Monitoring quality of care for patients with pancreatic cancer: a modified Delphi consensus

Abstract

Background: Best practise care optimises survival and quality of life in patients with pancreatic cancer (PC), but there is evidence of variability in management and suboptimal care for some patients. Monitoring practise is necessary to underpin improvement initiatives. We aimed to develop a core set of quality indicators that measure quality of care across the disease trajectory.Methods: A modified, three-round Delphi survey was performed among experts with wide experience in PC care across three states in Australia. A total of 107 potential quality indicators were identified from the literature and divided into five areas: diagnosis and staging, surgery, other treatment, patient management and outcomes. A further six indicators were added by the panel, increasing potential quality indicators to 113. Rated on a scale of 1-9, indicators with high median importance and feasibility (score 7-9) and low disagreement (<1) were considered in the candidate set.Results: From 113 potential quality indicators, 34 indicators met the inclusion criteria and 27 (7 diagnosis and staging, 5 surgical, 4 other treatment, 5 patient management, 6 outcome) were included in the final set. Conclusions:The developed indicator set can be applied as a tool for internal quality improvement, comparative quality reporting, public reporting and research in PC care.

European Cancer Organisation Essential Requirements for Quality Cancer Care (ERQCC): Pancreatic Cancer

“…• The Danish Pancreatic Cancer Database aims to prospectively describe the epidemiology, diagnostic workup, histological or cytological diagnosis, treatment and outcome of patients in Denmark [162]. • A group in Australia conducted a Delphi survey among pancreatic cancer experts and identified quality indicators in 5 areas: diagnosis and staging, surgery, other treatment, patient management and outcomes [163]. From 113 potential quality indicators, 34 indicators met the inclusion criteria and 27 (7 diagnosis and staging, 5 surgical, 4 other treatment, 5 patient management, 6 outcome) were included in the final set, which can be applied as a tool for internal quality improvement, comparative quality reporting, public reporting and research in care.…”

The Upper Gastrointestinal Cancer Registry (UGICR): a clinical quality registry to monitor and improve care in upper gastrointestinal cancers

“…This process involved 19 PC care experts from three states in Australia. A detailed description of the methods of the modified Delphi process and the selected indicators has been published separately 40. In addition, a review was undertaken of the Australian Optimal Care Pathways (OCP) for PC41 and OGC42 to ensure that indicators are aligned with the seven themes described in the OCP (prevention and early detection; presentation, initial investigations and referral; diagnosis, staging and treatment planning; treatment; care after initial treatment and recovery; managing recurrent, residual or metastatic disease; and end-of-life care).…”

Update on current pancreatic treatments: from molecular pathways to treatment

“…Furthermore; the novel poly(allylamine)-naphthalimide carrier it was observed to amplify the cytotoxic effect with drug treatment after 24 h. The result was reduction of 50% of cancer cell population 79. Monitoring quality of care for patients with pancreatic cancer was performed with novel quastionaires such as the modified Delphi consensus 80. There are novel circulating nucleic acids that are associated with outcomes of patients with pancreatic cancer 81.…”