Article type
Abstract
Background: The German Guideline Programme in Oncology, a joint initiative between the German Cancer Society, the Association of the Scientific Medical Societies in Germany and German Cancer Aid, supports the development of high-quality guidelines. To enhance implementation and evaluation, the suggestion of performance measures (PMs) derived from guideline recommendations is obligatory. PM teams are convened representing the multidisciplinary guideline development groups including clinical experts, methodologists and patient representatives as well as the organisations that take an active part in and share responsibility for documentation and quality improvement, i.e. clinical cancer registries and certified cancer centres. A standardised development process with 5 selection criteria i.a. relevance and clarity of definition is used.
Objectives: To review German guideline based PM in oncology and to evaluate potential for improvement concerning development process and reporting as part of a national research project.
Methods: Completing an earlier work (1), we extracted PM of 16 current guidelines (as to 8/16) and analysed them according to reporting criteria published 2016 (2) including i.a. development process, level of evidence (LoE) and measure appraisal. We further quantified and analysed outcome measures.
Results: Of 155 PM (7-13 per guideline), 144 were derived from strong recommendations,11 were based on other sources. 81 PM were classified as evidence based (46 x LoE 1). 74 PM were consensus based, mainly covering diagnostic interventions, with 17 PM citing literature not formally assessed. No psychometric test results (validity, reliability) or information on piloting were available. Of 11 PM measuring outcomes, 2 addressed patient reported outcomes and 2 used an international agreed definition.
Conclusions: The standardised process of PM development in oncology results in a high number of consensus based process PM. This shows the need for well justified recommendations. Examples will be presented. Piloting and validating of PM and the development of internationally agreed outcome PM were identified as further fields of improvement.
Objectives: To review German guideline based PM in oncology and to evaluate potential for improvement concerning development process and reporting as part of a national research project.
Methods: Completing an earlier work (1), we extracted PM of 16 current guidelines (as to 8/16) and analysed them according to reporting criteria published 2016 (2) including i.a. development process, level of evidence (LoE) and measure appraisal. We further quantified and analysed outcome measures.
Results: Of 155 PM (7-13 per guideline), 144 were derived from strong recommendations,11 were based on other sources. 81 PM were classified as evidence based (46 x LoE 1). 74 PM were consensus based, mainly covering diagnostic interventions, with 17 PM citing literature not formally assessed. No psychometric test results (validity, reliability) or information on piloting were available. Of 11 PM measuring outcomes, 2 addressed patient reported outcomes and 2 used an international agreed definition.
Conclusions: The standardised process of PM development in oncology results in a high number of consensus based process PM. This shows the need for well justified recommendations. Examples will be presented. Piloting and validating of PM and the development of internationally agreed outcome PM were identified as further fields of improvement.