The Dutch Institute for Clinical Auditing

Beck, Naomi; Bommel, Annelotte C van; Eddes, E.H.; Leersum, N.J. van; Tollenaar, Rob A.E.M.; Wouters, Michel W. J. M.

doi:10.1097/sla.0000000000003665

Cited by 60 publications

(45 citation statements)

References 12 publications

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“…Stimulating improvement is in line with the primary purpose of the DLCA-L: quality assurance of the diagnostics of lung cancer patients, the in-hospital processes, and the treatment with systemic therapies. Continuous feedback and the possibility to explore the data to individual patient level in the Codman dashboards, called after the founder of clinical auditing, made improvement cycles less time-consuming [16].…”

Section: Discussionmentioning

confidence: 99%

“…The registry is facilitated by the Dutch Institute for Clinical Auditing (DICA), a non-profit organization, which is structurally funded by the umbrella organization of healthcare insurers in the Netherlands (ZN) [15]. DICA facilitates 22 nation-wide quality registries [16]. The DLCA-L is part of the multidisciplinary Dutch Lung Cancer Audit (DLCA), which consists of three clinical audits: DLCA-Surgery (DLCA-S), DLCA-Radiotherapy (DLCA-R), and the sub-registry for the diagnosis and systemic treatment of lung cancer (DLCA-L).…”

Section: Organizational Structurementioning

confidence: 99%

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The Dutch Lung Cancer Audit: Nationwide quality of care evaluation of lung cancer patients

et al. 2020

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This study describes the initiation of the Dutch Lung Cancer Audit for Lung Oncology (DLCA-L) and reports the first results of three years of clinical auditing. Methods: The initiation, dataset, and data quality of the DLCA-L are described. For the analyses, all patients registered from 2017 to 2019 were included. Descriptive statistics were used to assess the first outcomes of the DLCA-L, including results from quality indicators, patient-and tumor characteristics, and the real-world use of immunotherapy. Results: The DLCA-L was initiated after the surgery and radiotherapy audit for lung cancer. In total, 33.788 NSCLC patients and 4.293 SCLC patients were registered in the DLCA-L from 2017 to 2019. Seventy-three (97 %) Dutch hospitals participated in the DLCA-L in 2019. The registry became nationwide in 2020. The data quality improved over the years, with complete cases in 90 % of the NSCLC patients. In total, 15 quality indicators were established based on DLCA-L data to improve processes and clinical outcomes. An example of these quality indicators was brain imaging at diagnosis of stage III NSCLC patients, which increased from 80 % in 2017 to 90 % in 2019 and hospital variation was reduced. The DLCA-L provided data on immunotherapy use in stage IV NSCLC (n = 4.415) patients. These patients had a median age of 67 years and 11 % of the patients had an ECOG PS ≥ 2. The number of patients treated with immunotherapy in different hospitals varied between 2 patients to 163 patients per hospital. Conclusion: The DLCA-L has become a valuable and complete data source with national coverage in 2020. A high number of registered patients and limited missing data resulted in better insights into hospital processes and outcomes of lung cancer care. Quality indicators were, with success, used to establish improvements and minimize hospital variation. The DLCA-L also provides hospitals real-world information on the use of (systemic) therapies.

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Section: Discussionmentioning

confidence: 99%

Section: Organizational Structurementioning

confidence: 99%

The Dutch Lung Cancer Audit: Nationwide quality of care evaluation of lung cancer patients

et al. 2020

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“…Data was retrieved from the Dutch Melanoma Treatment Registry (DMTR), a prospective population-based registry of patients with unresectable stage IIIc or IV melanoma, facilitated by the Dutch Institute for Clinical Auditing [30]. The DMTR contains information on baseline patient and tumor characteristics, local and systemic treatment, adverse events (only ≥ grade 3 according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.0), and clinical outcome [31].…”

Section: Data Collection: the Dutch Melanoma Treatment Registry (Dmtr)mentioning

confidence: 99%

Outcomes for systemic therapy in older patients with metastatic melanoma: Results from the Dutch Melanoma Treatment Registry

Jochems

Bastiaannet

Aarts

et al. 2021

Journal of Geriatric Oncology

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Background: The incidence of metastatic melanoma is increasing in all ages. Multiple trials with targeted drugs and immune checkpoint inhibitors showed improved survival in metastatic melanoma. However, patients aged ≥75 years are often under-represented in clinical trials, therefore raising questions on safety and efficacy of treatment. Patients and methods: We analyzed a real-world cohort of 3054 patients with metastatic melanoma stratified for age (≤65 years, 66-74 years and ≥ 75 years), and BRAF status, providing data on treatment strategies, toxicity, and survival. Kaplan Meier curves and Cox Proportional Hazard Models were used to present overall survival (OS) and Melanoma Specific Survival (MSS). Results: Overall, 52.2% of patients were ≤ 65 years and 18.4% of patients ≥75 years. BRAF mutated tumors were found less often in patients ≥75 years: 34.5% versus 65% in patients ≤65 years. Patients ≥75 years received systemic therapy less frequently compared to their younger counterparts independent of the BRAF status. When receiving treatment, no statistical significant difference in grade 3 or 4 toxicity was observed. Three year Overall Survival rate was 13.7% (9.1-19.3) in patients ≥75 years versus 26.7% (23.1-30.4) in patients ≤65 years, with a Hazard Ratio (HR) of 1.71 (95%CI 1.50-1.95), p < 0.001. Three year Melanoma Specific Survival was 30.4% (22.0-39.2) versus 34.0% (29.7-38.2), HR 1.26 (95% CI 1.07-1.49), p = 0.005 with an adjusted HR of 1.21 (1.00-1.47), p = 0.049. Conclusion: Patients with metastatic melanoma ≥75 years are less frequently treated, but when treated there is no statistical significant increase in toxicity and only a borderline statistical significant difference in Melanoma Specific Survival was seen, compared to younger patients.

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“…In 2017, delegates of The Netherlands Association of Internal Medicine (NIV), The Dutch Association for Paediatrics (NVK), and the Dutch federation of diabetes patients (DVN) united in the BIDON foundation have initiated DPARD. Since 2018, the Dutch Institute for Clinical Auditing (DICA), known for the facilitation of nationwide audits in a uniform format, is responsible for the facilitation of DPARD [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

DPARD: rationale, design and initial results from the Dutch national diabetes registry

Bak

Mul²,

Serné

et al. 2021

BMC Endocr Disord

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Background Treatment of diabetes mellitus has majorly improved over the past century, however, the disease burden is high and its prevalence still expanding. Further insight in the diabetes population is imperative to improve the quality of diabetes care by enhancement of knowledge-based diabetes management strategies. To this end, in 2017 a Dutch nationwide consortium of diabetologists, paediatric endocrinologists, and diabetes patients has founded a national outpatient diabetes care registry named Dutch Pediatric and Adult Registry of Diabetes (DPARD). We aim to describe the implementation of DPARD and to provide an overview of the characteristics of patients included during the first 2 years. Methods For the DPARD cohort with long-term follow-up of observational nature, hospital data are gathered directly from electronic health records and securely transferred and stored. DPARD provides weekly updated clinical information on the diabetes population care on a hospital-level benchmarked against the national average. Results Between November 2017 and January 2020, 20,857 patients were included from 8 (11%) Dutch hospitals with a level of care distribution representative of all diabetic outpatients in the Netherlands. Among patients with known diabetes type, 41% had type 1 diabetes, 51% type 2 diabetes, and 8% had diabetes due to other causes. Characteristics of the total patient population were similar to patients with unknown diabetes classification. HbA1c levels decreased over the years, while BMI levels showed an increase over time. Conclusions The national DPARD registry aims to facilitate investigation of prevalence and long-term outcomes of Dutch outpatients with diabetes mellitus and their treatment, thus allowing for quality improvement of diabetes care as well as allowing for comparison of diabetes care on an international level.

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The Dutch Institute for Clinical Auditing

Cited by 60 publications

References 12 publications

The Dutch Lung Cancer Audit: Nationwide quality of care evaluation of lung cancer patients

The Dutch Lung Cancer Audit: Nationwide quality of care evaluation of lung cancer patients

Outcomes for systemic therapy in older patients with metastatic melanoma: Results from the Dutch Melanoma Treatment Registry

DPARD: rationale, design and initial results from the Dutch national diabetes registry

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