The Quality of Medical Record Review Studies in the International Emergency Medicine Literature
Received 27 August 2004; received in revised form 6 October 2004 and 11 November 2004; accepted 12 November 2004. published online 15 February 2005.
Study objective
We assess the methodologic quality of studies using medical record review methodology in 4 international emergency medicine journals. A secondary aim was to compare methodology quality among these journals and across years.
Methods
This was an observational study of articles whose main methodology was medical record review published in Academic Emergency Medicine (AEM), Annals of Emergency Medicine (Annals), Emergency Medicine Journal (EMJ), and Emergency Medicine Australasia (EMA) between January 2002 and May 2004. Eligible articles were reviewed for reporting of a clear hypothesis or objective, training of abstractors, defined inclusion and exclusion criteria, use of a standard abstraction form, definition of important variables, monitoring of abstractor performance, blinding of abstractors to study hypothesis, reporting of interrater reliability, sample size or power calculation, reporting of ethics approval or waiver, and disclosure of funding source. The primary outcome was the proportion of articles meeting each criterion. Secondary outcomes were comparison of the proportions of articles meeting each criterion among journals and by years.
Results
One hundred seven articles were analyzed; 31 were published in AEM, 29 in Annals, 29 in EMJ, and 18 in EMA. A clear aim was reported in 93% of articles, standardized abstraction forms were reported in 51%, interrater reliability was reported in 25%, ethics approval or waiver was reported in 68%, and sample size or power calculation was reported in 10%.
Conclusion
Adherence to the quality criteria for medical record reviews was suboptimal, and there were significant differences among journals in overall methodologic quality.
SEE RELATED ARTICLE, P. 448, AND EDITORIAL, P. 452.
From the Department of Emergency Medicine (Badcock) and the Joseph Epstein Centre for Emergency Medicine Research (Kelly, Kerr), Western Hospital, Footscray, Victoria, Australia; the University of Melbourne (Kelly, Kerr), Melbourne, Victoria, Australia; and Sunshine Hospital (Reade), St. Albans, Victoria, Australia
Address for correspondence: Anne-Maree Kelly, MD, Department of Emergency Medicine, Western Hospital, Footscray 3011, Victoria, Australia; 03-8345-6315, fax 03-9318-4790
Author contributions: AMK and DB conceived the study. AMK designed the data collection instrument. AMK and DK identified qualifying papers. DK, DB, and TR performed the data collection and data entry. AMK and DK performed the data analysis. AMK and DB wrote the draft manuscript. All authors contributed to data interpretation and the final manuscript. AMK takes responsibility for the paper as a whole.
Funding and support: The authors report this study did not receive any outside funding or support.
ABSTRACT