Table 5.
GERD quality measures developed via RAM encompass the five existing AHRQ performance measures for GERD.
| AHRQ Performance Measures for GERD | Quality Measure Developed by RAM | Validity of Quality Measure Determined by RAM Process (Median Ranking; Dispersion of Rankings) |
|---|---|---|
| Percentage of patients seen for an initial evaluation, who were assessed for the presence or absence of the following alarm symptoms: involuntary weight loss, dysphagia, and GI bleeding | IF a patient with a diagnosis of GERD is seen for initial evaluation, THEN the patient should be assessed for the presence or absence of the following alarm symptoms: involuntary weight loss, dysphagia, and GI bleeding. | High Validity (Median ranking 8.5; Strict Agreement) |
| Percentage of patients seen for an initial evaluation of GERD with at least one alarm symptom who were either referred for upper endoscopy or had an upper endoscopy performed | IF a patient with a diagnosis of GERD has at least one alarm symptom, THEN upper endoscopy should be performed. | High Validity (Median ranking 9.0; Strict Agreement) |
| Percentage of patients with a diagnosis of GERD or heartburn whose endoscopy report indicates a suspicion of Barrett's esophagus who had a forceps esophageal biopsy performed | IF a patient with GERD has an endoscopy report that indicates a suspicion of Barrett's esophagus, THEN suspicious areas should be biopsied. | High Validity (Median ranking 9.0; Strict Agreement) |
| Percentage of patients seen for an initial evaluation of GERD who did not have a Barium swallow test ordered | IF a patient has suspected GERD without dysphagia, THEN a barium radiograph should not be used as a diagnostic test. | Moderate Validity (Median ranking 8.0; Relaxed Agreement) |
| Percentage of patients who have been prescribed continuous PPI or H2RA therapy who received an assessment of their GERD symptoms within 12 months | IF a patient with GERD is prescribed maintenance PPI or H2RAs, THEN the patient should receive a follow-up assessment of their GERD symptoms at least every 12 months. | High Validity (Median ranking 8.0; Strict Agreement) |
Agency for Healthcare Research & Quality (AHRQ); RAND/UCLA Appropriateness Methodology (RAM); Gastroesophageal Reflux Disease (GERD); Proton Pump Inhibitor (PPI); H2 Receptor Antagonist (H2RA).