The current ethics review process is inappropriate for clinical quality registries
Rigorous methods for assessing and improving the quality of health care have proven difficult to develop by traditional research approaches.1 Clinical quality registries (CQRs) systematically collect an agreed minimum dataset of data across multiple sites on clinically relevant outcome measures. Data are analysed, comparing procedures, providers and institutions.2 Feedback to practitioners has been shown to drive performance improvement, especially if the data are perceived to be high quality.3
- 1. Walshe K. Pseudoinnovation: the development and spread of healthcare quality improvement methodologies. Int J Qual Health Care 2009; 21: 153-159.
- 2. Levay C. Policies to foster quality improvement registries: lessons from the Swedish case. J Intern Med 2016. 279: 160-172.
- 3. van der Veer SN, de Keizer NF, Ravelli AC, et al. Improving quality of care. A systematic review on how medical registries provide information feedback to health care providers. Int J Med Inform 2010; 79: 305-323.
- 4. National Health and Medical Research Council. Ethical considerations in quality assurance and evaluation activities. Canberra: NHMRC, 2014. https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/e111_ethical_considerations_in_quality_assurance_140326.pdf (accessed July 2016).
- 5. Australian Commission on Safety and Quality in Healthcare. Operating principles and technical standards for Australian clinical quality registries. Canberra: ACSQH, 2008. http://www.med.monash.edu.au/sphpm/creps/docs/operating-principals-and-technical-standards-nov-2008.pdf (accessed July 2016).
- 6. Evans SM, Bohensky M, Cameron PA, McNeil J. A survey of Australian clinical registries: can quality of care be measured? Intern Med J 2011; 41: 42-48.
- 7. Casarett D, Karlawish JH, Sugarman J. Determining when quality improvement initiatives should be considered research: proposed criteria and potential implications. JAMA 2000; 283: 2275-2280.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.