School of Public Health and Preventative Medicine, Monash University, Victoria, Australia.
Monash Health, Victoria, Australia.
HPB (Oxford). 2022 Jun;24(6):950-962. doi: 10.1016/j.hpb.2021.11.005. Epub 2021 Nov 16.
This study: (i) assessed compliance with a consensus set of quality indicators (QIs) in pancreatic cancer (PC); and (ii) evaluated the association between compliance with these QIs and survival.
Four years of data were collected for patients diagnosed with PC. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). A multivariable analysis tested the relationship between significant patient and hospital characteristics, patient cluster effects within hospitals and survival.
1061 patients were eligible for this study. Significant association with improved survival were: (i) in the potentially resectable group having adjuvant chemotherapy administered following surgery or a reason documented (HR, 0.29; 95 CI, 0.19-0.46); (ii) in the locally advanced group included having chemotherapy ± chemoradiation, or a reason documented for not undergoing treatment (HR, 0.38; 95 CI, 0.25-0.58); and (iii) in the metastatic disease group included having documented performance status at presentation (HR, 0.65; 95 CI, 0.47-0.89), being seen by an oncologist in the absence of treatment (HR, 0.48; 95 CI, 0.31-0.77), and disease management discussed at a multidisciplinary team meeting (HR, 0.79; 95 CI, 0.64-0.96).
Capture of a concise data set has enabled quality of care to be assessed.
本研究：（i）评估了胰腺癌（PC）质量指标（QIs）共识集的依从性；（ii）评估了这些 QIs 的依从性与生存之间的关系。
收集了诊断为 PC 的患者四年的数据。使用 Cox 比例风险模型估计风险比（HRs）和 95%置信区间（CIs）。多变量分析测试了患者和医院特征、医院内患者聚类效应与生存之间的关系。
本研究纳入了 1061 名患者。与生存改善显著相关的因素包括：（i）在潜在可切除组中，术后给予辅助化疗或有记录的原因（HR，0.29；95%CI，0.19-0.46）；（ii）在局部进展组中，包括接受化疗±放化疗，或有记录的未接受治疗的原因（HR，0.38；95%CI，0.25-0.58）；（iii）在转移性疾病组中，包括在就诊时记录的体力状况（HR，0.65；95%CI，0.47-0.89），在没有治疗的情况下接受肿瘤学家的治疗（HR，0.48；95%CI，0.31-0.77），以及在多学科团队会议上讨论疾病管理（HR，0.79；95%CI，0.64-0.96）。
简洁数据集的捕获使我们能够评估医疗质量。
