Approaches of integrating the development of guidelines and quality indicators: a systematic review
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(2020) 20:875
RESEARCH ARTICLE
Open Access
Approaches of integrating the development of guidelines and quality indicators: a systematic review Miranda W. Langendam1, Thomas Piggott2, Monika Nothacker3, Arnav Agarwal4, David Armstrong5, Tejan Baldeh1, Jeffrey Braithwaite6, Carolina Castro Martins2,7, Andrea Darzi2, Itziar Etxeandia8, Ivan Florez1,9, Jan Hoving10, Samer G. Karam2, Thomas Kötter11, Joerg J. Meerpohl12, Reem A. Mustafa2,13, Giovanna E. U. Muti-Schünemann14, Philip J. van der Wees15, Markus Follmann16 and Holger J. Schünemann2,17,18*
Abstract Background: Guidelines and quality indicators (for example as part of a quality assurance scheme) aim to improve health care delivery and health outcomes. Ideally, the development of quality indicators should be grounded in evidence-based, trustworthy guideline recommendations. However, anecdotally, guidelines and quality assurance schemes are developed independently, by different groups of experts who employ different methodologies. We conducted an extension and update of a previous systematic review to identify, describe and evaluate approaches to the integrated development of guidelines and related quality indicators. Methods: On May 24th, 2019 we searched in Medline, Embase and CINAHL and included studies if they reported a methodological approach to guideline-based quality indicator development and were published in English, French, or German. Results: Out of 16,034 identified records, we included 17 articles that described a method to integrate guideline recommendations development and quality indicator development. Added to the 13 method articles from original systematic review we included a total 30 method articles. We did not find any evaluation studies. In most approaches, guidelines were a source of evidence to inform the quality indicator development. The criteria to select recommendations (e.g. level of evidence or strength of the recommendation) and to generate, select and assess quality indicators varied widely. We found methodological approaches that linked guidelines and quality indicator development explicitly, however none of the articles reported a conceptual framework that fully integrated quality indicator development into the guideline process or where quality indicator development was part of the question formulation for developing the guideline recommendations. Conclusions: In our systematic review we found approaches which explicitly linked guidelines with quality indicator development, nevertheless none of the articles reported a comprehensive and well-defined conceptual framework which integrated quality indicator development fully into the guideline development process. Keywords: Guidelines, Recommendations, Quality improvement, Quality assurance
* Correspondence: [email protected] 2 Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada 17 Department of Medicine, Hamilton, McMaster University, Hamilton, Canada Full list of author information is available at the end of the article © The
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