Development of review criteria for assessing the quality of management of stable angina, adult asthma, and non-insulin dependent diabetes mellitus in general practice.
OBJECTIVE
To develop review criteria to assess the quality of care for three major chronic diseases: adult asthma, stable angina, and non-insulin dependent diabetes mellitus.


METHODS
Modified panel process based upon the RAND/UCLA (University College of Los Angeles) appropriateness method. Three multiprofessional panels made up of general practitioners, hospital specialists, and practice nurses.


RESULTS
The RAND/UCLA appropriateness method of augmenting evidence with expert opinion was used to develop criteria for the care of the three conditions. Of those aspects of care which were rated as necessary by the panels, only 26% (16% asthma, 10% non-insulin dependent diabetes, 40% angina) were subsequently rated by the panels as being based on strong scientific evidence.


CONCLUSIONS
The results show the importance of a systematic approach to combining evidence with expert opinion to develop review criteria for assessing the quality of three chronic diseases in general practice. The evidence base for the criteria was often incomplete, and explicit methods need to be used to combine evidence with expert opinion where evidence is not available.
Campbell
S M
SM
National Primary Care Research and Development Centre, University of Manchester, UK. stephen.campbell@man.ac.uk
Roland
M O
MO
Shekelle
P G
PG
Cantrill
J A
JA
Buetow
S A
SA
Cragg
D K
DK
D000328:Adult; D000787:Angina Pectoris / Q000628:therapy*; D001249:Asthma / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D019317:Evidence-Based Medicine; D005194:Family Practice / Q000592:standards*; D006300:Health Services Misuse; D006801:Humans; D018024:Peer Review, Health Care; D011785:Quality Assurance, Health Care / Q000379:methods*; D019984:Quality Indicators, Health Care; D019564:Unnecessary Procedures