Hospital quality indicator may not be linked to patient survival after colon canc...(torial Marko Simunovic M.D. M.P.H. of Mc...),Health

researchers should not abandon efforts to identify potentially useful quality indicators through various study designs. Those who use such measures and endorsing agencies must recognize the inherent weaknesses of quality indicators derived from observational data; the potential for unintended consequences as clinicians and hospitals respond in varying ways to meet perceived indicator benchmarks; and should guard against the carrot or stick use of indicators. Using quality indicators as one part of a comprehensive, supportive, incremental quality-improvement project, such as those included under the rubric of total quality management or continuous quality improvement, is likely to be more constructivealthough even these strategies currently lack a compelling evidence base.

(JAMA. 2007;298(18):2194-2195. Available pre-embargo to the media at www.jamamedia.org)

Editors Note: Please see the article for additional information, including financial disclosures, funding and support, etc.

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