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Development of quality indicators for the diagnosis and management of achalasia.

Publication ,  Journal Article
Kamal, AN; Kathpalia, P; Otaki, F; Bredenoord, AJ; Castell, DO; Clarke, JO; Falk, GW; Fass, R; Prakash Gyawali, C; Kahrilas, PJ; Katz, PO ...
Published in: Neurogastroenterol Motil
October 2021

BACKGROUND: The management of achalasia has improved due to diagnostic and therapeutic innovations. However, variability in care delivery remains and no established measures defining quality of care for this population exist. We aimed to use formal methodology to establish quality indicators for achalasia patients. METHODS: Quality indicator concepts were identified from the literature, consensus guidelines and clinical experts. Using RAND/University of California, Los Angeles (UCLA) Appropriateness Method, experts in achalasia independently ranked proposed concepts in a two-round modified Delphi process based on 1) importance, 2) scientific acceptability, 3) usability, and 4) feasibility. Highly valid measures required strict agreement (≧ 80% of panelists) in the range of 7-9 for across all four categories. KEY RESULTS: There were 17 experts who rated 26 proposed quality indicator topics. In round one, 2 (8%) quality measures were rated valid. In round two, 19 measures were modified based on panel suggestions, and experts rated 10 (53%) of these measures as valid, resulting in a total of 12 quality indicators. Two measures pertained to patient education and five to diagnosis, including discussing treatment options with risk and benefits and using the most recent version of the Chicago Classification to define achalasia phenotypes, respectively. Other indicators pertained to treatment options, such as the use of botulinum toxin for those not considered surgical candidates and management of reflux following achalasia treatment. CONCLUSIONS & INFERENCES: Using a robust methodology, achalasia quality indicators were identified, which can form the basis for establishing quality gaps and generating fully specified quality measures.

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Published In

Neurogastroenterol Motil

DOI

EISSN

1365-2982

Publication Date

October 2021

Volume

33

Issue

10

Start / End Page

e14118

Location

England

Related Subject Headings

  • Quality Indicators, Health Care
  • Humans
  • Gastroesophageal Reflux
  • Gastroenterology & Hepatology
  • Esophageal Achalasia
  • Delivery of Health Care
  • Consensus
  • 3209 Neurosciences
  • 3208 Medical physiology
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kamal, A. N., Kathpalia, P., Otaki, F., Bredenoord, A. J., Castell, D. O., Clarke, J. O., … Leiman, D. A. (2021). Development of quality indicators for the diagnosis and management of achalasia. Neurogastroenterol Motil, 33(10), e14118. https://doi.org/10.1111/nmo.14118
Kamal, Afrin N., Priya Kathpalia, Fouad Otaki, Albert J. Bredenoord, Donald O. Castell, John O. Clarke, Gary W. Falk, et al. “Development of quality indicators for the diagnosis and management of achalasia.Neurogastroenterol Motil 33, no. 10 (October 2021): e14118. https://doi.org/10.1111/nmo.14118.
Kamal AN, Kathpalia P, Otaki F, Bredenoord AJ, Castell DO, Clarke JO, et al. Development of quality indicators for the diagnosis and management of achalasia. Neurogastroenterol Motil. 2021 Oct;33(10):e14118.
Kamal, Afrin N., et al. “Development of quality indicators for the diagnosis and management of achalasia.Neurogastroenterol Motil, vol. 33, no. 10, Oct. 2021, p. e14118. Pubmed, doi:10.1111/nmo.14118.
Kamal AN, Kathpalia P, Otaki F, Bredenoord AJ, Castell DO, Clarke JO, Falk GW, Fass R, Prakash Gyawali C, Kahrilas PJ, Katz PO, Katzka DA, Pandolfino JE, Penagini R, Richter JE, Roman S, Savarino E, Triadafilopoulos G, Vaezi MF, Vela MF, Leiman DA. Development of quality indicators for the diagnosis and management of achalasia. Neurogastroenterol Motil. 2021 Oct;33(10):e14118.
Journal cover image

Published In

Neurogastroenterol Motil

DOI

EISSN

1365-2982

Publication Date

October 2021

Volume

33

Issue

10

Start / End Page

e14118

Location

England

Related Subject Headings

  • Quality Indicators, Health Care
  • Humans
  • Gastroesophageal Reflux
  • Gastroenterology & Hepatology
  • Esophageal Achalasia
  • Delivery of Health Care
  • Consensus
  • 3209 Neurosciences
  • 3208 Medical physiology
  • 3202 Clinical sciences