Chiew K-L, Donnelly C, Harden S V, Hanna G G, Hardcastle N, Jolly S, Lehman M, Matuszak M M, McDonald F, Soon Y Y, Tsang Y M, Ynoe Moraes F, Vinod S K
Princess Alexandra Hospital, Division of Cancer Services, Brisbane, Australia; South Western Clinical School, University of New South Wales, Liverpool, Australia.
Faculty of Medicine and Health, University of Sydney, Camperdown, Australia.
Clin Oncol (R Coll Radiol). 2025 Aug;44:103886. doi: 10.1016/j.clon.2025.103886. Epub 2025 May 30.
While there are many published quality indicators (QIs) for assessing clinical care in lung cancer, few specifically measure the quality of radiotherapy (RT). To address this gap, we used a structured modified Delphi technique to develop a core set of QIs and benchmarks to evaluate RT processes for lung cancer treatment.
Candidate QIs identified from the systematic review were evaluated through survey consensus and deliberation by a multidisciplinary reference committee for inclusion in the initial survey and then after each round. A modified Delphi technique was employed across two rounds to reach consensus for QI development. The international expert survey panel consisting of radiation oncologists treating lung cancer rated QI importance, feasibility, and benchmarks, with consensus predefined as at least 70% of respondents reaching a threshold rating on a Likert scale.
There were 70 respondents over two surveys, with 30 of the 47 QIs reaching the threshold for importance in the first Delphi round and 29 after the final Delphi round. Agreement ranged from 71% to 97% with 12 QIs reaching a consensus of 90% or more. Final consensus was reached as all 29 QIs were identified as feasible, and 27 of the suggested benchmarks were deemed acceptable.
This core set of QIs provides a well-defined framework for evaluating RT processes in lung cancer treatment. They have the potential to establish a foundation for standardised quality measurement and benchmarking for guiding quality improvement efforts and improving patient outcomes.
虽然有许多已发表的用于评估肺癌临床护理的质量指标（QIs），但专门衡量放射治疗（RT）质量的指标却很少。为了填补这一空白，我们采用结构化的改良德尔菲技术来制定一套核心的质量指标和基准，以评估肺癌治疗的放射治疗过程。
通过多学科参考委员会的调查共识和审议，对系统评价中确定的候选质量指标进行评估，以纳入初始调查以及每一轮调查之后的评估。在两轮调查中采用改良德尔菲技术以达成质量指标制定的共识。由治疗肺癌的放射肿瘤学家组成的国际专家调查小组对质量指标的重要性、可行性和基准进行评分，将至少70%的受访者在李克特量表上达到阈值评分预定义为达成共识。
在两轮调查中有70名受访者，47个质量指标中有30个在第一轮德尔菲调查中达到重要性阈值，在最终德尔菲调查后有29个达到该阈值。一致性范围为71%至97%，其中12个质量指标达成了90%或更高的共识。由于所有29个质量指标都被确定为可行，并且所建议的27个基准被认为是可接受的，因此达成了最终共识。
这套核心质量指标为评估肺癌治疗中的放射治疗过程提供了一个明确界定的框架。它们有可能为标准化质量测量和基准设定奠定基础，以指导质量改进工作并改善患者预后。
