Yajima Nobuyuki, Tsujimoto Yasushi, Fukuma Shingo, Sada Ken-Ei, Shimizu Sayaka, Niihata Kakuya, Takahashi Ryo, Asano Yoshihide, Azuma Teruhisa, Kameda Hideto, Kuwana Masataka, Kohsaka Hitoshi, Sugiura-Ogasawara Mayumi, Suzuki Katsuya, Takeuchi Tsutomu, Tanaka Yoshiya, Tamura Naoto, Matsui Toshihiro, Mimori Tsuneyo, Fukuhara Shunichi, Atsumi Tatsuya
Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.
Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan.
Mod Rheumatol. 2020 May;30(3):525-531. doi: 10.1080/14397595.2019.1621419. Epub 2019 Jun 26.
Quality indicators (QIs) are tools that standardize evaluations in terms of the minimum acceptable quality of care, presumably contributing for the better management of patients with systemic lupus erythematosus (SLE). This study aimed to develop QIs for SLE using electronic health data. The modified RAND/UCLA Appropriateness Method was used to develop the QIs. First, a literature review was conducted. Second, the candidate QI items that were available to be evaluated using the electronic health data were extracted. Third, the appropriateness of the items was assessed via rating rounds and panelists' discussions. We found 3621 articles in the initial search. Finally, 34 studies were reviewed, from which 17 potential indicators were extracted as candidate QIs. Twelve indicators were selected as the final QI set through the process of appropriateness. The median appropriateness of these 12 indicators was at least 7.5, and all of them were without disagreement. The QI included assessment of disease activity, treatment of SLE, drug toxicity monitoring, treatment of glucocorticoid complications, and assessment of SLE complications. We formulated 12 QIs for the assessment of patients with SLE based on electronic medical data. Our QI set would be a practical tool as a quality measure.
质量指标（QIs）是用于根据可接受的最低护理质量来规范评估的工具，可能有助于更好地管理系统性红斑狼疮（SLE）患者。本研究旨在利用电子健康数据制定SLE的质量指标。采用改良的兰德/加州大学洛杉矶分校适宜性方法来制定质量指标。首先，进行文献综述。其次抽取可利用电子健康数据进行评估的候选质量指标项目。第三，通过评分轮次和专家小组讨论评估项目的适宜性。在初步检索中我们找到3621篇文章。最后，回顾了34项研究，从中提取出17项潜在指标作为候选质量指标。通过适宜性评估过程，12项指标被选为最终的质量指标集。这12项指标的适宜性中位数至少为7.5，且所有指标均无分歧。质量指标包括疾病活动度评估、SLE治疗、药物毒性监测、糖皮质激素并发症治疗以及SLE并发症评估。我们基于电子医疗数据制定了12项用于评估SLE患者的质量指标。我们的质量指标集将成为一种实用的质量衡量工具。
