PDF(Pubmed)
Abstract：
OBJECTIVE: Lung cancer continues to be the most common cause of cancer-related death and the leading cause of morbidity and burden of disease across Australia. There is an ongoing need to identify and reduce unwarranted clinical variation that may contribute to these poor outcomes for patients with lung cancer. An Australian national strategy acknowledges clinical quality outcome data as a critical component of a continuously improving healthcare system but there is a need to ensure clinical quality indicators adequately measure evidence-based contemporary care, including novel and emerging treatments. This study aimed to develop a suite of lung cancer-specific, evidence-based, clinically acceptable quality indicators to measure quality of care and outcomes, and an associated comparative feedback dashboard to provide performance data to clinicians and hospital administrators.
METHODS: A multistage modified Delphi process was undertaken with a Clinical Advisory Group of multidisciplinary lung cancer specialists, with patient representation, to update and prioritise potential indicators of lung cancer care derived from a targeted review of published literature and reports from national and international lung cancer quality registries. Quality indicators were piloted and evaluated with multidisciplinary teams in a retrospective observational cohort study using clinical audit data from the Embedding Research (and Evidence) in Cancer Healthcare Program, a prospective clinical cohort of over 2000 patients with lung cancer diagnosed from May 2016 to October 2021.
METHODS: Six tertiary specialist cancer centres in metropolitan and regional New South Wales, Australia.
RESULTS: From an initial 37 potential quality indicators, a final set of 10 indicators spanning diagnostic, treatment, quality of life and survival domains was agreed.
CONCLUSIONS: These indicators build on and update previously available measures of lung cancer care and outcomes in use by national and international lung cancer clinical quality registries which, to our knowledge, have not been recently updated to reflect the changing lung cancer treatment paradigm.
METHODS: A multistage modified Delphi process was undertaken with a Clinical Advisory Group of multidisciplinary lung cancer specialists, with patient representation, to update and prioritise potential indicators of lung cancer care derived from a targeted review of published literature and reports from national and international lung cancer quality registries. Quality indicators were piloted and evaluated with multidisciplinary teams in a retrospective observational cohort study using clinical audit data from the Embedding Research (and Evidence) in Cancer Healthcare Program, a prospective clinical cohort of over 2000 patients with lung cancer diagnosed from May 2016 to October 2021.
METHODS: Six tertiary specialist cancer centres in metropolitan and regional New South Wales, Australia.
RESULTS: From an initial 37 potential quality indicators, a final set of 10 indicators spanning diagnostic, treatment, quality of life and survival domains was agreed.
CONCLUSIONS: These indicators build on and update previously available measures of lung cancer care and outcomes in use by national and international lung cancer clinical quality registries which, to our knowledge, have not been recently updated to reflect the changing lung cancer treatment paradigm.
摘要：
目的：肺癌仍然是澳大利亚癌症相关死亡的最常见原因，也是发病率和疾病负担的主要原因。目前仍需要确定和减少可能导致肺癌患者这些不良结果的不必要的临床变异。澳大利亚国家战略承认临床质量结果数据是不断改进医疗保健系统的关键组成部分，但需要确保临床质量指标充分衡量基于证据的当代护理。包括新的和新兴的治疗方法。这项研究旨在开发一套肺癌特异性，以证据为基础,临床上可接受的质量指标，用于衡量护理质量和结果，和相关的比较反馈仪表板，向临床医生和医院管理员提供绩效数据。
方法：由多学科肺癌专家组成的临床咨询小组进行了多阶段的改良Delphi过程。有病人代表，更新和优先考虑肺癌治疗的潜在指标，这些指标来自对国家和国际肺癌质量登记处已发表的文献和报告的有针对性的审查。质量指标在回顾性观察队列研究中，使用来自癌症医疗保健计划中的嵌入研究（和证据）的临床审核数据，与多学科团队一起进行了试点和评估。对2016年5月至2021年10月诊断的2000多名肺癌患者进行前瞻性临床队列研究.
方法：新南威尔士州大都市和地区的六个三级癌症专科中心，澳大利亚。
结果：从最初的37项潜在质量指标来看，最后一组涵盖诊断的10个指标，治疗,生活质量和生存领域达成一致。
结论：这些指标建立并更新了国家和国际肺癌临床质量登记处以前可用的肺癌护理和结果衡量标准，根据我们的知识，最近没有更新以反映不断变化的肺癌治疗模式。
方法：由多学科肺癌专家组成的临床咨询小组进行了多阶段的改良Delphi过程。有病人代表，更新和优先考虑肺癌治疗的潜在指标，这些指标来自对国家和国际肺癌质量登记处已发表的文献和报告的有针对性的审查。质量指标在回顾性观察队列研究中，使用来自癌症医疗保健计划中的嵌入研究（和证据）的临床审核数据，与多学科团队一起进行了试点和评估。对2016年5月至2021年10月诊断的2000多名肺癌患者进行前瞻性临床队列研究.
方法：新南威尔士州大都市和地区的六个三级癌症专科中心，澳大利亚。
结果：从最初的37项潜在质量指标来看，最后一组涵盖诊断的10个指标，治疗,生活质量和生存领域达成一致。
结论：这些指标建立并更新了国家和国际肺癌临床质量登记处以前可用的肺癌护理和结果衡量标准，根据我们的知识，最近没有更新以反映不断变化的肺癌治疗模式。
