title: Developing a reliable, valid, and feasible plan for quality-of-care measurement for cancer: how should we measure?
abstract: BACKGROUND
  Recent changes in the US health care delivery system have raised expectations that the medical marketplace will compete on quality and cost of care. This effort will require a systematic evaluation of the measurement of quality of care as it applies to cancer and other critical conditions.
  
  
  OBJECTIVE
  To articulate the components of the design of quality-of-care measurement systems that must be considered and optimally manipulated to generate feasible, reliable, and valid data pertinent to patients with cancer.
  
  
  METHODS
  A synthesis of information obtained from literature reviews and experience.
  
  
  METHODS
  Four key areas of design that influence quality-of-care measurement scores are discussed: case identification, data source, data-collection strategies, and the quality of the care-measurement model.
  
  
  RESULTS
  Challenges associated with these design and measurement strategies are defined and discussed.
  
  
  CONCLUSIONS
  Policy analyses vary as a function of measurement domains. The design of a quality-of-care measurement system should consider trade-offs between validity and burden by considering the intricate relations between domains of measurement.
authors.affiliation: RAND, Santa Monica, California 90406, USA. kkahn@rand.org
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Kahn
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Malin
authors.forename: John
authors.initials: J
authors.lastname: Adams
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Ganz
mesh_terms: D003625:Data Collection; D005240:Feasibility Studies; D006801:Humans; D008485:Medical Audit; D009369:Neoplasms / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D019984:Quality Indicators, Health Care; D015203:Reproducibility of Results; D012107:Research Design; D020379:Risk Adjustment; D014481:United States