title: Developing and measuring a set of process and outcome indicators for breast cancer.
abstract: OBJECTIVE
  This study aimed at developing and measuring a set of indicators to monitor the quality of breast cancer care, to make comparisons over time and to support quality improvement for all practitioners and centres involved in the care of breast cancer women.
  
  
  METHODS
  Quality indicators were identified from a systematic literature search and the 2010 Belgian evidence-based clinical practice guideline. The selection process involved an expert panel evaluating reliability, relevance, interpretability and actionability of each indicator. The quality indicators were tested using the Belgian Cancer Registry data linked with claims data for all women registered with breast cancer in Belgium between 2001 and 2006 (n=50,039).
  
  
  RESULTS
  The selection process led to a final set of 32 indicators. Of these, 12 were measurable using the available data, while 1 indicator was measurable using proxy information. Five-year relative survival was 98%, 87%, 68% and 29% for pStage I, II, III and cStage IV respectively. Overall 5-year survival slightly improved for pStage II, III and cStage IV between 2001 and 2004. Of the surgically treated women, 60% underwent breast conserving surgery, 85% received adjuvant systemic treatment and 86% were irradiated postoperatively. In 80% of women treated for breast cancer, at least one mammography was performed within one year after the last treatment.
  
  
  CONCLUSIONS
  The present study demonstrates the feasibility to develop a multidisciplinary set of quality indicators for breast cancer. Using national cancer registry data linked to claims data, 13 indicators were measurable, showing results that largely correspond to other studies in the field.
authors: Belgian Health Care Knowledge Centre, Boulevard du Botanique 55, B-1000 Brussels, Belgium. Sabine.Stordeur@kce.fgov.be
authors: Sabine
authors: S
authors: Stordeur
authors: France
authors: F
authors: Vrijens
authors: Stephan
authors: S
authors: Devriese
authors: Koen
authors: K
authors: Beirens
authors: Elizabeth
authors: E
authors: Van Eycken
authors: Joan
authors: J
authors: Vlayen
mesh_terms: D000328:Adult; D000368:Aged; D001530:Belgium; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care; D019984:Quality Indicators, Health Care; D011788:Quality of Life; D012189:Retrospective Studies; D016019:Survival Analysis; D016387:Women's Health; D014932:Women's Health Services / Q000706:statistics & numerical data*; D055815:Young Adult