Table 2

Study methodology

First author, publication yearRRR methodMethod of record selectionMethod of review*> 1 AE/ patientCommission/omissionData on IRR outcomeTime frame of AE detection, in addition to index admissionAE definition†Preventability reporting
General care population, GTT/TT methodology
 Chapman, 201440TTRandom2-stage; (1) 40 triggers, trained reviewer; (2) trained physicianYesBothNoBefore; afterWider than IHINo
 Davenport, 201741GTTRandom2-stage; (1) 52 triggers, trained physicians; (2) trained physiciansYesNSYesBefore NS; afterIHI likeNo
 Fajreldines, 201945TTRandomNSYesNSNoNSNSNo
 Kirkendall, 201250GTTRandom2-stage; 1) 53 triggers, trained nurses; (2) physicianYesCommission onlyYesBefore; afterIHI likeNo
 Matlow, 201254–56TTRandom2-stage; (1) 35 triggers, trained nurses, health record technologists/medical record technicians; (2) trained physiciansYesBothYesBefore; afterHMPS likeYes
 Paredes Esteban, 201558GTTUnclear2-stage; (1) NS, trained nurses; (2) trained physiciansYesNSNoOnly indexHMPS likeNo
 Salimath, 202046 60TTRandom2-stage; (1) 40 triggers, trained pharmacists; (2) trained physiciansYesNSNoBefore NS; afterOtherNo
 Shah, 200951 61TTRandom2-stage; (1) 43 triggers, physicians; (2) physiciansYesBothYesBefore; after NSWider than IHINo
 Solevag, 201463TTConvenienceUnclear; 39 triggers, trained physicianYesNSNoBefore; afterWider than IHINo
 Stockwell, 201566TTRandom2-stage; (1) 51 triggers, trained nurses, pharmacists; (2) trained physiciansYesBothNoBefore NS; afterIHI likeYes
 Stockwell, 201813 67TTRandom2-stage; (1) 27 triggers, trained nurses; (2) trained physiciansYesNSYesBefore; afterIHI likeYes
 Stroupe, 201868TTRandom2-stage; (1) 54 triggers, trained nurses; (2) trained physiciansYesBothYesBefore NS; afterWider than IHIYes
 Unbeck, 201414TTRandom2-stage; (1) 88 triggers, trained nurses; (2) trained physiciansYesBothYesBefore; afterWider than IHIYes
General care population, HMPS methodology
 Brennan, 199111 47 52HMPSRandom2-stage; (1) 18 criteria, trained nurses, medical record analyst; (2) trained physiciansNo§BothYesBefore; afterHMPS likeNo
 Davis, 200242–44HMPSRandom2-stage; (1) 18 criteria, trained nurses; (2) trained medical officersNo§BothYesBefore; afterHMPS likeYes
 Letaief, 201053HMPSRandom2-stage; (1) 18 criteria, trained medical student; (2) physiciansNo§BothYesBefore; afterWider than IHIYes
 Requena, 201159HMPSRandom/total sample¶2-stage; (1) 19 criteria, NS; (2) NSYesNSNoNSWider than IHIYes
 Sommella, 201464HMPSRandom2-stage; (1) 16 criteria, trained physicians; (2) trained physiciansNoNSNoBefore NS; afterHMPS likeNo
 Soop, 200965HMPSRandom3-stage; (1) 18 criteria, trained nurses; (2) trained physicians; (3) member of the Scientific CouncilNo§BothYesBefore; afterHMPS likeYes
 Wilson, 199512HMPSRandom2-stage; (1) 18 criteria, trained nurses; (2) trained medical officersNo§BothYesBefore; afterHMPS likeYes
 Woods, 200569 70 74HMPSRandom2-stage; (1) 18 criteria, trained nurses; (2) trained physiciansNoBothYesBefore; afterHMPS likeYes
 Zegers, 200933 75HMPSRandom3-stage; (1) 18 criteria, trained nurses; (2–3) trained physiciansYesBothYesBefore; afterHMPS likeYes
Intensive care population, GTT/TT methodology**
 Agarwal, 201038TTRandom2-stage; (1) 22 triggers, trained nurses, physicians; (2) trained physician, pharmacistYesBothNoBefore; afterWider than IHIYes
 Barrionuevo, 201039TTTotal sample2-stage; (1) 19 triggers, trained nurses; (2) trained physicianYesNSNoNSWider than IHIYes
 Hooper, 201448TTRandomUnclear; 22 triggers, trained investigatorsYesCommission onlyYesBefore; afterWider than IHINo
 Jorro-Baron, 202149TTRandom2-stage; (1) 37 triggers, trained PICU staff; (2) trained physiciansYesBothNoNSNSYes
 Larsen, 20078TTEvery seventh admissionUnclear; 46 triggers, nurses, physiciansYesNSYesNSNSYes
 Maziero, 202057TTNS2-stage; (1) NS, reviewer; (2) physicianYesNSNoNSNSNo
 Sharek, 200662TTRandom2-stage; (1) 17 triggers, trained nurses; (2) trained physicianYesBothNoNSWider than IHIYes
 Ventura, 201271TTTotal sampleUnclear; 14 triggers, researcherYesNSNoNSWider than IHIYes
 Verlaat, 201872TTRandom2-stage; (1) 19 triggers, trained physician; 2) trained physicianYesNSYesBefore; afterHMPS likeYes
 Vermeulen, 201473TTRandom2-stage; (1) 23 triggers, trained medical student; (2) medical directorYesBothNoBefore NS; afterWider than IHINo
  • IHI does not require any additional monitoring, treatment or hospitalisation.

  • *Number of review stage(s); number of triggers/screening criteria, record review training, type of reviewer(s)/review stage.

  • †HMPS like requires temporary or permanent disability, death or prolonged hospitalisation; IHI like requires additional monitoring, treatment or hospitalisation, or that results in death; Wider than IHI does not require any additional monitoring, treatment, or hospitalization.

  • ‡Outcome for the total cohort, including both general and intensive care population.

  • §Additional data from authors.

  • ¶This study merged paediatric data from three studies which used different sampling techniques.

  • **No study using the HMPS methodology included mainly intensive care patients.

  • AE, adverse event; GTT, Global Trigger Tool; HMPS, Harvard Medical Practice Study methodology; IHI, Institute for Healthcare Improvement; IRR, interrater reliability; NS, not specified; RRR, retrospective record review; TT, Trigger Tool.