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Canadian Journal of Cardiology

An International Environmental Scan of Quality Indicators for Cardiovascular Care

  • Lusine Abrahamyan
    Affiliations
    Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
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  • Nicole Boom
    Affiliations
    Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
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  • Linda R. Donovan
    Affiliations
    Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
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  • Jack V. Tu
    Correspondence
    Corresponding author: Dr Jack V. Tu, Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue – G250, Toronto, Ontario M4N 3M5, Canada. Tel.: +1-416-480-4700; fax: +1-416-480-6048
    Affiliations
    Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada

    Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada

    Department of Medicine, University of Toronto, Toronto, Ontario, Canada

    Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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  • Canadian Cardiovascular Society Quality Indicators Steering Committee
    Author Footnotes
    ⁎ See Appendix I for a list of Quality Indicators Steering Committee members.
  • Author Footnotes
    ⁎ See Appendix I for a list of Quality Indicators Steering Committee members.
Published:December 12, 2011DOI:https://doi.org/10.1016/j.cjca.2011.09.019

      Abstract

      Quality indicators (QIs) are increasingly being used to measure and improve the quality of cardiac care. We conducted an international environmental scan to identify and critically appraise published QI development initiatives addressing cardiovascular disease (CVD). A review of the peer-reviewed and grey English-language literature was conducted to identify published CVD QI development initiatives. The quality of identified studies was assessed using a modified version of the Appraisal of Guidelines for Research and Evaluation (AGREE) II QI tool—an instrument originally developed for the assessment of the quality of clinical practice guidelines. An initial literature search identified 2314 potentially relevant abstracts of peer-reviewed articles. After a review of the abstracts, 120 full text articles were retrieved and reviewed. Of these, 20 articles and 1 peer-reviewed monograph were selected for critical appraisal (n = 21). Most of the initiatives were conducted in North America (76%) and were published after 2005 (62%). The majority (5 of 6) of the AGREE II QI domain scores were skewed toward higher values, including the median score for the ‘overall quality’ rating (83.3%). Of the CVD categories addressed within the 21 initiatives, heart failure was the most common (n = 10 QI indicator sets), followed by acute coronary syndromes (n = 8). Considerable variation was observed in the methods utilized and the degree of scientific rigour applied in the published international CVD QI development initiatives. Adoption of standardized methods could help improve the quality of QI development initiatives.

      Résumé

      Les indicateurs de la qualité (IQ) sont de plus en plus utilisés pour mesurer et améliorer la qualité des soins cardiaques. Nous avons mené une analyse environnementale internationale pour définir et évaluer de manière critique les publications sur les initiatives de développement des IQ portant sur la maladie cardiovasculaire (MCV). Une revue de la littérature grise anglophone examinée par des pairs a été menée pour définir les publications sur les initiatives de développement des IQ portant sur les MCV. La qualité de ces études a été évaluée en utilisant une version modifiée de l'outil d'IQ Appraisal of Guidelines for Research and Evaluation (AGREE) II – un instrument conçu au départ pour l'évaluation de la qualité des lignes directrices de la pratique clinique. Une recherche initiale de littérature a déterminé 2 314 résumés potentiellement pertinents d'articles examinés par des pairs. Après une revue des résumés, 120 articles en texte intégral ont été extraits et revus. Parmi ceux-ci, 20 articles et 1 monographie examinée par des pairs ont été sélectionnés pour une évaluation critique (n = 21). La plupart des initiatives ont été menées en Amérique du Nord (76 %) et ont été publiées après 2005 (62 %). La majorité (5 de 6) des scores du domaine des IQ de AGREE II ont été faussées par des valeurs plus élevées, incluant le score médian pour la notation de la « qualité globale » (83,3 %). Des catégories de MCV dont il est question dans les 21 initiatives, l'insuffisance cardiaque a été la plus fréquente (ensembles d'indicateurs IQ, n = 10), suivie par les syndromes coronariens aigus (n = 8). Une variation importante a été observée dans les méthodes utilisées et le degré de rigueur scientifique appliquée aux publications des initiatives internationales de développement des IQ portant sur la MCV. L'adoption de méthodes standardisées aiderait à améliorer la qualité des initiatives de développement des IQ.
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