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Table 2 Examples of quality indicators, performance measures and performance indicators for different health questions. (Note that the thresholds provided under performance indicator were contrived by the group for the purpose of these examples and not intended to represent an actual appropriate performance indicator for the topic)

From: Guideline-based quality assurance: a conceptual framework for the definition of key elements

Quality Indicator

[construct]

Performance Measure

[rate-based measure of construct]

Performance Indicator

[rate used to set threshold]

Outcome: Quality of Life, e.g. for cancer care.

Quality of Life

(health status indicator)

The Short Form (36) Health Survey (SF36)1

Scores above 50 on the SF36 functional domain

Outcome: Complication of rectal cancer surgery

Anastomotic leakage in rectal cancer2

(health status indicator)

Rate of anastomotic leakage grade B or C (measured as: n° of pts. with anastomotic leakage grade B or C after elective interventions/ All pts. with rectal cancer with creation of an anastomosis during elective primary tumour resection)

As seldom as possible: Grade B or C anastomotic leakage following the creation of an anastomosis during surgery to treat rectal cancer

Outcome: Mortality from colorectal cancer

Mortality from colorectal cancer

(health status indicator)

Proportion of deceased people at time point x among all people diagnosed

< 20%

Participation in screening

(process indicator)

Proportion of people, for whom screening is recommended, participating in screening among all the eligible people (e.g. governmental databases)

Higher than 95%

Existence of an organised screening programme

(structure indicator)

Audit in which the requirements for a screening programme are assessed

100%

Outcome: Venous thromboembolism (VTE) in hospitalized medical patients (deep venous thrombosis or pulmonary embolism)

VTE

(health status indicator)

Proportion of hospitalized medical patients developing VTE over all the hospitalised patients

Less than 5%

Risk stratification for VTE in hospitalized patients

(process indicator)

Proportion of eligible patients being risk stratified and treated according to risk stratification over all hospitalised patients eligible for risk stratification

100%

Clinical decision support system (CDSS) present

(structure indicator)

Audit in which the availability of CDSS and policy for adoption of the use of CDSS are assessed.

100%

  1. 1 https://www.rand.org/health-care/surveys_tools/mos/36-item-short-form.html
  2. 2 German Guideline Program in Oncology (GGPO): Evidence-based guideline for colorectal cancer. Version 2.1 – January 2019