Experiences with methodological requirements for guideline-based performance measures and their practical application. Evidence Map and protocol for a qualitative study.

Article type
Authors
Steudtner M1, Kopp I1, Arnold K2, Becker M3, Schmitt J2, Neugebauer E4, Nothacker M1
1AWMF-Institute for Medical Knowledge Management (AWMF-IMWi)
2Center for Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden
3Institute for Research in Operative Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, Building 38, 51109, Cologne
4Brandenburg Medical School Campus Neuruppin and Witten/Herdecke University
Abstract
Background: Implementation of clinical practice guidelines by means of guideline-based performance measures (GBPM) are subjects of current research. No methodological gold standard exists and the approaches are heterogeneous (1). Members of G-I-N reported that the procedure could be more rigorous (2). In 2016, international reporting standards for GBPM were published (3). To our knowledge, there has been no systematic analysis on how methodological and organisational factors affect the use of methodology to develop GBPM from the perspective of guidelines developers, methodologists and users.

Objectives: To search and analyse international qualitative research about barriers and facilitators for GBPM development.

Methods: We developed a search strategy to identify qualitative studies published in English or German reporting on barriers/facilitators affecting GBPM development. A search in MEDLINE covering 1998 to 1/2017 retrieved 2211 hits. Titles and abstracts were screened by one reviewer using pre-specified inclusion criteria. After title and abstract screening 30 articles were identified as potentially relevant. Full texts were screened by two independent reviewers. No study fully met the inclusion criteria. The studies were compiled into an Evidence Map (EM).

Results: Most studies (n=17) targeted guideline implementation and use without reference to GBPM. Seven studies addressed GBPM but not a qualitative analysis of barriers/facilitators. GBPM development process (n=7). Six studies focused on use and requirements of PM but did not report processes of GBPM development.

Conclusions: The EM showed a need for qualitative research with a focus on GBPM development. An international qualitative study consisting of at least 15 semistructured telephone interviews with PM developers, methodologists and users identified through G-I-N will be conducted as part of a national research project. Criterion sampling will be used for the recruitment of participants. The study will focus on processes and experiences with development and quality assessment of GBPM. The interview guide and first results will be presented at the Summit.