The development of radiotherapy quality indicators for lung cancer- a modified Delphi technique protocol

Abstract

Background Radiotherapy is an effective evidence-based treatment modality for the definitive management of both early and locally advanced lung cancer. Whilst the literature reports a wide range of quality indicators (QIs) to assess the surgical management of lung cancer there is a deficit of robust QIs available to measure the quality of radiotherapy received by patients[1]. We propose a literature review and modified Delphi technique to develop a set of radiotherapy specific quality indicators and benchmarks aimed at evaluating the processes involved in the planning and delivery of radiotherapy for lung cancer. Methods A modified Delphi technique will be used and will include an international expert panel in two formal rounds with a target of 40 participants and intervening steering committee review with a minimum of 9 stakeholders. Candidate radiotherapy QIs will be selected from literature review and assessed by a steering committee to be included in the Delphi process. Both QIs and proposed benchmarks will be ranked by the expert panel in 2 rounds and included in the final set of QIs if a pre-defined consensus definition for importance is met by at least 70% of responses with a score of 7 or more on a 9-point Likert scale. Consensus criteria for feasibility and proposed benchmarks will be achieved if at least 70% of responses are reported as 3 or more on a 3-point Likert scale. Discussion We aim to address the current lack of quality indicators for assessing radiotherapy in lung cancer by using a robust modified Delphi method to attain international expert consensus for a set of QIs specific to the process involved in planning and delivering radiotherapy for definitive management of lung cancer. These have the potential to provide a foundation for QI measurement and benchmarking to guide quality improvement in radiotherapy for lung cancer.