How do German guideline-based performance measures in oncology contribute to evidence-based, patient-centred care?




Poster session 4 Saturday: Evidence implementation and evaluation


Saturday 16 September 2017 - 12:30 to 14:00


All authors in correct order:

Nothacker M1, Schmitt J2, Deckert S2, Neugebauer E3, Kopp I1, Steudtner M1
1 AWMF-Institute for Medical Knowledge Management, Germany
2 Center for Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany, Germany
3 Brandenburg Medical School Campus Neuruppin and Witten/Herdecke University, Germany
Presenting author and contact person

Presenting author:

Monika Nothacker

Contact person:

Abstract text
Background: The German Guideline Programme in Oncology, a joint initiative between the German Cancer Society, the Association of the Scientific Medical Societies in Germany and German Cancer Aid, supports the development of high-quality guidelines. To enhance implementation and evaluation, the suggestion of performance measures (PMs) derived from guideline recommendations is obligatory. PM teams are convened representing the multidisciplinary guideline development groups including clinical experts, methodologists and patient representatives as well as the organisations that take an active part in and share responsibility for documentation and quality improvement, i.e. clinical cancer registries and certified cancer centres. A standardised development process with 5 selection criteria i.a. relevance and clarity of definition is used.

Objectives: To review German guideline based PM in oncology and to evaluate potential for improvement concerning development process and reporting as part of a national research project.

Methods: Completing an earlier work (1), we extracted PM of 16 current guidelines (as to 8/16) and analysed them according to reporting criteria published 2016 (2) including i.a. development process, level of evidence (LoE) and measure appraisal. We further quantified and analysed outcome measures.

Results: Of 155 PM (7-13 per guideline), 144 were derived from strong recommendations,11 were based on other sources. 81 PM were classified as evidence based (46 x LoE 1). 74 PM were consensus based, mainly covering diagnostic interventions, with 17 PM citing literature not formally assessed. No psychometric test results (validity, reliability) or information on piloting were available. Of 11 PM measuring outcomes, 2 addressed patient reported outcomes and 2 used an international agreed definition.

Conclusions: The standardised process of PM development in oncology results in a high number of consensus based process PM. This shows the need for well justified recommendations. Examples will be presented. Piloting and validating of PM and the development of internationally agreed outcome PM were identified as further fields of improvement.