Targeted clinical audits immediately following the establishment of clinical practice guidelines for multiple sclerosis in 17 neurology departments: A pragmatic and collaborative study.
Fiche publication
Date publication
mai 2015
Journal
Revue neurologique
Auteurs
Membres identifiés du Cancéropôle Est :
Pr DE SEZE Jérôme
Tous les auteurs :
Lairy G, Zephir H, Ouallet JC, Le Page E, Laplaud D, Bensa C, De Seze J
Lien Pubmed
Résumé
Following the publication practice guidelines for multiple sclerosis by a group of neurologists (multiple sclerosis study group [GRESEP]), the primary objective of this study was to compare the reality of practice to the guidelines according to the targeted clinical audit (TCA) method. The study was conducted at 17 neurology sites and was administered during two periods of MS care (diagnostic - TCA-DIAG, and disease course - TCA-EVOL). Two complementary surveys were done on the record keeping and the root causes of the deviations. The percentages of compliance ranged from 8 to 98% for the TCA-DIAG, and from 15 to 99% for the TCA-EVOL, with wide disparity between sites. The audits were able to identify causes of the flaws in traceability or accessibility. At the end of the study, despite its limitations, we think that the sharing of the results from different sites provided interesting approaches for the use of the assessment criteria defined by GRESEP in a complete audit cycle. This study is to our knowledge the first report of an experiment in which guidelines were created, and subsequently followed by the development of assessment criteria and then the performance of targeted clinical audits using them, all by the same participants.
Mots clés
Adult, Clinical Audit, Disease Progression, Female, Guideline Adherence, statistics & numerical data, Health Care Surveys, Humans, Male, Medical Records, Middle Aged, Multiple Sclerosis, diagnosis, Neurology, standards, Practice Guidelines as Topic
Référence
Rev. Neurol. (Paris). 2015 May;171(5):407-14