To the Editor: The Commentary by Drs Fonarow and Peterson1 presented a cogent picture of the current state of performance measurement. Performance measures are developed based on the best science available, but the science of measurement is evolving. Similarly, the underlying science delineating the critical steps in care is changing. The choice of measures must be derived from the underlying clinical evidence, and when steps are identified that ensure better patient outcomes, measures should be developed to augment or replace those in current use.
Loeb JM, Foster N. Process Measures, Outcome Measures, and Heart Failure. JAMA. 2010;303(1):35-36. doi:10.1001/jama.2009.1937