title: Development of quality indicators for colorectal cancer surgery, using a 3-step modified Delphi approach.
abstract: BACKGROUND
  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 for colorectal cancer surgery, using a 3-step modified Delphi approach.
  
  
  METHODS
  A multidisciplinary panel, comprising surgical and methodological co-chairs, 9 surgeons, a medical oncologist, a radiation oncologist, a nurse and a pathologist, reviewed potential indicators extracted from the medical literature through 2 consecutive rounds of rating followed by consensus discussion. The panel then prioritized the indicators selected in the previous 2 rounds.
  
  
  RESULTS
  Of 45 possible indicators that emerged from 30 selected articles, 15 were prioritized by the panel as benchmarks for assessing the quality of surgical care. The 15 indicators represent 3 levels of measurement (provincial/regional, hospital, individual provider) across several phases of care (diagnosis, surgery, adjuvant therapy, pathology and follow-up), as well as broad measures of access and outcome. The indicators selected by the panel were more often supported by evidence than those that were discarded.
  
  
  CONCLUSIONS
  This project represents a unique initiative, and the results may be applicable to colorectal cancer surgery in any jurisdiction.
authors.affiliation: Sunnybrook and Women's College Health Sciences Centre, Toronto.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Gagliardi
authors.forename: Marko
authors.initials: M
authors.lastname: Simunovic
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: D019985:Benchmarking; D015179:Colorectal Neoplasms / Q000601:surgery*; D003107:Colorectal Surgery / Q000592:standards*; D032921:Consensus; D003697:Delphi Technique; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D009864:Ontario; D019984:Quality Indicators, Health Care; D012680:Sensitivity and Specificity