OBJECTIVES Tackling the harm associated with acute kidney injury (AKI) is a global priority. In England, a national computerised AKI algorithm is being introduced across the National Health Service (NHS) to drive this change. The study sought to maximise its clinical utility and minimise the potential for burden on clinicians and patients in primary care. DESIGN An appropriateness ratings eva...

BACKGROUND Health-care quality in primary care depends largely on the appropriateness of General Practitioners' (GPs; Primary Care or Family Physicians) decisions, which may be influenced by how difficult they perceive decisions to be. Patient scenarios (clinical or case vignettes) are widely used to investigate GPs' decision making. This review aimed to identify the extent to which perceived d...

Determining whether persons with multiple sclerosis (MS) receive appropriate, comprehensive healthcare requires tools for measuring quality. The objective of this study was to develop quality indicators for the care of persons with MS. We used a modified version of the RAND/UCLA Appropriateness Method in a two-stage process to identify relevant MS care domains and to assess the validity of indi...

OBJECTIVE: To develop guidelines for performing initial skeletal survey (SS) in children ,24 months old with fractures, based on available evidence and collective judgment of experts from diverse pediatric specialties. METHODS: Following the Rand/UCLA Method, a multispecialty panel of 13 experts applied evidence from a literature review combined with their own expertise in rating the appropriat...

T hese Appropriate Use Criteria (AUC) for the Management of Anterior Cruciate Ligament (ACL) Injuries are based on a review of the available literature regarding the treatment and prevention of ACL injuries as well as a list of clinical patient scenarios constructed by an expert Writing Panel and voted on by a separate multidisciplinary Voting Panel. The AUC development methods are adapted from...

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BACKGROUND Clinical guidelines provide systematically developed recommendations for deciding on appropriate health care options for specific conditions and clinical circumstances. Up until recently, patients and caregivers have rarely been included in the process of developing care guidelines. OBJECTIVE This project will develop and test a new online method for including patients and their ca...

OBJECTIVE To develop quality indicators to measure asthma care in primary health care. METHOD A modified RAND was used, which included the systematic review of the literature in Embase, Cochrane and Pubmed Quality Agencies and Database. The work group identified the indicators, translated them into Spanish and resolved any duplicates. Each indicator is composed of several dimensions (access t...

BACKGROUND AND PURPOSE In the 1980s, carotid endarterectomy was controversial because proof of efficacy was lacking, complication rates were high, and one third of cases were reported to be inappropriate. Since publication of several randomized controlled trials (RCTs), rates of carotid endarterectomy have doubled nationwide. This study assesses the appropriateness and use of carotid endarterec...