Meisner Christoph, Brinkmann Friedhelm, Henke Dagmar, Junack Cornelia, Faisst Simone, Heidemann Else
Institut für Medizinische Biometrie, Eberhard-Karls Universität Tübingen.
Z Evid Fortbild Qual Gesundhwes. 2011;105(5):365-70. doi: 10.1016/j.zefq.2011.05.014.
Quality-controlled documentation and evaluation of long-term course of disease is essential for measuring the outcome quality in the care of cancer patients. This project, based on the ongoing clinical cancer registry of the Comprehensive Oncology Centre (COC) Stuttgart, was aimed to integrate a long-term follow-up documentation and to compare outcome quality between centres of the OCC.
In a prospective, non-randomised, multi-centred, registry-based cohort study overall survival, disease free survival and quality of life were evaluated as indicators of outcome quality. The study included all patients suffering from breast, colon or rectum cancer, who were treated with curative intent in one of the centres of the OCC between Sep 30, 2003, and Dec 31, 2008. Cox regressions were used for the statistical evaluation of differences between centres.
Patients suffering from breast cancer (n=3,213), colon cancer (n=1,216) and rectum cancer (n=847) were eligible for the analysis. They were treated in 10 of 13 centres of the OCC. Statistically significant differences in the overall survival could be demonstrated between centres.
This project initiated a regular comparative evaluation of the outcome quality and showed that there are statistically significant differences between centres. Based on these findings, the benchmarking process will have to be further developed and elaborated.
对癌症患者护理的长期病程进行质量控制的记录和评估对于衡量治疗结果质量至关重要。本项目基于斯图加特综合肿瘤中心（COC）正在进行的临床癌症登记，旨在整合长期随访记录，并比较肿瘤中心联盟（OCC）各中心之间的治疗结果质量。
在一项前瞻性、非随机、多中心、基于登记处的队列研究中，将总生存期、无病生存期和生活质量作为治疗结果质量的指标进行评估。该研究纳入了2003年9月30日至2008年12月31日期间在OCC各中心之一接受根治性治疗的所有乳腺癌、结肠癌或直肠癌患者。采用Cox回归对各中心之间的差异进行统计学评估。
患有乳腺癌（n = 3213）、结肠癌（n = 1216）和直肠癌（n = 847）的患者符合分析条件。他们在OCC的13个中心中的10个中心接受了治疗。各中心之间在总生存期方面存在统计学上的显著差异。
本项目启动了对治疗结果质量的定期比较评估，并表明各中心之间存在统计学上的显著差异。基于这些发现，基准化过程将需要进一步发展和完善。
