title: Demonstration of quality of care measurement using the Japanese liver cancer registry.
abstract: OBJECTIVE
  Despite advances in medical therapy, studies have reported gaps between current evidence and actual practice in many areas of medicine. Process-of-care quality indicators (QIs) are tools to measure the evidence-practice gap. This study aims to examine the feasibility of applying QIs for liver cancer care to the national registry database operated by the Liver Cancer Study Group of Japan.
  
  
  METHODS
  Prior research developed a set of process-of-care QIs developed on the basis of the Japanese Clinical Practice Guidelines for hepatocellular carcinoma. Each QI describes target patients and care processes indicated for such patients. Among the 25 developed QIs, six appeared scorable using the information contained in the dataset from the 17(th)  Nationwide Survey of Primary Liver Cancer.
  
  
  RESULTS
  In total, 16 187 patients were eligible for the six QIs for 34 599 times, among which the indicated care was provided 83.9% times. The scores ranged from 64.4% (surgical therapy in patients with HCC 3-5 cm in diameter) to 91.1% (indocyanine green checkup before surgical resection). The information was generally available to determine eligibility (78.3%-100%) and pass/fail (91.9%-99.9%) for the QIs.
  
  
  CONCLUSIONS
  Applying QIs to the liver cancer registry, the quality of hepatocellular carcinoma care can be measured. In future, providing feedback regarding the results to the participating society may improve the quality of liver cancer care nationwide.
authors: Departments of Health Policy/Public Health             Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo             Japanese Red Cross Medical Center             Department of Gastroenterology, Musashino Red Cross Hospital, Musashino             Department of Pathology, Keio University School of Medicine             Department of Biostatistics, School of Public Health, University of Tokyo             Division of Cancer Information and Statistics, Center for Cancer Control and Information Services, the National Cancer Center, Tokyo             Department of Gastroenterology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka             Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Sayama, Osaka             Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo             Department of Pathology, Kurume University School of Medicine, Kurume             Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa             Liver Cancer Study Group of Japan, Japan.
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