Wording of questions for online Delphi panel to assess validity, feasibility, relevance, and likelihood of use in comparison to previously used panelist questions for quality indicator development.
| Variables | Previously Published Panelist Questions19 | Questions Modified and Reclassified for the Present Study |
|---|---|---|
| Validity | Consider the following*: (1) Is there adequate scientific evidence or professional consensus to support the indicator? (2) Are there identifiable health benefits to patients who receive care specified by the indicator? (3) Based on your professional experience, would you consider physicians with significantly higher rates of adherence to the indicator higher quality providers? (4) Are the majority of factors that determine adherence to the indicator under the control of the physician (or are they subject to influence by the physician)? | Scientific support for the candidate measure: How strong is the scientific evidence or professional consensus supporting this measure? (1 = very weak, 9 = very strong) Face validity of the candidate measure: How likely is it that better performance on the proposed measure indicates a higher quality health system? (1 = very unlikely, 9 = very likely) Control over the candidate measure: How well can the factors that determine performance on this measure be controlled at the health system level? (1 = very poorly, 9 = very well) |
| Feasibility | Consider the following*: (1) Is the information necessary to determine adherence possible to find in an average medical record (or is failure to document such information itself a marker of poor quality)? (2) Is the estimate of adherence to the indicator based on medical record data likely to be reliable and unbiased? | Likelihood of information availability: How likely is it that the information required to report this measure will be available in a typical Canadian health system? (1 = very unlikely, 2 = very likely) Reliability of the candidate measure: How likely is it that the measure, calculated based on the available data sources, will be reliable and unbiased? (1 = very unlikely, 9 = very likely) |
| Relevance | N/A | How relevant is the aspect of care covered by this measure to high quality care of patients with inflammatory arthritis? (1 = very irrelevant, 2 = very relevant) |
| Likelihood of Use | N/A | What is the likelihood that you would use, or encourage the use of, this measure for quality improvement in your health system? (1 = very unlikely, 2 = very likely) |
↵* Participants are asked to consider all of the questions described and to provide a single overall validity and feasibility rating on a scale of 1–9, where 1 = not valid or not feasible and 9 = definitely valid or definitely feasible. N/A: not applicable.