title: Measuring physicians' performance in clinical practice: reliability, classification accuracy, and validity.
abstract: Much research has been devoted to addressing challenges in achieving reliable assessments of physicians' clinical performance but less work has focused on whether valid and accurate classification decisions are feasible. This study used 957 physicians certified in internal medicine (IM) or a subspecialty, who completed the American Board of Internal Medicine (ABIM) Diabetes Practice Improvement Module (PIM). Ten clinical and two patient-experience measures were aggregated into a composite measure. The composite measure score was highly reliable (r = .91) and classification accuracy was high across the entire score scale (>0.90), which indicated that it is possible to differentiate high-performing and low-performing physicians. Physicians certified in endocrinology and those who scored higher on their IM certification examination had higher composite scores, providing some validity evidence. In summary, it is feasible to create a psychometrically robust composite measure of physicians' clinical performance, specifically for the quality of care they provide to patients with diabetes.
authors.affiliation: American Board of Internal Medicine, Philadelphia, PA 19106, USA. wweng@abim.org
authors.lastname: Weifeng Weng
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Hess
authors.forename: Lorna A
authors.initials: LA
authors.lastname: Lynn
authors.forename: Eric S
authors.initials: ES
authors.lastname: Holmboe
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Lipner
mesh_terms: D000328:Adult; D000368:Aged; D008078:Cholesterol, LDL; D002983:Clinical Competence / Q000592:standards / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D004526:Efficiency; D017598:Efficiency, Organizational; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000592:standards / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011787:Quality of Health Care; D015203:Reproducibility of Results; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D013647:Task Performance and Analysis; D055815:Young Adult
chemical_list: D008078:Cholesterol, LDL