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Systemic Lupus Erythematosus
A quality indicator set for systemic lupus erythematosus
Article first published online: 26 FEB 2009
Copyright © 2009 by the American College of Rheumatology
Arthritis Care & Research
Volume 61, Issue 3, pages 370–377, 15 March 2009
How to Cite
Yazdany, J., Panopalis, P., Gillis, J. Z., Schmajuk, G., MacLean, C. H., Wofsy, D., Yelin, E. and Systemic Lupus Erythematosus Quality Indicators Project Expert Panels (2009), A quality indicator set for systemic lupus erythematosus. Arthritis & Rheumatism, 61: 370–377. doi: 10.1002/art.24356
- Issue published online: 26 FEB 2009
- Article first published online: 26 FEB 2009
- Manuscript Accepted: 4 DEC 2008
- Manuscript Received: 6 SEP 2008
- Arthritis Foundation
- American College of Rheumatology Research and Education Foundation
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. Grant Number: P60-AR-053308
- Rosalind Russell Medical Research Center for Arthritis at the University of California, San Francisco
To systematically develop a quality indicator (QI) set for systemic lupus erythematosus (SLE).
We used a validated process that combined available scientific evidence and expert consensus to develop a QI set for SLE. We extracted 20 candidate indicators from a systematic literature review of clinical practice guidelines pertaining to SLE. An advisory panel revised and augmented these candidate indicators and, through 2 rounds of voting, arrived at 25 QIs. These QIs advanced to the next phase of the project, in which we employed a modification of the RAND/UCLA Appropriateness Method. A systematic review of the literature was performed for each QI, linking the proposed process of care to potential improved health outcomes. After reviewing this scientific evidence, a second interdisciplinary expert panel convened to discuss the evidence and provide final ratings on the validity and feasibility of each QI.
The final expert panel rated 20 QIs as both valid and feasible. Areas covered included diagnosis, general preventive strategies (e.g., vaccinations, sun avoidance counseling, and screening for cardiovascular disease), osteoporosis prevention and treatment, drug toxicity monitoring, renal disease, and reproductive health.
We employed a rigorous multistep approach with systematic literature reviews and 2 expert panels to develop QIs for SLE. This new set of indicators provides an opportunity to assess health care quality in patients with SLE and represents an initial step toward the important goal of improving care in this patient population.