title: Development of ovarian cancer surgery quality indicators using a modified Delphi approach.
abstract: OBJECTIVE
  Little performance measurement has been undertaken in the area of oncology, particularly for surgery which is a pivotal event in the continuum of cancer care. This work was conducted to develop indicators of quality ovarian cancer surgery using a modified three-step Delphi approach.
  
  
  METHODS
  A multidisciplinary panel, comprised of surgical and methodologic co-chairs, nine surgeons, one medical oncologist, one radiation oncologist, a nurse, and a pathologist, reviewed potential indicators extracted from the medical literature through two consecutive rounds of rating followed by consensus discussion. The panel then prioritized the indicators selected in the previous two rounds.
  
  
  RESULTS
  Of 33 possible indicators that emerged from 41 selected articles, 14 were prioritized by the panel as benchmarks for assessing the quality of surgical care. The 14 indicators represent three levels of measurement (provincial/regional, hospital, individual provider) across several phases of care (diagnosis, surgery, pathology, and adjuvant therapy), as well as broad measures of access and outcomes. Some of the indicators selected by the panel were also recommended as standards of care by national initiatives in other countries.
  
  
  CONCLUSIONS
  A systematic evidence- and consensus-based approach was used to develop quality indicators of ovarian cancer care, with a focus on pre-, peri-, and postoperative care as well as outcomes, that are applicable in any jurisdiction.
authors.affiliation: Surgical Oncology Program, Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Gagliardi
authors.forename: Michael Fung Kee
authors.initials: MF
authors.lastname: Fung
authors.forename: Bernard
authors.initials: B
authors.lastname: Langer
authors.forename: Hartley
authors.initials: H
authors.lastname: Stern
authors.forename: Adalsteinn D
authors.initials: AD
authors.lastname: Brown
mesh_terms: D032921:Consensus; D003697:Delphi Technique; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods / Q000592:standards*; D006801:Humans; D010051:Ovarian Neoplasms / Q000601:surgery*; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care; D016896:Treatment Outcome