title: Measuring the improving quality of outpatient care in medical oncology practices in the United States.
abstract: OBJECTIVE
  The American Society of Clinical Oncology Quality Oncology Practice Initiative (QOPI) has provided a method for measuring process-based practice quality since 2006. We sought to determine whether QOPI scores showed improvement in measured quality over time and, if change was demonstrated, which factors in either the measures or participants were associated with improvement.
  
  
  METHODS
  The analysis included 156 practice groups from a larger group of 308 that submitted data from 2006 to 2010. One hundred fifty-two otherwise eligible practices were excluded, most commonly for insufficient data submission. A linear regression model that controlled for varied initial performance was used to estimate the effect of participation over time and evaluate participant and measure characteristics of improvement.
  
  
  RESULTS
  Participants completed a mean of 5.06 (standard deviation, 1.94) rounds of data collection. Adjusted mean quality scores improved from 0.71 (95% CI, 0.42 to 0.91) to 0.85 (95% CI, 0.60 to 0.95). Overall odds ratio of improvement over time was 1.09 (P < .001). The greatest improvement was seen in measures that assessed newly introduced clinical information, in which the mean scores improved from 0.05 (95% CI, 0.01 to 0.17) to 0.69 (95% CI, 0.33 to 0.91; P < .001). Many measures showed no change over time.
  
  
  CONCLUSIONS
  Many US oncologists have participated in QOPI over the past 6 years. Participation over time was highly correlated with improvement in measured performance. Greater and faster improvement was seen in measures concerning newly introduced clinical information. Some measures showed no change despite opportunity for improvement.
authors.affiliation: Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, 2220 Pierce Ave, #694 Preston Research Building, Nashville, TN 37232, USA. michael.n.neuss@vanderbilt.edu
authors.forename: Michael N
authors.initials: MN
authors.lastname: Neuss
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Malin
authors.forename: Stephanie
authors.initials: S
authors.lastname: Chan
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Kadlubek
authors.forename: John L
authors.initials: JL
authors.lastname: Adams
authors.forename: Joseph O
authors.initials: JO
authors.lastname: Jacobson
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Blayney
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Simone
mesh_terms: D000553:Ambulatory Care / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data / Q000639:trends; D005820:Genetic Testing / Q000379:methods / Q000592:standards; D006801:Humans; D016014:Linear Models; D008495:Medical Oncology / Q000379:methods / Q000592:standards*; D009369:Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000628:therapy; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards*; D058996:Quality Improvement / Q000592:standards* / Q000706:statistics & numerical data / Q000639:trends; D013997:Time Factors; D014481:United States