Related Experiment Video
Updated: Jan 31, 2026

Use of Capillary Aerosol Generator in Continuous Production of Controlled Aerosol for Non-Clinical Studies
Published on: April 12, 2022
Clinical indicators for common paediatric conditions: Processes, provenance and products of the CareTrack Kids study
Louise K Wiles1,2,3, Tamara D Hooper1,2,3, Peter D Hibbert1,2,3,4,5,6
1Australian Centre for Precision Health, School of Health Sciences, Cancer Research Institute, University of South Australia, Adelaide, South Australia, Australia.
Insights
This study developed clinical indicators to assess appropriate paediatric care in Australia. The final set of 234 indicators helps measure healthcare quality for children across various settings.
Area of Science:
- Healthcare Quality Improvement
- Clinical Practice Guidelines
- Paediatric Medicine
Background:
- Assessing the appropriateness of paediatric care in Australia is crucial for evidence-based practice.
- Clinical practice guidelines (CPGs) provide a foundation for defining appropriate care standards.
Purpose of the Study:
- To develop a comprehensive set of clinical indicators for evaluating the appropriateness of care for 21 common paediatric medical conditions in Australia.
- To establish a framework for measuring healthcare quality in paediatric settings.
Main Methods:
- Systematic extraction of recommendations from 121 national and international guidelines.
- Development and refinement of clinical indicators using a modified Delphi process and a collaborative online wiki involving 61 experts.
- Focus on indicators for under-use of healthcare services, with feasibility as a key selection criterion.
Main Results:
- A final set of 234 appropriateness indicators was developed, yielding 597 items for medical record audit.
- The majority of indicators (92%) focused on capturing under-use of care.
- Indicators were designed for diverse healthcare settings including emergency departments, hospitals, and general practices.
Conclusions:
- A robust set of clinical indicators for paediatric care appropriateness was successfully developed in the Australian healthcare context.
- The methodology, employing Delphi and wiki approaches, offers utility for creating consensus-based indicators.
- The finalized indicators provide a practical tool for clinicians and organizations to audit and improve paediatric healthcare quality.
Background:
In order to determine the extent to which care delivered to children is appropriate (in line with evidence-based care and/or clinical practice guidelines (CPGs)) in Australia, we developed a set of clinical indicators for 21 common paediatric medical conditions for use across a range of primary, secondary and tertiary healthcare practice facilities.
Methods:
Clinical indicators were extracted from recommendations found through systematic searches of national and international guidelines, and formatted with explicit criteria for inclusion, exclusion, time frame and setting. Experts reviewed the indicators using a multi-round modified Delphi process and collaborative online wiki to develop consensus on what constituted appropriate care.
Results:
From 121 clinical practice guidelines, 1098 recommendations were used to draft 451 proposed appropriateness indicators. In total, 61 experts (n = 24 internal reviewers, n = 37 external reviewers) reviewed these indicators over 40 weeks. A final set of 234 indicators resulted, from which 597 indicator items were derived suitable for medical record audit. Most indicator items were geared towards capturing information about under-use in healthcare (n = 551, 92%) across emergency department (n = 457, 77%), hospital (n = 450, 75%) and general practice (n = 434, 73%) healthcare facilities, and based on consensus level recommendations (n = 451, 76%). The main reason for rejecting indicators was 'feasibility' (likely to be able to be used for determining compliance with 'appropriate care' from medical record audit).
Conclusion:
A set of indicators was developed for the appropriateness of care for 21 paediatric conditions. We describe the processes (methods), provenance (origins and evolution of indicators) and products (indicator characteristics) of creating clinical indicators within the context of Australian healthcare settings. Developing consensus on clinical appropriateness indicators using a Delphi approach and collaborative online wiki has methodological utility. The final indicator set can be used by clinicians and organisations to measure and reflect on their own practice.
Related Concept Videos
Indicators
Common Ion Effect
Clinically Relevant Drug Product Specifications: Methods of Establishment
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Hypertension III: Clinical Manifestations and Diagnostic Studies
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

