[Which definition and taxonomy of incident to use for a French reporting system in primary care settings?].
BACKGROUND
There is no widely accepted definition of incident for primary care doctors in France and no taxonomic classification system for epidemiological use. In preparation for a future epidemiological study on primary care incidents in France (the ESPRIT study), this work was designed to identify the definitions and taxonomic classifications used internationally along with the usual methods and results in terms of frequency in the literature. The goal was to determine a French definition and taxonomy.


METHODS
Systematic review of the literature and consensus methods.


METHODS
An exhaustive search of epidemiological surveys was performed. A structured grid was used. After having identified the definitions used in the literature, a definition was chosen using the focus groups method. Taxonomies identified in the literature were classified by relationship, architecture, code number, and number of studies published. Subsequently, a consensus among experts, who independently tested these taxonomies on six incidents, was reached for choosing the most appropriate for epidemiological data collection (little information on a large number of cases).


RESULTS
Twenty-four papers reporting 17 studies were selected among 139 articles. Five definitions and eight taxonomies were found. The chosen definition of incident was based on the WHO definition "A patient safety incident is an event or circumstance that could have resulted, or did result, in harm to a patient, and whose wish it is not repeated again". The test of incidents resulted in the choice of the TAPS version of the International Taxonomy of Medical Error in Primary Care for a reproducible and internationally recognized codification and the tempos method for its current use in French general practice.


CONCLUSIONS
The definitions, taxonomies, data collection characteristics and frequency of incidents results in the international literature on incidents in primary care are key components for the preparation of an epidemiological survey on incidents in primary care.
Département de médecine générale, EA 4128 santé, individu, société, université Lyon I, 8, avenue Rockefeller, 69373 Lyon, France. Electronic address: maud.kerielg@free.fr.
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Keriel-Gascou
Faculté de médecine Paris-Descartes, Haute Autorité de santé, 75005 Paris, France. Electronic address: j.brami777@gmail.com.
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Brami
Département de médecine générale, EA 4128 santé, individu, société, université Lyon I, 8, avenue Rockefeller, 69373 Lyon, France. Electronic address: chaneliere.marc@wanadoo.fr.
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Chanelière
RéQua réseau qualité en Franche-Comté, 26, rue Proudhon, 25000 Besançon, France. Electronic address: a.haeringer-cholet@requa.fr.
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Haeringer-Cholet
Faculté de médecine Paris-Descartes, 75005 Paris, France. Electronic address: claire.larrieu@gmail.com.
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Larrieu
Département de médecine générale, université Paris Est Créteil, 94000 Créteil, France; Centres municipaux de santé, 93000 Saint-Denis, France. Electronic address: frederic.villebrun@gmail.com.
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Villebrun
Comité de coordination de l'évaluation clinique et de la qualité en Aquitaine (CCECQA), 33604 Pessac, France. Electronic address: tamara.roberts@hotmail.fr.
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Robert
Comité de coordination de l'évaluation clinique et de la qualité en Aquitaine (CCECQA), 33604 Pessac, France. Electronic address: philippe.michel@ccecqa.asso.fr.
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Michel
D016907:Adverse Drug Reaction Reporting Systems / Q000145:classification / Q000706:statistics & numerical data; D032921:Consensus; D003625:Data Collection / Q000379:methods; D005602:France / Q000453:epidemiology; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology; D008318:Malpractice / Q000145:classification / Q000706:statistics & numerical data; D019300:Medical Errors / Q000145:classification* / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data; D012308:Risk Management / Q000379:methods*; D009626:Terminology as Topic
Adverse event; Definition; Définition; Erreur médicale; General practice physician; Medical error; Médecin généraliste; Primary health care; Reporting system; Soins de santé primaires; Système de recueil; Taxonomie; Taxonomy; Événement indésirable