BACKGROUND Evidence-based clinical practice guidelines (CPGs) are relevant sources for generating quality indicators (QIs). The objective of this study was to compare guideline-based QIs of German and international CPGs and their underlying methodological approaches. METHODS We conducted systematic searches in the guideline databases of G-I-N (Guidelines International Network) and NGC (National Guideline Clearinghouse) between February and June 2017 to identify international CPGs matching the topics of German evidence-based CPGs (n = 35) that report QIs, which were identified in a preceding study. Additionally, we searched the websites of the particular CPG providers for separate documents with regard to QIs. We included evidence-based CPGs which report QIs. Reported QIs, the underlying guideline recommendations, and information on methods of development were extracted. The selection and extraction of CPGs were conducted by one reviewer and checked by another. For each matched pair of CPGs, we assessed whether the suggested QIs matched or were not directly comparable. RESULTS Twenty-five international CPGs, originating from seven CPG providers in total, met the criteria for inclusion. They matched the topics of 18 German CPGs. This resulted in 30 CPG pairs for the comparison of QIs (some of the international CPGs matched the topic of more than one German CPG). We found 27 QI pairs with QIs "not different or slightly different", corresponding to 13% (27 of 212) of the QIs in German CPGs and 16% (27 of 166) in international CPGs. Only two QI pairs were judged to be "different/inconsistent". For 183 of 212 (86%) QIs from German CPGs and 137 of 166 (83%) QIs from international CPGs, no direct comparison could be made. An explicit link to one or more guideline recommendations was found for 136 of 152 (89%) QIs from German CPGs and 82 of 166 (49%) QIs from international CPGs. Some information on methods for the development of QIs existed for 12 of 18 (67%) German CPGs and 8 of 25 (32%) international CPGs. CONCLUSIONS The majority of QIs in German and international CPGs were not comparable. Various reasons for this are conceivable. More transparent reporting of the underlying methods for generating guideline-based QIs is needed.

中文翻译：

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基于指南的质量指标-德国和国际临床实践指南的系统比较。

背景技术基于证据的临床实践指南（CPG）是用于产生质量指标（QI）的相关来源。这项研究的目的是比较德国和国际CPG的基于指南的QI及其基本方法学方法。方法我们于2017年2月至6月之间在GIN（国际准则网络）和NGC（国家准则交易所）的准则数据库中进行了系统搜索，以找出与报告QI的德国循证CPG（n = 35）主题相匹配的国际CPG，在先前的研究中已确定。此外，我们在特定CPG提供者的网站上搜索了有关QI的单独文件。我们纳入了报告QI的基于证据的CPG。已报告的QI，基本准则建议，并提取了有关开发方法的信息。CPG的选择和提取由一名审阅者进行，并由另一名审阅者进行检查。对于每对匹配的CPG，我们评估了建议的QI是否匹配或不直接可比。结果总共来自七家CPG提供者的二十五个国际CPG符合纳入标准。他们符合18个德国CPG的主题。这产生了30个CPG对，用于比较QI（一些国际CPG与不止一个德国CPG的主题相匹配）。我们发现了27个QI对“无异或略有不同”的QI对，分别相当于德国CPG中QI的13％（212个中的27个）和国际CPG中16％（166个中的27个）的QI。仅两个QI对被判断为“不同/不一致”。对于来自德国CPG的212个QI中的183个（86％）QI和来自国际CPG的166个QI中的137个（83％）QI，无法进行直接比较。与来自德国CPG的152个QI（占89％）QI和来自国际CPG的166个QI（占49％）中的82个存在明显的一个或多个准则建议链接。18个（67％）德国CPG和25个（32％）25个国际CPG中存在关于制定QI的方法的一些信息。结论德国和国际CPG中的大多数QI不可比。可以想到各种原因。需要更透明地报告用于生成基于准则的QI的基础方法。与来自德国CPG的152个QI（占89％）QI和来自国际CPG的166个QI（占49％）中的82个存在明显的一个或多个准则建议链接。18个（67％）德国CPG和25个（32％）25个国际CPG中存在关于制定QI的方法的一些信息。结论德国和国际CPG中的大多数QI不可比。可以想到各种原因。需要更透明地报告用于生成基于准则的QI的基础方法。与来自德国CPG的152个QI（占89％）QI和来自国际CPG的166个QI（占49％）中的82个存在明显的一个或多个准则建议链接。18个（67％）德国CPG和25个（32％）25个国际CPG中存在关于制定QI的方法的一些信息。结论德国和国际CPG中的大多数QI不可比。可以想到各种原因。需要更透明地报告用于生成基于准则的QI的基础方法。