Critical appraisal of clinical performance measures in Germany

BACKGROUND: One of the tasks of the Federal Co-ordinating Committee, as part of the self-governing health care system in Germany, is to develop clinical performance measures (CPMs). As these measures generally exert a strong impact on health care delivery, their methodological quality should meet the highest standards. OBJECTIVE: To develop, for use in the German health care system, methodological quality requirements for CPMs and performance assessment programs. MATERIALS AND METHODS: We assembled and reviewed internationally available materials on CPMs. From these we prepared lists of requirements for appraising the methodological quality of CPMs and CPM programs. PRODUCTS: Lists of criteria for use in appraising the appropriateness of the development, content, format and application of CPMs and their value to the health care system for performance measurement; a checklist for assessing the methodological quality of CPMs/CPM programs. CONCLUSION: The methods applied and the products from this project offer a useful framework for prospective CPM/CPM program developers and set a high threshold for the development of methodologically rigorous clinical performance measurement.