Quality indicators for the evaluation of patients with lung cancer.
BACKGROUND
Ideally, quality indicators are developed with the input of professional groups involved in the care of patients. This project, led by the Thoracic Oncology Network and Quality Improvement Committee of the American College of Chest Physicians (CHEST), had the goal of developing quality indicators related to the evaluation and staging of patients with lung cancer.


METHODS
Evidence-based guidelines were used to generate a list of process-of-care quality indicators, and project members revised the content and wording of this list. A survey of the Steering Committee of the Thoracic Oncology Network was performed to rate the validity, feasibility, and relevance of the indicators. Predefined thresholds were used to select indicators from the list. This process was repeated for the selected indicators through a survey available to all members of the Thoracic Oncology Network. Three academic medical centers determined if the surviving indicators were feasible and relevant within their practices.


RESULTS
Eighteen quality indicators were drafted. Eleven survived the first round of voting, and seven survived the second round of voting. One was related to tissue acquisition for molecular testing, four were related to staging and stage documentation, one was related to smoking cessation counseling, and one was related to documentation of a performance status measure. The indicators were feasible and relevant within the practices assessed.


CONCLUSIONS
We have defined seven process-of-care quality indicators related to the evaluation and staging of patients with lung cancer, which are felt to be valid, feasible, and relevant by lung cancer specialists.
Respiratory Institute, Cleveland Clinic, Cleveland, OH. Electronic address: mazzonp@ccf.org.
Peter J
PJ
Mazzone
University of Pennsylvania, Philadelphia, PA.
Anil
A
Vachani
University of Michigan, Ann Arbor, MI.
Andrew
A
Chang
Yale University, New Haven, CT.
Frank
F
Detterbeck
University of California, Davis, Davis, CA.
David
D
Cooke
Department of Thoracic Surgery, NorthShore University HealthSystem, Evanston, IL.
John
J
Howington
University of Michigan, Ann Arbor, MI.
Amos
A
Dodi
University of Michigan, Ann Arbor, MI.
Douglas
D
Arenberg
D003625:Data Collection; D055317:Evidence-Based Practice / Q000592:standards*; D005240:Feasibility Studies; D006040:Goals; D017408:Guidelines as Topic; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D009367:Neoplasm Staging; D010865:Pilot Projects; D019984:Quality Indicators, Health Care / Q000592:standards*; D015203:Reproducibility of Results