Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany.
Strahlenther Onkol. 2011 Feb;187(2):89-99. doi: 10.1007/s00066-010-2202-6. Epub 2011 Jan 21.
A voluntary, external, science-based benchmarking program was established in Germany in 2003 to analyze and improve the quality of breast cancer (BC) care. Based on recent data from 2009, we aim to show that such analyses can also be performed for individual interdisciplinary specialties, such as radiation oncology (RO).
Breast centers were invited to participate in the benchmarking program. Nine guideline-based quality indicators (QIs) were initially defined, reviewed annually, and modified, expanded, or abandoned accordingly. QI changes over time were analyzed descriptively, with particular emphasis on relevance to radiation oncology.
During the 2003-2009 study period, there were marked increases in breast center participation and postoperatively confirmed primary BCs. Starting from 9 process QIs, 15 QIs were developed by 2009 as surrogate indicators of long-term outcome. During 2003-2009, 2/7 RO-relevant QIs (radiotherapy after breast-conserving surgery or after mastectomy) showed considerable increases (from 20 to 85% and 8 to 70%, respectively). Another three, initially high QIs practically reached the required levels.
The current data confirm proof-of-concept for the established benchmarking program, which allows participating institutions to be compared and changes in quality of BC care to be tracked over time. Overall, marked QI increases suggest that BC care in Germany improved from 2003-2009. Moreover, it has become possible for the first time to demonstrate improvements in the quality of BC care longitudinally for individual breast centers. In addition, subgroups of relevant QIs can be used to demonstrate the progress achieved, but also the need for further improvement, in specific interdisciplinary specialties.
2003 年，德国建立了一个自愿的、外部的、基于科学的基准测试计划，旨在分析和提高乳腺癌（BC）护理质量。基于 2009 年的最新数据，我们旨在表明，这种分析也可以针对个别跨学科专业进行，如放射肿瘤学（RO）。
邀请乳腺中心参加基准测试计划。最初定义了九个基于指南的质量指标（QIs），每年进行审查，并相应地进行修改、扩展或放弃。通过描述性分析来分析 QI 随时间的变化，特别强调与放射肿瘤学的相关性。
在 2003-2009 年的研究期间，乳腺中心的参与度和术后确诊的原发性 BC 显著增加。从 9 个过程 QIs 开始，到 2009 年发展为 15 个 QIs，作为长期结果的替代指标。在 2003-2009 年期间，2/7 个与 RO 相关的 QIs（保乳手术后或乳房切除术后的放疗）显示出相当大的增加（分别从 20%增加到 85%和从 8%增加到 70%）。另外三个最初的高 QI 实际上达到了所需的水平。
目前的数据证实了既定基准测试计划的概念验证，该计划允许对参与机构进行比较，并跟踪 BC 护理质量随时间的变化。总体而言，QIs 的显著增加表明，2003-2009 年德国的 BC 护理质量有所提高。此外，现在首次有可能对各个乳腺中心的 BC 护理质量进行纵向改善。此外，相关 QIs 的子组可用于证明特定跨学科专业取得的进展，但也需要进一步改进。
