Development of Performance Indicators for the Primary Care Management of Pediatric Epilepsy: Expert Consensus Recommendations Based on the Available Evidence

Caplin, Deirdre; Rao, Jaya K.; Filloux, Francis; Bale, James F.; Orman, Colin Van

doi:10.1111/j.1528-1167.2006.00853.x

Cited by 29 publications

(19 citation statements)

References 70 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[32][33] Review by the co-chairs and facilitator resulted in 20 recommendation statements that were rated highest on importance, validity, strength of evidence, and gaps in care to serve as the evidence base for 12 candidate measures. The panel revised the draft measures and eliminated 4 of the measures at the face-to-face meeting on October 3, 2008.…”

Section: Resultsmentioning

confidence: 99%

Quality improvement in neurology: AAN epilepsy quality measures

Cheng¹,

Tonn²,

Swain-Eng³

et al. 2011

Neurology

193

View full text Add to dashboard Cite

Objective: Epilepsy is a common neurologic condition with significant personal, societal, medical, and economic burdens. There are considerable gaps in the quality of care delivered. Measuring the quality of care delivered is the first step to its improvement. Performance measures are easily identified and quantitated ways to assess whether specific activities were carried out during a patient encounter. Therefore, epilepsy performance measures were derived through a standardized systematic process and may be the basis for pay-for-performance initiatives and maintenance of certification requirements. Methods: Epilepsy measures were developed through the American Medical Association-convenedPhysician Consortium for Performance Improvement (PCPI) independent measure development process, which marked the first time a medical specialty society followed this process. Guidelines, measures, and consensus papers reviewed for the period 1998 to 2008 using the National Guidelines Clearinghouse, the National Quality Measures Clearinghouse, PubMed, MEDLINE, and the Cochrane Library were evaluated using a framework to determine the acceptability of each guideline or other evidence review document for measures development. Recommendation statements based on level of evidence, importance, validity, and gap in care were developed into candidate measures. A panel of experts from representative organizations vetted the measures. A period of public comment was followed by approval from the American Academy of Neurology and the PCPI.Results: Literature search identified 160 relevant recommendation statements from 19 guidelines and 2 consensus papers. Systematic assessment resulted in 20 recommendation statements that were refined to 8 candidate measures by the expert panel. The measures are relevant to seizure type and frequency, etiology or epilepsy syndrome, EEG, neuroimaging, antiepileptic drug side effects, safety issues, referral for refractory epilepsy, and issues for women of childbearing potential. Conclusion:There is a reasonable evidence base, and consensus for, deriving performance measures for quality of epilepsy care. It is anticipated that implementation of these performance measures will improve care for patients with epilepsy if adopted by providers. Neurology Epilepsy is a common and widely recognized neurologic condition, but it is often poorly understood, misdiagnosed, and improperly treated. Epilepsy is surprisingly common; approximately 3% of the American population will develop epilepsy by age 75. 1 The deficits in quality of life due to epilepsy and its treatment are comparable to conditions such as diabetes, heart disease, and depression for people with active epilepsy.2 Epilepsy causes considerable medical distress and an enormous economic burden. Editorial, page 16Supplemental data at www.neurology.org SPECIAL ARTICLE 94Copyright © 2010 by AAN Enterprises, Inc.The annual direct costs per patient are more than $11,000 and indirect costs are more than $3,000 in some settings. 3The epilepsy treatmen...

show abstract

Section: Resultsmentioning

confidence: 99%

Quality improvement in neurology: AAN epilepsy quality measures

Cheng¹,

Tonn²,

Swain-Eng³

et al. 2011

Neurology

193

View full text Add to dashboard Cite

show abstract

“…A set of performance indicators proposed for pediatric epilepsy care did not even mention genetic testing. 45 The impact of the diagnosis on the selection of treatment and on patient outcomes has not been studied in the modern context. US guidelines exist for infantile spasms, 30,31 but not for other common early-onset epilepsies.…”

Section: Patient-expressed Priorities Vs the Standard Approach: Do Wementioning

confidence: 99%

Priorities in pediatric epilepsy research

Berg¹,

Baca²,

Loddenkemper³

et al. 2013

Neurology

View full text Add to dashboard Cite

The Priorities in Pediatric Epilepsy Research workshop was held in the spirit of patient-centered and patient-driven mandates for developing best practices in care, particularly for epilepsy beginning under age 3 years. The workshop brought together parents, representatives of voluntary advocacy organizations, physicians, allied health professionals, researchers, and administrators to identify priority areas for pediatric epilepsy care and research including implementation and testing of interventions designed to improve care processes and outcomes. Priorities highlighted were 1) patient outcomes, especially seizure control but also behavioral, academic, and social functioning; 2) early and accurate diagnosis and optimal treatment; 3) role and involvement of parents (communication and shared decision-making); and 4) integration of school and community organizations with epilepsy care delivery. Key factors influencing pediatric epilepsy care included the child's impairments and seizure presentation, parents, providers, the health care system, and community systems. Care was represented as a sequential process from initial onset of seizures to referral for comprehensive evaluation when needed. We considered an alternative model in which comprehensive care would be utilized from onset, proactively, rather than reactively after pharmacoresistance became obvious. Barriers, including limited levels of evidence about many aspects of diagnosis and management, access to care-particularly epilepsy specialty and behavioral health care-and implementation, were identified. Progress hinges on coordinated research efforts that systematically address gaps in knowledge and overcoming barriers to access and implementation. The stakes are considerable, and the potential benefits for reduced burden of refractory epilepsy and lifelong disabilities may be enormous.

show abstract

“…Using literature review, expert panel and Delphi technique to develop the performance indicators was prevalent in previous studies [23][24][25][26]. As indicated in previous studies, Delphi method can be a useful and systematic approach to consensus building about a real subject [13,14,27,28] and facilitate the systematic cycle of indicator development [26]. This technique is a method to summarize, assess and compare the experts' opinions and combining them with the evidences to make a decision [29] so it will be a useful method to developing the new indicators.…”

Section: Discussionmentioning

confidence: 99%

“…Delphi method facilitates the systematic process of developing indicators [12]. It is a method to extract, evaluate and match experts' independent opinions [13]. Delphi method combines the experts' opinion and empirically derived information in decisions [12,13].…”

Section: -Indicators Assessmentmentioning

confidence: 99%

See 1 more Smart Citation

Tabriz Clinical Governance Research Project (TCGRP): Study Protocol

Sadeghi‐Bazargani

Saadati²,

Tabrizi

et al. 2014

j clin res gov

View full text Add to dashboard Cite

Ab s t r a c tThe Tabriz Clinical Governance Research Project (TCGRP) was conducted in Tabriz, East Azerbaijan Province of Iran. The project was done based on the National Clinical Governance Movement of the Iranian health system since 2009. The TCGRP aimed to monitor the progress of clinical governance in Tabriz hospitals. The TCGRP had three components: 1-A comprehensive literature review was conducted to identify draft indicators. 2-Draft indicators were evaluated by experts through Delphi technique and expert panels, 3-The indicators were assessed through data collection at three sampling levels of hospitals, patients and community. All Tabriz hospitals (n=21) with various ownerships were included in the study. Moreover, 3000 patients (inpatients and outpatients) as well as 1050 Tabriz households were investigated. The TCGRP protocol is designed to provide basic performance information for policymakers as well as the researchers in field of clinical governance. Results from TCGRP are assumed to identify the weaknesses and facilitate the development of effective interventions to improve the clinical governance practice.

show abstract

Development of Performance Indicators for the Primary Care Management of Pediatric Epilepsy: Expert Consensus Recommendations Based on the Available Evidence

Cited by 29 publications

References 70 publications

Quality improvement in neurology: AAN epilepsy quality measures

Quality improvement in neurology: AAN epilepsy quality measures

Priorities in pediatric epilepsy research

Tabriz Clinical Governance Research Project (TCGRP): Study Protocol

Contact Info

Product

Resources

About