A quality indicator set for systemic lupus erythematosus.
OBJECTIVE
To systematically develop a quality indicator (QI) set for systemic lupus erythematosus (SLE).


METHODS
We used a validated process that combined available scientific evidence and expert consensus to develop a QI set for SLE. We extracted 20 candidate indicators from a systematic literature review of clinical practice guidelines pertaining to SLE. An advisory panel revised and augmented these candidate indicators and, through 2 rounds of voting, arrived at 25 QIs. These QIs advanced to the next phase of the project, in which we employed a modification of the RAND/UCLA Appropriateness Method. A systematic review of the literature was performed for each QI, linking the proposed process of care to potential improved health outcomes. After reviewing this scientific evidence, a second interdisciplinary expert panel convened to discuss the evidence and provide final ratings on the validity and feasibility of each QI.


RESULTS
The final expert panel rated 20 QIs as both valid and feasible. Areas covered included diagnosis, general preventive strategies (e.g., vaccinations, sun avoidance counseling, and screening for cardiovascular disease), osteoporosis prevention and treatment, drug toxicity monitoring, renal disease, and reproductive health.


CONCLUSIONS
We employed a rigorous multistep approach with systematic literature reviews and 2 expert panels to develop QIs for SLE. This new set of indicators provides an opportunity to assess health care quality in patients with SLE and represents an initial step toward the important goal of improving care in this patient population.
Yazdany
Jinoos
J
Rosalind Russell Medical Research Center for Arthritis, University of California, San Francisco, CA 94143-0920, USA. jinoos.yazdany@ucsf.edu
Panopalis
Pantelis
P
Gillis
Joann Zell
JZ
Schmajuk
Gabriela
G
MacLean
Catherine H
CH
Wofsy
David
D
Yelin
Edward
E
D018501:Antirheumatic Agents / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000628:therapy*; D019984:Quality Indicators, Health Care; D011795:Surveys and Questionnaires
D018501:Antirheumatic Agents