Luyckx Annemie, Wyckmans Leen, Bonte Anne-Sophie, Trinh Xuan Bich, van Dam Peter A
Multidisciplinary Oncologic Centre Antwerp (MOCA), Antwerp University Hospital, Wilrijkstraat 10, B2650, Edegem, Belgium.
Centre for Oncological Research (CORE), University of Antwerp, B2610, Wilrijk, Belgium.
BMC Womens Health. 2020 Jul 23;20(1):151. doi: 10.1186/s12905-020-00999-3.
Measuring quality indicators (QI's) is a tool to improve the quality of care. The aim of this study was to evaluate the acceptability of 36 QI's, defined after a literature search for the management of endometrial, cervical and ovarian cancer. Relevant specialists in the field of interest were surveyed.
To quantify the opinions of these specialists, an online survey was sent out via mailing to members of gynaecological or oncological societies. The relevance of each QI was questioned on a scale from one to five (1 = irrelevant, 2 = less relevant, 3 = no opinion/neutral, 4 = relevant, 5 = very relevant). If a QI received a score of 4 or 5 in 65% or more of the answers, we state that the respondents consider this QI to be sufficiently relevant to use in daily practice.
The survey was visited 238 times and resulted in 53 complete responses (29 Belgian, 24 other European countries). The majority of the specialists were gynaecologists (45%). Five of the 36 QI's (13,9%) did not reach the cut-off of 65%: referral to a tertiary center, preoperative staging of endometrial cancer by MRI, preoperative staging of cervical cancer by positron-emission tomography, incorporation of intracavitary brachytherapy in the treatment of cervical cancer, reporting ASA and WHO score for each patient. After removing the 5 QI's that were not considered as relevant by the specialists and 3 additional 3 QI's that we were considered to be superfluous, we obtained an optimized QI list.
As QI's gain importance in gynecological oncology, their use can only be of value if they are universally interpreted in the same manner. We propose an optimized list of 28 QI's for the management of endometrial, cervical and ovarian cancer which responders of our survey found relevant. Further validation is needed to finalize and define a set of QI's that can be used in future studies, audits and benchmarking.
衡量质量指标是提高医疗质量的一种工具。本研究的目的是评估通过文献检索确定的36项用于子宫内膜癌、宫颈癌和卵巢癌管理的质量指标的可接受性。对相关领域的专家进行了调查。
为了量化这些专家的意见，通过邮件向妇科或肿瘤学会的成员发送了在线调查问卷。每个质量指标的相关性按照1至5分进行询问（1 = 不相关，2 = 相关性较低，3 = 无意见/中立，4 = 相关，5 = 非常相关）。如果一个质量指标在65%或更多的回答中获得4分或5分，我们就认为受访者认为该质量指标在日常实践中具有足够的相关性，可以使用。
该调查问卷被访问了238次，共收到53份完整回复（29份来自比利时，24份来自其他欧洲国家）。大多数专家是妇科医生（45%）。36项质量指标中有5项（13.9%）未达到65%的临界值：转诊至三级中心、通过磁共振成像对子宫内膜癌进行术前分期、通过正电子发射断层扫描对宫颈癌进行术前分期、在宫颈癌治疗中纳入腔内近距离放疗、报告每位患者的美国麻醉医师协会（ASA）和世界卫生组织（WHO）评分。在去除专家认为不相关的5项质量指标以及另外3项我们认为多余的质量指标后，我们得到了一份优化的质量指标清单。
随着质量指标在妇科肿瘤学中的重要性日益增加，只有当它们以相同的方式被普遍解释时，其使用才会有价值。我们提出了一份针对子宫内膜癌、宫颈癌和卵巢癌管理的28项优化质量指标清单，我们调查的受访者认为这些指标是相关的。需要进一步验证以最终确定并定义一组可用于未来研究、审核和基准测试的质量指标。
