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Table 3 Guideline-based QI development reporting standard items and report of these criteria in the method papers

From: Approaches of integrating the development of guidelines and quality indicators: a systematic review

Reporting standard item Reported in method papers
1a. Guideline selection: criteria Selection of guidelines was based on topic and
• evidence-based development (n = 18)
• methodological quality of the guideline (n = 2)
• use of GRADE (n = 1)
• structured format (n = 1)
• no other criterion (n = 1)
• unclear (n = 7)
1b. Guideline selection: appraisal of guidelines • AGREE (n = 8)
• criteria not fully specified (n = 4)
• not reported (n = 18)
2. Selection of guideline recommendations • based on topic (n = 2)
• impact on patient outcome (n = 4) / burden of illness (n = 1) / clinical utility (n = 1) / available treatment (n = 1)
• relevance (n = 4) / appropriateness (n = 1)
• value for money (n = 1)
• practice variability (n = 1)
• scope for improvement (n = 1) / gap in quality of care (n = 1)
• priority / feasibility for implementation (n = 3)
• validity (n = 2) / reliable (n = 1)
• (high) level of evidence (n = 8) / adequate scientific proof (n = 1)
• direct link to aim of guideline (n = 1)
• common to more than one guideline (n = 1)
• unclear (n = 3)
• no selection (n = 6)a
3. Selection of performance measures from recommendations • formal panel method (n = 11)
• other or informal consensus method (n = 13)
• not reported (n = 2)
• unclear (n = 4)
4. Core attributes of performance measures (criteria for selecting QI) • relevance (n = 4)
• potential for improvement (n = 9) / likely to change current practice (n = 2) / gap in quality of care (n = 2) / importance for health care (n = 4)
• burden of illness (n = 2) / improving patient outcomes (n = 9)
• cost-effectiveness (n = 4)
• influenced by service provider (n = 3)
• appropriateness (n = 1)
• evidence base/scientific soundness (n = 7)
• (strength of) association with patient important outcome (n = 2)
• feasibility (n = 7)
• no risk for unintended consequences (n = 3)
• unambiguous definition (n = 2) / clear (n = 1)
• data routinely collected (n = 1)
• measurable (n = 4) / interpretable (n = 1) / actionable (n = 2)
• applicable (n = 3) / acceptable (n = 1) / adherence (n = 1)
• reliable (n = 6) / face validity (n = 2) / construct validity (n = 1) / content validity (n = 2)
• precision (n = 1)
• minimum bias (n = 1)
• not reported (n = 4)
• unclear (n = 3)a
5. Specification of performance measures
Numerator and denominator is specified unambiguously and in detail.
• denominator: population eligible to receive the clinical interventions, numerator: desired intervention and subset of population that should receive it (n = 6)
• based on algorithm (n = 1)
• formulation of numerator and denominator in line with formulation of recommendation (n = 1)
• numerator and denominator including risk adjustment factors (n = 3)
• clinical researcher drafted an expanded text for each recommendation, using logical operators (e.g. ‘AND’ and ‘OR’) to link descriptive statements to produce numerators and denominators (n = 1)
• method not specified in detail (n = 15)
• not reported (n = 3)
6. Intended use of performance measure • quality improvement (n = 10)
• quality of care delivered (n = 2)
• monitoring compliance with guideline (n = 4)
• implementation of care (n = 1)
• clinical audit (n = 1)
• pay for performance program (n = 1)
• not specified (n = 8)
• unclear (n = 1)
• not reported (n = 2)
7. Practice test of performance measures • planned (n = 18)
• retrospective (n = 2)
• implicit (n = 1) / ad hoc (n = 1)
• not reported (n = 8)
8. Review and evaluation of performance measure • plan for evaluation and updating (n = 3)
• evaluation including criteria for retiring (n = 1)
• mentioned, but not explained in detail (n = 2)
• evaluation not reported, often because QI were developed but not yet implemented (n = 24)
9a. Composition of the panel • monodisciplinary (n = 2)
• multidisciplinary (n = 23)
• panel composition not reported (n = 5)
9b. Composition of the panel: patient involvement • yes (n = 10)
• no (n = 17)
• depends on guideline (n = 1)
• not reported (n = 2)
  1. amultiple criteria per methodological framework
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