gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Updating Guideline based Quality Indicators. The Methodology of the German Breast Cancer Guideline Development Group

Meeting Abstract

  • M. Follmann - German Cancer Society, Berlin, Germany
  • I. Kopp - Association of the Scientific Medical Societies in Germany, Düsseldorf, Germany
  • M. Klinkhammer-Schalke - Association of German Clinical Cancer Registries, Berlin, Germany
  • K. Pottkämper - AQUA – Institute for Applied Quality Improvement and Research in Health Care, Göttingen, Germany
  • S. Wesselmann - German Cancer Society, Berlin, Germany
  • A. Wöckel - Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
  • U.S. Albert - Breast Cancer Center, Department of Gynecology, Gyn. Endocrinology and Oncology, Marburg, Germany

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocO16

doi: 10.3205/12gin048, urn:nbn:de:0183-12gin0483

Veröffentlicht: 10. Juli 2012

© 2012 Follmann et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Background: According to the goals of the National Cancer Plan, the German Guideline Program in Oncology (GGPO) funds and supports the development, implementation, evaluation and update of evidence-based guidelines to improve cancer care. The development and update of guideline based Quality indicators (QI) is a key element of the GGPO methodology.

Context: 2011, the German Breast Cancer Guideline Development Group updated the 2008 version of their guideline. In this context, QI derived from the previous guideline version were reassessed.

Description of best practice: A 5 step strategy to update QI will be described and explained by examples:

  • Critical review of the necessity of QI in terms of a remaining potential for quality improvement based on data from cancer registries, audits of cancer centers and quality assurance according to the German social code book.
  • Critical appraisal of new evidence in terms of need for changes in guideline recommendations and aligned QI.
  • Assessment of the relevance, scientific soundness and feasibility of QI in a criteria-based Delphi-process with involvement of relevant stakeholders.
  • Allocation of QI to the different models and structures for quality improvement existing in Germany.
  • Reaching consensus on inclusion of QI.

Lessons for guideline developers, adaptors, implementers, and/or users: QI are important tools to assess the quality of care and the impact of guidelines. Like guideline recommendations, QI have to be updated regularly. QI performance and structures for implementation need to be considered. A standardized process involving all relevant stakeholders is recommended to achieve data economy.