TY - JOUR
T1 - Development of American College of Rheumatology Quality Measures for Systemic Lupus Erythematosus
T2 - A Modified Delphi Process With Rheumatology Informatics System for Effectiveness (RISE) Registry Data Review
AU - Bartels, Christie M.
AU - Jorge, April
AU - Feldman, Candace H.
AU - Zell, Jo Ann
AU - Bermas, Bonnie
AU - Barber, Claire E.H.
AU - Duarte-García, Alí
AU - Garg, Shivani
AU - Haseley, Leah
AU - Jatwani, Shraddha
AU - Johansson, Tracy
AU - Limanni, Alex
AU - Rodgers, Wendy
AU - Rovin, Brad H.
AU - Santiago-Casas, Yesenia
AU - Suter, Lisa G.
AU - Barnado, April
AU - Ude, Jennifer
AU - Aguirre, Alfredo
AU - Li, Jing
AU - Schmajuk, Gabriela
AU - Yazdany, Jinoos
N1 - Publisher Copyright:
© 2023 The Authors. Arthritis Care & Research published by Wiley Periodicals LLC on behalf of American College of Rheumatology.
PY - 2023/11
Y1 - 2023/11
N2 - Objective: We aimed to develop readily measurable digital quality measure statements for clinical care in systemic lupus erythematosus (SLE) using a multistep process guided by consensus methods. Methods: Using a modified Delphi process, an American College of Rheumatology (ACR) workgroup of SLE experts reviewed all North American and European guidelines from 2000 to 2020 on treatment, monitoring, and phenotyping of patients with lupus. Workgroup members extracted quality constructs from guidelines, rated these by importance and feasibility, and generated evidence-based quality measure statements. The ACR Rheumatology Informatics System for Effectiveness (RISE) Registry was queried for measurement data availability. In 3 consecutive Delphi sessions, a multidisciplinary Delphi panel voted on the importance and feasibility of each statement. Proposed measures with consensus on feasibility and importance were ranked to identify the top 3 measures. Results: Review of guidelines and distillation of 57 quality constructs resulted in 15 quality measure statements. Among these, 5 met high consensus for importance and feasibility, including 2 on treatment and 3 on laboratory monitoring measures. The 3 highest-ranked statements were recommended for further measure specification as SLE digital quality measures: 1) hydroxychloroquine use, 2) limiting glucocorticoid use >7.5 mg/day to <6 months, and 3) end-organ monitoring of kidney function and urine protein excretion at least every 6 months. Conclusion: The Delphi process selected 3 quality measures for SLE care on hydroxychloroquine, glucocorticoid reduction, and kidney monitoring. Next, measures will undergo specification and validity testing in RISE and US rheumatology practices as the foundation for national implementation and use in quality improvement programs. (Figure presented.).
AB - Objective: We aimed to develop readily measurable digital quality measure statements for clinical care in systemic lupus erythematosus (SLE) using a multistep process guided by consensus methods. Methods: Using a modified Delphi process, an American College of Rheumatology (ACR) workgroup of SLE experts reviewed all North American and European guidelines from 2000 to 2020 on treatment, monitoring, and phenotyping of patients with lupus. Workgroup members extracted quality constructs from guidelines, rated these by importance and feasibility, and generated evidence-based quality measure statements. The ACR Rheumatology Informatics System for Effectiveness (RISE) Registry was queried for measurement data availability. In 3 consecutive Delphi sessions, a multidisciplinary Delphi panel voted on the importance and feasibility of each statement. Proposed measures with consensus on feasibility and importance were ranked to identify the top 3 measures. Results: Review of guidelines and distillation of 57 quality constructs resulted in 15 quality measure statements. Among these, 5 met high consensus for importance and feasibility, including 2 on treatment and 3 on laboratory monitoring measures. The 3 highest-ranked statements were recommended for further measure specification as SLE digital quality measures: 1) hydroxychloroquine use, 2) limiting glucocorticoid use >7.5 mg/day to <6 months, and 3) end-organ monitoring of kidney function and urine protein excretion at least every 6 months. Conclusion: The Delphi process selected 3 quality measures for SLE care on hydroxychloroquine, glucocorticoid reduction, and kidney monitoring. Next, measures will undergo specification and validity testing in RISE and US rheumatology practices as the foundation for national implementation and use in quality improvement programs. (Figure presented.).
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U2 - 10.1002/acr.25143
DO - 10.1002/acr.25143
M3 - Article
C2 - 37165898
AN - SCOPUS:85162050503
SN - 2151-464X
VL - 75
SP - 2295
EP - 2305
JO - Arthritis Care and Research
JF - Arthritis Care and Research
IS - 11
ER -