t look in the bag for about a week. When I opened thebag, I had 2 completely wrong Medications. One was an ul-cer Medication and one was a tranquilizer, but they weresupposed to be antiretroviral Medications.It was very frustrating because I count on these people todo it right and count on having the right medicines. The ag-gravation of having to go through that process again is likecontacting City Hall. I think that you have to be an informedconsumer of the medical system. I didn’t lose confidence inthe system—I always thought it was poorly run. I go to thehospital because the doctors are very good, but the system isverypoor.IfIranabusinessthewaythehospitalisrun,Iwouldbe out of business. The hospital is like a mill—it’s deperson-alized. The Error was just indicative of my feeling about theprocess—it reinforced that no one is watching the store.As much as I go to the same pharmacy every month andbuy the same Medications, I remain very anonymous. I waswondering,howmanypeoplespend$15000ayearatthatphar-macy? Those are the customers who should be treated prettywell. But, to them, you’re just another packet of pantyhose.The disturbing part of the whole thing for me is, what if Ididn’t know better not to take those Medications—supposeit was the first time I ever got them—and I took them. Luck-ily, I’m an informed consumer of my Medications. But forsomeone who is not, it could have been disastrous.DR T: HER VIEWSThere’s no question in my mind that this case was a nearmiss.Inthevastmajorityofcases,itwouldhavebeenagraveError had an intelligent, astute patient not caught it.IwasquitedisturbedtoseehowcompletelyunrelatedtheMedication she received was to what had been prescribed.I mean, stavudine and Stelazine sound somewhat similar,but lamivudine and ranitidine are not that close. I checkedhermedicalrecordtoseewhatwehadlistedashavinggiven
-
the impact of computerized physician order entry on Medication Error prevention
Journal of the American Medical Informatics Association, 1999Co-Authors: David W Bates, Jonathan M Teich, Joshua Lee, Diane L Seger, Gilad J Kuperman, Nell Maluf, Deborah Boyle, Lucian L LeapeAbstract:Background: Medication Errors are common, and while most such Errors have little potential for harm they cause substantial extra work in hospitals. A small proportion do have the potential to cause injury, and some cause preventable adverse drug events. Objective: To evaluate the impact of computerized physician order entry (POE) with decision support in reducing the number of Medication Errors. Design: Prospective time series analysis, with four periods. Setting and participants: All patients admitted to three medical units were studied for seven to ten-week periods in four different years. The baseline period was before implementation of POE, and the remaining three were after. Sophistication of POE increased with each successive period. Intervention: Physician order entry with decision support features such as drug allergy and drug-drug interaction warnings. Main outcome measure: Medication Errors, excluding missed dose Errors. Results: During the study, the non-missed-dose Medication Error rate fell 81 percent, from 142 per 1,000 patient-days in the baseline period to 26.6 per 1,000 patient-days in the final period (P < 0.0001). Non-intercepted serious Medication Errors (those with the potential to cause injury) fell 86 percent from baseline to period 3, the final period (P = 0.0003). Large differences were seen for all main types of Medication Errors: dose Errors, frequency Errors, route Errors, substitution Errors, and allergies. For example, in the baseline period there were ten allergy Errors, but only two in the following three periods combined (P < 0.0001). Conclusions: Computerized POE substantially decreased the rate of non-missed-dose Medication Errors. A major reduction in Errors was achieved with the initial version of the system, and further reductions were found with addition of decision support features. n JAMIA. 1999;6:313-321.
Rita Snyder - One of the best experts on this subject based on the ideXlab platform.
-
reliability evaluation of the adapted national coordinating council Medication Error reporting and prevention ncc merp index
Pharmacoepidemiology and Drug Safety, 2007Co-Authors: Rita Snyder, Jacob Abarca, Jane L Meza, Jeffrey M Rothschild, Albert Rizos, David W BatesAbstract:PURPOSE: Adapted National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Index criteria were used in a study undertaken to evaluate commercial computerized provider order entry (CPOE) system impact on community hospital Medication Errors. This article describes: (1) adaptation of the Index, (2) classification criteria and processes used to assess the adapted Index, and (3) inter-rater reliability results. METHODS: A random sample of 130 (17%) of 2251 Medication safety events (MSEs) were classified based on event type, that is, adverse drug event (ADE) or potential ADE (PADE); preventability, that is, 'yes' or 'no,' and outcome severity. Event outcome severity was categorized using adapted Index categories E-I (ADEs) and B-D (PADEs). Decision rules were used for rule-based classification, while an MSE Case Review Panel used judgment-based classification when decision rules did not apply. Inter-rater reliability for both classification approaches was assessed with kappa coefficients, percentage agreement, and confidence intervals (CI). RESULTS: Level of agreement was substantial for both rule-based and judgment-based MSE classification for event type (6 = 0.70-0.90), preventability (6 = 0.67-0.82), and decision rule application (6 = 0.79). Rule-based agreement for ADE and PADE severity was almost perfect for discrete (6 = 0.83-0.84) and combined (6 = 0.87-0.90) Index categories. Judgment-based agreement was substantial for discrete (6 = 0.63-0.67) and combined (6 = 0.66-0.84) Index categories. CONCLUSIONS: The adapted Index yielded substantial agreement for event type, preventability, and severity. Adaptation of the Index to support classification of non-preventable ADEs was an important improvement.
-
reliability evaluation of the adapted national coordinating council Medication Error reporting and prevention ncc merp index
Pharmacoepidemiology and Drug Safety, 2007Co-Authors: Rita Snyder, Jacob Abarca, Jane L Meza, Jeffrey M Rothschild, Albert Rizos, David W BatesAbstract:Purpose Adapted National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Index criteria were used in a study undertaken to evaluate commercial computerized provider order entry (CPOE) system impact on community hospital Medication Errors. This article describes: (1) adaptation of the Index, (2) classification criteria and processes used to assess the adapted Index, and (3) inter-rater reliability results. Methods A random sample of 130 (17%) of 2251 Medication safety events (MSEs) were classified based on event type, that is, adverse drug event (ADE) or potential ADE (PADE); preventability, that is, ‘yes’ or ‘no,’ and outcome severity. Event outcome severity was categorized using adapted Index categories E–I (ADEs) and B–D (PADEs). Decision rules were used for rule-based classification, while an MSE Case Review Panel used judgment-based classification when decision rules did not apply. Inter-rater reliability for both classification approaches was assessed with kappa coefficients, percentage agreement, and confidence intervals (CI). Results Level of agreement was substantial for both rule-based and judgment-based MSE classification for event type (6 = 0.70–0.90), preventability (6 = 0.67–0.82), and decision rule application (6 = 0.79). Rule-based agreement for ADE and PADE severity was almost perfect for discrete (6 = 0.83–0.84) and combined (6 = 0.87–0.90) Index categories. Judgment-based agreement was substantial for discrete (6 = 0.63–0.67) and combined (6 = 0.66–0.84) Index categories. Conclusions The adapted Index yielded substantial agreement for event type, preventability, and severity. Adaptation of the Index to support classification of non-preventable ADEs was an important improvement. Copyright © 2007 John Wiley & Sons, Ltd.
Mardo Leleuly - One of the best experts on this subject based on the ideXlab platform.
-
gambaran sikap perawat tentang pelaporan insiden Medication Error di siloam hospitals labuan bajo description of nurse attitude about incident Medication Error reporting at siloam hospitals labuan bajo
2018Co-Authors: Mardo LeleulyAbstract:Pelaporan insiden Medication Error merupakan langkah awal dalam mengevaluasi insiden Medication Error. Pelaporan insiden berkaitan dengan sikap yang dimiliki perawat. Sikap memiliki empat tingkatan yaitu menerima, merespon, menghargai dan bertanggung jawab. Perawat dituntut agar bisa memiliki sikap positif tersebut. Tujuan penelitian ini adalah mengetahui gambaran sikap perawat tentang pelaporan insiden Medication Error di Siloam Hospitals Labuan Bajo (SHLB). Metode yang digunakan adalah deskriptif kuantitatif dengan teknik total sampling dengan jumlah 27 perawat yakni 18 perawat IPD (In Patient Department), 9 perawat ICU (Intensive Care Unit) dan NICU (Neonate Intensive Care Unit). Instrumen yang digunakan adalah kuesioner berupa 20 butir pernyataan positif yang telah uji validitas, reabilitas dan normalitas. Hasil penelitian adalah seimbang, respon positif (50%) dan respon negatif (50%). Empat tingkatan sikap seimbang pada aspek menerima (50%), aspek merespon, menghargai, bertanggung jawab berbeda. Aspek menghargai memiliki respon negatif sangat tinggi (65,38%) jika dibandingkan dengan aspek merespon (42,30%) dan bertanggung jawab (46,15%). Kesimpulan adalah 50% perawat di SHLB menunjukan respon positif dalam melakukan pelaporan insiden Medication Error. Saran bagi peneliti selanjutnya untuk menunjukan hasil dalam presentase favorable maupun unfavorable / Incident Medication Error reporting is the first step in evaluating the incidence of Medication Error. Incident reporting is related with a nurse attitude. Attitude have a four levels is receiving, responding, valuting and responsible. Nurses are required to have a positive attitude. The purpose of this research is to know description of nurse attitude about incident Medication Error reporting at inpatient department in Siloam Hospitals Labuan Bajo (SHLB). The method used is descriptive quantitative total sampling with 27 nurse at inpatient is 18 inpatient department nurse (IPD), 9 Intensive Care Unit nurse (ICU) and Neonate Intensive Care Unit nurse (NICU). The instrument used is a questionnaire of 20 items of positive statements that have been tested for validity, reliability and normality. The results were balanced, positive responses (50%) and negative responses (50%). Four levels of balanced attitude on receiving aspect (50%), responding, valuting and responsible is different. Valuting aspect have very high negative response (65,38%) when compered with responding aspect (42,30%) and reponsible aspect (46,15%). The conclusion is 50% inpatien showing a positive response in conducting incident Medication Error reporting. Suggestions for the next researcher to show the results in percentable favorable or unfavorable.
-
gambaran sikap perawat tentang pelaporan insiden Medication Error di siloam hospitals labuan bajo description of nurse attitude about incident Medication Error reporting at siloam hospitals labuan bajo
2018Co-Authors: Mardo LeleulyAbstract:Pelaporan insiden Medication Error merupakan langkah awal dalam mengevaluasi insiden Medication Error. Pelaporan insiden berkaitan dengan sikap yang dimiliki perawat. Sikap memiliki empat tingkatan yaitu menerima, merespon, menghargai dan bertanggung jawab. Perawat dituntut agar bisa memiliki sikap positif tersebut. Tujuan penelitian ini adalah mengetahui gambaran sikap perawat tentang pelaporan insiden Medication Error di Siloam Hospitals Labuan Bajo (SHLB). Metode yang digunakan adalah deskriptif kuantitatif dengan teknik total sampling dengan jumlah 27 perawat yakni 18 perawat IPD (In Patient Department), 9 perawat ICU (Intensive Care Unit) dan NICU (Neonate Intensive Care Unit). Instrumen yang digunakan adalah kuesioner berupa 20 butir pernyataan positif yang telah uji validitas, reabilitas dan normalitas. Hasil penelitian adalah seimbang, respon positif (50%) dan respon negatif (50%). Empat tingkatan sikap seimbang pada aspek menerima (50%), aspek merespon, menghargai, bertanggung jawab berbeda. Aspek menghargai memiliki respon negatif sangat tinggi (65,38%) jika dibandingkan dengan aspek merespon (42,30%) dan bertanggung jawab (46,15%). Kesimpulan adalah 50% perawat di SHLB menunjukan respon positif dalam melakukan pelaporan insiden Medication Error. Saran bagi peneliti selanjutnya untuk menunjukan hasil dalam presentase favorable maupun unfavorable / Incident Medication Error reporting is the first step in evaluating the incidence of Medication Error. Incident reporting is related with a nurse attitude. Attitude have a four levels is receiving, responding, valuting and responsible. Nurses are required to have a positive attitude. The purpose of this research is to know description of nurse attitude about incident Medication Error reporting at inpatient department in Siloam Hospitals Labuan Bajo (SHLB). The method used is descriptive quantitative total sampling with 27 nurse at inpatient is 18 inpatient department nurse (IPD), 9 Intensive Care Unit nurse (ICU) and Neonate Intensive Care Unit nurse (NICU). The instrument used is a questionnaire of 20 items of positive statements that have been tested for validity, reliability and normality. The results were balanced, positive responses (50%) and negative responses (50%). Four levels of balanced attitude on receiving aspect (50%), responding, valuting and responsible is different. Valuting aspect have very high negative response (65,38%) when compered with responding aspect (42,30%) and reponsible aspect (46,15%). The conclusion is 50% inpatien showing a positive response in conducting incident Medication Error reporting. Suggestions for the next researcher to show the results in percentable favorable or unfavorable.
Albert Rizos - One of the best experts on this subject based on the ideXlab platform.
-
reliability evaluation of the adapted national coordinating council Medication Error reporting and prevention ncc merp index
Pharmacoepidemiology and Drug Safety, 2007Co-Authors: Rita Snyder, Jacob Abarca, Jane L Meza, Jeffrey M Rothschild, Albert Rizos, David W BatesAbstract:PURPOSE: Adapted National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Index criteria were used in a study undertaken to evaluate commercial computerized provider order entry (CPOE) system impact on community hospital Medication Errors. This article describes: (1) adaptation of the Index, (2) classification criteria and processes used to assess the adapted Index, and (3) inter-rater reliability results. METHODS: A random sample of 130 (17%) of 2251 Medication safety events (MSEs) were classified based on event type, that is, adverse drug event (ADE) or potential ADE (PADE); preventability, that is, 'yes' or 'no,' and outcome severity. Event outcome severity was categorized using adapted Index categories E-I (ADEs) and B-D (PADEs). Decision rules were used for rule-based classification, while an MSE Case Review Panel used judgment-based classification when decision rules did not apply. Inter-rater reliability for both classification approaches was assessed with kappa coefficients, percentage agreement, and confidence intervals (CI). RESULTS: Level of agreement was substantial for both rule-based and judgment-based MSE classification for event type (6 = 0.70-0.90), preventability (6 = 0.67-0.82), and decision rule application (6 = 0.79). Rule-based agreement for ADE and PADE severity was almost perfect for discrete (6 = 0.83-0.84) and combined (6 = 0.87-0.90) Index categories. Judgment-based agreement was substantial for discrete (6 = 0.63-0.67) and combined (6 = 0.66-0.84) Index categories. CONCLUSIONS: The adapted Index yielded substantial agreement for event type, preventability, and severity. Adaptation of the Index to support classification of non-preventable ADEs was an important improvement.
-
reliability evaluation of the adapted national coordinating council Medication Error reporting and prevention ncc merp index
Pharmacoepidemiology and Drug Safety, 2007Co-Authors: Rita Snyder, Jacob Abarca, Jane L Meza, Jeffrey M Rothschild, Albert Rizos, David W BatesAbstract:Purpose Adapted National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Index criteria were used in a study undertaken to evaluate commercial computerized provider order entry (CPOE) system impact on community hospital Medication Errors. This article describes: (1) adaptation of the Index, (2) classification criteria and processes used to assess the adapted Index, and (3) inter-rater reliability results. Methods A random sample of 130 (17%) of 2251 Medication safety events (MSEs) were classified based on event type, that is, adverse drug event (ADE) or potential ADE (PADE); preventability, that is, ‘yes’ or ‘no,’ and outcome severity. Event outcome severity was categorized using adapted Index categories E–I (ADEs) and B–D (PADEs). Decision rules were used for rule-based classification, while an MSE Case Review Panel used judgment-based classification when decision rules did not apply. Inter-rater reliability for both classification approaches was assessed with kappa coefficients, percentage agreement, and confidence intervals (CI). Results Level of agreement was substantial for both rule-based and judgment-based MSE classification for event type (6 = 0.70–0.90), preventability (6 = 0.67–0.82), and decision rule application (6 = 0.79). Rule-based agreement for ADE and PADE severity was almost perfect for discrete (6 = 0.83–0.84) and combined (6 = 0.87–0.90) Index categories. Judgment-based agreement was substantial for discrete (6 = 0.63–0.67) and combined (6 = 0.66–0.84) Index categories. Conclusions The adapted Index yielded substantial agreement for event type, preventability, and severity. Adaptation of the Index to support classification of non-preventable ADEs was an important improvement. Copyright © 2007 John Wiley & Sons, Ltd.
Jeffrey M Rothschild - One of the best experts on this subject based on the ideXlab platform.
-
reliability evaluation of the adapted national coordinating council Medication Error reporting and prevention ncc merp index
Pharmacoepidemiology and Drug Safety, 2007Co-Authors: Rita Snyder, Jacob Abarca, Jane L Meza, Jeffrey M Rothschild, Albert Rizos, David W BatesAbstract:PURPOSE: Adapted National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Index criteria were used in a study undertaken to evaluate commercial computerized provider order entry (CPOE) system impact on community hospital Medication Errors. This article describes: (1) adaptation of the Index, (2) classification criteria and processes used to assess the adapted Index, and (3) inter-rater reliability results. METHODS: A random sample of 130 (17%) of 2251 Medication safety events (MSEs) were classified based on event type, that is, adverse drug event (ADE) or potential ADE (PADE); preventability, that is, 'yes' or 'no,' and outcome severity. Event outcome severity was categorized using adapted Index categories E-I (ADEs) and B-D (PADEs). Decision rules were used for rule-based classification, while an MSE Case Review Panel used judgment-based classification when decision rules did not apply. Inter-rater reliability for both classification approaches was assessed with kappa coefficients, percentage agreement, and confidence intervals (CI). RESULTS: Level of agreement was substantial for both rule-based and judgment-based MSE classification for event type (6 = 0.70-0.90), preventability (6 = 0.67-0.82), and decision rule application (6 = 0.79). Rule-based agreement for ADE and PADE severity was almost perfect for discrete (6 = 0.83-0.84) and combined (6 = 0.87-0.90) Index categories. Judgment-based agreement was substantial for discrete (6 = 0.63-0.67) and combined (6 = 0.66-0.84) Index categories. CONCLUSIONS: The adapted Index yielded substantial agreement for event type, preventability, and severity. Adaptation of the Index to support classification of non-preventable ADEs was an important improvement.
-
reliability evaluation of the adapted national coordinating council Medication Error reporting and prevention ncc merp index
Pharmacoepidemiology and Drug Safety, 2007Co-Authors: Rita Snyder, Jacob Abarca, Jane L Meza, Jeffrey M Rothschild, Albert Rizos, David W BatesAbstract:Purpose Adapted National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Index criteria were used in a study undertaken to evaluate commercial computerized provider order entry (CPOE) system impact on community hospital Medication Errors. This article describes: (1) adaptation of the Index, (2) classification criteria and processes used to assess the adapted Index, and (3) inter-rater reliability results. Methods A random sample of 130 (17%) of 2251 Medication safety events (MSEs) were classified based on event type, that is, adverse drug event (ADE) or potential ADE (PADE); preventability, that is, ‘yes’ or ‘no,’ and outcome severity. Event outcome severity was categorized using adapted Index categories E–I (ADEs) and B–D (PADEs). Decision rules were used for rule-based classification, while an MSE Case Review Panel used judgment-based classification when decision rules did not apply. Inter-rater reliability for both classification approaches was assessed with kappa coefficients, percentage agreement, and confidence intervals (CI). Results Level of agreement was substantial for both rule-based and judgment-based MSE classification for event type (6 = 0.70–0.90), preventability (6 = 0.67–0.82), and decision rule application (6 = 0.79). Rule-based agreement for ADE and PADE severity was almost perfect for discrete (6 = 0.83–0.84) and combined (6 = 0.87–0.90) Index categories. Judgment-based agreement was substantial for discrete (6 = 0.63–0.67) and combined (6 = 0.66–0.84) Index categories. Conclusions The adapted Index yielded substantial agreement for event type, preventability, and severity. Adaptation of the Index to support classification of non-preventable ADEs was an important improvement. Copyright © 2007 John Wiley & Sons, Ltd.
