ArticleBMJ health & care informatics2026
From quality indicator to quality measurement: design and implementation of an automated audit and feedback tool for chronic kidney disease in Belgian primary care.
Article in BMJ health & care informatics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo design and implement an automated audit and feedback (A&F) tool for Belgian Electronic Medical Record (EMR) systems to assess and improve the quality of primary care for chronic kidney disease (CKD).
methods36 quality indicators (QIs) for primary CKD care were translated into conjugations and queries programmable within EMR systems. In the development phase, executable queries were constructed, taking into account technical constraints and the reliability of available data. The Intego database, a Belgian general practice-based morbidity registration network and A&F implementation laboratory, was used to test the feasibility and pilot the intervention. Visual feedback dashboards were designed using SAS Enterprise Guide and SAS Visual Analytics.
resultsA final set of 80 queries that could be built into EMR systems was developed, allowing for an automated audit. The design of visual feedback and follow-up queries to make the feedback actionable was described. During the selection process 16 of the 36 indicators were excluded and 10 were adapted for the audit and/or feedback due to technical limitations or unreliable data. The final feedback included 14 indicators presented to clinicians through interactive dashboards. DISCUSSION: This study describes the design of an automated A&F tool to improve the quality of primary CKD care in Belgium. Challenges included data accuracy within EMRs, the variability in data completeness and limitations in EMR query functionality. Future improvements in EMR systems and coding practices, such as the implementation of the Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) and improving feedback accessibility, could enhance the effectiveness of the tool.
conclusionThis study provides building blocks for implementing automated A&F interventions in Belgian EMR systems to improve primary CKD care quality. These building blocks could be applied internationally after validating the QIs.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.