title: Pulmonary function outcomes for assessing cystic fibrosis care.
abstract: BACKGROUND
  Assessing cystic fibrosis (CF) patient quality of care requires the choice of an appropriate outcome measure. We looked systematically and in detail at pulmonary function outcomes that potentially reflect clinical practice patterns.
  
  
  METHODS
  Epidemiologic Study of Cystic Fibrosis data were used to evaluate six potential outcome variables (2002 best FVC, FEV(1), and FEF(25-75) and rate of decline for each from 2000 to 2002). We ranked CF care sites by outcome measure and then assessed any association with practice patterns and follow-up pulmonary function.
  
  
  RESULTS
  Sites ranked in the top quartile had more frequent monitoring, treatment of exacerbations, and use of chronic therapies and oral corticosteroids. The follow-up rate of pulmonary function decline was not predicted by site ranking.
  
  
  CONCLUSIONS
  Different pulmonary function outcomes associate slightly differently with practice patterns, although annual FEV(1) is at least as good as any other measure. Current site ranking only moderately predicts future ranking.
authors.affiliation: University of Colorado Denver School of Medicine, Aurora, CO, United States. Electronic address: jeff.wagener@ucdenver.edu.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Wagener
authors.affiliation: ICON Clinical Research, San Francisco, CA, United States.
authors.forename: Eric P
authors.initials: EP
authors.lastname: Elkin
authors.affiliation: ICON Clinical Research, San Francisco, CA, United States.
authors.forename: David J
authors.initials: DJ
authors.lastname: Pasta
authors.affiliation: Virginia Commonwealth University Medical School, Richmond, VA, United States.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Schechter
authors.affiliation: Case Western Reserve University School of Medicine and Rainbow Babies and Children's Hospital, Cleveland, OH, United States.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Konstan
authors.affiliation: University of Arizona, Tucson, AZ, United States.
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: Morgan
mesh_terms: D000293:Adolescent; D002648:Child; D003422:Critical Care / Q000379:methods*; D003550:Cystic Fibrosis / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology*; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D009017:Morbidity / Q000639:trends; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
keywords: Benchmarking; Clinical care; Cystic fibrosis; Lung function; Outcomes