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Table 3 Triggers given the first and second time of screening

From: The Harvard medical practice study trigger system performance in deceased patients

Triggers

Description

First time positive (N)1

Second time positive (N)a

Percentage agreement (%)

Kappa agreement (95%CI)

McNemar’s test (p-value)

PABAKb (95%CI)

Bias index

Prevalence index

Trigger 1

Unplanned readmissionc (within 3 months) after discharge from index admission

13

17

88

0.53 (0.30–0.76)

0.39

0.76 (0.58–0.88)

− 0.04

− 0.7

Trigger 2

Hospital-incurred patient injury (temporarily or lasting)

8

4

90

0.12 (−0.17–0.41)

0.34

0.80 (0.63–0.90)

0.04

−0.88

Trigger 3

Adverse drug reaction

2

6

92

−0.03 (− 0.06–0.002)

0.29

0.84 (0.68–0.93)

− 0.04

− 0.92

Trigger 4

Unplanned transfer to the ICU

15

18

93

0.75 (0.57–0.92)

0.45

0.86 (0.70–0.94)

−0.03

− 0.67

Trigger 5

Unplanned return to the operating room

8

12

96

0.78 (0.59–0.99)

0.13

0.92 (0.78–0.98)

−0.04

− 0.80

Trigger 6

Unplanned removal, injury or repair of an organ during surgery

5

6

95

0.52 (0.15–0.89)

1.00

0.90 (0.75–0.97)

−0.01

−0.89

Trigger 7

Healthcare related infection or sepsis

20

22

88

0.64 (0.45–0.83)

0.77

0.76 (0.58–0.88)

−0.02

− 0.58

Trigger 8

Other complications such as CVA/lung embolism/acute myocardial infarction/TIA

17

16

89

0.60 (0.38–0.81)

1.00

0.78 (0.60–0.89)

0.01

−0.67

Trigger 9

Development of neurological deficit which was not present on admission

5

7

92

0.29 (−0.06–0.65)

0.73

0.84 (0.68–0.93)

−0.02

− 0.88

Trigger 10

(Initial) unexpected and/or sudden death, (no palliative care)

12

14

84

0.29 (0.03–0.55)

0.80

0.68 (0.49–0.81)

−0.02

−0.74

Trigger 11

Cardiac or respiratory arrest

12

11

93

0.66 (0.42–0.89)

1.00

0.86 (0.70–0.94)

0.01

−0.77

Trigger 12d

Injury related to abortion or delivery

Trigger 13

Dissatisfaction with care documented in the record

2

5

95

0.27 (−0.17–0.71)

0.38

0.90 (0.75–0.97)

−0.03

− 0.93

Trigger 14

Documentation indicating a legal claim or complaint proceduree

0

2

Trigger 15

Other patient complication

5

27

72

0.04 (−0.10–0.189)

0.00

0.44 (0.23–0.62)

−0.22

− 0.68

  1. aNegative is 100-N
  2. bPABAK: prevalence and bias adjusted kappa
  3. cA readmission was considered as unplanned if admission was through the emergency department
  4. dThis trigger was not found in both rounds of the medical record analysis
  5. eNo statistics could be computed because trigger 14 is not present in the first round