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A Standardized Method for the Evaluation of Adherence to Practice Guidelines

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  • Stephanie Thomas

Abstract

Practice guidelines are widely used in medical settings as a means of improving efficiency and quality of care by aligning service provision with evidence of what is effective. The objective of this work is to propose a methodology for the effective evaluation of the match of clinical practice data with a practice guideline. The proposed methodology uses a combination of existing analytical techniques which minimize the need for the analyst to specify a functional form for the process generating the clinical data. The methodology is illustrated in an application to a set of field data on the supplemental oxygen administration decisions of volunteer medical first responders. The result is a methodology for evaluation of guideline adherence which leverages existing patient care records and is generalizable across clinical contexts. In addition, the results are visually intuitive, supporting communication across diverse audiences.

Suggested Citation

  • Stephanie Thomas, 2016. "A Standardized Method for the Evaluation of Adherence to Practice Guidelines," Department of Economics Working Papers 2016-14, McMaster University.
  • Handle: RePEc:mcm:deptwp:2016-14
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    File URL: http://socserv.mcmaster.ca/econ/rsrch/papers/archive/McMasterEconWP2016-14.pdf
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    References listed on IDEAS

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    1. Li, Qi & Racine, Jeff, 2003. "Nonparametric estimation of distributions with categorical and continuous data," Journal of Multivariate Analysis, Elsevier, vol. 86(2), pages 266-292, August.
    2. Hayfield, Tristen & Racine, Jeffrey S., 2008. "Nonparametric Econometrics: The np Package," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 27(i05).
    3. Peter Hall & Jeff Racine & Qi Li, 2004. "Cross-Validation and the Estimation of Conditional Probability Densities," Journal of the American Statistical Association, American Statistical Association, vol. 99, pages 1015-1026, December.
    4. Sofia Dimakou & David Parkin & Nancy Devlin & John Appleby, 2009. "Identifying the impact of government targets on waiting times in the NHS," Health Care Management Science, Springer, vol. 12(1), pages 1-10, March.
    5. Frey, Bruno S & Jegen, Reto, 2001. " Motivation Crowding Theory," Journal of Economic Surveys, Wiley Blackwell, vol. 15(5), pages 589-611, December.
    6. Stephanie Thomas, 2016. "Playing by the rules? Agreement between predicted and observed binary choices," Department of Economics Working Papers 2016-12, McMaster University.
    7. Jan Erik Askildsen & Tor Helge Holmås & Oddvar Kaarboe, 2011. "Monitoring prioritisation in the public health‐care sector by use of medical guidelines. The case of Norway," Health Economics, John Wiley & Sons, Ltd., vol. 20(8), pages 958-970, August.
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    More about this item

    Keywords

    adherence to guidelines; health care utilization; performance evaluation; medical first responders;

    JEL classification:

    • C12 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Hypothesis Testing: General
    • C18 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Methodolical Issues: General
    • C52 - Mathematical and Quantitative Methods - - Econometric Modeling - - - Model Evaluation, Validation, and Selection
    • I1 - Health, Education, and Welfare - - Health
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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