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Using Clinical Trial Summary Results to Establish Quality Measures
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To the Editor: The Commentary by Drs Kent and Hayward1 about the limits of applying summary results of clinical trials to individual patients is very relevant in a practice climate in which physicians and hospitals are judged on quality clinical criteria. In 2001, the Department of Health and Human Services began the Quality Initiative, a program that was predicated on the premise that the quality of health care in the United States was lacking and could be improved.2 For example, the Hospital Quality Initiative (HQI), a component of the Quality Initiative, includes 20 hospital quality measures, one of which is β-blocker prescription at discharge for patients with acute myocardial infarction (AMI).2 The assumption behind HQI quality criteria is that patients who do not achieve these criteria are undertreated, and therefore quality medicine is not being practiced.
However, these quality measures, developed from clinical trials, are based on mean results. Kent . . . [Full Text of this Article]
Tracey L. Yap, BSN
yaptl@email.uc.edu
College of Nursing
University of Cincinnati
Cincinnati, Ohio
Winston Y. Yap, MD
Carroll County Memorial Hospital
Carrollton, Kentucky
RELATED LETTER
Using Clinical Trial Summary Results to Establish Quality Measures—Reply
Rodney Hayward and David M. Kent
JAMA. 2007;298(23):2741.
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RELATED ARTICLE
Limitations of Applying Summary Results of Clinical Trials to Individual Patients: The Need for Risk Stratification
David M. Kent and Rodney A. Hayward
JAMA. 2007;298(10):1209-1212.
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