关节炎护理的测量过程：关节炎基金会针对类风湿关节炎的质量指标集

Measuring process of arthritis care: the Arthritis Foundation's quality indicator set for rheumatoid arthritis.

作者信息

Khanna Dinesh, Arnold Erin L, Pencharz James N, Grossman Jennifer M, Traina Shana B, Lal Anand, MacLean Catherine H

机构信息

Division of Immunology, University of Cincinnati and VAMC, OH, USA.

出版信息

Semin Arthritis Rheum. 2006 Feb;35(4):211-37. doi: 10.1016/j.semarthrit.2005.08.004.

DOI:10.1016/j.semarthrit.2005.08.004

PMID:16461068

Abstract

OBJECTIVE

To describe the scientific evidence that supports each of the explicit process measures in the Arthritis Foundation's Quality Indicator Set for Rheumatoid Arthritis.

METHODS

For each of the 27 measures in the Arthritis Foundation's Quality Indicator set, a comprehensive literature review was performed for evidence that linked the process of care defined in the indicator with relevant clinical outcomes and to summarize practice guidelines relevant to the indicators.

RESULTS

Over 7500 titles were identified and reviewed. For each of the indicators the scientific evidence to support or refute the quality indicator was summarized. We found direct evidence that supported a process-outcome link for 15 of the indicators, an indirect link for 7 of the indicators, and no evidence to support or refute a link for 5. The processes of care described in the indicators for which no supporting/refuting data were found have been assumed to be so essential to care that clinical trails assessing their importance have not, and probably never will be, performed. The process of care described in all but 2 of the indicators is recommended in 1 or more practice guidelines.

CONCLUSION

There are sufficient scientific evidence and expert consensus to support the Arthritis Foundation's Quality Indicator Set for Rheumatoid Arthritis, which defines a minimal standard of care that can be used to assess health care quality for patients with rheumatoid arthritis.

摘要

目的

描述支持关节炎基金会类风湿关节炎质量指标集中每项明确过程指标的科学证据。

方法

针对关节炎基金会质量指标集中的27项指标，分别进行了全面的文献综述，以寻找将指标中定义的护理过程与相关临床结果相联系的证据，并总结与这些指标相关的实践指南。

结果

共识别并审查了7500多篇文献。针对每项指标，总结了支持或反驳该质量指标的科学证据。我们发现，有直接证据支持15项指标的过程-结果联系，间接证据支持7项指标，没有证据支持或反驳5项指标的联系。对于未找到支持/反驳数据的指标所描述的护理过程，已假定其对护理至关重要，以至于尚未（可能永远也不会）开展评估其重要性的临床试验。除2项指标外，所有指标所描述的护理过程均在1项或多项实践指南中得到推荐。