Development of prostate cancer quality indicators: a modified Delphi approach.
OBJECTIVE
There is evidence of variation in both the processes and outcomes of prostate cancer care, resulting in possible harm to patients and increased costs to the health system. Care could be improved by first identifying critical, measurable indicators that correlate with quality of care. This work was conducted to develop indicators of prostate cancer care using a modified three-step Delphi approach.


METHODS
A 17-member multidisciplinary panel 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 31 possible indicators that emerged from 49 reviewed articles, 11 were prioritized by the panel as benchmarks for assessing the quality of surgical care for prostate cancer. The 11 indicators represent three levels of measurement (regional, hospital, individual provider) across several phases of care (diagnosis, surgery, pathology, and follow-up), as well as broad measures of outcomes.


CONCLUSIONS
A systematic evidence- and consensus-based approach was used to develop quality indicators of prostate cancer care, with a focus on pre-, peri- and post-operative care as well as outcomes. Some of the indicators selected by the panel were also recommended by a similarly structured panel process. These indicators can be used by individual providers and organizations to monitor the quality of their services, and develop interventions to address any variations.
Gagliardi
Anna R
AR
Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada.
Fleshner
Neil
N
Langer
Bernard
B
Stern
Hartley
H
Brown
Adalsteinn D
AD
D003697:Delphi Technique; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000601:surgery*; D019984:Quality Indicators, Health Care; D014572:Urology / Q000592:standards*