Choong Miew Keen, Tsafnat Guy, Hibbert Peter, Runciman William B, Coiera Enrico
Centre for Health Informatics, Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
Centre for Population Health Research, University of South Australia, Adelaide, South Australia.
BMC Health Serv Res. 2017 Jul 21;17(1):502. doi: 10.1186/s12913-017-2324-y.
Clinical quality indicators are used to monitor the performance of healthcare services and should wherever possible be based on research evidence. Little is known however about the extent to which indicators in common use are based on research. The objective of this study is to measure the extent to which clinical quality indicators used in asthma management in children with outcome measurements can be linked to results in randomised controlled clinical trial (RCT) reports. This work is part of a broader research program to trial methods that improve the efficiency and accuracy of indicator development.
National-level indicators for asthma management in children were extracted from the National Quality Measures Clearinghouse database and the National Institute for Health and Care Excellence quality standards by two independent appraisers. Outcome measures were extracted from all published English language RCT reports for asthma management in children below the age of 12 published between 2005 and 2014. The two sets were then linked by manually mapping both to a common set of Unified Medical Language System (UMLS) concepts.
The analysis identified 39 indicators and 562 full text RCTs dealing with asthma management in children. About 95% (37/39) of the indicators could be linked to RCT outcome measures.
It is possible to identify relevant RCT reports for the majority of indicators used to assess the quality of asthma management in childhood. The methods reported here could be automated to more generally support assessment of candidate indicators against the research evidence.
临床质量指标用于监测医疗服务的表现，应尽可能基于研究证据。然而，对于常用指标基于研究的程度知之甚少。本研究的目的是衡量用于儿童哮喘管理且有结局测量的临床质量指标与随机对照临床试验（RCT）报告结果的关联程度。这项工作是一个更广泛研究项目的一部分，该项目旨在试验提高指标开发效率和准确性的方法。
两名独立评估人员从国家质量措施信息中心数据库和英国国家卫生与临床优化研究所质量标准中提取儿童哮喘管理的国家级指标。从2005年至2014年发表的所有关于12岁以下儿童哮喘管理的英文RCT报告中提取结局测量。然后通过将两者手动映射到一组通用的统一医学语言系统（UMLS）概念来建立这两组之间的联系。
分析确定了39项指标和562篇关于儿童哮喘管理的全文RCT。约95%（37/39）的指标可与RCT结局测量相关联。
对于大多数用于评估儿童哮喘管理质量的指标，有可能识别出相关的RCT报告。此处报告的方法可以自动化，以更广泛地支持根据研究证据对候选指标进行评估。
