The development of quality indicators for systemic lupus erythematosus using electronic health data: A modified RAND appropriateness method

<b>Objective:</b> Quality indicators (QIs) are tools that standardize evaluations in terms of the minimum acceptable quality of care, presumably contributing for the better management of patients with systemic lupus erythematosus (SLE). This study aimed to develop QIs for SLE using electronic health data. <b>Methods:</b> The modified RAND/UCLA Appropriateness Method was used to develop the QIs. First, a literature review was conducted. Second, the candidate QI items that were available to be evaluated using the electronic health data were extracted. Third, the appropriateness of the items was assessed via rating rounds and panelists’ discussions. <b>Results:</b> We found 3621 articles in the initial search. Finally, 34 studies were reviewed, from which 17 potential indicators were extracted as candidate QIs. Twelve indicators were selected as the final QI set through the process of appropriateness. The median appropriateness of these 12 indicators was at least 7.5, and all of them were without disagreement. The QI included assessment of disease activity, treatment of SLE, drug toxicity monitoring, treatment of glucocorticoid complications, and assessment of SLE complications. <b>Conclusion:</b> We formulated 12 QIs for the assessment of patients with SLE based on electronic medical data. Our QI set would be a practical tool as a quality measure.

<b>研究目标：</b> 质量指标（Quality Indicators, QIs）是一类以最低可接受照护质量为基准开展标准化评估的工具，有望助力系统性红斑狼疮（Systemic Lupus Erythematosus, SLE）患者的优化管理。本研究旨在基于电子健康数据制定针对SLE的QIs。<b>研究方法：</b> 本研究采用改良RAND/UCLA适宜性方法制定QIs。具体实施步骤如下：首先开展文献综述；其次提取可通过电子健康数据进行评估的候选QIs条目；最后通过评分轮次与专家小组讨论完成各条目适宜性评估。<b>研究结果：</b> 初始文献检索共获取3621篇文献，最终纳入34篇进行综述，从中提取出17项潜在指标作为候选QIs。经适宜性评估流程，最终筛选出12项指标作为正式QIs集。该12项指标的适宜性中位数不低于7.5，且均无意见分歧。本次制定的QIs涵盖疾病活动度评估、SLE治疗、药物毒性监测、糖皮质激素并发症治疗以及SLE并发症评估五大类内容。<b>研究结论：</b> 本研究基于电子医疗数据制定了12项用于SLE患者评估的QIs，该指标集可作为实用的质量评估工具。