Bao Han, Yang Fengjuan, Wang Xinyu, Su Shaofei, Liu Dan, Fu Rong, Zhang Huimin, Liu Meina
Department of Biostatistics, Public Health College, Harbin Medical University, Harbin, PR China.
Int J Qual Health Care. 2015 Aug;27(4):291-6. doi: 10.1093/intqhc/mzv042. Epub 2015 Jun 23.
Large gaps exist between clinical practice and recommended care of breast cancer. Evidence demonstrates that assessment of breast cancer care can help bridge these gaps. However, no valid indicators are currently available for measurement of breast cancer care in China. This study aimed to develop a set of quality indicators to measure and improve the quality of breast cancer care.
A modified Delphi process was implemented, and each of the six selection criteria (scientific evidence, utility, interpretability, validity, preventability and data availability) for potential indicators was evaluated on a 5-point scale.
A 16-member expert panel was assembled, including 10 medical oncologists, 5 surgical oncologists and 1 radiation oncologist.
Quality indicators with mean ratings ≥4, coefficient of variation equal to or <25% and selectivity ≥81.25% in each of the six selection criteria were retained for the face-to-face round.
Twenty-six indicators were retained from the rating round and five indicators were retrieved in the face-to-face round. A total of 31 indicators constituted the final set of quality indicators, and the number of indicators pertaining to structure, process, communication and cooperation, management of symptoms or treatment toxicity and outcome was 1, 24, 2, 2 and 2, respectively.
Quality indicators for breast cancer care can be systematically developed and will be utilized as a quality measurement tool for breast cancer care.
乳腺癌的临床实践与推荐治疗之间存在较大差距。有证据表明,对乳腺癌治疗进行评估有助于缩小这些差距。然而,目前中国尚无用于衡量乳腺癌治疗的有效指标。本研究旨在制定一套质量指标,以衡量和提高乳腺癌治疗质量。
采用改良的德尔菲法,对潜在指标的六个选择标准(科学证据、实用性、可解释性、有效性、可预防性和数据可用性)分别采用5分制进行评估。
组建了一个由16名成员组成的专家小组,包括10名医学肿瘤学家、5名外科肿瘤学家和1名放射肿瘤学家。
在六个选择标准中,平均评分≥4、变异系数等于或<25%且选择性≥81.25%的质量指标被保留用于面对面轮次。
在评分轮次中保留了26项指标,在面对面轮次中检索到5项指标。共有31项指标构成了最终的质量指标集,与结构、过程、沟通与合作、症状或治疗毒性管理以及结局相关的指标数量分别为1、24、2、2和2。
乳腺癌治疗质量指标可以系统地制定,并将用作乳腺癌治疗的质量衡量工具。