Quality indicators for oesophageal and gastric cancer: a population-based study in Belgium, 2004-2008

Abstract

This study aimed at developing and measuring quality indicators for oesophageal cancer (OC) and gastric cancer (GC) and to support quality improvement for practitioners. Quality indicators were identified from a systematic literature search including clinical guidelines. The selection process involved experts evaluating relevance, reliability, interpretability and actionability of each indicator. Three national databases were linked: the cancer registry, the population registry and the claims database. Completeness and validity of the data were validated before being measured for 10,660 patients diagnosed between 2004 and 2008. From a final set of 29 indicators, 18 were measurable using the available data. In 2008, less than 50% of patients were discussed at a multidisciplinary team meeting and less than 90% underwent a computed tomography scan 1 month after incidence date for cancer staging. Five-year relative survival was 22% for OC and 34.3% for GC. The post-operative mortality in OC patients was 4.8% (30 days) and 9.9% (90 days), whereas it reached 5.6 and 12.0% respectively in GC patients. This study demonstrates the feasibility to develop a set of quality indicators for gastro-oesophageal cancer. A mixed picture of the quality of care was illustrated for some relevant care processes. Nevertheless, 5-year survival is higher than reported in neighbouring countries.

A narrative synthesis of the quality of cancer care and development of an integrated conceptual framework

“…,Jean-Pierre et al (2011),Klumpp (2013),Levit et al (2013),Manchon-Walsh, Borras, Espinas, Aliste, and Catalonian Rectal Cancer (2011),Nazareth et al (2008), NQF (2009),Pamphilon et al (2009), Raval, Bilimoria, andTalamonti (2010),Rizzo et al (2011), Spencer et al (2008,Stordeur et al (2015),van de Velde et al (2013),Wang, Ahmed, Khan, and Dasgupta (2012),Zhu, Zhang, Shah, al. (2008),Anderson (2016),Arrighi et al (2015),Jensen, Nissen, and Vedstad (2014),Jensen, Torring, Olesen, Overgaard, and Vedsted (2014),Lebeau et al (2011),Levit et al (2013),Mano et al (2008), McCavit and Winick (2012), Molassiotis, Wilson, Brunton, and Chandler (2010), NQF (2009), Raval et al (2010), van de Velde et al (2013), Wang et al (2012) al.…”

“…(2008), ASCO-ESMO (2006), ACoSCo (2016), Edwards (2016), National Quality Forum (NQF) (2009), Grunfeld et al (2008), Jensen, Torring et al (2014), Jensen et al (2016), Levit et al (2013), Parker et al (2007), Raval et al (2010), Vargas, Ryan, Jackson, Rodriguez, and Freeman al. (2008), Almeida et al (2013), Arrighi et al (2015), ASCO (2006), Barocas and Penson (2010), Burmeister et al (2016), ACoSCo (2016), Earle (2007), Feld and Feld (2010), Forum (2009), Grunfeld et al (2008), Holland and Weiss (2008), Holland, Watson, and Dunn (2011), Langer and Stern (2007), Lebeau et al (2011), Levit et al (2013), Manchon-Walsh et al (2011), Mano et al (2008), Mathis and Cima (2014), Meert and Sculier (2008), Numico et al (2014), Ost, Niu, Elting, Buchholz, and Giordano (2014), Pagano et al (2010), Raval et al (2010), Rizzo et al (2011), Saini et al (2016), Samson, Porter, Hurley, Adams, and Eberth (2016), Schrader et al (2010), Spencer et al (2008), Stordeur et al (2015), Taflampas et al (2008), van de Velde et al (2013), Wang et al ), AielloBowles et al (2008),Anderson (2016),Arrighi et al (2015),ASCO (2006),Burmeister et al (2016),Earle (2007),Grooss, Hjertholm, Carlsen, and Vedsted (2016),Grunfeld et al (2008),Holland and Weiss (2008),Lamb, Brown, et al (2011), Lamb, Sevdalis, Mostafid, Vincent, and Green (2011), Lamb, Sevdalis, Vincent, and Green (2012,Lebeau et al (2011),Levit et al (2013),Nazareth et al (2008), NQF (2009),Riquet et al (2013),Rizzo et al (2011), Stordeur et al (2015,Tremblay et al (2011), Vargas et al (2008,Wang et al (2012)…”

“…,Goldman et al (2008),Lebeau et al (2011),Levit et al (2013),Manchon-Walsh et al (2011),Mano et al (2008),Mathis and Cima (2014),Rasky, Regitnig, Schenouda, Burkert, and Freidl (2013),Rees et al (2014),Saini et al (2016),Spencer et al (2008),Stordeur et al (2015),Taflampas et al (2008), van de Velde et al (2013), Wang et al (2012) Outcomes Safety, errors and adverse events • Complication rates or mortality rates for surgical therapeutic procedures • Complication or mortality rates for surgical diagnostic procedures 17 Almeida et al (2013), Eck et al (2012), Feld and Feld (2010), Forsberg et al (2010), Forum (2009), Gore et al (2012), Kellokumpu et al (2012), Langer and Stern (2007), Levit et al (2013), Lucas and Pawlik (2014), Manchon-Walsh et al (2011), Mathis and Cima (2014), Raval et al (2010), Rees et al (2014), Stordeur et al (2015), Taflampas et al (2008), Wang et al (2012) Outcomes Patient-centred outcomes • Symptoms • Long-term side effects and function • Quality of Life 8 Badalucco and Reed (2011), Barocas and Penson (2010), Carey et al (2012), Lee et al (2015), Levit et al (2013), NQF (2009), van Ryn et al (2014), Wang et al (2012) Outcomes Disease-specific outcomes • Incidence rate • Local recurrence rate • Survival • Long-term side effects and function 15 Barocas and Penson (2010), Edwards (2016), Forsberg et al (2010), Gore et al (2012), Kellokumpu et al (2012), Levit et al (2013), Manchon-Walsh et al (2011), NQF (2009), Pagano et al (2010), Raval et al (2010), Saini et al (2016), Samson et al (2016), Stordeur et al (2015), Taflampas et al (2008), Wang et al ), Arrighi et al (2015), ASCO (2006), Grunfeld et al (2008), Handy et al (2016), Holland and Weiss (2008), Langer and Stern (2007), Levit et al (2013), Mano et al (2008), NQF (2009), Rizzo et al (2011), Taflampas et al (2008) Structure Process Outcomes Value 3 Ramsey and Schickedanz (2010), Roman et al (2015), Saini et al (2016)…”

Measuring the costs of cancer treatment - what model should we use?

“…Stordeur et al . () examine indicators of quality for oesophageal and gastric cancer in Belgium – they describe a rigorous process for developing indicators based on relevance, reliability, interpretability and actionability.…”

“…Arrighi et al (2015) report on a 'patient jury' approach; the paper provides fascinating insights into patient perspectives on cancer care in Spain. Stordeur et al (2015) examine indicators of quality for oesophageal and gastric cancer in Belgium -they describe a rigorous process for developing indicators based on relevance, reliability, interpretability and actionability.…”