 |
|
Pitfalls of Converting Practice Guidelines Into Quality Measures—Reply
|
|
| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
|
|
|
In Reply: We agree with Dr Pawlson and colleagues and Drs Fleming and Petzel that using a random sample of patients will improve the CRC screening performance measure, and we are delighted that the VHA has made this change. However, we disagree that sample selection was the only problem needing correction. In our article we discussed the need for better measures that consider not only who received testing for CRC, but why it was done and whether the patient wanted it. Pawlson et al make several assumptions that diagnostic tests and refusals will be randomly distributed across samples from different facilities and therefore will not affect target rates (benchmarks). We believe these are tenuous and untested assumptions that require further research to determine whether they are true. Since VHA performs chart reviews, it has a unique opportunity to validate these assumptions.
In addition, both letters assume that higher screening rates . . . [Full Text of this Article]
Louise C. Walter, MD
louisew@itsa.ucsf.edu
Division of Geriatrics
VA Medical Center
Paul A. Heineken, MD;
Kenneth E. Covinsky, MD, MPH
San Francisco, Calif
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
RELATED ARTICLES
Cancer Screening in Elderly Patients: A Framework for Individualized Decision Making
and
JAMA. ;285():2750-2756.
FULL TEXT
Cervical Cancer Screening Among Women Without a Cervix
and
JAMA. ;291():2990-2993.
FULL TEXT
Pitfalls of Converting Practice Guidelines Into Quality Measures
, , and
JAMA. ;292():1301-1301.
FULL TEXT
Pitfalls of Converting Practice Guidelines Into Quality Measures
and
JAMA. ;292():1301-1302.
FULL TEXT
|
