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. 2010 Jun;22(3):201-9.
doi: 10.1093/intqhc/mzq018. Epub 2010 Apr 9.

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

Adolfo Peña  1 , Sandeep S Virk, Richard M Shewchuk, Jeroan J Allison, O Dale Williams, Catarina I Kiefe
Affiliations

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

Adolfo Peña et al. Int J Qual Health Care. 2010 Jun.

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.

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Figures

Figure 1
Figure 1
Validity rating and variance. Rate average: validity average ratings of quality indicators. Rate variance: variability of expert panel responses.
Figure 2
Figure 2
Feasibility average ranking and variance. Feasibility rank: feasibility average rank of quality indicators. Feasibility variance: variability of expert panel responses.
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References

    1. Phillips KA, Shlipak MG, Coxson P, et al. Health and economic benefits of increased beta-blocker use following myocardial infarction. JAMA. 2000;284:2748–54. doi:10.1001/jama.284.21.2748. - DOI - PubMed
    1. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the Twenty-first Century. Washington, DC: National Academies Press; 2001. - PubMed
    1. Liang L. The gap between evidence and practice. Health Aff. 2007;26:w119–w121. doi:10.1377/hlthaff.26.2.w119. - DOI - PubMed
    1. Timmermans S, Mauck A. The promises and pitfalls of evidence based medicine. Health Aff. 2005;24:18–28. doi:10.1377/hlthaff.24.1.18. - DOI - PubMed
    1. Bunge M. Development indicators. Soc Indicators Res. 1981;9:369–81. doi:10.1007/BF00300662. - DOI

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