Table 1.

Characteristics for selecting screening performance measures in primary care

Importance of the issue to the patients and physicians in the practice
  • Patients, physicians, and other team members in a practice should decide on what issues are most important

  • Practices with different patient populations, settings, and health care organizations could choose different performance measures to meet their individual practice needs

  • Priorities of individual practices could be different from those of other stakeholders in the health care system

Quality of evidence
  • Use systematic reviews and a rigorous approach to evaluation of the quality of evidence (eg, GRADE) in developing recommendations

  • Consideration should be given to strong vs weak or conditional recommendations and the balance of benefit vs harms for screening maneuvers

  • Consider the availability and quality of evidence on patient values and preferences for the screening maneuver and the availability of strategies shown to be effective for quality improvement

  • Individual patients might be eligible for multiple screening maneuvers at different screening intervals

  • The overall screening needs of individual patients, in contrast to the uptake of a single screening intervention, need to be assessed

Measurable, feasible, interpretableConsider whether ...
  • the data can be easily obtained in your practice setting

  • existing electronic medical records capture the data needed to measure the issues considered important (eg, shared decision making)

  • there are human resources to help analyze and report on the outcomes of performance measurement

  • other physicians and primary care team members will be able to easily interpret the results

Patient participation in selection of performance measures
  • Ideally, values and preferences of patients would be reflected in the choice of performance measures; however, it can be potentially challenging for individual practices to engage patients in the process of performance measure selection

Influence of other stakeholders in the health care system
  • Demands from health care administrators about the choice and number of performance measures will be inevitable

  • Performance measures important to other health system stakeholders might not be relevant at the individual practice level

  • GRADE—Grading of Recommendations Assessment, Development and Evaluation.