title: Development of quality indicators for an integrated approach of knee osteoarthritis.
abstract: OBJECTIVE
  Osteoarthritis (OA) is a common cause of disability worldwide. Knee OA care is often suboptimal. A first necessary step in quality improvement is to gain a clear insight into usual care. We developed a set of evidence-based quality indicators for multidisciplinary high-quality knee OA care.
  
  
  METHODS
  A Rand-modified Delphi method was used to develop quality indicators for knee OA diagnosis, therapy, and followup. Recommendations were extracted from international guidelines as well as existing sets of quality indicators and scored by a multidisciplinary expert panel. Based on median score, prioritization, and agreement, recommendations were labeled as having a high, uncertain, or low potential to measure quality of care and were discussed in a consensus meeting for inclusion or exclusion. Two final validation rounds yielded a core set of recommendations, which were translated into quality indicators.
  
  
  RESULTS
  From a total of 86 recommendations and existing indicators, a core set of 29 recommendations was derived that allowed us to define high-quality knee OA care. From this core set, 22 recommendations were considered to be measurable in clinical practice and were transformed into a final set of 21 quality indicators regarding diagnosis, lifestyle/education/devices, therapy, and followup.
  
  
  CONCLUSIONS
  Our study provides a robust set of 21 quality indicators for high-quality knee OA care, measurable in clinical practice. These process indicators may be used to measure usual care and evaluate quality improvement interventions across the entire spectrum of disciplines involved in knee OA care.
authors.affiliation: From the Academic Center for General Practice, KU Leuven, Leuven; Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium; IQ Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Division of Orthopedics and Traumatology, Department of Development and Regeneration, University Hospitals Leuven; Physical Medicine and Rehabilitation, University Hospitals Leuven, Pellenberg; and Department of Rehabilitation Sciences, KU Leuven, Heverlee, Belgium. lies.grypdonck@med.kuleuven.be.
authors.forename: Lies
authors.initials: L
authors.lastname: Grypdonck
authors.affiliation: From the Academic Center for General Practice, KU Leuven, Leuven; Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium; IQ Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Division of Orthopedics and Traumatology, Department of Development and Regeneration, University Hospitals Leuven; Physical Medicine and Rehabilitation, University Hospitals Leuven, Pellenberg; and Department of Rehabilitation Sciences, KU Leuven, Heverlee, Belgium.
authors.forename: Bert
authors.initials: B
authors.lastname: Aertgeerts
authors.affiliation: From the Academic Center for General Practice, KU Leuven, Leuven; Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium; IQ Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Division of Orthopedics and Traumatology, Department of Development and Regeneration, University Hospitals Leuven; Physical Medicine and Rehabilitation, University Hospitals Leuven, Pellenberg; and Department of Rehabilitation Sciences, KU Leuven, Heverlee, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Luyten
authors.affiliation: From the Academic Center for General Practice, KU Leuven, Leuven; Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium; IQ Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Division of Orthopedics and Traumatology, Department of Development and Regeneration, University Hospitals Leuven; Physical Medicine and Rehabilitation, University Hospitals Leuven, Pellenberg; and Department of Rehabilitation Sciences, KU Leuven, Heverlee, Belgium.
authors.forename: Hub
authors.initials: H
authors.lastname: Wollersheim
authors.affiliation: From the Academic Center for General Practice, KU Leuven, Leuven; Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium; IQ Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Division of Orthopedics and Traumatology, Department of Development and Regeneration, University Hospitals Leuven; Physical Medicine and Rehabilitation, University Hospitals Leuven, Pellenberg; and Department of Rehabilitation Sciences, KU Leuven, Heverlee, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Bellemans
authors.affiliation: From the Academic Center for General Practice, KU Leuven, Leuven; Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium; IQ Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Division of Orthopedics and Traumatology, Department of Development and Regeneration, University Hospitals Leuven; Physical Medicine and Rehabilitation, University Hospitals Leuven, Pellenberg; and Department of Rehabilitation Sciences, KU Leuven, Heverlee, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Peers
authors.affiliation: From the Academic Center for General Practice, KU Leuven, Leuven; Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium; IQ Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Division of Orthopedics and Traumatology, Department of Development and Regeneration, University Hospitals Leuven; Physical Medicine and Rehabilitation, University Hospitals Leuven, Pellenberg; and Department of Rehabilitation Sciences, KU Leuven, Heverlee, Belgium.
authors.forename: Sabine
authors.initials: S
authors.lastname: Verschueren
authors.affiliation: From the Academic Center for General Practice, KU Leuven, Leuven; Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium; IQ Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Division of Orthopedics and Traumatology, Department of Development and Regeneration, University Hospitals Leuven; Physical Medicine and Rehabilitation, University Hospitals Leuven, Pellenberg; and Department of Rehabilitation Sciences, KU Leuven, Heverlee, Belgium.
authors.forename: Patrik
authors.initials: P
authors.lastname: Vankrunkelsven
authors.affiliation: From the Academic Center for General Practice, KU Leuven, Leuven; Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium; IQ Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Division of Orthopedics and Traumatology, Department of Development and Regeneration, University Hospitals Leuven; Physical Medicine and Rehabilitation, University Hospitals Leuven, Pellenberg; and Department of Rehabilitation Sciences, KU Leuven, Heverlee, Belgium.
authors.forename: Rosella
authors.initials: R
authors.lastname: Hermens
mesh_terms: D003697:Delphi Technique; D019317:Evidence-Based Medicine; D006801:Humans; D020370:Osteoarthritis, Knee / Q000628:therapy*; D019984:Quality Indicators, Health Care
keywords: EVIDENCE-BASED PRACTICE; KNEE OSTEOARTHRITIS; QUALITY INDICATORS; QUALITY OF CARE