Background Quality assessment in health care is a process of planned activities with the ultimate goal of achieving a continuous improvement of medical care through the evaluation of structure, process, and outcome measures. Physicians and health care specialists involved with quality issues are faced with an enormous and nearly always increasing amount of literature to read and integrate. Nevertheless, the novelty and quality of these articles (in terms of evidence-based medicine) has not been systematically assessed and described. Objective The objective of this study was to test the hypothesis that the number of high-evidence journal articles (according to the pyramid of evidence), such as randomized control trials, systematic reviews, and ultimately, practice guidelines, increases over time, relative to lower-evidence journal articles, such as editorials, reviews, and letters to the editors. Methods We used PubMed database to retrieve relevant articles published during the 31-year period between January 1, 1989, and December 31, 2021. The search was conducted in April 2022. We used the keywords “quality care,” “quality management,” “quality indicators,” and “quality improvement” and limited the search fields to title and abstract in order to limit our search results to articles nearly exclusively related to health care quality. Results During this 31-year evaluation period, there was a significant cubic increase in the total number of publications, reviews, clinical trials (peaking in 2017, with a sharp decline until 2021), controlled trials (peaking in 2016, with a sharp drop until 2021), randomized controlled trials (peaking in 2017, with a sharp drop until 2021), systematic reviews (nearly nonexistent in the 1980s through 1990s to a peak of 222 in 2021), and meta-analyses (from nearly none in the 1980s through 1990s to a peak of approximately 40 per year in 2020). There was a linear increase in practice guidelines from none during 1989-1991 to approximately 25 per year during 2019-2021, including a cubic increase in editorials, peaking in 2021 at 125 per year, and in letters to the editor, peaking at 50-78 per year in the last 4 years (ie, 2018-2021). Conclusions Over the past 31 years, the field of quality in health care has seen a significant yearly increase of published original studies with a relative stagnation since 2015. We suggest that contributors to this dynamic field of research should focus on producing more evidence-based publications and guidelines.
BACKGROUND Quality assessment in health care is a process of planned activities whose ultimate goal is to achieve a continuous improvement of medical care through the evaluation of structure, process, and outcome measures. Physicians and health care specialists involved with quality issues are faced with an enormous and nearly always increasing amount of literature to read and integrate OBJECTIVE To test the hypothesis that the number of publications in the field of health care quality increases over time, and particularly the number of high-evidence journal articles such as randomized control trials, systematic reviews, and ultimately, practice guidelines. METHODS We used MEDLINE database to retrieve relevant articles published between during the 29 year-period between 1/1/1989 and 12/31/2018. The search was conducted in March 2021. Publications from 2019 and 2020 were excluded because of incomplete data. We used the keywords "quality care", "quality management", "quality indicators" and "quality improvement” and limited the search fields to title and abstract. RESULTS During the 29-year evaluation period there was a significant cubic increase in the number of publications both in total number of publications and in the variety of publication types studied The rate of increase varied for different types of publications, with the largest increase in reviews, and the smallest increase in case reports. There was a systematic stagnation or even decrease in the number of publications starting in 2015 regardless of publication type. CONCLUSIONS Over the past 29 years the field of quality in health care has seen a significant yearly increase of published original studies with a relative stagnation since 2015. We suggest that contributors to this dynamic field of research should focus on producing more evidence based publications and guidelines
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