Development of a core set of quality indicators for paediatric primary care practices in Europe, COSI-PPC-EU

Ewald, Dominik; Huss, Gottfried; Auras, Silke; Cáceres, Juan Ruiz-Canela; Hadjipanayis, Adamos; Geraedts, Max

doi:10.1007/s00431-018-3140-z

Cited by 14 publications

(11 citation statements)

References 40 publications

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“…To address this deficiency the RCWG chose a modification of the RAND Appropriateness Method (RAM) 21 developed by the RAND Corporation-University of California Los Angeles, that helps synthesize the available empirical evidence using the collective experience of a panel of experts. The RAM approach has been widely used in the development of clinical practice guidelines, including in adult respiratory care 22 , in primary pediatric care 23 and in rare pediatric conditions such as Duchenne Muscular Dystrophy [24][25][26] .…”

Section: Methodsmentioning

confidence: 99%

Care Recommendations for the Respiratory Complications of Esophageal Atresia-Tracheoesophageal Fistula: The International Network of Esophageal Atresia, Respiratory Complications Working Group

Koumbourlis

Belessis

Cataletto

et al. 2020

Preprint

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Tracheoesophageal fistula (TEF) with esophageal atresia (EA) is a common congenital anomaly that is associated with significant respiratory morbidity throughout life. The objective of this document is to provide a framework for the diagnosis and management of the respiratory complications that are associated with the condition. As there are no randomized controlled studies on the subject, a group of experts used a modification of the Rand Appropriateness Method to describe the various aspects of the condition in terms of their relative importance, and to rate the available diagnostic methods and therapeutic interventions on the basis of their appropriateness and necessity. Specific recommendations were formulated and reported as Level A, B, C based on whether they were based on "strong", "moderate" or "weak" agreement. The tracheomalacia that exists in the site of the fistula was considered the main abnormality that predisposes to all other respiratory complications due to airway collapse and impaired clearance of secretions. Aspiration due to impaired airway protection reflexes is the main underlying contributing mechanism. Flexible bronchoscopy is the main diagnostic modality, aided by imaging modalities, especially CT scans of the chest. Non-invasive positive airway pressure support, surgical techniques such as tracheopexy and rarely tracheostomy are required for the management of severe tracheomalacia. Regular long-term follow-up by a multidisciplinary team was considered imperative. Specific templates outlining the elements of the clinical respiratory evaluation according to the patients' age were also developed.

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Section: Methodsmentioning

confidence: 99%

Care Recommendations for the Respiratory Complications of Esophageal Atresia-Tracheoesophageal Fistula: The International Network of Esophageal Atresia, Respiratory Complications Working Group

Koumbourlis

Belessis

Cataletto

et al. 2020

Preprint

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“… 5 , 12 ] and prevent contamination of the set [e.g. 40 , 47 ]. Some studies also emphasized the need to consider the assessment purpose when developing indicator sets and to ensure transparency about methods and limitations ( Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

What makes a good quality indicator set? A systematic review of criteria

Schang

Blotenberg

Boywitt

2021

International Journal for Quality in Health Care

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Background While single indicators measure a specific aspect of quality (e.g. timely support during labour), users of these indicators such as patients, providers and policy-makers are typically interested in some broader construct (e.g. quality of maternity care) whose measurement requires a set of indicators. However, guidance on desirable properties of indicator sets is lacking. Based on the premise that a set of valid indicators does not guarantee a valid set of indicators, the aim of this review is twofold: First, we introduce content validity as a desirable property of indicator sets and review the extent to which studies in the peer-reviewed health care quality literature address this criterion. Second, to obtain a complete inventory of criteria, we examine what additional criteria of quality indicator sets were used so far. Methods : We searched the databases Web of Science, Medline, Cinahl and PsycInfo from inception to May 2021 and the reference lists of included studies. English- or German-language, peer-reviewed studies concerned with desirable characteristics of quality indicator sets were included. Applying qualitative content analysis, two authors independently coded the articles using a structured coding scheme and discussed conflicting codes until consensus was reached. Results Of 366 studies screened, 62 were included in the review. 85% (53/62) of studies addressed at least one of the component criteria of content validity (content coverage, proportional representation, contamination) and 15% (9/62) addressed all component criteria. Studies used various content domains to structure the targeted construct (e.g., quality dimensions, elements of the care pathway, policy priorities), providing a framework to assess content validity. The review revealed four additional substantive criteria for indicator sets: cost of measurement (21% [13/62] of the included studies), prioritization of “essential” indicators (21% [13/62]), avoidance of redundancy (13% [8/62]) and size of the set (15% [9/62]). Additionally, four procedural criteria were identified: stakeholder involvement (69% [43/62]), using a conceptual framework (44% [27/62]), defining the purpose of measurement (26% [16/62]) and transparency of the development process (8% [5/62]). Conclusion The concept of content validity and its component criteria help assessing whether conclusions based on a set of indicators are valid conclusions about the targeted construct. To develop a valid indicator set, careful definition of the targeted construct including its (sub-)domains is paramount. Developers of quality indicators should specify the purpose of measurement and consider trade-offs with other criteria for indicator sets whose application may reduce content validity (e.g. costs of measurement) in light thereof.

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“…Up until now, there have been only limited indicators of child health (neonatal mortality rate, the infant mortality rate, the mortality rate for children under five, delayed development, malnourishment), and this has made it difficult to quantify other aspects of paediatric care for effective comparisons (as antibiotic prescription, vaccinations or adherence to clinical practice guidelines). Recently, the first study of paediatric indicators has been published 65 . We hope that these indicators will facilitate these comparisons in the future.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the first study of paediatric indicators has been published. 65 We hope that these indicators will facilitate these comparisons in the future. Van Esso, 3 lasts for three to six months with an average of four months.…”

Section: Ta B L E 7 (Continued)mentioning

confidence: 99%

Paediatricians provide higher quality care to children and adolescents in primary care: A systematic review

et al. 2020

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Aim The number of primary care paediatricians is decreasing in Europe without a justifiable reason. We aimed to compare the clinical practice of paediatricians and family doctors attending children and adolescents in primary care. Methods MEDLINE, Embase, CENTRAL, TRIP and Google Scholar were searched from December 2008 to February 2018. No language or study design restrictions were applied. Three reviewers assessed eligibility of the studies. Seven pairs of reviewers performed the data extraction and assessed the methodological quality independently. Discrepancies were resolved by consensus. Results Fifty‐four, out of 1150 studies preselected, were included. We found that paediatricians show more appropriate pharmacology prescription patterns for the illness being treated; they achieve higher vaccination rates and have better knowledge of vaccines and fewer doubts about vaccine safety; their knowledge and implementation of different screening tests are better; they prescribe psychoactive drugs more cautiously and more in line with current practice guidelines; their evaluation and treatment of obesity and lipid disorders follow criteria more consistently with current clinical practice guidelines; and they perform fewer diagnostic test, show a more suitable use of the test and request fewer referrals to specialists. Conclusion According to published data, in developed countries, paediatricians provide higher quality care to children than family doctors.

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Development of a core set of quality indicators for paediatric primary care practices in Europe, COSI-PPC-EU

Cited by 14 publications

References 40 publications

Care Recommendations for the Respiratory Complications of Esophageal Atresia-Tracheoesophageal Fistula: The International Network of Esophageal Atresia, Respiratory Complications Working Group

Care Recommendations for the Respiratory Complications of Esophageal Atresia-Tracheoesophageal Fistula: The International Network of Esophageal Atresia, Respiratory Complications Working Group

What makes a good quality indicator set? A systematic review of criteria

Paediatricians provide higher quality care to children and adolescents in primary care: A systematic review

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