Kemeny M E, Hargreaves W A, Gerbert B, Stone G C, Gullion D S
Med Care. 1984 Jul;22(7):620-31.
Issues that arise in the development of methods for measuring adequacy of physician performance (MAPP) are discussed. The comparative content validity, scorability, cost, and acceptability of four MAPP strategies are assessed using a sample of clinic-based physicians treating 30 patients with chronic obstructive pulmonary disease (COPD). Criteria for adequate care are contained in a "criteria map." No one of the four methods (physician interview, patient interview, videotaped observation, and chart audit) was best at capturing all aspects of the management of COPD. The relative content validity of a method depended on the aspect of care evaluated. The interviews provided the broadest range of information and the chart audit the most limited. The patient interview yielded the largest proportion of encounters upon which physician performance could be scored, although specific criteria map subscales were differentially scorable depending on the method used. Relative cost and acceptability are also discussed.
讨论了在衡量医生绩效充分性方法（MAPP）开发过程中出现的问题。使用一组治疗30例慢性阻塞性肺疾病（COPD）患者的临床医生样本，评估了四种MAPP策略的比较内容效度、可评分性、成本和可接受性。充分护理的标准包含在一张“标准图”中。四种方法（医生访谈、患者访谈、录像观察和病历审核）中没有一种在捕捉COPD管理的所有方面都表现最佳。一种方法的相对内容效度取决于所评估的护理方面。访谈提供了最广泛的信息范围，而病历审核提供的信息最有限。患者访谈产生了可对医生绩效进行评分的最大比例的诊疗过程，尽管具体的标准图子量表根据所使用的方法不同而具有不同的可评分性。还讨论了相对成本和可接受性。
