SynthesisBMC health services research2021
Guideline-based quality assurance: a conceptual framework for the definition of key elements.
Synthesis in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Improvement of Clinical Practice Guideline Appraisal by Human Experts and AI Agents by Using Structured Guidance: Systematic Review, Meta-Analysis, and Validation Study.Journal of medical Internet research · 2026Pooled it
- The GIN-McMaster guideline tool extension for the integration of quality improvement and quality assurance in guidelines: a description of the methods for its development.Journal of clinical epidemiology · 2023Pooled it
- Protocol for the Development of The Australian Motor Neurone Disease (MND) Guideline.Clinical and public health guidelines · 2026Article
- Evaluation of breast cancer screening programmes: Candidate performance indicators and their association with breast cancer mortality.Breast (Edinburgh, Scotland) · 2025Article
- Utilisation of a cocreation methodology to develop claims-based indicators for feedback on implementation of comparative effectiveness research results into practice.BMJ open quality · 2025Article
- Developing a set of emergency department performance measures to evaluate delirium care quality for older adults: a modified e-Delphi study.BMC emergency medicine · 2024Article
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 2017, the European Commission's Joint Research Centre (JRC) started developing a methodological framework for a guideline-based quality assurance (QA) scheme to improve cancer quality of care. During the first phase of the work, inconsistency emerged about the use of terminology for the definition, the conceptual underpinnings and the way QA relates to health questions that are answered in guidelines. The objective of this final of three articles is to propose a conceptual framework for an integrated approach to guideline and QA development and clarify terms and definitions for key elements. This work will inform the upcoming European Commission Initiative on Colorectal Cancer (ECICC).
methodsA multidisciplinary group of 23 experts from key organizations in the fields of guideline development, performance measurement and quality assurance participated in a mixed method approach including face-to-face dialogue and several rounds of virtual meetings. Informed by results of a systematic literature review that indicated absence of an existing framework and practical examples, we first identified the relations of key elements in guideline-based QA and then developed appropriate concepts and terminology to provide guidance.
resultsOur framework connects the three key concepts of quality indicators, performance measures and performance indicators integrated with guideline development. Quality indicators are constructs used as a guide to monitor, evaluate, and improve the quality of the structure, process and outcomes of healthcare services; performance measures are tools that quantify or describe measurable elements of practice performance; and performance indicators are quantifiable and measurable units or scores of practice, which should be guided by guideline recommendations.
conclusionsThe inconsistency in the way key terms of QA are used and defined has confused the field. Our conceptual framework defines the role, meaning and interactions of the key elements for improving quality in healthcare. It directly builds on the questions asked in guidelines and answered through recommendations. These findings will be applied in the forthcoming ECICC and for the future updates of ECIBC. These are large-scale integrated projects aimed at improving healthcare quality across Europe through the development of guideline-based QA schemes; this will help in implementing and improving our approach.
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Registered trials
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