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Kwaliteitsindicatoren in oncologie

Authors
Publisher
KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre
Keywords
  • Wj 858 Urogenital System - - Male Genitalia - - Neoplasms
  • Testicular Neoplasms
  • Quality Of Health Care
  • Quality Indicators
  • Health Care
  • Quality Assurance
  • Health Care
  • Physician'S Practice Patterns
  • R149
  • 2008-52
Disciplines
  • Medicine

Abstract

1 INTRODUCTION 4 -- 2 SELECTION PROCESS OF QUALITY INDICATORS 5 -- 2.1 METHODOLOGY 5 -- 2.1.1 Literature search 5 -- 2.1.2 Addition of guideline-based quality indicators 5 -- 2.1.3 Selection process 5 -- 2.2 RESULTS 6 -- 3 DATA SELECTION 8 -- 3.1 PRIMARY SELECTION 8 -- 3.2 ADDITIONAL SELECTION 10 -- 3.3 EXPLORATION AND CHECK OF BCR DATA 11 -- 3.4 DATA LINKAGE 14 -- 3.4.1 Linking BCR data to IMA data 14 -- 3.4.2 Linking BCR data to MCD data 14 -- 4 DESCRIPTIVE STATISTICS 16 -- 4.1 DEMOGRAPHIC INFORMATION 16 -- 4.2 TUMOUR CHARACTERISTICS 16 -- 4.2.1 Solitary vs. multiple tumours 16 -- 4.2.2 Morphology 17 -- 4.2.3 Stage 17 -- 4.2.4 Incidence rates 18 -- 4.3 DIAGNOSIS AND STAGING 19 -- 4.4 TREATMENT 19 -- 4.5 HOSPITALIZATION 21 -- 5 INDICATOR RESULTS 22 -- 5.1 OVERALL MEASURABILITY OF THE SELECTED QUALITY INDICATORS 22 -- 5.2 INDICATOR RESULTS 23 -- 5.2.1 Diagnosis and staging 23 -- 5.2.2 Treatment 24 -- 5.2.3 Residual disease assessment after systemic treatment for stage II and III disease 29 -- 5.2.4 Mortality 29 -- 6 DISCUSSION 32 -- 6.1 INDICATOR RESULTS 32 -- 6.1.1 National level 32 -- 6.1.2 Comparison between centres 35 -- 6.2 INDICATOR MEASURABILITY AND INTERPRETABILITY 36 -- 6.3 DESIRABILITY OF A QUALITY INDICATOR SET FOR TESTICULAR CANCER 39 -- 6.4 CONCLUSIONS 39 -- 7 APPENDICES 40 -- 7.1 SEARCH STRATEGY OVID MEDLINE 40 -- 7.2 EVALUATION SCORES OF THE LONG LIST OF QUALITY INDICATORS 41 -- 7.3 CONSTRUCTION OF AN ALGORITHM TO ATTRIBUTE A PATIENT TO A HOSPITAL -- BASED ON IMA ADMINISTRATIVE DATA 44 -- 7.3.1 Introduction 44 -- 7.3.2 Methods 45 -- 7.3.3 Results 47 -- 7.4 METHODS OF ANALYSIS 50 -- 7.4.1 Descriptive statistics by type of outcome 50 -- 7.4.2 Graphical description of the variability per centre (funnel plots) 50 -- 7.5 TECHNICAL FILES INDICATORS 53 -- 7.5.1 TC1: Proportion of patients with testicular cancer undergoing tumour marker -- assessment before any treatment 53 -- 7.5.2 TC2: Proportion of patients with testicular cancer undergoing CE-CT or MRI for -- primary staging 57 -- 7.5.3 TC3: Proportion of patients with testicular cancer discussed at the MDT meeting 59 -- 7.5.4 TC4: Number of annually surgically treated patients with testicular cancer per centre 61 -- 7.5.5 TC5: Radiation dose and field in patients with testicular cancer treated with -- radiotherapy by stage 65 -- 7.5.6 TC6: Proportion of patients with stage I non-seminoma treated with active surveillance -- . 67 -- 7.5.7 TC7: Proportion of patients receiving CE-CT or MRI for residual disease assessment at -- the end of systemic treatment 71 -- 7.5.8 TC8: Degree and duration of active surveillance in patients with stage I NSGCT or -- SGCT 73 -- 7.5.9 TC9: Proportion of patients with relapsing testicular cancer after curative treatment -- that are included in a clinical trial 79 -- 7.5.10 TC10: Overall 5-year survival by stage 81 -- 7.5.11 TC11: Disease-specific 5-year survival by stage 84 -- 7.5.12 TC12: Disease-free 5-year survival by stage 85 -- 7.6 ADMINISTRATIVE CODES 88 -- 7.6.1 Diagnosis and staging 88 -- 7.6.2 Surgery 100 -- 7.6.3 Radiotherapy 101 -- 7.6.4 Chemotherapy 101

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