title: Validity of and interrater agreement on the LINNEAUS Euro-PC medication safety incident classification system in primary care in Poland.
abstract: BACKGROUND
  Medication safety incidents occur in all health care sectors and cause considerable morbidity and mortality, with 8.5% of all related incidents reported estimated to occur in primary care. A common incident classification system could facilitate collective learning from the analysis of medication-related errors and improve patient safety
  
  
  OBJECTIVE
  The objective of this study was to assess the validity of a new classification system of medication safety incidents in primary care in Poland.
  
  
  METHODS
  Analysis of data from a descriptive, cross-sectional, self-reported survey on the Learning from International Networks about Errors and Understanding Safety in Primary Care (LINNEAUS Euro-PC) medication safety incident classification for primary care with assessment of 10 case-based clinical scenarios done by doctors and pharmacists form community-based family medicine clinics and pharmacies in Lodz.
  
  
  METHODS
  The percentages of overall agreement on judgements and a fixed-marginal multirater kappa (κ) coefficient as statistical measures of interrater agreement for categorical items.
  
  
  RESULTS
  The overall agreement levels were: category 1 - 86.3%; category 2 - 85.6%; category 3 - 72.1%; category 4 - 71.8%; and category 5 - 70.4%. The interrater agreement between the 15 evaluators varied as follows: category 1 fixed-marginal κ = 0.144; category 5 fixed-marginal κ = 0.565; category 3 fixed-marginal κ = 0.607; category 4 fixed-marginal κ = 0.634; and category 2 fixed-marginal κ = 0.807.
  
  
  CONCLUSIONS
  This is the first known study on levels of agreement on the perception of medication safety incidents and assessment of the validity of a related classification system in primary health care in Poland. Interrater agreement in this study was surprisingly high, but still leaves room for improvement.
authors.affiliation: Medical University of Lodz, Lodz, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kosiek
authors.forename: Anna
authors.initials: A
authors.lastname: Vögele
authors.forename: Miriam
authors.initials: M
authors.lastname: Lainer
authors.forename: Andreas
authors.initials: A
authors.lastname: Sönnichsen
authors.forename: Paul
authors.initials: P
authors.lastname: Bowie
authors.forename: Maciek
authors.initials: M
authors.lastname: Godycki-Cwirko
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems / Q000592:standards*; D003430:Cross-Sectional Studies; D006801:Humans; D008508:Medication Errors / Q000145:classification*; D061214:Patient Safety; D010595:Pharmacists; D011044:Poland; D011320:Primary Health Care; D057566:Self Report
keywords: clinical safety; medical error