Development of quality measures for the care of patients with gastro esophageal reflux disease
Clinical Gastroenterology and Hepatology, 11/21/2014 Clinical Article
Yadlapati R, et al. – The objective of this study was to use a well–described, formal methodology to develop valid, physician–led, quality measures for all aspects of care for patients with gastroesophageal reflux disease (GERD). The authors used RAND/University of California, Los Angeles Appropriateness Methodology (RAM) to develop quality measures for GERD care. By examining performance on these valid, formally developed quality measures, clinical practices and individual providers can assess their adherence with them and direct quality improvement efforts accordingly.
Methods
- Quality measures were identified from the literature, consensus guidelines, and GERD experts.
- Eight clinical experts ranked potential measures for validity on the basis of the RAND/University of California, Los Angeles Appropriateness Methodology (RAM).
Results
- Of the 52 proposed quality measures, 24 were rated as valid and 1 new measure was developed.
- These valid measures were related to initial diagnosis and management (9), monitoring (3), further diagnostic testing (4), proton pump inhibitor refractory symptoms (2), symptoms of chest pain (1), erosive esophagitis (3), esophageal stricture or ring (1), and surgical therapy (2).
- Fifteen of these measures were ranked with the highest validity.
- Twenty-seven measures were determined to be equivocal; 89% of these were extracted from guidelines based on low or moderate level evidence.
Development of quality measures for the care of patients with gastro esophageal reflux disease Clinical Gastroenterology and Hepatology, 11/21/2014 Clinical Article
Yadlapati R, et al. – The objective of this study was to use a well–described, formal methodology to develop valid, physician–led, quality measures for all aspects of care for patients with gastroesophageal reflux disease (GERD). The authors used RAND/University of California, Los Angeles Appropriateness Methodology (RAM) to develop quality measures for GERD care. By examining performance on these valid, formally developed quality measures, clinical practices and individual providers can assess their adherence with them and direct quality improvement efforts accordingly.
Methods
- Quality measures were identified from the literature, consensus guidelines, and GERD experts.
- Eight clinical experts ranked potential measures for validity on the basis of the RAND/University of California, Los Angeles Appropriateness Methodology (RAM).
Results
- Of the 52 proposed quality measures, 24 were rated as valid and 1 new measure was developed.
- These valid measures were related to initial diagnosis and management (9), monitoring (3), further diagnostic testing (4), proton pump inhibitor refractory symptoms (2), symptoms of chest pain (1), erosive esophagitis (3), esophageal stricture or ring (1), and surgical therapy (2).
- Fifteen of these measures were ranked with the highest validity.
- Twenty-seven measures were determined to be equivocal; 89% of these were extracted from guidelines based on low or moderate level evidence.
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| Whipple's operation |
| Opened pancreatic duct |
| AV Malformation of small intestine |
| Ca Stomach and patial gastrectomy |
| GIST tumour |
