{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T01:33:42Z","timestamp":1790213622340,"version":"4.1.0"},"reference-count":53,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2017,4,21]],"date-time":"2017-04-21T00:00:00Z","timestamp":1492732800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>A substantial amount of aggressive life-prolonging treatments in the final stages of life has been reported for people with progressive life-shortening conditions. Monitoring appropriate and inappropriate end-of-life care is an important public health challenge and requires validated quality indicators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To develop indicators of appropriate and inappropriate end-of-life care for people with cancer, chronic obstructive pulmonary disease or Alzheimer\u2019s disease, measurable with population-level administrative data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>modified RAND\/UCLA appropriateness method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/participants:<\/jats:title>\n                    <jats:p>Potential indicators were identified by literature review and expert interviews and scored in a survey among three panels of experts (one for each disease group). Indicators for which no consensus was reached were taken into group discussions. Indicators with consensus among the experts were retained for the final quality indicator sets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The final sets consist of 28 quality indicators for Alzheimer\u2019s disease, 26 quality indicators for cancer and 27 quality indicators for chronic obstructive pulmonary disease. The indicator sets measure aspects of aggressiveness of care, pain and symptom treatment, specialist palliative care, place of care and place of death and coordination and continuity of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We developed a comprehensive set of quality indicators of appropriate and inappropriate end-of-life care in people with Alzheimer\u2019s disease, cancer or chronic obstructive pulmonary disease, to be used in population-level research. Our focus on administrative healthcare databases limits us to treatment and medication, excluding other important quality aspects such as communication, which can be monitored using complementary approaches. Nevertheless, our sets will enable an efficient comparison of healthcare providers, regions and countries in terms of their performance on appropriateness of end-of-life care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0269216317705099","type":"journal-article","created":{"date-parts":[[2017,4,21]],"date-time":"2017-04-21T05:49:30Z","timestamp":1492753770000},"page":"932-945","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":91,"title":["Developing indicators of appropriate and inappropriate end-of-life care in people with Alzheimer\u2019s disease, cancer or chronic obstructive pulmonary disease for population-level administrative databases: A RAND\/UCLA appropriateness study"],"prefix":"10.1177","volume":"31","author":[{"given":"Robrecht","family":"De Schreye","sequence":"first","affiliation":[{"name":"End-of-life Care Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Houttekier","sequence":"additional","affiliation":[{"name":"End-of-life Care Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc","family":"Deliens","sequence":"additional","affiliation":[{"name":"End-of-life Care Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium"},{"name":"Department of Medical Oncology, Ghent University, Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Cohen","sequence":"additional","affiliation":[{"name":"End-of-life Care Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,4,21]]},"reference":[{"key":"bibr1-0269216317705099","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.50.2.123"},{"key":"bibr2-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-014-2268-2"},{"key":"bibr3-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.35.7996"},{"key":"bibr4-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.58.6362"},{"key":"bibr5-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1198"},{"key":"bibr6-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.43.6055"},{"key":"bibr7-0269216317705099","doi-asserted-by":"publisher","DOI":"10.3747\/co.23.2946"},{"key":"bibr8-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-015-2733-6"},{"key":"bibr9-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp035232"},{"key":"bibr10-0269216317705099","volume-title":"Dying in America: improving quality and honoring individual preferences near the end of life","author":"Institute of Medicine"},{"key":"bibr11-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198601303140505"},{"key":"bibr12-0269216317705099","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.76.7.766"},{"key":"bibr13-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23428"},{"key":"bibr14-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1080\/1067828X.2013.777378"},{"key":"bibr15-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-007748"},{"key":"bibr16-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-007749"},{"key":"bibr17-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1396416"},{"key":"bibr18-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2013.05.016"},{"key":"bibr19-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-012-2229-8"},{"key":"bibr20-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2015.01.012"},{"key":"bibr21-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.03.059"},{"key":"bibr22-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzi061"},{"key":"bibr23-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.16.3956"},{"key":"bibr24-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2008.07.008"},{"key":"bibr25-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2012.09.013"},{"key":"bibr26-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(98)00134-1"},{"key":"bibr27-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2006.00693.x"},{"key":"bibr28-0269216317705099","unstructured":"IMA-AIM, http:\/\/www.aim-ima.be\/ (accessed 13 April 2016)."},{"key":"bibr29-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1177\/0269216306072553"},{"key":"bibr30-0269216317705099","doi-asserted-by":"publisher","DOI":"10.17269\/cjph.104.3775"},{"key":"bibr31-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2009.04.024"},{"key":"bibr32-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2006.00925.x"},{"key":"bibr33-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2011.06.002"},{"key":"bibr34-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1177\/0269216311429619"},{"key":"bibr35-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0034188"},{"key":"bibr36-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d989"},{"key":"bibr37-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1177\/082585970902500403"},{"key":"bibr38-0269216317705099","unstructured":"WHO | The top 10 causes of death, http:\/\/www.who.int\/mediacentre\/factsheets\/fs310\/en\/ (accessed 27 April 2016)."},{"key":"bibr39-0269216317705099","unstructured":"OECD. Leading causes of burden of disease, http:\/\/www.oecd.org\/els\/health-systems\/48831921.pdf (accessed 27 April 2016)."},{"key":"bibr40-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7393.816"},{"key":"bibr41-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1988.03410120089033"},{"key":"bibr42-0269216317705099","unstructured":"The RAND\/UCLA appropriateness method user\u2019s manual \u2013 MR1269, https:\/\/www.rand.org\/content\/dam\/rand\/pubs\/monograph_reports\/2011\/MR1269.pdf (accessed 13 April 2016)."},{"key":"bibr43-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1177\/1049909116642174."},{"key":"bibr44-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.3212"},{"key":"bibr45-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-016-0159-7"},{"key":"bibr46-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1390027"},{"key":"bibr47-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.18603"},{"key":"bibr48-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1177\/2050312115601692"},{"key":"bibr49-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.7842"},{"key":"bibr50-0269216317705099","unstructured":"International benchmarking and best practice management: in search of health care and hospital excellence. Adv Health Care Manag, http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25985514 (accessed 6 June 2016)."},{"key":"bibr51-0269216317705099","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19981130)17:22<2625::AID-SIM957>3.0.CO;2-4"},{"key":"bibr52-0269216317705099","volume-title":"Health economics, policy and management","author":"Smith PC","year":"2009"},{"key":"bibr53-0269216317705099","volume-title":"Quality indicators for palliative care from an international perspective","author":"De Roo ML","year":"2014"}],"container-title":["Palliative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0269216317705099","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0269216317705099","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0269216317705099","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:25:40Z","timestamp":1777659940000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0269216317705099"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,21]]},"references-count":53,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2017,12]]}},"alternative-id":["10.1177\/0269216317705099"],"URL":"https:\/\/doi.org\/10.1177\/0269216317705099","relation":{},"ISSN":["0269-2163","1477-030X"],"issn-type":[{"value":"0269-2163","type":"print"},{"value":"1477-030X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4,21]]}}}