From: 3, Results

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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}

From: 3, Results

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.

Rockville (MD): Agency for Healthcare Research and Quality (US); 2004 Sep.

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