gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Clinical Practice Guidelines as sources of scientific evidence for quality of care indicators: an experience from the province of Québec

Meeting Abstract

  • M.D. Beaulieu - Institut national d'excellence en santé et en services sociaux (INESSS), Montréal, Canada; Département de médecine familiale et médecine d'urgence, Université de Montréal, Montréal, QC, Canada
  • M.P. Pomey - Institut national d'excellence en santé et en services sociaux (INESSS), Montréal, Canada; Département d'administration de la santé, Université de Montréal, Montréal, Canada
  • B. Côté - Institut national d'excellence en santé et en services sociaux (INESSS), Montréal, Canada; Département d'administration de la santé, Université de Montréal, Montréal, Canada
  • C. Del Grande - Institut national d'excellence en santé et en services sociaux (INESSS), Montréal, Canada
  • M. Ghorbel - Institut national d'excellence en santé et en services sociaux (INESSS), Montréal, Canada
  • É. Tremblay - Institut national d'excellence en santé et en services sociaux (INESSS), Montréal, Canada
  • P. Hua - Institut national d'excellence en santé et en services sociaux (INESSS), Montréal, Canada

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocO77

DOI: 10.3205/12gin109, URN: urn:nbn:de:0183-12gin1091

Veröffentlicht: 10. Juli 2012

© 2012 Beaulieu et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: A mandate was given by the Ministry of Health to develop quality of care indicators for chronic conditions. Indicators were to be based on the best available evidence, relevant to clinical providers and measurable, given the current informational infrastructure.

Objectives: To describe the process and reflect on the usefulness CPGs as sources of evidence level.

Methods: Indicators, identified from the literature, were matched to recommendations from the most current CPGs. The quality of CPGs was assessed with the AGREE-II instrument. Indicators were submitted to different panels: scientific experts (25); patients (n=20), providers (n=30) and experts in IT (n=16).

Results: Of the 166 indicators identified, 39% matched level 1 or 2 evidence. Discrepancies in levels of evidence between CPGs were observed in about 30% of the indicators. 144 indicators were retained as being supported either by fair evidence, high clinical relevance andhigh measurability. A set of 44 indicators deemed highly relevant and strongly supported by evidence were targeted as high level of priority for methodological development.

Discussion: Some indicators highly relevant to clinicians were not supported by high level evidence. Inversely, high level evidence indicators were not always perceived as relevant or leaving enough room to professional judgement. Ranking the indicators on science, relevance and measurability was considered useful, as it gives users the latitude to make their own choices.

Implications for guideline developers/users: Having quality of care indicators, based on CPG recommendations, with patient and provider input, could facilitate better integration of guidelines in policy-making and practice.