TY - JOUR
T1 - Quality improvement in neurology
T2 - AAN epilepsy quality measures: Report of the quality measurement and reporting subcommittee of the American Academy of Neurology
AU - Fountain, N. B.
AU - Van Ness, P. C.
AU - Swain-Eng, R.
AU - Tonn, S.
AU - Bever, C. T.
N1 - Funding Information:
Dr. Fountain serves on the National Association of Epilepsy Centers Board of Directors; has received funding for travel from UCB; serves on the editorial board of Epilepsy Currents; estimates that 10% of his clinical effort at the University of Virginia EEG Lab is spent on EEG interpretation; and receives research support from UCB, Vertex Pharmaceuticals, Sepracor Inc., Medtronic, Inc., NeuroPace, Inc., and the NIH (R01 NS 058634-01A2m [Site PI] and U01 NS 053998 [Site PI]. Dr. Van Ness is a board member for the National Association of Epilepsy Centers; serves on scientific advisory boards for Cyberonics, Inc. and Lundbeck Inc.; serves on the editorial board of Archives of Neurology; estimates that 33% of his clinical effort at University of Texas Southwestern Medical Center is spent on epilepsy monitoring; and receives research support from UCB, NeuroPace, Inc., and Eisai Inc. R. Swain-Eng is a full-time employee of the American Academy of Neurology. S. Tonn is a full-time employee of the American Academy of Neurology (AAN) and served as project director for AAN grants from Pfizer Inc. and the CDC. Dr. Bever serves on the editorial board of the MS Quarterly Report; is listed as a coinventor on and receives royalties from Abraxis BioScience, Inc. for a pending patent re: Use of hematogenous stem cells in neuronal replacement therapy and gene delivery; receives royalties from the publication of Ambulatory Medicine, 7th ed (Lippincott Williams & Wilkins, 2006); and has received research support from the Department of Veterans Affairs and the National MS Society.
PY - 2011/1/4
Y1 - 2011/1/4
N2 - Objective: Epilepsy is a common neurologic condition with significant personal, societal, medical, and economic burdens. There are considerable gaps in the quality of care delivered. Measuring the quality of care delivered is the first step to its improvement. Performance measures are easily identified and quantitated ways to assess whether specific activities were carried out during a patient encounter. Therefore, epilepsy performance measures were derived through a standardized systematic process and may be the basis for pay-for-performance initiatives and maintenance of certification requirements. Methods: Epilepsy measures were developed through the American Medical Association-convened Physician Consortium for Performance Improvement (PCPI) independent measure development process, which marked the first time a medical specialty society followed this process. Guidelines, measures, and consensus papers reviewed for the period 1998 to 2008 using the National Guidelines Clearinghouse, the National Quality Measures Clearinghouse, PubMed, MEDLINE, and the Cochrane Library were evaluated using a framework to determine the acceptability of each guideline or other evidence review document for measures development. Recommendation statements based on level of evidence, importance, validity, and gap in care were developed into candidate measures. A panel of experts from representative organizations vetted the measures. A period of public comment was followed by approval from the American Academy of Neurology and the PCPI. Results: Literature search identified 160 relevant recommendation statements from 19 guidelines and 2 consensus papers. Systematic assessment resulted in 20 recommendation statements that were refined to 8 candidate measures by the expert panel. The measures are relevant to seizure type and frequency, etiology or epilepsy syndrome, EEG, neuroimaging, antiepileptic drug side effects, safety issues, referral for refractory epilepsy, and issues for women of childbearing potential. Conclusion: There is a reasonable evidence base, and consensus for, deriving performance measures for quality of epilepsy care. It is anticipated that implementation of these performance measures will improve care for patients with epilepsy if adopted by providers.
AB - Objective: Epilepsy is a common neurologic condition with significant personal, societal, medical, and economic burdens. There are considerable gaps in the quality of care delivered. Measuring the quality of care delivered is the first step to its improvement. Performance measures are easily identified and quantitated ways to assess whether specific activities were carried out during a patient encounter. Therefore, epilepsy performance measures were derived through a standardized systematic process and may be the basis for pay-for-performance initiatives and maintenance of certification requirements. Methods: Epilepsy measures were developed through the American Medical Association-convened Physician Consortium for Performance Improvement (PCPI) independent measure development process, which marked the first time a medical specialty society followed this process. Guidelines, measures, and consensus papers reviewed for the period 1998 to 2008 using the National Guidelines Clearinghouse, the National Quality Measures Clearinghouse, PubMed, MEDLINE, and the Cochrane Library were evaluated using a framework to determine the acceptability of each guideline or other evidence review document for measures development. Recommendation statements based on level of evidence, importance, validity, and gap in care were developed into candidate measures. A panel of experts from representative organizations vetted the measures. A period of public comment was followed by approval from the American Academy of Neurology and the PCPI. Results: Literature search identified 160 relevant recommendation statements from 19 guidelines and 2 consensus papers. Systematic assessment resulted in 20 recommendation statements that were refined to 8 candidate measures by the expert panel. The measures are relevant to seizure type and frequency, etiology or epilepsy syndrome, EEG, neuroimaging, antiepileptic drug side effects, safety issues, referral for refractory epilepsy, and issues for women of childbearing potential. Conclusion: There is a reasonable evidence base, and consensus for, deriving performance measures for quality of epilepsy care. It is anticipated that implementation of these performance measures will improve care for patients with epilepsy if adopted by providers.
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U2 - 10.1212/WNL.0b013e318203e9d1
DO - 10.1212/WNL.0b013e318203e9d1
M3 - Article
C2 - 21205698
AN - SCOPUS:78751616855
SN - 0028-3878
VL - 76
SP - 94
EP - 99
JO - Neurology
JF - Neurology
IS - 1
ER -