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    Validity versus feasibility for quality of care indicators: expert panel results from the MI-Plus study

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    Authors
    Pena, Adolfo
    Virk, Sandeep S.
    Shewchuk, Richard M.
    Allison, Jeroan J.
    Williams, O. Dale
    Kiefe, Catarina I.
    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2010-04-13
    Keywords
    Delphi Technique
    Guideline Adherence
    Humans
    Myocardial Infarction
    Practice Guidelines as Topic
    Quality Indicators, Health Care
    Quality of Health Care
    Randomized Controlled Trials as Topic
    Reproducibility of Results
    Bioinformatics
    Biostatistics
    Epidemiology
    Health Services Research
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    Link to Full Text
    http://dx.doi.org/10.1093/intqhc/mzq018
    Abstract
    BACKGROUND: In the choice and definition of quality of care indicators, there may be an inherent tension between feasibility, generally enhanced by simplicity, and validity, generally enhanced by accounting for clinical complexity. OBJECTIVE: To study the process of developing quality indicators using an expert panel and analyze the tension between feasibility and validity. DESIGN AND PARTICIPANTS: A multidisciplinary panel of 12 expert physicians was engaged in two rounds of modified Delphi process to refine and choose a smaller subset from 36 indicators; these were developed by a research team studying the quality of care in ambulatory post-myocardial infarction patients with co-morbidities. We studied the correlation between validity/feasibility ranks provided by the expert panel. The correlation between the quality indicators ranks on validity and feasibility scale and variance of experts' responses was also individually studied. RESULTS: Ten of 36 indicators were ranked in both the highest validity and feasibility groups. The strength of association between validity and feasibility of indicators measured by Kendall tau-b was 0.65. In terms of validity, a strong negative correlation was observed between the ranks of indicators and the variability in expert panel responses (Spearman's rho, r = -0.85). A weak correlation was found between the ranks of feasibility and the variability of expert panel responses (Spearman's rho, r = 0.23). CONCLUSION: There was an unexpectedly strong association between the validity and feasibility of quality indicators, with a high level of consensus among experts regarding both feasibility and validity for indicators rated highly on each of these attributes.
    Source
    Int J Qual Health Care. 2010 Jun;22(3):201-9. Epub 2010 Apr 9. Link to article on publisher's site
    DOI
    10.1093/intqhc/mzq018
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47762
    PubMed ID
    20382663
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1093/intqhc/mzq018
    Scopus Count
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    Population and Quantitative Health Sciences Publications

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