Indicators of guideline-concordant care in lung cancer defined with a modified Delphi method and piloted in a cohort of over 5,800 cases.
Guideline adherence
Health information systems
Lung neoplasms
Quality indicators, health care
Quality of health care
Journal
Archives of public health = Archives belges de sante publique
ISSN: 0778-7367
Titre abrégé: Arch Public Health
Pays: England
ID NLM: 9208826
Informations de publication
Date de publication:
25 Jan 2021
25 Jan 2021
Historique:
received:
06
08
2020
accepted:
05
01
2021
entrez:
26
1
2021
pubmed:
27
1
2021
medline:
27
1
2021
Statut:
epublish
Résumé
To identify indicators of guideline-concordant care in lung cancer, to implement such indicators with cancer registry data linked to health databases, and to pilot them in a cohort of patients from the cancer registry of the Milan Province. Thirty-four indicators were selected by revision of main guidelines by cancer epidemiologists, and then evaluated by a multidisciplinary panel of clinicians involved in lung cancer care and working on the pathway of lung cancer diagnosis and treatment in the Lombardy region, Italy. With a modified Delphi method, they assessed for each indicator the content validity as a quality measure of the care pathway, the degree of modifiability from the health professional, and the relevance to the health professional. Feasibility was assessed using the cancer registry and the routine health records of the Lombardy region. Feasible indicators were then calculated in the cohort of lung cancer patients diagnosed in 2007-2012 derived from the cancer registry of the Milan Province. Criterion validity was assessed reviewing clinical records of a random sample of 114 patients (threshold for acceptable discordance ≤20%). Finally, reliability was evaluated at the provider level. Initially, 34 indicators were proposed for evaluation in the first Delphi round. Of the finally 22 selected indicators, 3 were not feasible because the required information was actually not available. The remaining 19 were calculated on the pilot cohort. After assessment of criterion validity (3 eliminated), 16 indicators were retained in the final set and evaluated for reliability. The developed and piloted set of indicators is now available to implement and monitor, over time, quality initiatives for lung cancer care in the studied health system.
Sections du résumé
BACKGROUND
BACKGROUND
To identify indicators of guideline-concordant care in lung cancer, to implement such indicators with cancer registry data linked to health databases, and to pilot them in a cohort of patients from the cancer registry of the Milan Province.
METHODS
METHODS
Thirty-four indicators were selected by revision of main guidelines by cancer epidemiologists, and then evaluated by a multidisciplinary panel of clinicians involved in lung cancer care and working on the pathway of lung cancer diagnosis and treatment in the Lombardy region, Italy. With a modified Delphi method, they assessed for each indicator the content validity as a quality measure of the care pathway, the degree of modifiability from the health professional, and the relevance to the health professional. Feasibility was assessed using the cancer registry and the routine health records of the Lombardy region. Feasible indicators were then calculated in the cohort of lung cancer patients diagnosed in 2007-2012 derived from the cancer registry of the Milan Province. Criterion validity was assessed reviewing clinical records of a random sample of 114 patients (threshold for acceptable discordance ≤20%). Finally, reliability was evaluated at the provider level.
RESULTS
RESULTS
Initially, 34 indicators were proposed for evaluation in the first Delphi round. Of the finally 22 selected indicators, 3 were not feasible because the required information was actually not available. The remaining 19 were calculated on the pilot cohort. After assessment of criterion validity (3 eliminated), 16 indicators were retained in the final set and evaluated for reliability.
CONCLUSION
CONCLUSIONS
The developed and piloted set of indicators is now available to implement and monitor, over time, quality initiatives for lung cancer care in the studied health system.
Identifiants
pubmed: 33494836
doi: 10.1186/s13690-021-00528-0
pii: 10.1186/s13690-021-00528-0
pmc: PMC7830847
doi:
Types de publication
Journal Article
Langues
eng
Pagination
12Subventions
Organisme : Italian Ministry of Health
ID : RF 2011-02348859
Investigateurs
Milena Andruccioli
(M)
Antonio Ardizzoia
(A)
Agnese Assi
(A)
Alessandro Baisi
(A)
Amedeo Vittorio Bedini
(AV)
Giordano Beretta
(G)
Maurizio Bersani
(M)
Francesco Bertagna
(F)
Elisabetta Berti
(E)
Alessandro Bertolini
(A)
Anna Bettini
(A)
Mario Bignardi
(M)
Francesco Bini
(F)
Claudio Bnà
(C)
Francesca Bono
(F)
Daniele Bonora Ottoni
(DB)
Andrea Borghesi
(A)
Paolo Borghetti
(P)
Antonio Brunelli
(A)
Alberto Buffoli
(A)
Carlo Cacioppo
(C)
Angelomaria Calati
(A)
Anna Calcagno
(A)
Sabrina Casagrande
(S)
Clelia Casartelli
(C)
Massimo Castellani
(M)
Antonino Castro
(A)
Gianpiero Catalano
(G)
Laura Catena
(L)
Giovanni Luca Ceresoli
(GL)
Massimiliano Cergnul
(M)
Gianluigi Ciocia
(G)
Annamaria Colombo
(A)
Barbara Conti
(B)
Daniela Corti
(D)
Diego Cortinovis
(D)
Claudio Cozzi
(C)
Flavio Crippa
(F)
Andrea De Monte
(A)
Daniela De Candis
(D)
Domenico De Toma
(D)
Filippo De Marinis
(F)
Biancamaria DiMarco
(B)
Franca Di Nuovo
(F)
Claudio Doglioni
(C)
Valentina Fabbris
(V)
Paolo Faccioli
(P)
Daniele Fagnani
(D)
Gabriella Farina
(G)
Laura Fariselli
(L)
Virginio Filipazzi
(V)
Francesca Franzi
(F)
Paolo Frata
(P)
Ana Maria Samanes Gajate
(AMS)
Gianstefano Gardani
(G)
Massimo Gasparini
(M)
Monica Giordano
(M)
Fabrizio Grignani
(F)
Claudio Landoni
(C)
Carlo Lombardi
(C)
Fabrizio Lombardi
(F)
Andrea Luciani
(A)
Lorenzo Stefano Maffioli
(LS)
Roberta Marchione
(R)
Paola Mariani
(P)
Anna Maspero
(A)
Fausto Meriggi
(F)
Aurora Miedico
(A)
Patrizia Morbini
(P)
Giovanni Muriana
(G)
Giulio Orlandoni
(G)
Enrica Paris
(E)
Paolo Pedrazzoli
(P)
Giuseppe Pepe
(G)
Ezio Pezzica
(E)
Fabio Piccoli
(F)
Gianpaolo Pinotti
(G)
Antonello Quadri
(A)
Andrea Ravasio
(A)
Franco Ravenna
(F)
Elisabetta Ricchiuti
(E)
Davide Rinaldo
(D)
Gianni Roda
(G)
Gerolamo Rossi
(G)
Armando Santoro
(A)
Carlo Pietro Soatti
(CP)
Francesco Stiglich
(F)
Luca Tagliabue
(L)
Valeria Tirelli
(V)
Andrea Tironi
(A)
Maurizio Tomirotti
(M)
Laura Lavinia Travaini
(LL)
Giovanni Ucci
(G)
Adriano Vaghi
(A)
Angelo Vanzulli
(A)
Giulia Veronesi
(G)
Isabella Vittimberga
(I)
Claudia Zambelli
(C)
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