TY - JOUR
T1 - Development of Quality Measures in Cirrhosis by the Practice Metrics Committee of the American Association for the Study of Liver Diseases
AU - Kanwal, Fasiha
AU - Tapper, Elliot B.
AU - Ho, Chanda
AU - Asrani, Sumeet K.
AU - Ovchinsky, Nadia
AU - Poterucha, John
AU - Flores, Avegail
AU - Ankoma-Sey, Victor
AU - Luxon, Bruce
AU - Volk, Michael
N1 - Funding Information:
Received October 22, 2018; accepted October 23, 2018. Additional Supporting Information may be found at onlinelibrary.wiley.com/doi/10.1002/hep.30489/suppinfo. Supported by the American Association for the Study of Liver Diseases. Dr. Kanwal’s research is supported by the Veterans Administration Center for Innovations in Quality, Effectiveness and Safety (CIN 13-413), Michael E. DeBakey VA Medical Center, Houston, Texas and the Center for Gastrointestinal Development, Infection and Injury (NIDDK P30 DK 56338). © 2018 by the American Association for the Study of Liver Diseases. View this article online at wileyonlinelibrary.com. DOI 10.1002/hep.30489
Funding Information:
Acknowledgment: Funding for the development of these quality measures was provided by the American Association for the Study of Liver Diseases.The expert panel consisted of Amit Singal, M.D., Rony Ghaoui, M.D., Hashem El-Serag, M.D., John Vierling, M.D., Bruce Runyon, M.D., Arun Sanyal, M.D., Scott Biggins, M.D., Jasmohan Bajaj, M.D., Timothy Morgan, M.D., and Guadalupe Garcia-Tsao, M.D.
Publisher Copyright:
© 2018 by the American Association for the Study of Liver Diseases.
PY - 2019/4
Y1 - 2019/4
N2 - Health care delivery is increasingly evaluated according to quality measures, yet such measures are underdeveloped for cirrhosis. The Practice Metrics Committee of the American Association for the Study of Liver Diseases was charged with developing explicit process-based and outcome-based measures for adults with cirrhosis. We identified candidate measures from comprehensive reviews of the literature and input from expert clinicians and patient focus groups. We conducted an 11-member expert clinician panel and used a modified Delphi method to systematically identify a set of quality measures in cirrhosis. Among 119 candidate measures, 46 were identified as important measures to define the quality of cirrhosis care, including 26 process measures, 7 clinical outcome measures, and 13 patient-reported outcome measures. The final process measures captured care processes for ascites (n = 5), varices/bleeding (n = 7), hepatic encephalopathy (n = 4), hepatocellular cancer (HCC) screening (n = 1), liver transplantation evaluation (n = 2), and other care (n = 7). Clinical outcome measures included survival, variceal bleeding and rebleeding, early-stage HCC, liver-related hospitalization, and rehospitalization within 7 and 30 days. Patient-reported outcome measures covered physical symptoms, physical function, mental health, general function, cognition, social life, and satisfaction with care. The final list of patient-reported outcomes was validated in 79 patients with cirrhosis from nine institutions in the United States. Conclusion: We developed an explicit set of evidence-based quality measures for adult patients with cirrhosis. These measures are a tool for providers and institutions to evaluate their care quality, drive quality improvement, and deliver high-value cirrhosis care. The quality measures are intended to be applicable in any clinical care setting in which care for patients with cirrhosis is provided.
AB - Health care delivery is increasingly evaluated according to quality measures, yet such measures are underdeveloped for cirrhosis. The Practice Metrics Committee of the American Association for the Study of Liver Diseases was charged with developing explicit process-based and outcome-based measures for adults with cirrhosis. We identified candidate measures from comprehensive reviews of the literature and input from expert clinicians and patient focus groups. We conducted an 11-member expert clinician panel and used a modified Delphi method to systematically identify a set of quality measures in cirrhosis. Among 119 candidate measures, 46 were identified as important measures to define the quality of cirrhosis care, including 26 process measures, 7 clinical outcome measures, and 13 patient-reported outcome measures. The final process measures captured care processes for ascites (n = 5), varices/bleeding (n = 7), hepatic encephalopathy (n = 4), hepatocellular cancer (HCC) screening (n = 1), liver transplantation evaluation (n = 2), and other care (n = 7). Clinical outcome measures included survival, variceal bleeding and rebleeding, early-stage HCC, liver-related hospitalization, and rehospitalization within 7 and 30 days. Patient-reported outcome measures covered physical symptoms, physical function, mental health, general function, cognition, social life, and satisfaction with care. The final list of patient-reported outcomes was validated in 79 patients with cirrhosis from nine institutions in the United States. Conclusion: We developed an explicit set of evidence-based quality measures for adult patients with cirrhosis. These measures are a tool for providers and institutions to evaluate their care quality, drive quality improvement, and deliver high-value cirrhosis care. The quality measures are intended to be applicable in any clinical care setting in which care for patients with cirrhosis is provided.
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U2 - 10.1002/hep.30489
DO - 10.1002/hep.30489
M3 - Article
C2 - 30586188
AN - SCOPUS:85062833780
SN - 0270-9139
VL - 69
SP - 1787
EP - 1797
JO - Hepatology
JF - Hepatology
IS - 4
ER -
