Using QRRO survey data to assess compliance with quality indicators for breast and prostate cancer.
OBJECTIVE
Quality Research in Radiation Oncology (QRRO) has embarked on a new national process survey to provide benchmark data that will allow radiation oncologists to assess the quality of care in their own practices by measuring quality indicators (QIs) and comparing individual with national practice.


METHODS
Investigators at QRRO developed QIs on the basis of nationally recognized, evidence-based guidelines such as those of the National Comprehensive Cancer Network, as well as additional emerging QIs for processes involving rapidly emerging technology. They specifically defined the QIs as clinical performance measures. Published results of the national survey database for patients treated in 1998 and 1999 were reviewed and additional analyses conducted to assess data adequacy to measure compliance with these clinical performance measures.


RESULTS
Examples of workup QIs for breast cancer patients showed that 97% underwent diagnostic bilateral mammography, 96% underwent pathology reviews, 83% underwent the determination of estrogen receptor status, 81% underwent the determination of progesterone receptor status, and 31% underwent the determination of human epidermal growth factor receptor 2 status. Compliance with treatment QIs for field recommendations on the basis of nodal findings can be measured. Of patients with prostate cancer, 90% underwent digital rectal examinations, 99% underwent prostate-specific antigen tests, and 99% had their Gleason scores determined. Compliance with QIs on the basis of prognostic group can also be measured.


CONCLUSIONS
Benchmarking utilization patterns provides a foundation for assessing the appropriateness of cancer care in the future. The QRRO database is a rich data source, and the new survey will provide contemporary benchmark data for these measures.
Owen
Jean B
JB
Quality Research in Radiation Oncology, American College of Radiology, 1818 Market Street, Philadelphia, PA 19103, USA. jowen@phila.acr.org
White
Julia R
JR
Zelefsky
Michael J
MJ
Wilson
J Frank
JF
D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D003952:Diagnostic Imaging / Q000592:standards* / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D011785:Quality Assurance, Health Care / Q000592:standards / Q000706:statistics & numerical data*; D018787:Radiation Oncology / Q000592:standards*; D014481:United States / Q000453:epidemiology