Inflammatory Bowel Diseases

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Inflammatory Bowel Diseases:
doi: 10.1097/mib.0b013e31828278a2
Clinical Guidelines

Quality Indicators for Inflammatory Bowel Disease: Development of Process and Outcome Measures

Melmed, Gil Y. MD, MS1,2; Siegel, Corey Allan MD, MS3,4; Spiegel, Brennan M. MD, MDHS2,5,6,7; Allen, John I. MD8; Cima, Robert MD9; Colombel, Jean-Frederic MD10; Dassopoulos, Themistocles MD11; Denson, Lee A. MD12; Dudley-Brown, Sharon PhD, RNP-BC, FAAN13; Garb, Andrew JD, MS, LLM14; Hanauer, Stephen B. MD15; Kappelman, Michael D. MD, MPH16; Lewis, James D. MD, MS18; Lynch, Isabelle RN, MBA19; Moynihan, Amy RN3,4; Rubin, David T. MD15; Sartor, R. Balfour MD17; Schwartz, Ronald M. MD20; Wolf, Douglas C. MD21; Ullman, Thomas A. MD22

Supplemental Author Material


In the article on page 662 of volume 19, issue 3, there is an error in footnote d of Table 1. The footnote should read “IF a patient with ulcerative colitis has co-existing PSC (of any duration), THEN surveillance colonoscopy should be performed annually.

Inflammatory Bowel Diseases. 19(9):2040, August 2013.

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Introduction: Variation in adherence to management guidelines for inflammatory bowel disease (IBD) suggests variable quality of care. Quality indicators (QIs) can be developed to measure the structure, processes, and outcomes of health care delivery. The RAND/UCLA appropriateness method was used to develop a set of process and outcome QIs to define quality of care for IBD.

Methods: Guidelines and position papers for IBD published from 2006 to 2011 were reviewed for potential QIs, which were rated by a multidisciplinary panel. Potential process and outcome QIs were discussed at 3 moderated in-person meetings, with pre-meeting and post-meeting confidential electronic voting. Panelists rated the validity and feasibility of QIs on a 1 through 9 scale; disagreement was assessed using a validated index. QIs rated above 8 were selected for the final set.

Results: More than 500 potential process QIs were extracted from guidelines. Following ratings and discussion by the first panel, 35 process QIs were selected for literature review. After the second panel, 10 process QIs were included in the final set. Candidate outcome QIs were then derived from physician, nurse, and patient input and ratings, in addition to outcomes associated with candidate process QIs. None of the top QIs exhibited disagreement.

Conclusions: A set of QIs for IBD was developed with expert interpretation of the literature and multidisciplinary input. Outcome QIs focused largely on remission and quality of life, whereas process QIs were aimed at therapeutic optimization and patient safety. Evaluation of these QIs in clinical practice is needed to assess the correlation of performance on process QIs with performance on outcome QIs.

© Crohn's & Colitis Foundation of America, Inc.

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