title: Quality indicators of clinical cancer care (QC3) in colorectal cancer.
abstract: OBJECTIVE
  Assessing the quality of cancer care (QoCC) has become increasingly important to providers, regulators and purchasers of care worldwide. The aim of this study was to develop evidence-based quality indicators (QIs) for colorectal cancer (CRC) to be applied in a population-based setting.
  
  
  METHODS
  A comprehensive evidence-based literature search was performed to identify the initial list of QIs, which were then selected and developed using a two-step-modified Delphi process involving two multidisciplinary expert panels with expertise in CRC care, quality of care and epidemiology.
  
  
  METHODS
  The QIs of the clinical cancer care (QC3) population-based project, which involves all the public and private hospitals and clinics present on the territory of Canton Ticino (South Switzerland).
  
  
  METHODS
  Ticino Cancer Registry, The Colorectal Cancer Working Group (CRC-WG) and the external academic Advisory Board (AB).
  
  
  METHODS
  Set of QIs which encompass the whole diagnostic-treatment process of CRC.
  
  
  RESULTS
  Of the 149 QIs that emerged from 181 sources of literature, 104 were selected during the in-person meeting of CRC-WG. During the Delphi process, CRC-WG shortened the list to 89 QI. AB finally validated 27 QIs according to the phase of care: diagnosis (N=6), pathology (N=3), treatment (N=16) and outcome (N=2).
  
  
  CONCLUSIONS
  Using the validated Delphi methodology, including a literature review of the evidence and integration of expert opinions from local clinicians and international experts, we were able to develop a list of QIs to assess QoCC for CRC. This will hopefully guarantee feasibility of data retrieval, as well as acceptance and translation of QIs into the daily clinical practice to improve QoCC. Moreover, evidence-based selected QIs allow one to assess immediate changes and improvements in the diagnostic-therapeutic process that could be translated into a short-term benefit for patients with a possible gain both in overall and disease-free survival.
authors.affiliation: Cantonal Institute of Pathology, Ticino Cancer Registry, Locarno, Switzerland.
authors.forename: Valentina
authors.initials: V
authors.lastname: Bianchi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Spitale
authors.forename: Laura
authors.initials: L
authors.lastname: Ortelli
authors.forename: Luca
authors.initials: L
authors.lastname: Mazzucchelli
authors.forename: Andrea
authors.initials: A
authors.lastname: Bordoni
keywords: Gastrointestinal tumours < Gastroenterology; Gastrointestinal tumours < Oncology; Qualitative Research; Quality in health care < Health Services Administration & Management