Sample.

To test for feasibility of the QMs the two examiners
Sample. To test for feasibility of the QMs the two examiners reviewed databases and selected medical records, reporting when it was not possible to assess some QMs and related reasons. Predictable reasons encountered were: difficulty to identify cases or misreported information in medical records.Intra-rater and inter-rater designs were used to examine the reliability of QMs. To test for intra-rater reliability, an examiner assessed each QM in two occasions spaced out over a period of 7 days. To test inter-rater reliability, 4-((2-Hydroxyethyl)(methyl)amino)benzaldehyde an additional examiner carried out assessments using the same subjects' medical records. Reliability indexes were determined through the calculation of the Kappa index using SPSS v.15. Alternatively, we used the general agreement percentage when occurrence or absence of evaluated processes of care was higher than 85 , because Kappa index could be biased. We interpreted Kappa levels using established conventions: values ranging from 0.40 to 0.59 may be considered moderate, 0.60 to 0.79 substantial, and 80 excellent [21]. When the values of the Kappa index were less than 0.60 or the values of the general agreement index where less than 0.95, the quality indicators were reviewed by the whole panel.Results Table 1 includes the recommendations identified in the first phase, and their evidence level and strength. NoneMinaya-Mu z et al. BMC Musculoskeletal Disorders 2013, 14:310 http://www.biomedcentral.com/1471-2474/14/Page 4 ofFigure 2 Exemplary presentation of standardized report for an evidence-based quality measure.were based on CPG. From these recommendations, a total of 12 potential QMs were created and accepted for the pilot testing: 3 were related to assessment interventions, 1 to educational interventions and 8 to therapeutic interventions (Table 2).Feasibility and reliabilityIn the pilot testing, items with feasibility problems were evidenced for 2 QMs, due to a lack of specific information in medical records. They are indicated in Table 2. For example, this occurred in the QM `Surgery intervention inMinaya-Mu z et al. BMC Musculoskeletal Disorders 2013, 14:310 http://www.biomedcentral.com/1471-2474/14/Page 5 PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/13867361 ofTable 1 Evidence-based recommendations for lateral epicondylalgia careComponents of care I. Patient exam Physical Examination 1. IF a patient begins a treatment for lateral epicondylalgia, THEN evidence that the affected tendon was examined should be documented (at least orthopaedic tests). 2. IF a patient has symptomatic lateral epicondylalgia, THEN pain should be assessed (at least the intensity level) upon initiation of a new treatment at least once. 3. IF a patient has symptomatic lateral epicondylalgia, THEN functional status should be assessed upon initiation of a new treatment at least once. II. Educational interventions Education 4. IF a patient has symptomatic lateral 1-(4-Bromo-2-pyridyl)piperazine epicondylalgia, THEN education about self-management of risk factors (repetitive movements, etc.) should be given or recommended at least once. A / Strong [28-30] B / Strong [22] Evidence-based recommendations Evidence level / strength recommendationPain and functional assessmentB / Strong [23,39,43]B / Strong [23,39,43]III. Therapeutic interventions 1. Pharmacological therapy PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/21715270 First line Prophylaxis 5. IF a patient is started on pharmacological therapy to treat lateral epicondylalgia, THEN NSAIDs should be tried first. 6. IF a patient with a risk factor for GI bleeding (age 75, peptic ulcer disease, history of GI bleeding) is treat.