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. 2018 Jan 12;7(1):5.
doi: 10.1186/s13643-017-0669-2.

Guideline-based quality indicators-a systematic comparison of German and international clinical practice guidelines: protocol for a systematic review

Monika Becker  1 , Jessica Breuing  2 , Monika Nothacker  3 , Stefanie Deckert  4 , Mirco Steudtner  3 , Jochen Schmitt  4 , Edmund Neugebauer  2   5 , Dawid Pieper  2
Affiliations

Guideline-based quality indicators-a systematic comparison of German and international clinical practice guidelines: protocol for a systematic review

Monika Becker et al. Syst Rev. .

Abstract

Background: Quality indicators (QIs) are used in assessing the quality of healthcare. Evidence-based clinical practice guidelines (CPGs) are relevant sources for generating QIs. In this context, QIs are important tools to assess the implementation of guideline recommendations. However, the methodological approaches to guideline-based QI development vary considerably. In Germany, the guideline classification scheme of the AWMF (German Association of the Scientific Medical Societies) differentiates between S1-, S2k-, S2e-, and S3-CPGs depending on the methodological approach. Thus, S3-CPGs are consensus- and evidence-based CPGs and have the highest methodological standard in Germany. An analysis of the status quo of reported QIs in S3-CPGs found 35 current S3-CPGs, which report 372 different QIs. Currently, there is no gold standard for the development of guideline-based QIs. To our knowledge, no studies have investigated to what extent guideline-based QIs from different CPGs that are related to the same topic are consistent. The objective of this study is to compare guideline-based QIs and their underlying methodological approaches of German S3-CPGs with those of topic-related international CPGs.

Methods: Based on the previous identified German S3-CPGs (n = 35), which report quality indicators, we will conduct systematic searches in the guidelines databases of G-I-N (Guidelines International Network) and NGC (National Guideline Clearinghouse) to identify international CPGs matching the topics of the S3-CPGs. If necessary, we will search additionally the websites of the particular CPG providers for separate documents with regard to QIs. We will include evidence-based CPGs which report QIs. Reported QIs as well as methods of development and the rationale for QIs will be extracted and compared with those of the S3-CPGs.

Discussion: This study will be part of the project "Systematic analysis of the translation of guideline recommendations into quality indicators and development of an evidence- and consensus-based standard," supported by the German Research Association (DFG). The results of this analysis will feed into a subsequent qualitative study, which will consist of structured interviews with developers of international CPGs. Further, the results will be considered in a consensus study on standards of the translation of guideline recommendations into quality indicators in Germany.

Keywords: Guidelines; Performance measures; Quality indicator; Systematic review.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

MN was involved in the development of several S3-CPGs that are considered in this review. MB was involved in the preparation of the evidence report for one CPG that is considered in this review. MB, JB, MN, JS, EN, and DP were involved in the development of several S3-CPGs that are not considered in this review. DS and MS declare no competing interests (financial and non-financial).

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Figures

Fig. 1
Fig. 1
Overview of the overall project. QI = quality indicator
See this image and copyright information in PMC

References

    1. Lawrence M, Frede O. Indicators of quality in health care. Eur J Gen Pract. 1997;3:103–108. doi: 10.3109/13814789709160336. - DOI
    1. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Characteristics of clinical indicators. Qual Rev Bull. 1989;11:330–339. - PubMed
    1. Kelley Edward, Jermy H. Health care quality indicators project conceptual framework paper. 2006: OECD Health Working Papers: 23, https://www.oecd.org/els/health-systems/36262363.pdf. Accessed 08 May 2017.
    1. Reiter A, et al. QUALIFY—a tool for assessing quality indicators. Z Arztl Fortbild Qualitatssich. 2007;101(10):683–688. - PubMed
    1. National Quality Forum, Measure evaluation criteria and guidance for evaluating measures for endorsement. 2016: http://www.qualityforum.org/Measuring_Performance/Endorsed_Performance_M.... Assessed 08 May 2017.

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