Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice Guidelines and Quality Certification Do Not Avert Variability in Clinical Practice

Torras, M.G.; Canals, E; Jurado-Bruggeman, D.; Marín-Borras, S.; Maciá, M.; Jové, Josep; Boladeras, A.; Muñoz-Montplet, C.; Molero, J.; Picon, C.; Puigdemont, Montserrat; Aliste, Luisa; Torrents, Abiguei; Guedea, Ferrán; Borrás, Josep María

doi:10.1016/j.tranon.2018.03.015

Cited by 7 publications

(7 citation statements)

References 26 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Navarra showed a higher adherence to the guidelines recommendation. This study was not designed to determine the reasons for geographic disparities; however, it seems possible that some organisational factors, such as diagnosis outside the reference centres, hospital size, internal quality programmes and coordination mechanisms to provide multidisciplinary care, could potentially explain practice variation (Torras et al, ).…”

Section: Discussionmentioning

confidence: 99%

Disparities in the management of cutaneous malignant melanoma. A population‐based high‐resolution study

et al. 2019

View full text Add to dashboard Cite

Population‐based cancer registry data from three Spanish areas were used to assess the patterns of care and adherence to guidelines for cutaneous malignant melanoma. We included 934 cases diagnosed in 2009–2013. Completeness of the pathology reports, imaging for detecting distant metastasis and the use of sentinel lymph node biopsy (SLNB) were analysed. The proportion of pathology reports that mentioned the essential pathological features required for T staging was 93%, ranging across geographic areas from 81% to 98% (p < 0.001). The percentage of low‐risk patients who underwent no imaging studies, as proposed by guidelines, or only chest imaging ranged among areas from 0.6% to 84% (p < 0.001). Of the patients with clinically node‐negative melanoma >1 mm thick and no distant metastases, 68% underwent SLNB, varying by area from 61% to 78% (p = 0.017). This study revealed wide geographic variation in different aspects of melanoma care. The use of a standardised structured pathology report could strengthen the completeness of reporting. Improvement strategies should also include efforts to reduce overuse of imaging in low‐risk patients and to increase the adherence to guidelines recommendations on the use of SLNB.

show abstract

Section: Discussionmentioning

confidence: 99%

Disparities in the management of cutaneous malignant melanoma. A population‐based high‐resolution study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Quality and clinical indicators were selected by a working group of radiation oncologists and medical physicists from the participating centres, who also developed the clinical audit model, which was broadly based on models used in previous clinical audits 2 , 10 . The clinical audit was performed to assess adherence to standard clinical practice for the study indicators.…”

Section: Methodsmentioning

confidence: 99%

Results of the IROCA international clinical audit in prostate cancer radiotherapy at six comprehensive cancer centres

Castro

Fundowicz

Roselló

et al. 2021

Sci Rep

View full text Add to dashboard Cite

To assess adherence to standard clinical practice for the diagnosis and treatment of patients undergoing prostate cancer (PCa) radiotherapy in four European countries using clinical audits as part of the international IROCA project. Multi-institutional, retrospective cohort study of 240 randomly-selected patients treated for PCa (n = 40/centre) in the year 2015 at six European hospitals. Clinical indicators applicable to general and PCa-specific radiotherapy processes were evaluated. All data were obtained directly from medical records. The audits were performed in the year 2017. Adherence to clinical protocols and practices was satisfactory, but with substantial inter-centre variability in numerous variables, as follows: staging MRI (range 27.5–87.5% of cases); presentation to multidisciplinary tumour board (2.5–100%); time elapsed between initial visit to the radiation oncology department and treatment initiation (42–102.5 days); number of treatment interruptions ≥ 1 day (7.5–97.5%). The most common deviation from standard clinical practice was inconsistent data registration, mainly failure to report data related to diagnosis, treatment, and/or adverse events. This clinical audit detected substantial inter-centre variability in adherence to standard clinical practice, most notably inconsistent record keeping. These findings confirm the value of performing clinical audits to detect deviations from standard clinical practices and procedures.

show abstract

“…For the present study, quality indicators and clinical indicators were selected by a working group of radiation oncologists and medical physicists from the participating centres, led by a senior clinician in rectal cancer at each institution after a review of the relevant guidelines, as described below. This same team also developed the clinical audit model, which was broadly based on models used in two previous clinical audits conducted by members of the IROCA group [9,11].…”

Section: Methodsmentioning

confidence: 99%

“…In recent years, the role of clinical audits in improving quality has been increasing recognized. However, to date only a limited number have been conducted in the field of radiation oncology [4][5][6][7][8], and even fewer have specifically focused on rectal cancer [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Multicentre clinical radiotherapy audit in rectal cancer: results of the IROCA project

et al. 2020

View full text Add to dashboard Cite

Purpose: To perform a clinical audit to assess adherence to standard clinical practice for the diagnosis, treatment, and follow-up of patients undergoing radiotherapy for rectal cancer treatment in four European countries. Materials and methods: Multi-institutional, retrospective cohort study of 221 patients treated for rectal cancer in 2015 at six European cancer centres. Clinical indicators applicable to general radiotherapy processes were evaluated. All data were obtained from electronic medical records. Results: The audits were performed in the year 2017. We found substantial inter-centre variability in adherence to standard clinical practices: 1) presentation of cases at departmental clinical sessions (range, 0-100%) or multidisciplinary tumour board (50-95%); 2) pretreatment MRI (61.5-100%) and thoracoabdominal CT (15.0-100%). Large inter-centre differences were observed in the mean interval between biopsy and first visit to the radiotherapy department (range, 21.6-58.6 days) and between the first visit and start of treatment (15.1-38.8 days). Treatment interruptions ≥ 1 day occurred in 43.9% (2.5-90%) of cases overall. Treatment compensation was performed in 2.1% of cases. Treatment was completed in the prescribed time in 55.7% of cases. Conclusions: This multi-institutional clinical audit revealed that most centres adhered to standard clinical practices for most of the radiotherapy processes-related variables assessed. However, the audit revealed marked inter-centre variability for certain quality indicators, particularly inconsistent record keeping. Multiple targets for improvement and/or harmonisation were identified, confirming the value of routine clinical audits to detect potential deviations from standard clinical practice.

show abstract

Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice Guidelines and Quality Certification Do Not Avert Variability in Clinical Practice

Cited by 7 publications

References 26 publications

Disparities in the management of cutaneous malignant melanoma. A population‐based high‐resolution study

Disparities in the management of cutaneous malignant melanoma. A population‐based high‐resolution study

Results of the IROCA international clinical audit in prostate cancer radiotherapy at six comprehensive cancer centres

Multicentre clinical radiotherapy audit in rectal cancer: results of the IROCA project

Contact Info

Product

Resources

About