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Các chỉ số chất lượng dựa trên hướng dẫn - so sánh hệ thống giữa các hướng dẫn thực hành lâm sàng của Đức và quốc tế
Tóm tắt
Các hướng dẫn thực hành lâm sàng dựa trên bằng chứng (CPGs) là nguồn thông tin quan trọng để phát triển các chỉ số chất lượng (QIs). Mục tiêu của nghiên cứu này là so sánh các QIs dựa trên hướng dẫn của các CPGs Đức và quốc tế cùng với các phương pháp phương pháp luận mà chúng dựa trên. Chúng tôi đã thực hiện các tìm kiếm hệ thống trong các cơ sở dữ liệu hướng dẫn của G-I-N (Mạng lưới Hướng dẫn Quốc tế) và NGC (Trung tâm Hướng dẫn Quốc gia) trong khoảng thời gian từ tháng Hai đến tháng Sáu năm 2017 để xác định các CPGs quốc tế phù hợp với các chủ đề của các CPGs Đức dựa trên bằng chứng (n = 35) báo cáo QIs, được xác định trong một nghiên cứu trước. Ngoài ra, chúng tôi đã tìm kiếm trên các trang web của các nhà cung cấp CPG cụ thể để lấy các tài liệu riêng biệt liên quan đến QIs. Chúng tôi đã bao gồm các CPGs dựa trên bằng chứng báo cáo QIs. Các QIs được báo cáo, khuyến nghị từ hướng dẫn cơ sở và thông tin về phương pháp phát triển đã được trích xuất. Việc lựa chọn và trích xuất CPGs được thực hiện bởi một người đánh giá và được kiểm tra bởi một người khác. Đối với mỗi cặp CPGs được khớp, chúng tôi đã đánh giá xem các QIs đề xuất có phù hợp hay không thể so sánh trực tiếp. Hai mươi lăm CPG quốc tế, xuất phát từ bảy nhà cung cấp CPG khác nhau, đáp ứng tiêu chí bao gồm. Chúng phù hợp với các chủ đề của 18 CPG Đức. Điều này dẫn đến 30 cặp CPGs cho việc so sánh QIs (một số CPG quốc tế phù hợp với chủ đề của hơn một CPG Đức). Chúng tôi tìm thấy 27 cặp QIs có QIs “không khác nhau hoặc khác nhau một chút”, tương ứng với 13% (27 trong số 212) của các QIs trong CPGs Đức và 16% (27 trong số 166) trong các CPG quốc tế. Chỉ có hai cặp QIs được đánh giá là “khác nhau/không đồng nhất”. Đối với 183 trong số 212 (86%) QIs từ CPG Đức và 137 trong số 166 (83%) QIs từ các CPG quốc tế, không thể thực hiện so sánh trực tiếp. Một liên kết rõ ràng đến một hoặc nhiều khuyến nghị hướng dẫn đã được tìm thấy cho 136 trong số 152 (89%) QIs từ CPGs Đức và 82 trong số 166 (49%) QIs từ các CPG quốc tế. Một số thông tin về phương pháp phát triển QIs tồn tại cho 12 trong số 18 (67%) CPG Đức và 8 trong số 25 (32%) CPG quốc tế. Phần lớn các QIs trong các CPG Đức và quốc tế là không thể so sánh. Có nhiều lý do khác nhau cho điều này. Cần có báo cáo minh bạch hơn về các phương pháp cơ sở để tạo ra các QIs dựa trên hướng dẫn.
Từ khóa
#Hướng dẫn thực hành lâm sàng #chỉ số chất lượng #phương pháp luận #so sánh quốc tế #căn cứ bằng chứngTài liệu tham khảo
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