Instruments and methodologies used for detecting and characterizing adverse events in ambulatory care: A systematic review

Article type
Authors
Gaitán Duarte H1, Vallejo Ortega M1, García Dieguez M2, Esandi M2, de Luca M2, Milberg M2, Cho M3, Monserrat-Capella D3, Reveiz L3
1Universidad Nacional de Colombia, Colombia
2Academia Nacional de Medicina, Argentina
3Organizaci’n Panamericana de la Salud, Estados Unidos
Abstract
Background: Unintentional damage to a patient caused by health care is known as an adverse event (AE).The World Health Organization (WHO) published a review about methods and measures used in research to assess patient safety in primary care. The search was limited to studies published in English up to 2007; the review included only studies that evaluate one type of adverse event. A systematic review updating and complementing previous evidence is proposed.

Objectives: 1. To describe methods, sources of information and tools used to estimate the frequency of adverse events. 2. To describe the adverse events reported in studies, according to their type, frequency, origin, preventability, and seriousness. 3. To compare instruments focusing on their constitutive domains, resources and applicability.

Methods: An advanced search was performed in MEDLINE (PubMed), The Cochrane Library, LILACS, SciELO and EMBASE to look for randomized controlled trials; cohorts; case control studies; before and after studies; and cross-sectional studies. Studies had to include at least two different types of AE on ambulatory care regardless age or underlying condition. Tools to detect, qualify and classify AE were identified and compared. Two authors independently will review titles and abstracts to identify the eligibility criteria. Full text will be assessed to check the inclusion criteria and to extract data.

Results: The search in MEDLINE identified 1836 articles, EMBASE 3846, LILACS 24, the Cochrane Database of Systematic Reviews 12, and DARE 37. Full results of the assessment of the identified Cochrane Reviews will be completed by October 2011.

Conclusions: Findings will be relevant for further investigations on AE. Results of this systematic review will be used as a basis for the elaboration of the Investigation Protocol on Adverse Events in Outpatient Care for Latin America and Caribbean countries supported by PAHO.