Quality indicators of oropharyngeal cancer care in the elderly

Gourin, Christine G.; Herbert, Robert J.; Fakhry, Carole; Quon, Harry; Kang, Hyunseok; Kiess, Ana P.; Koch, Wayne M.; Eisele, David W.; Frick, Kevin D.

doi:10.1002/lary.27050

Cited by 3 publications

(10 citation statements)

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“…[8][9][10] The incidence of dysphagia, weight loss, airway obstruction, tracheostomy tube dependence, and pneumonia was highest in the first year following treatment, with the incidence of airway obstruction and pneumonia increasing in subsequent years. Initial treatment consisted of chemoradiation in 38%, radiation alone in 28%, surgery with postoperative radiation in 26%, and surgery alone in 8%.…”

Section: Resultsmentioning

confidence: 99%

“…The distribution of patients by treatment, quality indicators, and the incidence of posttreatment outcomes has been previously described. [8][9][10] The incidence of dysphagia, weight loss, airway obstruction, tracheostomy tube dependence, and pneumonia was highest in the first year following treatment, with the incidence of airway obstruction and pneumonia increasing in subsequent years. The incidence of weight loss and gastrostomy tube use decreased over time, while the incidence of esophageal stricture increased over time ( Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…Quality indicators were derived from the NCCN guidelines for oropharynx cancer care as previously described, with additional indicators derived for end-of-life care and performance based on literature defining these as markers for quality care 8 (Supplemental Table 1). The overall summary measure of quality was used to determine the effect of higher vs lower quality of care.…”

Section: Methodsmentioning

confidence: 99%

“…6 Higher quality care was associated with a reduced odds of airway and swallowing impairment, a reduced risk of death in patients who developed airway and swallowing impairment, and lower costs of care associated with airway and swallowing impairment. 8 Airway and swallowing impairment was common following treatment and associated with poorer survival. 8 Airway and swallowing impairment was common following treatment and associated with poorer survival.…”

Section: Introductionmentioning

confidence: 99%

“…7 Using the same summary quality indicators for oropharyngeal SCC (OPSCC) care, we similarly found that higher quality care was associated with improved survival, but was not associated with differences in costs. 8 Airway and swallowing impairment was common following treatment and associated with poorer survival. 9 We undertook the present study to determine the association between quality of care, survival and costs with long-term treatment-related airway, and swallowing impairment in elderly patients with OPSCC.…”

Section: Introductionmentioning

confidence: 99%

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Quality of care and short and long‐term outcomes of oropharyngeal cancer care in the elderly

et al. 2019

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Objective To examine associations between quality, short‐term and long‐term treatment‐related outcomes, and costs in elderly patients treated for oropharyngeal squamous cell cancer (OPSCC). Methods We retrospectively evaluated Surveillance, Epidemiology, and End Results (SEER)‐Medicare data from 666 patients diagnosed with OPSCC from 2004 to 2007 using multivariate regression and survival analysis. Quality indicators were derived from guidelines for recommended care and performance measures. Results Higher quality care was associated with lower risk of death in patients with dysphagia (hazard ratio [HR] = 0.44 [0.32‐0.60]), weight loss (HR = 0.42 [0.28‐0.62]), gastrostomy (HR = 0.47 [0.33‐0.68]), airway obstruction (HR = 0.41 [0.27‐0.62]), tracheostomy (HR = 0.17 [0.05‐0.67]), and pneumonia (HR = 0.53 [0.33‐0.85]). There were no significant differences in mean incremental costs associated with airway and swallowing impairment for patients receiving higher quality care. Conclusions Higher quality OPSCC care was associated with improved survival in elderly patients with airway and swallowing impairment. These data suggest that greater adherence to evidence‐based guidelines has favorable implications for long‐term outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Quality of care and short and long‐term outcomes of oropharyngeal cancer care in the elderly

et al. 2019

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Head and neck cancers: Monitoring quality and reporting outcomes

2021

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Introduction Head and neck cancers (HNC) require high level multidisciplinary care to achieve optimal outcomes. Reporting of quality indicators (QIs) has been instigated by some health services in an effort to improve quality of care. The aim of this study was to determine the quality of care provided to patients with HNC at a single institution by analysing compliance with QIs and to explore the feasibility and utility of collecting this data. Methods This was a single institution retrospective chart review of all patients with squamous cell HNC at Townsville Hospital who were treated with curative intent between June 2011 and June 2019. Data was entered into a RedCap database and then exported to Stata V16 for analysis. Results A total of 537 patients were included in the overall study, with six patients who had a synchronous non‐HNC and two patients who received previous radiotherapy (RT) to the head and neck region excluded from the outcome analysis. Overall, compliance with pre‐treatment, treatment and post‐treatment QIs was high, with the exception of smoking cessation support (66%), post‐treatment dental review and time to post‐operative RT (33% of patients within 6 weeks). The 5‐year overall survival was 69.4% (CI; 64–73.2%). The cumulative incidence of locoregional relapse for the overall study cohort was 18% (CI; 14.8–21.4%). Conclusion Collecting and evaluating quality metrics is feasible and helps identify areas for improvement. Centres treating HNC patients should strive towards monitoring quality against benchmarks and demonstrate transparency in outcome data.

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An ontology-guided semantic data integration framework to support integrative data analysis of cancer survival

Zhang¹,

Guo²,

Li³

et al. 2018

BMC Med Inform Decis Mak

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BackgroundCancer is the second leading cause of death in the United States, exceeded only by heart disease. Extant cancer survival analyses have primarily focused on individual-level factors due to limited data availability from a single data source. There is a need to integrate data from different sources to simultaneously study as much risk factors as possible. Thus, we proposed an ontology-based approach to integrate heterogeneous datasets addressing key data integration challenges.MethodsFollowing best practices in ontology engineering, we created the Ontology for Cancer Research Variables (OCRV) adapting existing semantic resources such as the National Cancer Institute (NCI) Thesaurus. Using the global-as-view data integration approach, we created mapping axioms to link the data elements in different sources to OCRV. Implemented upon the Ontop platform, we built a data integration pipeline to query, extract, and transform data in relational databases using semantic queries into a pooled dataset according to the downstream multi-level Integrative Data Analysis (IDA) needs.ResultsBased on our use cases in the cancer survival IDA, we created tailored ontological structures in OCRV to facilitate the data integration tasks. Specifically, we created a flexible framework addressing key integration challenges: (1) using a shared, controlled vocabulary to make data understandable to both human and computers, (2) explicitly modeling the semantic relationships makes it possible to compute and reason with the data, (3) linking patients to contextual and environmental factors through geographic variables, (4) being able to document the data manipulation and integration processes clearly in the ontologies.ConclusionsUsing an ontology-based data integration approach not only standardizes the definitions of data variables through a common, controlled vocabulary, but also makes the semantic relationships among variables from different sources explicit and clear to all users of the same datasets. Such an approach resolves the ambiguity in variable selection, extraction and integration processes and thus improve reproducibility of the IDA.

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Quality indicators of oropharyngeal cancer care in the elderly

Abstract: 2c. Laryngoscope, 128:2312-2319, 2018.

Cited by 3 publications

References 17 publications

Quality of care and short and long‐term outcomes of oropharyngeal cancer care in the elderly

Quality of care and short and long‐term outcomes of oropharyngeal cancer care in the elderly

Head and neck cancers: Monitoring quality and reporting outcomes

An ontology-guided semantic data integration framework to support integrative data analysis of cancer survival

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