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- Page navigation anchor for The role of the QOF in the care of long-term conditions: Response to Dr HopayianThe role of the QOF in the care of long-term conditions: Response to Dr HopayianThank you for your comments. We did not include the systematic review by Gillam et al1 because its search date was earlier than the three systematic reviews cited. Its conclusion was that ‘improvements in quality of care for chronic diseases in the framework were modest, and the impact on costs, professional behavior, and patient experience remains uncertain.’ We are not therefore convinced that the conclusions are substantially different from those of the more recent systematic reviews, or indeed our own.In assessing quality of the systematic reviews and the primary research studies included, we did not formally assign scores because we applied fairly strict quality criteria for inclusion and therefore included all studies that met the criteria. In any case, the use of scales in the assessment of quality in systematic reviews is explicitly discouraged in the Cochrane Collaboration’s guidance.2 Two authors checked that each paper met the criteria (LF and CM) and differences were resolved by a third author (SP).References1. Gillam SJ, Siriwardena AN, Steel N. Pay-for-performance in the United Kingdom: impact of the quality and outcomes framework: a systematic review. Ann Fam Med 2012; 10(5): 461-8.2. Higgins JPT, Green S, (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1....Show MoreCompeting Interests: None declared.
- Page navigation anchor for The role of the QOF in the care of long-term conditionsThe role of the QOF in the care of long-term conditionsThe authors are to be congratulated for tackling the difficult task of evaluating of the effectiveness of QOF.1 However, there are some missing details that need clarification before placing confidence in their conclusions.
1. A systematic review specifically about QOF appears to have been excluded.2 Why was this? The review by Gillam et al included many more studies and concluded that QOF had made a difference.
2. This review differed in its conclusions from the three reviews that it did include. Did the authors have any explanation for the progressive change in conclusions reached by all four reviews over time?
3. The authors state "The systematic reviews were of good quality…the primary research studies…were of good quality for observational studies" and reference the quality assessment methods they used, but what were the quality scores? Who made the assessments and how were differences resolved?
References1. Forbes LJL, Marchand C, Doran T, Peckham S. The role of the Quality and Outcomes Framework in the care of long-term conditions: a systematic review. Br J Gen Pract 2017;67(664):e775.2. Gillam SJ, Siriwardena AN, Steel N. Pay-for-performance in the United Kingdom: impact of the quality and outcomes framework: a systematic revi...Show MoreCompeting Interests: None declared.