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类风湿关节炎的质量指标:来自 METEOR 数据库的结果。

Quality indicators in rheumatoid arthritis: results from the METEOR database.

机构信息

Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands,

Department of Internal Medicine III, Medical University of Vienna 2nd Department of Medicine, Center for Rheumatic Diseases, Hietzing Hospital, Vienna, Austria.

出版信息

Rheumatology (Oxford). 2015 Sep;54(9):1630-9. doi: 10.1093/rheumatology/kev108. Epub 2015 Apr 14.

Abstract

OBJECTIVE

To test the feasibility of collecting, storing, retrieving and analysing necessary information to fulfil a preliminary set of quality indicators (QIs) that have been proposed by an international task force in a large multinational clinical practice database of patients with RA.

METHODS

Data from all 12 487 patients with 46 005 visits in the Measurement of Efficacy of Treatment in the Era of Outcome in Rheumatology database from January 2008 until January 2012 were analysed to test the feasibility of collecting information on 10 QIs: time to diagnosis; frequency of visits; assessment of autoantibodies and radiographs, disease activity and function; disease remission, low disease activity, normal function; time to first DMARD and type of first DMARD. For each QI, two aspects were assessed: information availability and target achievement.

RESULTS

Information was available for <50% of patients regarding the following QIs: time to diagnosis, assessment of ACPAs or radiographs, time to first DMARD and type of first DMARD. Information was available for function assessment in 49% of visits and 67% of patients and for disease activity assessment in 85% of visits and 86% of patients. Information relevant to the QI frequency of visits was available for all patients. Relevant information to calculate the proportion of patients who achieved a defined target could be obtained for all QIs.

CONCLUSION

Collecting storing, retrieving and analysing the core data necessary to meaningfully assess quality of care is feasible in a multinational, practice-based electronic database.

摘要

目的

测试在大型跨国临床实践数据库中收集、存储、检索和分析必要信息以满足国际工作组提出的初步质量指标(QIs)的可行性,这些信息适用于类风湿关节炎患者。

方法

对 2008 年 1 月至 2012 年 1 月期间,来自 Rheumatology 数据库中治疗效果评估时代的疗效测量数据库中的 12487 例患者的 46005 次就诊数据进行分析,以测试收集以下 10 个 QIs 信息的可行性:诊断时间;就诊频率;自身抗体和影像学评估、疾病活动度和功能;疾病缓解、低疾病活动度、正常功能;首次 DMARD 时间和首次 DMARD 的类型。对于每个 QI,评估了两个方面:信息可用性和目标达成情况。

结果

以下 QIs 的患者信息可用性<50%:诊断时间、ACPA 或影像学评估、首次 DMARD 时间和首次 DMARD 的类型。49%的就诊和 67%的患者可获得功能评估信息,85%的就诊和 86%的患者可获得疾病活动度评估信息。所有患者的就诊频率相关信息均可获得。所有 QIs 都可以获得计算达到定义目标的患者比例的相关信息。

结论

在跨国、基于实践的电子数据库中,收集、存储、检索和分析评估护理质量所需的核心数据是可行的。

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