Wayne State University School of Medicine, Detroit, Michigan, USA.
Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.
Head Neck. 2021 Jun;43(6):1788-1796. doi: 10.1002/hed.26640. Epub 2021 Feb 17.
The standardization of quality measures has been key in advancing the aims of the National Quality Forum established to improve health outcomes.
The National Cancer Database was used to identify eligible patients. Two quality metrics were evaluated including time to treatment initiation (TTI) and chemotherapy in locoregionally head and neck squamous cell carcinoma (HNSCC).
TTI was significantly associated with mortality reflected by a hazard ratio (HR) of 1.13 for 60-90 days of TTI (95% CI 1.08-1.17), 1.19 for >90 days of TTI (95% CI 1.13-1.26). Patients with locoregionally advanced HNSCC had an 87% adherence to chemotherapy, which correlated with reduced mortality (HR 0.57; 95% CI 0.55-0.59). Patients treated at high quality centers had a 9% increase in survival (HR 0.91; 95% CI 0.88-0.93).
We identified that both TTI and chemotherapy for locoregionally advanced HNSCC meet criteria for valid quality metrics potentially suitable for national adoption.
为了提高国家质量论坛的目标，标准化质量指标一直是关键，该论坛旨在改善健康结果。
利用国家癌症数据库确定合格患者。评估了两个质量指标，包括局部区域头颈部鳞状细胞癌（HNSCC）的治疗开始时间（TTI）和化疗时间。
TTI 与死亡率显著相关，60-90 天 TTI 的风险比（HR）为 1.13（95% CI 1.08-1.17），90 天以上 TTI 的 HR 为 1.19（95% CI 1.13-1.26）。局部晚期 HNSCC 患者化疗的依从率为 87%，死亡率降低（HR 0.57；95% CI 0.55-0.59）。在高质量中心治疗的患者生存率提高了 9%（HR 0.91；95% CI 0.88-0.93）。
我们发现局部区域晚期 HNSCC 的 TTI 和化疗均符合有效质量指标的标准，可能适合全国采用。
