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

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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.