Abstract
Ideas and OpinionsMay 2022Integrating Quality Assurance and Quality Improvement With Guidelines: Systematic Stakeholder-Driven Development of an Extension of the Guidelines International Network–McMaster Guideline Development ChecklistThomas Piggott, MD, MSc, Miranda W. Langendam, PhD, Elena Parmelli, PhD, Jan Adolfsson, MD, PhD, Elie A. Akl, MD, MPH, PhD, David Armstrong, MA, MB BChir, Jeffrey Braithwaite, PhD, Romina Brignardello-Petersen, DDS, MSc, PhD, Jan Brozek, MD, PhD, Markus Follmann, MD, MPH, MSc, Ina Kopp, MD, Joerg J. Meerpohl, MD, Luciana Neamtiu, PhD, Monika Nothacker, MD, MPH, Amir Qaseem, MD, PhD, MHA, Paolo Giorgi Rossi, PhD, Zuleika Saz-Parkinson, PhD, MS, Philip J. van der Wees, PhD, and Holger J. Schünemann, MD, PhD, MScThomas Piggott, MD, MScDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada (T.P., R.B., J.B.)Search for more papers by this author, Miranda W. Langendam, PhDDepartment of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands (M.W.L.)Search for more papers by this author, Elena Parmelli, PhDEuropean Commission, Joint Research Centre (JRC), Ispra, Italy (E.P., L.N., Z.S.)Search for more papers by this author, Jan Adolfsson, MD, PhDSwedish Agency for Health Technology Assessment and Assessment of Social Services, and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (J.A.)Search for more papers by this author, Elie A. Akl, MD, MPH, PhDDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada, and American University of Beirut, Beirut, Lebanon (E.A.A.)Search for more papers by this author, David Armstrong, MA, MB BChirFarncombe Family Digestive Health Research Institute and Department of Medicine, McMaster University, Hamilton, Ontario, Canada (D.A.)Search for more papers by this author, Jeffrey Braithwaite, PhDAustralian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia (J.B.)Search for more papers by this author, Romina Brignardello-Petersen, DDS, MSc, PhDDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada (T.P., R.B., J.B.)Search for more papers by this author, Jan Brozek, MD, PhDDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada (T.P., R.B., J.B.)Search for more papers by this author, Markus Follmann, MD, MPH, MScGerman Cancer Society, Berlin, Germany (M.F.)Search for more papers by this author, Ina Kopp, MDInstitute for Medical Knowledge Management, Association of the Scientific Medical Societies, Philipps-University, Marburg, Germany (I.K., M.N.)Search for more papers by this author, Joerg J. Meerpohl, MDInstitute for Evidence in Medicine, Medical Center and Faculty of Medicine, University of Freiburg, and Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany (J.J.M.)Search for more papers by this author, Luciana Neamtiu, PhDEuropean Commission, Joint Research Centre (JRC), Ispra, Italy (E.P., L.N., Z.S.)Search for more papers by this author, Monika Nothacker, MD, MPHInstitute for Medical Knowledge Management, Association of the Scientific Medical Societies, Philipps-University, Marburg, Germany (I.K., M.N.)Search for more papers by this author, Amir Qaseem, MD, PhD, MHAAmerican College of Physicians, Philadelphia, Pennsylvania (A.Q.)Search for more papers by this author, Paolo Giorgi Rossi, PhDEpidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy (P.G.R.)Search for more papers by this author, Zuleika Saz-Parkinson, PhD, MSEuropean Commission, Joint Research Centre (JRC), Ispra, Italy (E.P., L.N., Z.S.)Search for more papers by this author, Philip J. van der Wees, PhDRadboud University Medical Center, Department of IQ Healthcare and Rehabilitation, Nijmegen, the Netherlands (P.J.V.)Search for more papers by this author, and Holger J. Schünemann, MD, PhD, MScDepartment of Health Research Methods, Evidence, and Impact and Department of Medicine, McMaster University, Hamilton, Ontario, Canada, Institute for Evidence in Medicine, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany, and Dipartimento di Scienze Biomediche, Humanitas University, Milan, Italy (H.J.S.).Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M21-3977 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Practice guidelines and quality assurance and improvement (QAI) schemes are 2 sides of the same coin for improving health outcomes (1). One frequently cited set of characteristics specifies that a good quality indicator should be relevant, understandable, measurable, behaviorable, and achievable (the RUMBA rule) (2). However, we suggest that the characteristics of candidate quality indicators should include the following: 1) certainty, also known as scientific soundness (high-certainty evidence supporting selection is at low risk of bias, precise, direct, relevant, consistent, and without publication bias); 2) responsiveness or sensitivity to change; and 3) feasibility to measure, implement, and monitor. Thus, an ...
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