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American Journal of Public Health logoLink to American Journal of Public Health
. 1999 Jan;89(1):61–65. doi: 10.2105/ajph.89.1.61

Can data-driven benchmarks be used to set the goals of healthy people 2010?

J Allison 1, C I Kiefe 1, N W Weissman 1
PMCID: PMC1508488  PMID: 9987466

Abstract

OBJECTIVES: Expert panels determined the public health goals of Healthy People 2000 subjectively. The present study examined whether data-driven benchmarks provide a better alternative. METHODS: We developed the "pared-mean" method to define from data the best achievable health care practices. We calculated the pared-mean benchmark for screening mammography from the 1994 National Health Interview Survey, using the metropolitan statistical area as the "provider" unit. Beginning with the best-performing provider and adding providers in descending sequence, we established the minimum provider subset that included at least 10% of all women surveyed on this question. The pared-mean benchmark is then the proportion of women in this subset who received mammography. RESULTS: The pared-mean benchmark for screening mammography was 71%, compared with the Healthy People 2000 goal of 60%. CONCLUSIONS: For Healthy People 2010, benchmarks derived from data reflecting the best available care provide viable alternatives to consensus-derived targets. We are currently pursuing additional refinements to the data-driven pared-mean benchmark approach.

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Selected References

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  1. Ballard D. J. The RAND/AMA/AMCC Clinical Appropriateness Initiative: insights for multi-site appropriateness studies derived from the abdominal aortic aneurysm surgery project. Int J Qual Health Care. 1994 Jun;6(2):187–198. doi: 10.1093/intqhc/6.2.187. [DOI] [PubMed] [Google Scholar]
  2. Berkey T. Benchmarking in health care: turning challenges into success. Jt Comm J Qual Improv. 1994 May;20(5):277–284. doi: 10.1016/s1070-3241(16)30072-4. [DOI] [PubMed] [Google Scholar]
  3. Bero L., Rennie D. The Cochrane Collaboration. Preparing, maintaining, and disseminating systematic reviews of the effects of health care. JAMA. 1995 Dec 27;274(24):1935–1938. doi: 10.1001/jama.274.24.1935. [DOI] [PubMed] [Google Scholar]
  4. Berwick D. M. Continuous improvement as an ideal in health care. N Engl J Med. 1989 Jan 5;320(1):53–56. doi: 10.1056/NEJM198901053200110. [DOI] [PubMed] [Google Scholar]
  5. Cook D. J., Mulrow C. D., Haynes R. B. Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med. 1997 Mar 1;126(5):376–380. doi: 10.7326/0003-4819-126-5-199703010-00006. [DOI] [PubMed] [Google Scholar]
  6. Coulter I., Adams A., Shekelle P. Impact of varying panel membership on ratings of appropriateness in consensus panels: a comparison of a multi- and single disciplinary panel. Health Serv Res. 1995 Oct;30(4):577–591. [PMC free article] [PubMed] [Google Scholar]
  7. Eddy D. M. Clinical decision making: from theory to practice. Guidelines for policy statements: the explicit approach. JAMA. 1990 Apr 25;263(16):2239-40, 2243. doi: 10.1001/jama.263.16.2239. [DOI] [PubMed] [Google Scholar]
  8. Eddy D. M. Practice policies: where do they come from? JAMA. 1990 Mar 2;263(9):1265–passim. doi: 10.1001/jama.263.9.1265. [DOI] [PubMed] [Google Scholar]
  9. Fink A., Kosecoff J., Chassin M., Brook R. H. Consensus methods: characteristics and guidelines for use. Am J Public Health. 1984 Sep;74(9):979–983. doi: 10.2105/ajph.74.9.979. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Goodman D. C., Fisher E. S., Bubolz T. A., Mohr J. E., Poage J. F., Wennberg J. E. Benchmarking the US physician workforce. An alternative to needs-based or demand-based planning. JAMA. 1996 Dec 11;276(22):1811–1817. doi: 10.1001/jama.276.22.1811. [DOI] [PubMed] [Google Scholar]
  11. Guyatt G. H., Rennie D. Users' guides to the medical literature. JAMA. 1993 Nov 3;270(17):2096–2097. [PubMed] [Google Scholar]
  12. Guyatt G. H., Sackett D. L., Sinclair J. C., Hayward R., Cook D. J., Cook R. J. Users' guides to the medical literature. IX. A method for grading health care recommendations. Evidence-Based Medicine Working Group. JAMA. 1995 Dec 13;274(22):1800–1804. doi: 10.1001/jama.274.22.1800. [DOI] [PubMed] [Google Scholar]
  13. Hadorn D. C., Baker D. Development of the AHCPR-sponsored heart failure guideline: methodologic and procedural issues. Jt Comm J Qual Improv. 1994 Oct;20(10):539–547. doi: 10.1016/s1070-3241(16)30099-2. [DOI] [PubMed] [Google Scholar]
  14. Hagenfeldt K., Brorsson B. När är det lämpligt att göra hysterektomi? RAM-metoden en hjälp att hitta rätt behandlingsalternativ. Lakartidningen. 1996 Jan 24;93(4):240–245. [PubMed] [Google Scholar]
  15. Hayward R. S., Wilson M. C., Tunis S. R., Bass E. B., Guyatt G. Users' guides to the medical literature. VIII. How to use clinical practice guidelines. A. Are the recommendations valid? The Evidence-Based Medicine Working Group. JAMA. 1995 Aug 16;274(7):570–574. doi: 10.1001/jama.274.7.570. [DOI] [PubMed] [Google Scholar]
  16. Hoyt D. B. Clinical practice guidelines. Am J Surg. 1997 Jan;173(1):32–36. doi: 10.1016/S0002-9610(96)00378-9. [DOI] [PubMed] [Google Scholar]
  17. Hunt D. L., McKibbon K. A. Locating and appraising systematic reviews. Ann Intern Med. 1997 Apr 1;126(7):532–538. doi: 10.7326/0003-4819-126-7-199704010-00006. [DOI] [PubMed] [Google Scholar]
  18. Huston P. Cochrane Collaboration helping unravel tangled web woven by international research. CMAJ. 1996 May 1;154(9):1389–1392. [PMC free article] [PubMed] [Google Scholar]
  19. Mason J. O., McGinnis J. M. "Healthy People 2000": an overview of the national health promotion and disease prevention objectives. Public Health Rep. 1990 Sep-Oct;105(5):441–446. [PMC free article] [PubMed] [Google Scholar]
  20. McClellan M., Brook R. H. Appropriateness of care. A comparison of global and outcome methods to set standards. Med Care. 1992 Jul;30(7):565–586. [PubMed] [Google Scholar]
  21. McGinnis J. M., Lee P. R. Healthy People 2000 at mid decade. JAMA. 1995 Apr 12;273(14):1123–1129. [PubMed] [Google Scholar]
  22. Mulrow C. D., Cook D. J., Davidoff F. Systematic reviews: critical links in the great chain of evidence. Ann Intern Med. 1997 Mar 1;126(5):389–391. doi: 10.7326/0003-4819-126-5-199703010-00008. [DOI] [PubMed] [Google Scholar]
  23. Mulrow C. D. Rationale for systematic reviews. BMJ. 1994 Sep 3;309(6954):597–599. doi: 10.1136/bmj.309.6954.597. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Oxman A. D., Cook D. J., Guyatt G. H. Users' guides to the medical literature. VI. How to use an overview. Evidence-Based Medicine Working Group. JAMA. 1994 Nov 2;272(17):1367–1371. doi: 10.1001/jama.272.17.1367. [DOI] [PubMed] [Google Scholar]
  25. Oxman A. D., Sackett D. L., Guyatt G. H. Users' guides to the medical literature. I. How to get started. The Evidence-Based Medicine Working Group. JAMA. 1993 Nov 3;270(17):2093–2095. [PubMed] [Google Scholar]
  26. Palmer R. H. Quality health care. JAMA. 1996 Jun 19;275(23):1851–1852. [PubMed] [Google Scholar]
  27. Plokker H. W. Quality control for invasive cardiology: Holland. Herz. 1996 Oct;21(5):288–290. [PubMed] [Google Scholar]
  28. Powe N. R., Turner J. A., Maklan C. W., Ersek M. Alternative methods for formal literature review and meta-analysis in AHCPR Patient Outcomes Research Teams. Agency for Health Care Policy and Research. Med Care. 1994 Jul;32(7 Suppl):JS22–JS37. [PubMed] [Google Scholar]
  29. Rennie D. Consensus statements. N Engl J Med. 1981 Mar 12;304(11):665–666. doi: 10.1056/NEJM198103123041110. [DOI] [PubMed] [Google Scholar]
  30. Schroeder S. A. How can we tell whether there are too many or too few physicians? The case for benchmarking. JAMA. 1996 Dec 11;276(22):1841–1843. [PubMed] [Google Scholar]
  31. Shiffman R. N., Leape L. L., Greenes R. A. Translation of appropriateness criteria into practice guidelines: application of decision table techniques to the RAND criteria for coronary artery bypass graft. Proc Annu Symp Comput Appl Med Care. 1993:248–252. [PMC free article] [PubMed] [Google Scholar]
  32. Sullivan L. W. Healthy people 2000. N Engl J Med. 1990 Oct 11;323(15):1065–1067. doi: 10.1056/NEJM199010113231511. [DOI] [PubMed] [Google Scholar]
  33. Wilson M. C., Hayward R. S., Tunis S. R., Bass E. B., Guyatt G. Users' guides to the Medical Literature. VIII. How to use clinical practice guidelines. B. what are the recommendations and will they help you in caring for your patients? The Evidence-Based Medicine Working Group. JAMA. 1995 Nov 22;274(20):1630–1632. doi: 10.1001/jama.274.20.1630. [DOI] [PubMed] [Google Scholar]
  34. Woolf S. H. Practice guidelines, a new reality in medicine. II. Methods of developing guidelines. Arch Intern Med. 1992 May;152(5):946–952. [PubMed] [Google Scholar]
  35. Woolf S. H. Practice guidelines: a new reality in medicine. I. Recent developments. Arch Intern Med. 1990 Sep;150(9):1811–1818. [PubMed] [Google Scholar]

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