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|Title:||Novel quality indicators for metastatic colorectal cancer management identify significant variations in these measures across treatment centers in Australia.|
|Epworth Authors:||Zimet, Allan|
|Other Authors:||Turner, N. H.|
Wong, Hui Li
Metastatic Colorectal Cancer
Quality of Care Indicators
Quality of Health Care
Treatment of Recurrent and Advanced Colorectal Cancer Registry
Cancer Services Clinical Institiute, Epworth HealthCare, Victoria, Australia
|Citation:||Asia Pac J Clin Oncol. 2015 Sep;11(3):262-71|
|Abstract:||AIMS: Defining multidisciplinary quality of care indicators (QCIs) for (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.|
|Journal Title:||Asia-Pacific Journal of Clinical Oncology|
|Affiliated Organisations:||The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia.|
Department of Medical Oncology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Department of Medical Oncology, Eastern Health, Melbourne, Victoria, Australia
Eastern Health Medical School, Monash University, Melbourne, Victoria, Australia
Cabrini Health, Melbourne, Victoria, Australia
The Canberra Hospital, Canberra, Australian Capital Territory, Australia
Calvary Hospital, Canberra, Australian Capital Territory, Australia.
ANU Medical School, Australian National University, Canberra, Australian Capital Territory, Australia.
Royal Hobart Hospital, Hobart, Tasmania, Australia.
Department of Medical Oncology, Western Hospital, Melbourne, Victoria, Australia.
Goulburn Valley Health, Shepparton, Victoria, Australia.
University of Melbourne Rural Health Academic Centre, Shepparton, Victoria, Australia.
BioGrid Australia, Melbourne, Victoria, Australia.
|Type of Clinical Study or Trial:||Multicentre Studies|
|Appears in Collections:||Cancer Services|
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