Development of performance indicators for the primary care management of pediatric epilepsy: expert consensus
Deirdre A Caplin1, Jaya K Rao, Francis Filloux
1Department of Pediatrics, Division of General Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah 84132, USA. deirdre.caplin@hsc.utah.edu
Insights
This study developed 30 performance indicators for pediatric epilepsy care using expert consensus. These indicators cover diagnosis, treatment, and quality of life for children with epilepsy.
Area of Science:
- Pediatric Neurology
- Epilepsy Management
- Healthcare Quality Improvement
Background:
- Pediatric epilepsy requires standardized evaluation and management strategies.
- Existing guidelines may not fully address all aspects of care for children with epilepsy.
- Developing consensus-based performance indicators is crucial for improving care quality.
Purpose of the Study:
- To establish evidence-based performance indicators for the evaluation and management of pediatric epilepsy.
- To create a consensus-driven framework for assessing the quality of care in pediatric epilepsy.
Main Methods:
- A three-step process involving evidence compilation, advisory panel review, and a two-round Delphi process with international experts.
- Evidence tables were created, and a preliminary set of indicators was drafted by an advisory group.
- Experts rated indicators on a 5-point scale, with consensus defined by >80% agreement.
Main Results:
- Thirty performance indicators achieved positive consensus among experts.
- Indicators were categorized into diagnostic strategies/seizure classification (8), antiepileptic drug use (9), cognitive/behavioral issues (6), quality of life (6), and specialty referrals (3).
Conclusions:
- A set of 30 validated performance indicators for pediatric epilepsy care has been identified.
- Future research should correlate these indicators with clinical outcomes and healthcare utilization in pediatric epilepsy patients.
Purpose:
To use available evidence and expert consensus to develop performance indicators for the evaluation and management of pediatric epilepsy.
Methods:
We used a three-step process to develop the performance indicators. First, research findings were compiled into evidence tables focusing on different clinical issues. Second, an advisory panel of clinicians, educational and public health experts, and families of children with epilepsy reviewed the evidence. The advisory group used the evidence to draft a preliminary set of performance indicators for pediatric epilepsy management. Third, 13 internationally recognized experts in pediatric neurology or epilepsy rated the value of these indicators on a 5-point scale [1 (essential) to 5 (not necessary)] in a two-round Delphi process. Positive consensus was reached if >or=80% of experts gave an indicator a "1" rating and negative consensus if >80% gave an indicator a "5" rating. Indicators that achieved positive consensus during either round of the Delphi process constituted the final set of indicators.
Results:
Of the 68 draft performance indicators, the expert panel members achieved positive consensus on 30 performance indicators: eight indicators related to diagnostic strategies and seizure classification, nine related to antiepileptic drug use, six related to cognitive and behavioral issues, six related to quality of life, and three related to specialty referrals.
Conclusions:
We identified 30 potential indicators for evaluating the care provided to pediatric patients with epilepsy. The next step is to examine the relation of these performance indicators to clinical outcomes and health care utilization among pediatric patients with epilepsy.
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