Development of quality indicators for monitoring of the disease course in rheumatoid arthritis

Hulst, Laura T. C. van; Fransen, Jaap; Broeder, Alfons A den; Grol, Richard; Riel, P.L.C.M. van; Hulscher, Marlies

doi:10.1136/ard.2009.108555

Cited by 37 publications

(48 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After quality rating, a total of 13 were included ( Figure 1). From the 13 sources ( 16,17 , and 1 was a pan-European set 18 ). Most of the sets were for RA 6,7,9,11,12,13,[15][16][17][18] (n = 10, 77%) with 1 each (8%) for JIA 10 , PsA 14 , and inflammatory arthritis 8 .…”

Section: Resultsmentioning

confidence: 99%

“…Similarly, there was variability in the consensus procedures used to finalize the measurement sets: a modified Delphi in conjunction with Nominal Group Technique in 1 set 10 , a modified RAND/University of California, Los Angeles (UCLA) Appropriateness Method in 4 sets 11,12,16,17 , an online modified Delphi using a platform called ExpertLens (RAND Corp.) in 3 sets 6,7,8 , a modified Delphi in another 17 , and other study-specific consensus methods in 4 sets 9,13,14,15 .…”

Section: Rheumatologymentioning

confidence: 99%

“…For example, considering the evidence base used for the measure development, only 3 sets of quality measures were based on systematic reviews of existing guidelines and measures 7,16,18 , with another 3 based on nonsystematic literature reviews 6,8,11 . The rest of the measures were developed based on discussions and/or questionnaires with those involved or on existing guidelines.…”

Section: Rheumatologymentioning

confidence: 99%

“…Three measure development panels included physician experts exclusively 9,11,16 , while the other 10 included a diverse set of medical professionals such as nurses, occupational therapists, and physiotherapists. All 10 also included patients in the development process (Table 5).…”

Section: Rheumatologymentioning

confidence: 99%

See 3 more Smart Citations

A Systematic Review of Quality Measures for Inflammatory Arthritis

Cooper

Rouhi²,

Barber³

2017

J Rheumatol

View full text Add to dashboard Cite

ABSTRACT. Objective. To conduct a systematic review and quality appraisal of quality measures for inflammatory arthritis, including rheumatoid arthritis (RA), spondyloarthritis, psoriatic arthritis (PsA), and juvenile idiopathic arthritis (JIA). Methods. Embase, MEDLINE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched from January 1, 2000, to October 23, 2016, using Medical Subject Headings terms for inflammatory arthritis and quality measures. A "grey literature" search of international arthritis organizations and quality measure libraries was also conducted. Two reviewers independently considered the papers for inclusion, with disagreements resolved by consensus. A modified guideline appraisal tool (AGREE II) was used to appraise the measure development process, which determined final inclusion. Quality measures are tools for measuring whether care provided is concordant with evidence-based practices. They often represent minimum standards of care and are derived from quality indicators, which are statements about best practices that are associated with high-quality care. Quality indicators are usually specified in the following format: If (a specific clinical scenario), then (a clinical action) 1 . An oftencited example of a quality indicator would be if a patient has rheumatoid arthritis (RA), then they should be prescribed a disease-modifying antirheumatic drug (DMARD) 1 . Quality indicators can be further specified into quality measures, which have a specific numerator, denominator, and exclusions and can be reported as a percentage representing a quality or performance measure (depending on whether the subject of measurement is associated with improved quality or just healthcare performance). Quality measures can be used for benchmarking and quality improvement efforts, and in some countries and jurisdictions, are used in pay-forperformance programs. An example of a quality measure based on the above quality indicator would be "the percentage of patients with RA who have been prescribed a DMARD." According to a classic Donabedian framework 2 , quality measures are often classified into process, structure, or outcome. Process measures determine whether clinical processes are concordant with evidence-based best practice and improved patient outcomes; structure measures record whether the health system or clinic infrastructures are present RheumatologyThe Journal of on May 11, 2018 -Published by www.jrheum.org Downloaded from to support best practices; and outcome measures determine the effect on the health status of the patient. While outcome measures may seem the most obvious to measure, patient outcomes are the result of many factors, some of which are beyond the control of physicians. Several domains of quality exist, and the most commonly cited framework is the Institute of Medicine's 6 Domains of Health Care Quality 3 : safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity.The present systematic review of quality measures in rheumatology was...

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Rheumatologymentioning

confidence: 99%

Section: Rheumatologymentioning

confidence: 99%

Section: Rheumatologymentioning

confidence: 99%

See 2 more Smart Citations

A Systematic Review of Quality Measures for Inflammatory Arthritis

Cooper

Rouhi²,

Barber³

2017

J Rheumatol

View full text Add to dashboard Cite

show abstract

“…In a recent study, quality indicators for monitoring patients with rheumatoid arthritis (RA) were developed that prescribe frequent monitoring and registration of disease activity and functionality, together with subsequent treatment adjustments 1 . From the literature it is clear that frequent monitoring of disease activity with adjusted treatment improves outcome 2 .…”

Section: To the Editormentioning

confidence: 99%

Disease Activity Monitoring in Rheumatoid Arthritis in Daily Practice: Experiences with METEOR, a Free Online Tool

Koevoets¹,

Allaart²,

Heijde³

et al. 2010

J Rheumatol

View full text Add to dashboard Cite

Rheumatoid arthritis patients and rheumatologists approach the decision to escalate care differently: Results of a maximum difference scaling experiment

Hulst¹,

Kievit²,

Bommel³

et al. 2011

Arthritis Care & Research

View full text Add to dashboard Cite

Objective Anti-rheumatic drugs are frequently not appropriately modified, according to ACR Guidelines, in patients with active rheumatoid arthritis (RA) as defined by a DAS28 score greater than 3.2. The objective was to determine which factors most strongly influence patients’ and rheumatologists’ decisions to escalate care. Methods We administered a Maximum Difference Scaling survey to 106 rheumatologists and 213 RA patients. The survey included 58 factors related to the decision to escalate care in RA. Participants answered 24 choice tasks. In each task, participants were asked to choose the most important factor from a set of five. We used Hierarchical Bayes modeling to generate the mean relative importance score (RIS) for each factor. Results For rheumatologists, the five most influential factors were: number of swollen joints (RIS: 5.2; sd: 0.4), DAS28 score (RIS 5.2; sd 0.5), physician global assessment of disease activity (RIS 5.2. sd 0.6), worsening erosions over the last year (RIS: 5.2; sd: 0.6) and RA disease activity now compared to three months ago (RIS 5.1; sd: 0.6). For patients, the 5 most important factors were: current level of physical functioning (RIS: 4.3; sd: 1.1), motivation to get better (RIS: 3.5; sd: 1.4), trust in their rheumatologist (RIS: 3.5; sd: 1.6), satisfaction with current DMARDs (RIS: 3.4; sd: 1.4) and current number of painful joints (RIS 3.4; sd: 1.4). Conclusions Factors influencing the decision to escalate care differ between rheumatologists and patients. Better communication between patients and their physicians may improve treatment planning in RA patients with active disease.

show abstract

Development of quality indicators for monitoring of the disease course in rheumatoid arthritis

Cited by 37 publications

References 28 publications

A Systematic Review of Quality Measures for Inflammatory Arthritis

A Systematic Review of Quality Measures for Inflammatory Arthritis

Disease Activity Monitoring in Rheumatoid Arthritis in Daily Practice: Experiences with METEOR, a Free Online Tool

Rheumatoid arthritis patients and rheumatologists approach the decision to escalate care differently: Results of a maximum difference scaling experiment

Contact Info

Product

Resources

About