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Novel quality indicators for metastatic colorectal cancer management identify significant variations in these measures across treatment centers in Australia.

AbstractAIMS:
Defining multidisciplinary quality of care indicators (QCIs) for metastatic colorectal cancer (mCRC) could improve understanding of variations in routine practice care. This may identify areas of below-average performance, which could then be addressed by clinicians to improve the quality of care delivered. This study aimed to define a panel of QCIs in mCRC and, based on these QCIs, to evaluate quality of care across multiple Australian sites.
METHODS:
A panel of clinicians with expertise in colorectal cancer defined evidence-based or best practice-based QCIs relevant to the routine multidisciplinary management of mCRC patients through structured consensus discussion. Related data were extracted from the Treatment of Recurrent and Advanced Colorectal Cancer (TRACC) registry, a prospectively maintained database recording comprehensive details on consecutive mCRC patients across multiple Australian hospitals. Variations in QCIs across sites were explored.
RESULTS:
Of 13 QCIs defined, data related to 10 were reliably extracted from TRACC. Analysis of data on 1276 patients across 10 sites demonstrated low rates of screening for hereditary nonpolyposis colorectal cancer in young patients and significant variation in surveillance-detected recurrences, lung resection rates and palliative chemotherapy use. Exploratory analyses suggested correlation between liver resection rates and survival.
CONCLUSIONS:
We have defined a novel set of mCRC QCIs and have demonstrated wide variation in the quality of care of mCRC across multiple Australian sites. With further validation to confirm a direct correlation between QCI and patient outcomes, these QCIs could be applied to improve the quality of care received by all mCRC patients.
AuthorsNatalie Heather Turner, Hui-Li Wong, Kathryn Field, Rachel Wong, Jeremy Shapiro, Desmond Yip, Louise Nott, Jeanne Tie, Suzanne Kosmider, Ben Tran, Jayesh Desai, Joseph McKendrick, Allan Zimet, Gary Richardson, Mahesh Iddawela, Peter Gibbs
JournalAsia-Pacific journal of clinical oncology (Asia Pac J Clin Oncol) Vol. 11 Issue 3 Pg. 262-71 (Sep 2015) ISSN: 1743-7563 [Electronic] Australia
PMID25871458 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
Copyright© 2015 Wiley Publishing Asia Pty Ltd.
Topics
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Australia
  • Colorectal Neoplasms (pathology, therapy)
  • Disease Management
  • Female
  • Humans
  • Male
  • Middle Aged
  • Molecular Sequence Data
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local (drug therapy)
  • Quality Indicators, Health Care
  • Young Adult

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