New research has identified indicators of surgical quality for colorectal cancer patients, according to a study published in the November 15 issue of the Journal of the National Cancer Institute.
Quality of care measures have been developed for many diseases and are used by agencies like the Centers for Medicare and Medicaid Services to evaluate the quality of care for a variety of diseases. No regulatory agencies have currently adopted quality of care measures for colorectal cancer surgery, but practice guidelines for this surgery were created by a consensus panel sponsored by the National Cancer Institute (NCI) in 2000.
Marcia L. McGory, M.D., of the University of California in Los Angeles, and colleagues updated and extended the NCI-sponsored guidelines. Using a modification of the RAND/UCLA Appropriateness Methodology, which assesses indicators of care using a series of ratings by a panel of experts, they conducted interviews with leading specialists in colorectal cancer, general surgery, and surgical oncology, and reviewed the literature to identify candidate quality of care measures for colorectal cancer surgery. An expert panel then evaluated the candidate indicators.
The authors identified 142 candidate indicators of quality care in the fields of surgical credentials, preoperative evaluation, patient-provider discussions, medication use, intraoperative care, and postoperative management. The expert panel rated 92 of these indicators as valid. The authors suggest that these indicators of quality care for colorectal cancer surgery can be used to measure the quality of care for colorectal cancer patients and create quality-improvement programs.
"These indicators identify potentially meaningful and important steps for providing high quality cancer care among health care systems, hospitals, and providers offering surgical care to patients with colorectal cancer," they write.