Quality indicators in radiation oncology: proposal of the Spanish Society of Radiation Oncology (SEOR) for a continuous improvement of the quality of care in oncology

Abstract

Current cancer treatment options include surgical intervention, radiotherapy and chemotherapy. The quality of the provision of each of them and their effective coordination determines the results in terms of benefit/risk.Regarding the radiation oncology treatments, there are not stabilised quality indicators to be used to perform control and continuous improvement processes for healthcare services. Therefore, the Spanish Society of Radiation Oncology has undertaken a comprehensive project to establish quality indicators for use with the information systems available in most Spanish healthcare services. Methods: A two-round Delphi study, examining consensus of several possible quality indicators (n=28) in daily practice. These indicators were defined after a bibliographic search and the assessment by radiation oncology specialists (n=8). They included aspects regarding treatment equipment, patient preparation, treatment and follow-up processes and were divided in structure, process and outcome indicators. Results: After the evaluation of the defined quality indicators (n=28) by an expert panel (38 radiation oncologist); 26 indicators achieved consensus in terms of agreement with the statement. Two quality indicators did not achieve consensus. Conclusions: There is a high degree of consensus in Spanish Radiation Oncology specialists on which indicators in routine clinical practice can best measure quality. These indicators can be used to classify services based on several parameters (patients, equipments, complexity of the techniques used and scientific research). Furthermore, these indicators allow assess our current situation and set improvements objectives.

Quality indicators for radiation oncology

“…Perhaps the most recent and relevant ROQI development paper comes from the Spanish Society of Radiation Oncology (SEOR) 23 . They carried out a systematic literature search and 2‐round Delphi process for 28 ROQIs.…”

“…Increasing the number of meaningful ROQIs relating to structure also requires collection to be feasible and reproducible. One possible example, as suggested by SEOR is to consider a ROQI relating to RT facility volume for highly complex definitive curative intent RT, like for surgery 23 . A retrospective multivariate analysis from the American national cancer database recently showed that for certain tumour sites treated with definitive RT (Lung and head and neck cancers) this correlated with improved overall survival 39 .…”

“…Perhaps the most recent and relevant ROQI development paper comes from the Spanish Society of Radiation Oncology (SEOR). 23 They carried out a systematic literature search and 2-round Delphi process for 28 ROQIs. 26 gained a consensus from the expert group as best measuring quality for RO and being feasible for the majority of Spanish HCOs information systems.…”

“…One possible example, as suggested by SEOR is to consider a ROQI relating to RT facility volume for highly complex definitive curative intent RT, like for surgery. 23 A retrospective multivariate analysis from the American national cancer database recently showed that for certain tumour sites treated with definitive RT (Lung and head and neck cancers) this correlated with improved overall survival. 39 Therefore, should the number of cases planned per year by individual ROs or by RT provider, be included in internal standards and accreditation?…”

Public reporting of outcomes in radiation oncology: the National Prostate Cancer Audit

“…Quality Research in Radiation Oncology). [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] However, these measures remain quite limited in defining the quality of care received. 33 This is due to a lack of a clearly defined link between process and outcome, as well as uncertainty regarding the magnitude of effect on functional and oncological outcomes from non-adherence.…”