Novel quality indicators for metastatic colorectal cancer management identify significant variations in these measures across treatment centers in Australia. Issue 3 (14th April 2015)

• Record Type: Journal Article
• Authors: Turner, Natalie Heather; Wong, Hui‐li; Field, Kathryn; Wong, Rachel; Shapiro, Jeremy; Yip, Desmond; Nott, Louise; Tie, Jeanne; Kosmider, Suzanne; Tran, Ben; Desai, Jayesh; McKendrick, Joseph; Zimet, Allan; Richardson, Gary; Iddawela, Mahesh; Gibbs, Peter
• Is Part Of: Asia-Pacific journal of clinical oncology. Volume 11:Issue 3(2015:Sep.)
• Page Start: 262
• Page End: 271
• Publication Date: 2015-04-14
• Subjects: Oncology -- Pacific Area -- Periodicals; Cancer -- Treatment -- Pacific Area -- Periodicals; Cancer -- Pacific Area -- Periodicals; Cancer -- Treatment -- Periodicals; 616.9940095
• DOI: 10.1111/ajco.12355
• Languages: English
• ISSNs: 1743-7555

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="ajco12355-sec-0001" sec-type="section"> <title>Aims</title> <p>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.</p> </sec> <sec id="ajco12355-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="ajco12355-sec-0003" sec-type="section"> <title>Results</title> <p>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.</p> </sec> <sec id="ajco12355-sec-0004" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>