Lung cancer (internet-based) Delphi (LUCiD): A modified eDelphi consensus process to establish Australasian clinical quality indicators for thoracic cancer.
Delphi consensus process
best practice
lung cancer
mesothelioma
Journal
Respirology (Carlton, Vic.)
ISSN: 1440-1843
Titre abrégé: Respirology
Pays: Australia
ID NLM: 9616368
Informations de publication
Date de publication:
13 Aug 2024
13 Aug 2024
Historique:
received:
18
04
2024
accepted:
24
07
2024
medline:
14
8
2024
pubmed:
14
8
2024
entrez:
13
8
2024
Statut:
aheadofprint
Résumé
Approximately 16,000 new cases of lung cancer are diagnosed each year in Australia and Aotearoa New Zealand, and it is the leading cause of cancer death in the region. Unwarranted variation in lung cancer care and outcomes has been described for many years, although clinical quality indicators to facilitate benchmarking across Australasia have not been established. The purpose of this study was to establish clinical quality indicators applicable to lung and other thoracic cancers across Australia and Aotearoa New Zealand. Following a literature review, a modified three round eDelphi consensus process was completed between October 2022 and June 2023. Participants included clinicians from all relevant disciplines, patient advocates, researchers and other stakeholders, with representatives from all Australian states and territories and Aotearoa New Zealand. Consensus was set at a threshold of 70%, with the first two rounds conducted as online surveys, and the final round held as a hybrid in person and virtual consensus meeting. The literature review identified 422 international thoracic oncology indicators, and a total of 71 indicators were evaluated over the course of the Delphi consensus. Ultimately, 27 clinical quality indicators reached consensus, covering the continuum of thoracic oncologic care from diagnosis to first line treatment. Indicators benchmarking supportive care were poorly represented. Attendant numeric quality standards were developed to facilitate benchmarking. Twenty-seven clinical quality indicators relevant to thoracic oncology care in Australasia were developed. Real world implementation will now be explored utilizing a prospective dataset collected across Australia.
Sections du résumé
BACKGROUND AND OBJECTIVE
OBJECTIVE
Approximately 16,000 new cases of lung cancer are diagnosed each year in Australia and Aotearoa New Zealand, and it is the leading cause of cancer death in the region. Unwarranted variation in lung cancer care and outcomes has been described for many years, although clinical quality indicators to facilitate benchmarking across Australasia have not been established. The purpose of this study was to establish clinical quality indicators applicable to lung and other thoracic cancers across Australia and Aotearoa New Zealand.
METHODS
METHODS
Following a literature review, a modified three round eDelphi consensus process was completed between October 2022 and June 2023. Participants included clinicians from all relevant disciplines, patient advocates, researchers and other stakeholders, with representatives from all Australian states and territories and Aotearoa New Zealand. Consensus was set at a threshold of 70%, with the first two rounds conducted as online surveys, and the final round held as a hybrid in person and virtual consensus meeting.
RESULTS
RESULTS
The literature review identified 422 international thoracic oncology indicators, and a total of 71 indicators were evaluated over the course of the Delphi consensus. Ultimately, 27 clinical quality indicators reached consensus, covering the continuum of thoracic oncologic care from diagnosis to first line treatment. Indicators benchmarking supportive care were poorly represented. Attendant numeric quality standards were developed to facilitate benchmarking.
CONCLUSION
CONCLUSIONS
Twenty-seven clinical quality indicators relevant to thoracic oncology care in Australasia were developed. Real world implementation will now be explored utilizing a prospective dataset collected across Australia.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Author(s). Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.
Références
Australian Institute of Health and Welfare. Cancer in Australia. 2019.
Te Aho o Te Kahu—Cancer Control Agency. What are our most common cancers? Accessed 7 August, 2023. Available from: https://teaho.govt.nz/cancer-numbers/common-cancers
Te Aho o Te Kahu—Cancer Control Agency. What are our most common causes of cancer death? Accessed 7 August, 2023. Available from: https://teaho.govt.nz/cancer-numbers/cancer-deaths
Australian Institute of Health and Welfare. Burden of cancer in Australia. 2017. Available from: https://www.aihw.gov.au/getmedia/a1aec7bd-ddb7-416f-9a7e-f2133cd5d4cb/20965.pdf.aspx?inline=true
Cancer Australia. National cancer control indicators: lung cancer. Australia. Accessed 27 April, 2021. Available from: https://ncci.canceraustralia.gov.au/cancer-types/lung-cancer
Health Quality & Safety Commission New Zealand. Atlas of Healthcare Variation: Lung Cancer. 2016. Available from: https://www.hqsc.govt.nz/our‐programmes/health‐quality‐evaluation/projects/atlas‐of‐healthcare‐variation/lung‐cancer/
Queensland Government. Queensland Lung Cancer Quality Index, Indicators of safe, quality cancer care, Lung cancer care in public and private hospitals, 2011–2016. 2020.
Brand MSR, Martin C, Lloyd M, Samankula U, Zalcberg J, on behalf of the Victorian Lung Cancer Registry. The Victorian Lung Cancer Registry Annual Report 2021. 6. 2023.
Nash J, Leong T, Dawkins P, Stone E, Marshall H, Brims F. The TSANZ and Lung Foundation Australia 2023 landscape survey of lung cancer care across Australia and Aotearoa New Zealand. Respirology. 2024;29(5):405–412. https://doi.org/10.1111/resp.14693
Roder D, You H, Baker D, Walton R, McCaughan B, Sranda S, et al. Using linked lung cancer registry and hospital data for guiding health service improvement. Asia Pacific Journal of Health Management. 2016;11(1):66–75.
Walters S, Maringe C, Coleman MP, Peake MD, Butler J, Young N, et al. Lung cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK: a population‐based study, 2004–2007. Thorax Jun. 2013;68(6):551–564. https://doi.org/10.1136/thoraxjnl-2012-202297
Mainz J. Defining and classifying clinical indicators for quality improvement. International J Qual Health Care Dec. 2003;15(6):523–530. https://doi.org/10.1093/intqhc/mzg081
Campbell SM, Braspenning J, Hutchinson A, Marshall M. Research methods used in developing and applying quality indicators in primary care. Qual Saf Health Care Dec. 2002;11(4):358–364. https://doi.org/10.1136/qhc.11.4.358
Donabedian A. Evaluating the quality of medical care. Milbank Q. 2005;83(4):691–729. https://doi.org/10.1111/j.1468-0009.2005.00397.x
Mainz J. Developing evidence‐based clinical indicators: a state of the art methods primer. International J Qual Health Care Dec. 2003;15(Suppl 1):i5–i11. https://doi.org/10.1093/intqhc/mzg084
Jakobsen E, Green A, Oesterlind K, Rasmussen TR, Iachina M, Palshof T. Nationwide quality improvement in lung cancer care: The role of the Danish Lung Cancer Group and Registry. J Thorac Oncol. 2013;8(10):1238–1247. https://doi.org/10.1097/JTO.0b013e3182a4070f
Ismail RK, Schramel FMNH, vanDartel M, Hilarius DL, de Boer A, Wouters MWJM, et al. The Dutch Lung Cancer Audit: Nationwide quality of care evaluation of lung cancer patients. Lung Cancer. 2020;149:68–77. https://doi.org/10.1016/j.lungcan.2020.08.011
Royal College of Surgeons of England. National Lung Cancer Audit: State of the Nation Report 2023. 2023.
Brown B, Galpin K, Simes J, Boyer M, Brown C, Chin V, et al. Development of clinically meaningful quality indicators for contemporary lung cancer care, and piloting and evaluation in a retrospective cohort; experiences of the Embedding Research (and Evidence) in Cancer Healthcare (EnRICH) Program. BMJ Open. 2024;14(2):e074399. https://doi.org/10.1136/bmjopen-2023-074399
Te Aho o Te Kahu. Lung Cancer Quality Improvement Monitoring Report 2021. 2021.
Smith S, Brand M, Harden S, Briggs L, Leigh L, Brims F, et al. Development of an Australia and New Zealand Lung Cancer Clinical Quality Registry: a protocol paper. BMJ Open Aug 29. 2022;12(8):e060907. https://doi.org/10.1136/bmjopen-2022-060907
Fitch KBSJ, Aguilar MD, Burnard B, LaCalle JR, Lázaro P, van hetLoo M, et al. The RAND/UCLA appropriateness method user's manual. RAND. 2001.
Zheng J, Sampurno F, George DJ, Morgans AK, Nguyen H, Abrahm JL, et al. Establishing metastatic prostate cancer quality indicators using a modified Delphi approach. Clin Genitourin Cancer Apr. 2022;20(2):e151–e157. https://doi.org/10.1016/j.clgc.2021.11.018
Jobson D, Roffey B, Arnold C, Azzi A, Button‐Sloan A, Dawson T, et al. Development of melanoma clinical quality indicators for the Australian melanoma clinical outcomes registry (MelCOR): A modified Delphi study. Australas J Dermatol Aug. 2022;63(3):344–351. https://doi.org/10.1111/ajd.13848
Keeney S, Hasson F, McKenna H. The Delphi technique in nursing and health research. 2011.
McKenna HP. The Delphi technique: a worthwhile research approach for nursing? J Adv Nurs Jun. 1994;19(6):1221–1225. https://doi.org/10.1111/j.1365-2648.1994.tb01207.x
Murphy MK, Black NA, Lamping DL, McKee CM, Sanderson CF, Askham J, et al. Consensus development methods, and their use in clinical guideline development. Health Technol Assess. 1998;2(3):i–iv, 1–88.
Chia‐Chien Hsu BAS. The Delphi Technique: Making Sense of Consensus. Pract Assess Res Eval. 2007;12:1–8. https://doi.org/10.7275/pdz9-th90
Powell C. The Delphi technique: myths and realities. J Adv Nurs Feb. 2003;41(4):376–382. https://doi.org/10.1046/j.1365-2648.2003.02537.x
Nash J, Brims F. International standards of care in thoracic oncology: A narrative review of clinical quality indicators. Lung Cancer Nov 17. 2023;186:107421. https://doi.org/10.1016/j.lungcan.2023.107421
Nash J, Brims F, Stone E, Stirling R, Dawkins P, Leong T. Lung Cancer (internet‐based) Delphi (LuCiD): Setting the standard for lung cancer care in Australia and New Zealand—a modified eDelphi consensus to determine clinical quality indicators for lung cancer [Research Protocol]. 2022.
Cancer Council. Optimal care pathway for people with lung cancer. 2021. June 2021. https://www.cancer.org.au/assets/pdf/lung-cancer-optimal-cancer-care-pathway
Ettinger DS, Wood DE, Aisner DL, Akerley W, Bauman JR, Bharat A, et al. Non‐Small Cell Lung Cancer, Version 3.2023, NCCN Clinical Practice Guidelines in Oncology. 2023.
Schneider L, Shargall Y, Schieman C, Seely AJ, Srinathan S, Malthaner RA, et al. Design of a consensus‐derived synoptic operative report for lung cancer surgery. Ann Thorac Surg Apr. 2014;97(4):1163–1168. https://doi.org/10.1016/j.athoracsur.2013.12.042
Johnson MJ, Yorke J, Hansen‐Flaschen J, Lansing R, Ekström M, Similowski T, et al. Towards an expert consensus to delineate a clinical syndrome of chronic breathlessness. Eur Respir J May. 2017;49(5):1602277. https://doi.org/10.1183/13993003.02277-2016
Public Health Scotland. Lung cancer quality performance indicators. 2023.
Baas P, Scherpereel A, Nowak AK, Fujimoto N, Peters S, Tsao AS, et al. First‐line nivolumab plus ipilimumab in unresectable malignant pleural mesothelioma (CheckMate 743): a multicentre, randomised, open‐label, phase 3 trial. Lancet Jan 30. 2021;397(10272):375–386. https://doi.org/10.1016/s0140-6736(20)32714-8
Department of Health and Aged Care. $148 million in new Medicare rebates for genetic testing. Updated 1 November 2023. Accessed 1 December, 2023. Available from: https://www.health.gov.au/ministers/the‐hon‐mark‐butler‐mp/media/148‐million‐in‐new‐medicare‐rebates‐for‐genetic‐testing
Department of Health and Aged Care. National Lung Cancer Screening Program. Australian Government—Department of Health and Aged Care. Updated 2 June 2023. Accessed 7 August, 2023. https://www.health.gov.au/our-work/national-lung-cancer-screening-program
Health Research Council of New Zealand. Māori‐led trial of lung cancer screening a first for New Zealand. Updated 19 May. Accessed 7 August, 2023. https://hrc.govt.nz/news-and-events/maori-led-trial-lung-cancer-screening-first-new-zealand
Mileshkin LR, Yoong J, Eggins R, Philip J, Brown C, Wright GM, et al. PEARL: A randomised phase 3 trial of palliative care early in advanced lung cancers (ALTG/TOGA 13/008). J Clin Oncol. 2022;40(Suppl_16):12020. https://doi.org/10.1200/JCO.2022.40.16_suppl.12020
Lai‐Kwon J, Rutherford C, Jefford M, Gore C, Best S. Using implementation science frameworks to guide the use of electronic patient‐reported outcome symptom monitoring in routine cancer care. JCO Oncol Pract. 2024;20:335–349. https://doi.org/10.1200/op.23.00462
Te Aho o Te Kahu. Lung cancer quality performance indicators: descriptions. 2021.
Cancer Quality Council of Ontario. Cancer System Quality Index 2021. 2021.
Jakobsen E, Rasmussen TR. The Danish Lung Cancer Registry. Clin Epidemiol. 2016;8:537–541. https://doi.org/10.2147/CLEP.S99458
Andreano A, Valsecchi MG, Russo AG, Siena S. Indicators of guideline‐concordant care in lung cancer defined with a modified Delphi method and piloted in a cohort of over 5,800 cases. Arch Public Health Jan 25. 2021;79(1):12. https://doi.org/10.1186/s13690-021-00528-0
Cerfolio RJ, Bryant AS. Optimal care of patients with non‐small cell lung cancer reduces perioperative morbidity. J Thorac Cardiovasc Surg Jan. 2011;141(1):22–33. https://doi.org/10.1016/j.jtcvs.2010.09.013
Stirling R, Martin C, Brand M, Zalcberg J, on behalf of the Victorian Lung Cancer Registry. The Victorian Lung Cancer Registry Annual Report 2020. Report No. 6.
Gattrell WT, Logullo P, vanZuuren EJ, Price A, Hughes EL, Blazey P, et al. ACCORD (ACcurate COnsensus Reporting Document): A reporting guideline for consensus methods in biomedicine developed via a modified Delphi. PLoS Med. 2024;21(1):e1004326. https://doi.org/10.1371/journal.pmed.1004326
Nasa P, Jain R, Juneja D. Delphi methodology in healthcare research: How to decide its appropriateness. World J Methodol Jul 20. 2021;11(4):116–129. https://doi.org/10.5662/wjm.v11.i4.116