Measuring Performance

Gastrointestinal / Genitourinary Measures 

Project Status: Completed

Gastrointestinal / Genitourinary Measures

Access the Stage 2 Final Report: National Voluntary Consensus Standards: Gastrointestinal and Genitourinary Endorsement Maintenance: Two-Stage Pilot, 2013 

Access the Evaluation Report: NQF's Proposed Two-Stage CDP Process 

Access the Stage 1 Final Report: National Voluntary Consensus Standards: Gastrointestinal and Genitourinary Endorsement Maintenance: Two-Stage Pilot, 2012 

The Opportunity

Gastrointestinal (GI) motility and functional bowel disorders (e.g., gastroesophageal reflux disease, gastroparesis, irritable bowel syndrome), comprise about 40% of the GI problems for which patients seek care and affect up to 25% of the US population.1  These disorders not only cause symptoms and pose a heavy burden of illness but also impact quality of life and work productivity. With such a high prevalence within the population, the financial burden of the treatment of GI disorders is also high and has been estimated at nearly $10 billion annually in direct costs, and $20 billion annually in indirect costs.1 

Similarly, genitourinary (GU) conditions, including urinary tract infections (UTI), cystitis, benign prostate hypertrophy (BPH), and urinary incontinence (UI) post a heavy burden on quality of life and healthcare spending:

  • In 2000, costs associated with evaluation and treatment of BPH Cost were estimated at $1.1 billion annually2 
  • 8.27 million of the adult outpatient visits in 2000 (1.41 million men; 6.86 million women) were attributed to UTI’s as the primary diagnosis with an estimated $3.5 billion expended for evaluation and treatment2  
  • In 2007 UI was estimated to affect 9-22 percent of U.S. adults with an estimated cost of $463.1 million expended annually for evaluation and treatment2 

NQF has endorsed several consensus standards to evaluate the quality of care for GI/GU conditions over the past decade. As quality measurement has matured, better data systems have become available, electronic health records are closer to widespread adoption, and the demand for meaningful performance measures has prompted development of more sophisticated measures of healthcare processes and outcomes for GI/GU conditions.


  1. Camilleri M, Dubois D, Coulie B, et al. Prevalence and socioeconomic impact of upper gastrointestinal disorders in the United States: results of the US Upper Gastrointestinal Study. Clin Gastroenterol Hepatol,2005;3(6):543-552.
  2. Litwin MS, Saigal CS. Introduction. In: Litwin MS, Saigal CS, eds. Urologic Diseases in America. Washington, D.C.: Government Printing Office; 2007; NIH publication 07–5512:3–7. Available at Last accessed May 2012.

About The Project

This project began in April 2012.


To ensure the currency of NQF's portfolio of voluntary consensus standards for GI/GU, both newly submitted fully specified and tested measures, and currently endorsed measures due for maintenance review will undergo the consensus development process together. In addition to ensuring currency of specifications and evidence for the focus of the measure, endorsement maintenance provides the opportunity to harmonize specifications and to ensure that an endorsed measure represents the "best in class."

In this call, NQF is seeking fully specified and tested performance measures that could be used for accountability and quality improvement in the following topic areas related to gastrointestinal (GI) and genitourinary (GU) health for adults and children in all settings of care. Fully specified and tested performance measures for quality of treatments, diagnostic studies, interventions, screening or procedures associated with these organ systems and conditions will be considered:


  • Gastroesophageal reflux disease (GERD)
  • Gastroenteritis
  • GI bleeding
  • Peptic ulcer disease (PUD)
  • Liver disease (cirrhosis, end-stage liver disease)
  • Colitis
  • Diverticulitis
  • Irritable bowel syndrome (IBS)
  • Gallstones
  • Diarrhea/constipation
  • Pancreatitis
  • Appendicitis
  • Celiac disease
  • Other related conditions


  • Incontinence
  • Neurogenic bladder
  • Urinary tract infection
  • Urinary tract stones
  • Cystitis
  • Hernias
  • Congenital anomalies of the urinary tract
  • Benign prostate hypertrophy (BPH)
  • Other related conditions

NQF Process

The GI/GU measure endorsement project is a pilot of the proposed two-stage Consensus Development Process (CDP), which is consistent with but not identical to the NQF CDP version 1.9. The pilot will begin with the evaluation of concepts and measures against the importance criteria in stage one, including measures that are submitted with full specifications and testing. Measures with full specifications and completed testing that pass the importance criterion will be further evaluated against the remaining criteria (scientific acceptability, usability, and feasibility) in stage two. This project will involve the active participation of representatives from across the spectrum of healthcare stakeholders and will be guided by a multiple-stakeholder Steering Committee.

By using an actual measure endorsement project with both concepts and fully specified and tested measures for the pilot, NQF will be able to obtain tangible experience from the perspectives of measure developers, Steering Committee members, membership, and other stakeholders, which will help to refine and improve the proposed process. This pilot will allow NQF to specifically assess the new process steps, estimated timeline for each stage of work, and tools and educational materials needed to ensure success.


This endorsement project is supported under a contract provided by the Department of Health and Human Services. The proposed pilot of the two-stage CDP is under consideration by HHS.

Related NQF Work

Contact Information

For further information, call 202-783-1300 or via email at

Project Search


Related Information