title: Estimation of an optimal chemotherapy utilisation rate for colon cancer: an evidence-based benchmark for cancer care.
abstract: BACKGROUND
  Optimal chemotherapy (CT) utilisation rates can serve as benchmarks to assess the quality of cancer care. This study aims to determine the optimal proportion of patients with colon cancer that should receive chemotherapy at least once.
  
  
  METHODS
  An optimal chemotherapy utilisation tree was constructed using indications for chemotherapy identified from evidence-based treatment guidelines. Data on the proportion of patient and tumour-related attributes for which chemotherapy was indicated were obtained and merged with the treatment indications to calculate an optimal chemotherapy utilisation rate (CTU rate). This optimal rate was compared with reported actual rates of chemotherapy utilisation.
  
  
  RESULTS
  Chemotherapy is indicated at least once in 55% of patients with colon cancer. While 89% of colon cancer patients presenting with Stage IV disease should optimally receive chemotherapy, 38-52% actually received chemotherapy as part of their initial treatment.
  
  
  CONCLUSIONS
  The optimal chemotherapy utilisation rate can serve as an evidence-based benchmark in the planning and evaluation of chemotherapy services. Chemotherapy may be under-utilised in the initial management of patients presenting with metastatic colon cancer.
authors.affiliation: Collaboration for Cancer Outcomes Research and Evaluation, Liverpool Hospital, Locked Bag 7103, Liverpool BC, NSW 1871, Sydney, Australia. Susannah.Jacob@sswahs.nsw.gov.au
authors.forename: Susannah
authors.initials: S
authors.lastname: Jacob
authors.forename: Weng
authors.initials: W
authors.lastname: Ng
authors.forename: Ray
authors.initials: R
authors.lastname: Asghari
authors.forename: Geoff P
authors.initials: GP
authors.lastname: Delaney
authors.forename: Michael B
authors.initials: MB
authors.lastname: Barton
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001315:Australia; D019985:Benchmarking; D002648:Child; D002675:Child, Preschool; D003110:Colonic Neoplasms / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents