Development and Validation of Quality Indicators for Pulmonary Arterial Hypertension Management in Japan: A Modified Delphi Consensus Study
Yuichi Tamura,
Kazuya Hosokawa,
Koshin Horimoto,
Satoshi Ikeda,
Takumi Inami,
Kayoko Kubota,
Naohiko Nakanishi,
Yuichiro Shirai,
Nobuhiro Tanabe,
Ichizo Tsujino,
Hiromi Matsubara
Affiliations
Yuichi Tamura
Pulmonary Hypertension Center, International University of Health and Welfare Mita Hospital, Tokyo 108-8329, Japan
Kazuya Hosokawa
Faculty of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
Koshin Horimoto
Department of Cardiology, Matsuyama Red Cross Hospital, Matsuyama 790-0826, Japan
Satoshi Ikeda
Stroke and Cardiovascular Diseases Support Center, Nagasaki University Hospital, Nagasaki 852-8501, Japan
Takumi Inami
Department of Cardiovascular Medicine, Kyorin University School of Medicine, Tokyo 181-8611, Japan
Kayoko Kubota
Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-0065, Japan
Naohiko Nakanishi
Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
Yuichiro Shirai
Department of Allergy and Rheumatology, Nippon Medical School, Graduate School of Medicine, Tokyo 113-8602, Japan
Nobuhiro Tanabe
Pulmonary Hypertension Center, Chibaken Saiseikai Narashino Hospital, Chiba 275-8580, Japan
Ichizo Tsujino
Division of Respiratory and Cardiovascular Innovative Research, Faculty of Medicine, Hokkaido University, Sapporo 060-8638, Japan
Hiromi Matsubara
Department of Cardiology, NHO Okayama Medical Center, Okayama 701-1192, Japan
Background: Quality indicators (QIs) are used to standardize care and improve outcomes in patients with pulmonary arterial hypertension (PAH). It is important that QIs are validated within specific healthcare contexts. Therefore, this study aimed to validate QIs for PAH management in Japan using a modified Delphi consensus method. Methods: QI candidates were identified from published European QIs and clinical practice guidelines. An expert panel of 11 PAH specialists from diverse Japanese institutions anonymously rated the 36 initial QI candidates in two rounds using a nine-point appropriateness scale. Results: In the first round, 35 QIs received a median score of ≥7 points. A panel discussion was held between rounds to address the single low-scored QI, biomarker modifications, and invasive examinations, resulting in 36 modified QIs. In the second round, all modified QIs received median scores of ≥7 points and were judged to be valid as the final Japanese set of QIs. Conclusions: The findings of this study validated a set of QIs for PAH management tailored to the Japanese healthcare context. These QIs can be used to standardize care, identify areas for improvement, and ultimately enhance outcomes for Japanese patients with PAH.
