Systematic analysis of the translation of guideline-based recommendations into quality indicators and development of an evidence-based and consensus-based standard

质量指标在医疗保健中被广泛用于衡量医疗保健提供的质量。然而，目前尚缺乏制订和确认质量指标的标准化、系统化方法。此外，还没有在常规护理中评估和利用已确定的质量指标的一般方法。这妨碍了患者、医生和付款人对质量指标的解释。临床指南被跨部门接受，并用于将研究知识转化为常规护理。在德国，S3指南代表了临床指南的黄金标准。申请人的初步工作表明，S3--准则往往不包括质量指标。在临床指南中定义质量指标的情况下，缺少一种通用的系统方法。在制定和评价质量指标方面缺乏证据和标准化，这对实现以证据为基础、以质量为导向的病人医疗保健的卫生政治目标构成了重大障碍。计划中的研究项目旨在应用系统证据合成方法以及定性研究方法，调查目前将临床试验中的过程和结果转化为德国S3-指南中的质量指标的方法。此外，还将确定测量特性的要求和证据以及性能和评估方法。随后，这一新的研究证据将作为定性共识研究的基础，为临床指南中质量指标的开发、验证和使用制定一个方法学上合理的标准。关键利益攸关方将参与这一协商一致进程。

Quality indicators are widely used in health care to measure the quality of healthcare provision. However, a standardized systematic method for the development and validation of quality indicators is currently missing. Moreover, a general approach for the evaluation and utilization of defined quality indicators within routine care is not available. This hampers the interpretation of quality indicators by patients, physicians, and payers. Clinical guidelines are accepted cross-sectorally and are used to transfer research knowledge into routine care. In Germany, S3-guidelines represent the gold standard of clinical guidelines. Preliminary work of the applicants indicates that S3-guidelnes frequently do not comprise quality indicators. In case quality indicators are defined in clinical guidelines, a common systematic approach is missing. The absence of evidence and standardization concerning the development and evaluation of quality indicators constitutes a significant barrier towards the achievement of the health political goals of an evidence-based and quality-oriented medical care of patients. The planned research project aims to apply methods of systematic evidence synthesis as well as qualitative research methods to investigate current methods of translation of processes and outcomes in clinical trials into quality indicators in German S3-guidelines. In addition, the demands and the evidence of measurement properties as well as performance and evaluation methods will be determined. Subsequently, this new research evidence will serve as the basis of a qualitative consensus study to develop a methodologically sound standard for the development, validation, and utilization of quality indicators in clinical guidelines. The key stakeholders will be involved in this consensus process.