Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
-
Z Evid Fortbild Qual Gesundhwes · Aug 2019
[Development of the German version of EQ-5D-Y-5L to measure health-related quality of life in children and adolescents: Identification of response labels and pilot testing].
EQ-5D-Y-3L is a generic, youth-specific instrument to measure health-related quality of life (HRQoL). It contains five dimensions with three severity levels each. The aim of this study was to identify response levels to extend the German EQ-5D-Y version to four or five severity levels (4L or 5L) and to conduct a pilot test of both versions. ⋯ Involving the target group of children and adolescents, a German EQ-5D-Y version with five severity levels was developed (EQ-5D-Y-5L) that can be used in children and adolescents aged 8 to 15 years. However, the psychometric properties of the instrument need further investigation. In addition, value sets need to be to developed before the questionnaire is suitable for all fields of application.
-
Z Evid Fortbild Qual Gesundhwes · Aug 2019
[GRADE: Using evidence to decision frameworks for adoption, adaptation and de novo generation of trustworthy guideline recommendations - GRADE-ADOLOPMENT].
Guideline developers can: (1) adopt existing recommendations from others; (2) adapt existing recommendations to their own context; or (3) create recommendations de novo. Monetary and nonmonetary resources, credibility, maximization of uptake, as well as logical arguments should guide the choice of the approach and processes. ⋯ The "GRADE-ADOLOPMENT" approach to guideline production combines adoption, adaptation, and, as needed, de novo development of recommendations. If guideline developers apply EtD criteria more widely and make their work publically available, this approach should prove even more useful.
-
Z Evid Fortbild Qual Gesundhwes · May 2019
[Content validity of a culturally adapted checklist for self-assessment of critical incident reporting system audit teams in a Swiss university hospital].
Critical Incident Reporting Systems (CIRS) support the analysis of critical incidents and foster quality improvement in healthcare. The analysis of CIRS reports by designated CIRS teams enable organizational learning. To maintain a constructive work flow CIRS teams should be able to self-assess their work. We adapted the checklist used by the Dutch Healthcare Inspectorate to judge the quality of sentinel event analysis reports provided by hospitals. ⋯ The adapted checklist for self-assessment of the CIRS teams' work flow received good ratings for content validity but its usefulness for CIRS teams was found to be limited. The checklist may benefit from further development.
-
Z Evid Fortbild Qual Gesundhwes · Mar 2019
[GRADE: Evidence to Decision (EtD) frameworks - a systematic and transparent approach to making well informed healthcare choices. 2: Clinical guidelines].
Clinical guidelines are based on the best available evidence and produced systematically. In this context, the transparent presentation of the decision-making process from evidence to recommendation is indispensable. The Evidence to Decision (EtD) frameworks for clinical practice recommendations enables guideline panels to structure their approach and make it comprehensible. ⋯ These include the priority of the problem, benefits and harms, certainty of the evidence, importance of the outcome, balance, resource use, equity, acceptability and feasibility. To make a recommendation, a panel must consider the implication and importance of each of the above judgments. The EtD framework helps ensure consideration of key criteria that determine whether an intervention should be recommended and that judgments are informed by the best available evidence.
-
Z Evid Fortbild Qual Gesundhwes · Sep 2018
Review[Patient involvement in clinical practice guidelines is poor after 12 years of German guideline standards: A review of guideline methodologies].
As early as 1997, the German Guideline for Guidelines laid down patient participation in guideline development as the cornerstone of good, trustworthy medical guidelines. The German Guideline Assessment Tool (DELBI) published in 2005 requires patients or relatives to be involved in the development of medical guidelines. Ideally, this should be effected through membership in the author group. The Association of the Scientific Medical Societies in Germany (AWMF) recommends this approach for the so-called S3 guidelines (systematically developed guidelines) and S2k guidelines (consensus-based guidelines). The present study addresses the question of whether and to what extent German guideline publishers adhere to these principles of patient orientation. ⋯ A substantial gap remains between patient / public involvement standards for guideline development and practice in Germany, even 12 years after the publication of national guideline standards. This is a missed opportunity since guidelines without adequate participation of those affected by the recommendations have a problem of legitimacy and transparency. Only guidelines where patients were involved in all voting processes during development build and strengthen trust between patients and the medical profession. And only those who present the rationale for medical recommendations in a generally understandable and comprehensible manner let affected individuals make individual decisions.