Centre of Research Excellence in Patient Safety, Monash University, Melbourne, Australia.
BJU Int. 2013 Apr;111(4 Pt B):E158-66. doi: 10.1111/j.1464-410X.2012.11530.x. Epub 2012 Nov 1.
To establish a pilot population-based clinical registry with the aim of monitoring the quality of care provided to men diagnosed with prostate cancer.
All men aged >18 years from the contributing hospitals in Victoria, Australia, who have a diagnosis of prostate cancer confirmed by histopathology report notified to the Victorian Cancer Registry are eligible for inclusion in the Prostate Cancer Registry (PCR). A literature review was undertaken aiming to identify existing quality indicators and source evidence-based guidelines from both Australia and internationally.
A Steering Committee was established to determine the minimum dataset, select quality indicators to be reported back to clinicians, identify the most effective recruitment strategy, and provide a governance structure for data requests; collection, analysis and reporting of data; and managing outliers. A minimum dataset comprising 72 data items is collected by the PCR, enabling ten quality indicators to be collected and reported. Outcome measures are risk adjusted according to the established National Comprehensive Cancer Network and Cancer of the Prostate Risk Assessment Score (surgery only) risk stratification model. Recruitment to the PCR occurs concurrently with mandatory notification to the state-based Cancer Registry. The PCR adopts an opt-out consent process to maximize recruitment. The data collection approach is standardized, using a hybrid of data linkage and manual collection, and data collection forms are electronically scanned into the PCR. A data access policy and escalation policy for mortality outliers has been developed.
The PCR provides potential for high-quality population-based data to be collected and managed within a clinician-led governance framework. This approach satisfies the requirement for health services to establish quality assessment, at the same time as providing clinically credible data to clinicians to drive practice improvement.
建立一个基于人群的试点临床注册系统，旨在监测为被诊断为前列腺癌的男性提供的医疗质量。
所有来自澳大利亚维多利亚州参与医院的年龄>18 岁的男性，其前列腺癌的诊断通过组织病理学报告通知维多利亚癌症登记处，有资格被纳入前列腺癌登记处（PCR）。进行了文献回顾，旨在确定现有的质量指标，并从澳大利亚和国际上寻找基于证据的指南。
成立了一个指导委员会，以确定最小数据集，选择要向临床医生报告的质量指标，确定最有效的招募策略，并为数据请求提供治理结构；数据的收集、分析和报告；以及管理异常值。PCR 收集了一个包含 72 个数据项的最小数据集，能够收集和报告 10 个质量指标。根据既定的国家综合癌症网络和前列腺癌风险评估评分（仅手术）风险分层模型，对结果进行风险调整。PCR 的招募与向州癌症登记处的强制性通知同时进行。PCR 采用退出同意过程，以最大限度地提高招募率。数据收集方法是标准化的，采用数据链接和手动收集的混合方法，并将数据收集表电子扫描到 PCR 中。制定了数据访问政策和死亡率异常值的升级政策。
PCR 提供了在以临床医生为主导的治理框架内收集和管理高质量人群数据的潜力。这种方法满足了卫生服务机构建立质量评估的要求，同时为临床医生提供了有临床可信度的数据，以推动实践改进。
