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Evaluation of guideline quality using GEM-Q.

A Agrawal1, R N Shiffman

  • 1Yale Center for Medical Informatics, New Haven, CT, USA. abha.agrawal@yale.edu

Studies in Health Technology and Informatics
|October 18, 2001
PubMed
Summary

Automated evaluation of clinical practice guideline quality is feasible. A new application, GEM-Q, automates quality assessment using the Guidelines Quality Assessment Questionnaire (GQAQ), demonstrating reliable results comparable to expert evaluations.

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Area of Science:

  • Health Services Research
  • Medical Informatics

Background:

  • Numerous instruments exist for evaluating practice guideline quality, but manual application is often burdensome.
  • The Guidelines Quality Assessment Questionnaire (GQAQ) and Appraisal Instrument for Clinical Guidelines (AICG) are validated, comprehensive tools, with AICG offering broader scope including implementability.

Purpose of the Study:

  • To develop and test GEM-Q, a Guideline Elements Model (GEM)-derived application designed for automated quality assessment of clinical practice guidelines.
  • To assess the reliability and feasibility of automated guideline quality evaluation using GEM-Q.

Main Methods:

  • A literature review identified GQAQ and AICG as suitable instruments for guideline quality evaluation.
  • GEM-Q was developed by mapping GQAQ items to the GEM hierarchy and creating a custom XSL stylesheet.

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  • GEM-Q selectively extracts relevant text for quality assessment and presents results in HTML format.

    • Main Results:

    • GEM-Q was applied to six guidelines, categorizing them as "good" (2), "intermediate" (2), or "poor" (2) quality.
    • The automated rankings by GEM-Q consistently matched expert evaluations based on the GQAQ.
    • This demonstrates the reliability and effectiveness of the automated approach.

    Conclusions:

    • Automated evaluation of clinical practice guideline quality is a feasible and reliable method.
    • GEM-Q offers a practical solution to streamline the assessment of guideline quality, saving time and resources.
    • Further development could enhance the efficiency and scope of automated guideline appraisal.