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December 19, 2007

Using Clinical Trial Summary Results to Establish Quality Measures

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;298(23):2740-2741. doi:10.1001/jama.298.23.2740-b

To the Editor: The Commentary by Drs Kent and Hayward1 about the limits of applying summary results of clinical trials to individual patients is very relevant in a practice climate in which physicians and hospitals are judged on quality clinical criteria. In 2001, the Department of Health and Human Services began the Quality Initiative, a program that was predicated on the premise that the quality of health care in the United States was lacking and could be improved.2 For example, the Hospital Quality Initiative (HQI), a component of the Quality Initiative, includes 20 hospital quality measures, one of which is β-blocker prescription at discharge for patients with acute myocardial infarction (AMI).2 The assumption behind HQI quality criteria is that patients who do not achieve these criteria are undertreated, and therefore quality medicine is not being practiced.