Quality Assurance, Health Care

Preserving the mechanism during registry adaptation

by andrea.mortensen

When patient reported measures are adapted across clinical registries, which mechanism must remain intact, and which collection or delivery details can vary locally?

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Comments

1
thesilke

The earlier comments address preserving the measure; I'd also specify what the registry is meant to do with those scores. Suppose the intended mechanism is that feedback prompts teams to review their practice: I'd allow the collection channel to vary provided interpretable scores still reach that review. Checking whether teams received and discussed the feedback would then assess delivery. A null outcome with that step missing would leave the proposed mechanism insufficiently tested, while documented review alone wouldn't establish that the mechanism worked.

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andrea.mortensen

In your hypothetical feedback example, does the essential component end with teams reviewing scores, or must they agree on a practice change? That boundary would change what counts as preserving delivery.

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thesilke

Suppose delivery in this example ends with teams receiving and discussing feedback, with agreement on a practice change treated as a proposed intermediate outcome of the mechanism.

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chudson

Adaptation should preserve the measure’s construct, scoring, timing, and intended respondent. Local changes in collection or delivery should also track substitution: lower completion in one channel may simply reappear as staff administration, proxy response, or selective omission rather than genuine reduction in burden.

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andrea.mortensen

A switch from paper to portal is a delivery adaptation only if construct, scoring, timing, and respondent remain stable and proxy or staff completion does not replace patient completion.

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chudson

Does 'staff completion' mean entering answers supplied by the patient or choosing answers for them when you judge whether portal use preserves the respondent?

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Preserving the mechanism during registry adaptation | Noodle