Development Of The Reporting Checklist For Clinical Pathway

Obejective: On the basis of literature research, the status of the items reporting for clinical pathway was investigated and the related items were collected. Then the reporting checklist of clinical pathway was developed by Delphi method. This stuy aimed to provide reference for the development of clinical pathways.Methods: All related diseases and reporting checklists of clinical pathway home and abroad were collected to evaluate the reporting status of clincial pathway by using systematic and comprehensive search. By comparing the difference between the reporting items, and related items were abstracted so that the preliminary framework of clincial pathway was formed. The form of questionnaire was used to collect the advice of experts by Delphi. The reporting checklist was modified and improved untiled the experts reached a consensus by three rounds expert consultations. Statistical analysis was done by SPSS19.0. The evaluation opinions of experts were sorted out and then evaluated the importance of items by questionnarie response rate, the consistency of expert opinions and the coordination of expert opinions. The final reporting checklist for clinical pathway was developed through a comprehensive assessment of the reporting items.Results: Four hundred and nineteen related clinical pathways were retrieved from five countries/regions, The results showed that there was a large discrepancy among the reporting items. Simultaneously, five reporting checklists of clinical pathway were also identified and there were different requirements for reporting. The reporting items were abstracted to form the preliminary framework of clincial pathway. Three rounds of Delphi were conducted, the questionnaire reponse rate of round 1 was 92%, round 2 was 90.91%, and round 3 was 100%. The results showed that the Kendall coefficient of concordance on round 3 was higher than round 2, so the consistency of expert opinions was well at round 3. Finally, 7 domains of “The title and summary of clinical pathways”, “Features and benefits of clinical pathways”,“Quality control and outcomes of clinical pathway”,“the standardized process of hospitalization”,“the form of clinical pathway”,“the patient form of clinical pathway”,“the rigor of clinical pathway development and the evidence based medicine” were identified. The items of “Classification of diseases”, “Sources of funding、financing”,“Allergy record”,“Signature of treatment Consultants”,“Allergy record” and “Variation record”were deleted. 50 subdomains were included in the final reporting checklist.Conclusion: It is found that there is a large discrepancy and no unified standard among the report specifications on clinical pathway by comparative analysis the related diseases and reporting checklists worldwide. Through the three rounds of Delphi, the comprehensive reporting checklist of clinical pathway is established and expected to provide references for the standardization of the formulation and reporting on clinical pathways.