Abstract：
Measuring and benchmarking quality of care in surgical oncology has been gaining popularity. In autologous breast reconstruction (ABR), a standardized set of indicators to assess quality of care is lacking. In this study, we defined a set of evidence-based quality indicators for autologous breast reconstruction. First, we performed a systematic review to identify factors related to quality of care in ABR. Variables were categorized depending on their function: indicators related to outcome, indicators related to process and case-mix variables. The review was followed by a 3-round Delphi Consensus to determine which indicators and case-mix-variables were considered relevant and feasible for inclusion in an ABR standard set of indicators. 932 unique articles were identified, of which 110 papers were included in the study. Indicators were categorized by function: outcome, process and case-mix variables. In total, 8 process indicators and 41 outcome indicators were extracted. 30 case-mix-variables were included. Following 3 rounds of questioning in the Delphi Consensus, all respondents agreed on type of ABR, oncological outcomes and patient satisfaction for the standard set. Indicators related to complications were consistently ranked highly. Most process indicators were not chosen after 3 rounds of questioning. 11 case-mix-variables were included in the final set. Following the Delphi Consensus, it was possible to identify 33 process and outcome indicators and 11 case-mix-variables for inclusion for a standard set of quality indicators. With the inclusion of both objective and patient-reported outcome measures, this set of indicators provides a multidimensional measurement tool for quality assessment for ABR.
摘要：
肿瘤外科护理质量的测量和基准化已经越来越受欢迎。在自体乳房重建（ABR）中，缺乏一套评估护理质量的标准化指标.在这项研究中,我们定义了一套基于证据的自体乳房重建质量指标.首先,我们进行了系统评价,以确定与ABR护理质量相关的因素.变量根据其功能进行分类：与结果相关的指标，与过程和案例混合变量相关的指标。审查之后是三轮德尔菲共识，以确定哪些指标和病例组合变量被认为是相关的和可行的，可以纳入ABR标准指标集。确定了932篇独特文章，其中110篇论文被纳入研究。指标按功能分类：结果，过程和案例混合变量。总的来说,提取了8个过程指标和41个结果指标。包括30个病例混合变量。在德尔菲共识的三轮质疑之后，所有受访者都同意ABR的类型，肿瘤结果和患者对标准集的满意度。与并发症相关的指标一直排名很高。经过3轮询问后，大多数过程指标都没有选择。最终集合中包括11个病例混合变量。根据德尔福共识，有可能确定33项过程和结果指标以及11项病例组合变量,以纳入一套标准质量指标.包括客观和患者报告的结果指标，这组指标为ABR的质量评估提供了多维测量工具.
