Identifying adverse events: reflections on an imperfect gold standard after 20 years of patient safety research.
This commentary discusses the two ‘gold standard’ research methods used to identify adverse events– retrospective record review and prospective surveillance using triggers. The authors note that these approaches have served to demonstrate the scope of the patient safety problem and to engage clinicians, managers, researchers and policy makers. However, looking forward, they advocate moving away from the imperfect gold standard of adverse event rates and embracing more specific measures of important safety problems.