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David Aron, MD, MS; Leonard Pogach, MD, MBA

JAMA. 2009;301(2):210-212.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Regardless of the direction US health care reform takes, performance measurement, public reporting, and accountability will play major roles. Presently, a number of entities have staked out business models for developing, collecting, and disseminating operational data about performance at the hospital, health plan, and clinician levels. Critical to such a system are valid measures that permit fair comparisons. Indeed, generalization of randomized controlled trials to larger populations for performance measurement is a complex process that invariably involves judgment of the health benefit of the proposed measure as well as technical issues. Such factors include importance, scientific evidence, reproducibility, validity, precision, specification (including inclusion and exclusion criteria for the measure denominator), and feasibility in practice. The validity of methods measurement development, and adoption must be transparent. Transparency has been defined as "a process by which information about existing conditions, decisions and actions is . . . [Full Text of this Article]

Author Affiliations: Louis Stokes Cleveland Department of Veterans Affairs Medical Center and Case Western Reserve University, Cleveland, Ohio (Dr Aron); and New Jersey Veterans Health Administration Healthcare System, East Orange, and University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark (Dr Pogach).

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