Estimation of an optimal chemotherapy utilisation rate for primary malignant brain tumours: an evidence-based benchmark for cancer care.
OBJECTIVE
The optimal chemotherapy utilisation rate can serve as a benchmark to assess the quality of cancer care. The aim of this study was to determine the optimal proportion of patients with primary malignant brain tumours for whom there was evidence that they 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. This optimal rate was compared with reported actual rates of chemotherapy utilisation.


RESULTS
Chemotherapy is indicated at least once, either as an initial treatment or at recurrence (in those who have not previously received chemotherapy), in 72% of all patients with primary malignant brain tumours. No recent published data on actual chemotherapy utilisation rates were identified for comparison with the optimal rate.


CONCLUSIONS
The optimal chemotherapy utilisation rate can serve as an evidence-based benchmark in the planning and evaluation of chemotherapy services for brain cancer. There are no recent published patterns of care studies that report on chemotherapy utilisation rates for primary malignant brain tumours; future research should focus on filling this gap.
University of New South Wales and Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Liverpool Hospital, Liverpool, New South Wales, Australia. Susannah.Jacob@sswahs.nsw.gov.au
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Jacob
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Delaney
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Barton
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D019985:Benchmarking; D001932:Brain Neoplasms / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D019983:Guideline Adherence; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care; D016032:Randomized Controlled Trials as Topic; D018426:SEER Program; D012680:Sensitivity and Specificity
D000970:Antineoplastic Agents