Quality Indicators for Global Benchmarking of Localized Prostate Cancer Management

Fanny Sampurno; Jia Zheng; Lydia Di Stefano; Jeremy L Millar; Claire Foster; Ferran Fuedea; Celestia Higano; Hartwig Hulan; Stephen Mark; Caroline Moore; Alison Richardson; Frank Sullivan; Neil S Wenger; Daniela Wittmann; Sue Evans

doi:10.1016/j.juro.2018.02.071

Quality Indicators for Global Benchmarking of Localized Prostate Cancer Management

J Urol. 2018 Aug;200(2):319-326. doi: 10.1016/j.juro.2018.02.071. Epub 2018 Mar 1.

Authors

Affiliations

¹ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
² William Buckland Radiotherapy Centre, Alfred Health, Melbourne, Victoria, Australia.
³ Faculty of Health Sciences, University of Southampton and University Hospital Southampton, Southampton and Urology, London, United Kingdom.
⁴ Radiation Oncology Department, Institut Català d'Oncologia, Radiation Oncology, Barcelona University and Radiobiology and Cancer Group, Bellvitge Biochemical Research Institute, Barcelona, Spain.
⁵ Department of Medicine, Division of Medical Oncology, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington.
⁶ Martini-Klinik, Prostate Cancer Centre, University Hamburg, Hamburg, Germany.
⁷ Department of Urology, Christchurch Hospital and University of Otago, Christchurch, New Zealand.
⁸ Division of Surgical and Interventional Science, University College London, London, United Kingdom.
⁹ Cancer Nursing and End of Life Care, Faculty of Health Sciences, University of Southampton and University Hospital Southampton, Southampton and Urology, London, United Kingdom.
¹⁰ Prostate Cancer Institute, National University of Ireland Galway and Department of Radiation Oncology, Galway Clinic, Galway, Ireland.
¹¹ Division of General Internal Medicine, University of California-Los Angeles, Los Angeles, California.
¹² Department of Urology, University of Michigan, Ann Arbor, Michigan.
¹³ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. Electronic address: Sue.Evans@monash.edu.

PMID: 29477721
DOI: 10.1016/j.juro.2018.02.071

Abstract

Purpose: We sought to develop a core set of clinical indicators to enable international benchmarking of localized prostate cancer management using data available in the TrueNTH Global Registry.

Materials and methods: An international expert panel completed an online survey and participated in a face-to-face meeting. Participants included 3 urologists, 3 radiation oncologists, 2 psychologists, 1 medical oncologist, 1 nurse and 1 epidemiologist with prostate cancer expertise from a total of 7 countries. Current guidelines on prostate cancer treatment and potential quality indicators were identified from a literature review. These potential indicators were refined and developed through a modified Delphi process during which each panelist independently and repeatedly rated each indicator based on importance (satisfying the indicator demonstrated a provision of high quality care) and feasibility (the likelihood that data used to construct the indicator could be collected at a population level). The main outcome measure was items with panel agreement indicated by a disagreement index less 1, median importance 8.5 or greater and median feasibility 9 or greater.

Results: The expert panel endorsed 33 indicators. Seven of these 33 prostate cancer quality indicators assessed care relating to diagnosis, 7 assessed primary treatment, 1 assessed salvage treatment and 18 assessed health outcomes.

Conclusions: We developed a set of quality indicators to measure prostate cancer care using numerous international evidence-based clinical guidelines. These indicators will be pilot tested in the TrueNTH Global Registry. Reports comparing indicator performance will subsequently be distributed to groups at participating sites with the purpose of improving the consistency and quality of prostate cancer management on a global basis.

Keywords: Delphi technique; evidence-based medicine; health care; practice guidelines as topic; prostatic neoplasms; quality indicators.

MeSH terms

Benchmarking / methods*
Benchmarking / standards
Delphi Technique
Global Health / standards*
Humans
Interdisciplinary Communication
International Cooperation
Male
Outcome Assessment, Health Care / methods*
Outcome Assessment, Health Care / standards
Practice Guidelines as Topic
Prostatic Neoplasms / diagnosis
Prostatic Neoplasms / therapy*
Quality Indicators, Health Care / standards*
Registries / statistics & numerical data
Surveys and Questionnaires
Treatment Outcome