Table 5a, Association between improvement in glycemic control and number of quality improvement strategies stratified by study sample size* - Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies (Vol. 2: Diabetes Care)

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	Median Reduction in HbA_1c
	[inter-quartile range]^†
	N=Number of comparisons
Number of QI Strategies	All Comparisons	Comparisons with sample size in lowest quartile	Comparisons with sample size in lower 2 quartiles	Comparisons with sample sizein upper 2 quartiles	Comparisons with sample size in highest quartile
Any number of strategies	0.48	1.35	1.30	0.21	0.10
	[0.20, 1.38]	[0.81,1.73]	[0.41, 1.49]	[0.10, 0.55]	[0.10, 0.33]
	N=38	N=10	N=19	N=19	N=10

1 strategy only	0.00	0.56	0.10	0.00	0.00
	[-0.08, 0.16]	——	[-0.15, 0.23]	[0.00, 0.11]	[0.00, 0.00]
	N=6	N=1	N=3	N=3	N=2 ^†

≥ 2 strategies	0.60	1.40	1.40	0.34	0.15
	[0.30, 1.40]	[1.10, 1.80]	[0.63, 1.58]	[0.10, 0.60]	[0.10, 0.40]
	N= 32	N=9	N=16	N=16	N=8

≥ 3 strategies	0.66	1.30	1.40	0.47	0.35
	[0.33, 1. 40]	[1.10, 1.40]	[0.91, 1.44]	[0.20, 0.60]	[0.17, 0.53]
	N=22	N=5	N=11	N=11	N=4

≥ 4 strategies	0.48		1.47	0.47	0.50
	[0.30, 0.82]		[0.89, 1.69]	[0.30, 0.50]	[0.35, 0.55]
	N=8	N=0	N=3	N=5	N=3

5 strategies**	0.53		1.47	0.47	0.40
	[0.40, 0.82]		——	[0.33, 0.53]	[0.20, 0.60]
	N=4	N=0	N=1	N=3	N=2 ^§

st: Sample size stratification for HbA1c: 1 quartile=69, median=123, 3^rd quartile=226
†: The median number of strategies was 2, with 16 studies involving 2 of fewer strategies and 22 employing 3 or more.
‡: All changes were standardized to reflect reductions. Thus, the negative sign here indicates an increase in serum HbA_1c.
§: When N=2, the numbers in square brackets reflect the results for each of the two studies rather than the interquartile range.
**: No study involved an intervention with more than 5 QI types. Using the alternate taxonomy shown in Table 1 (Appendix H) in which substrategies of provider education and organizational change are treated as distinct categories, 2 studies reported interventions involving 6 strategies.^140, ¹⁴⁶

Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies (Vol. 2: Diabetes Care).

Technical Reviews, No. 9.2.

Shojania KG, Ranji SR, Shaw LK, et al.

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