European Nephrology Quality Improvement Network



WP4 - Indicators

This WP addresses the Public Health Programme areas 2.1.4 "Developing strategies and mechanisms for preventing, exchanging information on and responding to non-communicable disease threats, including gender-specific health threats and rare diseases" where it covers nephrology disorders, an area not yet covered.

As a preparation to NephroQUEST, the main partner (ERA-EDTA) set up four European nephrology expert committees, including renowned nephrologists from almost all EU countries to set up a provisional list of indicators for the quality of RRT care. These experts, whom were selected by their national registries, have:

(1) determined a provisional list of candidate indicators for quality of RRT care. These indicators were taken from 4 clinical areas of crucial importance to the health and to the prevention of complications in RRT patients (anaemia, calcium-phosphate metabolism, cardiovascular risk and dialysis adequacy) and they were based on evidence based best practice guidelines in these areas;
(2) evaluated and prioritized these potential indicators on the basis of different dimensions of their importance, scientific soundness and feasibility of data collection using OECD methodology;
(3) standardized their definitions, time of assessment and preferred methods (e.g. lab methods, coding system) to increase their comparability.

Also registry representatives have attended these past expert committee meetings to advice the clinical experts during their selection with regard to the point of feasibility of data collection. This effort has resulted in a provisional list of almost 30 standardized and prioritized indicators.

Under the NephroQUEST project this provisional list will be provided to the boards of the national and regional societies of nephrology and their registries for their comments and suggestions. On the basis of these comments and suggestions a discussion will take place between the expert committees (the external advisors) and the registries (the associated partners within this project) to come to a final list of standardized and prioritized indicators during the first WP4 meeting. It is expected that consensus will be reached on a somewhat shorter final list of standardized and prioritized indicators that will be added as process measures (indicators reflecting clinical quality of care) to existing outcome measures already used in registries (patient mortality, RRT technique failure). Thereafter, potential remaining differences between countries (e.g. due to national regulations) will be documented and analyzed to assess their potential impact on future international comparisons.

The work to be carried out by all partners representing registries and national societies is to present the provisional list of indicators to their boards and prepare reports including their comments and suggestions, so that the expert committees will be able to draw up the final list of standardized indicators. In addition, they will provide information to make it possible to analyze potential remaining differences. Through these actions the different partners will put technical expertise in the project together with their knowledge regarding the specific national situation and contribute to its dissemination.

WP lead: Academic Medical Center (ERA-EDTA Registry), The Netherlands

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Department of Medical Informatics
Academic Medical Center
European Union