Table 1

List of applied quality indicators
Indicator
 Description
 References
Hypoglycaemiaa
 Represented in different ways. In most studies it is represented as the number or percentage of measurements below a certain BGL value and/or number or percentage of patients who experienced at least one measurement below a predefined BGL value
 43 articles [8-13,15-35,42-57]
BGLs over time
 Represented as mean and/or median BGL values. Each BGL measurement or each patient was regarded the unit of observation. In one study, it was calculated as area under the glucose/time curve divided by total time per admission [10]. Mean or median BGL was also calculated:
• at the end of IIT [52];
• after the target range was achieved [9,33,49,54];
• after stopping IIT [45,55];
• for patients who had admission BGL above a threshold [10];
• during IIT [27] or during the last 5 hours of IIT [57];
• after 24 hours [15]; or
• 24 hours before, within and after IIT [39] or 48 hours after IIT [11]
 37 articles [8-12,15,17,18,20-22,24,26,27,29,30,32-36,39,42-47,49-52,54-58]
Measurements in predefined BGL ranges
 Represented as the number or percentage of measurements in a predefined BGL range:
• during the study;
• after the target is achieved [27,49,55,56]; or
• at the start of IIT [21]
Each BGL measurement, and in one study each patient [11], was considered the unit of observation
 31 articles [9,11,12,17-21,25-28,30-33,35,36,42-45,47,49-51,55-57,59,60]
Time to capture defined BGL target
 Represented as:
• mean and median of time; or
• by Kaplan-Meier curve, as in [17,20,23,25,49]
In one study two successive BGL measurements in the target range were required before calculating time [20]
 25 articles [8,9,11,15-17,20,21,23,25,27,29,30,32-34,43,45,46,49,52,53,55,56,59]
Frequency of measurements during the study
 Represented as:
• mean or median per patient [11,16,17,23-28];
• mean or median per patient treatment day or days [12,15,21,22,26,27,29-31];
• sampling interval (time) [13,31-36];
• median frequency per patient-hour [23];
• percentage of patients with more than one measurement in predefined time interval (every 2 hours, and so on) [31];
• frequency overall per day [12,21]; or
• percentage of time in which at least one measurement per 2 hours was taken [32].
 23 articles [11-13,15-17,20-36]
BGL at starting IIT
 Represented as mean and median BGL
 14 articles [9,11,13,16,21,27,29,33,46,52,54-56,59]
Protocol compliance
 Compare measurement times suggested by protocol with actual times of measurements and/or pump speed during IIT and/or at the time of hypoglycaemic events [9,21]. In one studya time-motion method was used to measure discrepancy in timing of BGL measurements between protocol and actual [28]
 13 articles [9,11,13,14,16,21,28-31,33,46,57]
Time in predefined range
 Represented as:
• mean of percentage of time per patient [12,32,58];
• median of fraction of time per patient [13,15,21,34];
• median of fraction of time per day [29];
• percentage of time for all patients [14,17,21,25]; or
• percentage of time 24 hours before, within and after trial [39]
 12 articles [12-15,17,21,25,29,32,34,39,58]
Hyperglycaemic events
 Represented as:
• percentage of time >180b, >250 (severe hyperglycaemia) [16], or between 151 and 200 and >200 (severe hyperglycaemia) [21];
• percentage of patients with at least one measurement per day ≥ 250 and ≥ 200) [22];
• percentage of measurements above 150 [11] or 180 [17-20]; or
• percentage of measurements and patients with at least one BGL above the 180 level for more than 2 hours [13]
 9 articles [11,13,16-22]
Morning BGLs
 Represent as:
• mean BGL around 06:00 hours [43], between 06:00 and 12:00 hours [50], or between 06:00 and 09:00 hours [19];
• mean lowest BGL between 06:00 and 09:00 [43];
• median between 06:00 and 08:00 hours [24] or between 03:00 and 06:00 hours [27]; or
• mean of BGL, but morning time was not mentioned [20]
 6 articles [19,20,24,27,43,50]
Hyperglycaemic index
 Represented as median area between glucose-time curve and upper normal range divided by time per patient during the trial [15,24], in first 24 hours [23,25] or in first 48 hours [17]. Upper normal range was 207 [23], 117 [15], 108 [24], 120 [17], and 150 [25]. It was calculated with the same definition but without labeling as hypoglycaemic index [23,25]
 5 articles [15,17,23-25]
Time until starting or adjusting IIT
 Represented as mean or median of time until starting and/or adjusting IIT [9,10,27,28], or proportion of patients per time until starting IIT [12]. In one study a time-motion method was used [28]
 5 articles [9,10,12,27,28]
Minimum and maximum recorded BGL
 Represented as:
• minimum and maximum recorded BGL over all patients [35,47]; or
• median of minimum and maximum recorded BGL per patients [24] or per patient-day [29]
 4 articles [24,29,35,47]
Number of patients with at least one BGL in predefined range
 Represented as number and percentage per month [31] or at defined time interval after starting TGC [11] or during the study periods [60]
 3 articles [11,31,60]
BGL change over time
 Represented as:
• speed of BGL change per hour [54]; or
• BGL change in first 24 hours [15]
 2 articles [15,54]
Number of patients who achieved or did not achieve target or predefined range
 Represented as number and percentage
 2 articles [17,27]
Number of positive culture
 Represented as median (per patient) or rate (per year per patient).
 2 article [31,59]
Target acquisition error
 Represented as absolute value and percentage of difference between the target BGL and achieved BGL
 2 articles [32,48]

aHypoglycaemia is a concept in this table and related quality indicators are described in table 3. bUnit of all BGL thresholds is mg/dl. BGL, blood glucose level; IIT, intensive insulin therapy; TGC, tight glycaemic control.

Eslami et al. Critical Care 2008 12:R139   doi:10.1186/cc7114

Open Data