An interpretation of implicit judgments in chart review.
The effects of methods that are commonly employed to summarize implicit judgments about quality-of-care assessments, based on medical records, are examined. A sample of 250 medical records, from three outpatient clinics in a municipal hospital, was studied. Two, or three, reviewers judged the quality of both the process of care and the outcome of care, as reflected in each medical record; the reviewers were medical school faculty members. Thirty-seven combinations of the data were used to summarize the judgments made on each medical record. These combinations resulted in significant differences in interpretation within each clinic, but there were only insignificant differences in interpretation across the three clinics. Hence, the use of a single method to summarize data may distort the conclusions. These results demonstrate that data often should be summarized by several methods and that measures of association should be used to supplement tests of significance so as to develop a comprehensive understanding of a set of data.
D005163:Factor Analysis, Statistical; D006784:Hospitals, Teaching; D006801:Humans; D007600:Judgment; D008396:Maryland; D008499:Medical Records; D008962:Models, Theoretical; D010044:Outpatient Clinics, Hospital; D010380:Peer Review / Q000379:methods*; D011787:Quality of Health Care