Assurance de qualité pour le cancer rectal – phase 2 ...

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100 PROCARE – phase 2 KCE reports 81PROPORTION OF PATIENTS WITH LOCAL RECURRENCEMeasurement in prospective PROCARE database (Figure 22)In the hospital data section of the PROCARE data entry form, the variable ‘AD_V111’ ischecked if the patient underwent rectal surgery. Variable ‘SG_V216’ permits thedistinction between R0, R1 and R2 resections. However, the results of the pathologyreport and intra-operative tumour perforation are not taken into account in thisvariable.Local recurrence is measured through variable ‘FU_V139’ in the follow-up section ofthe data entry form. However, since the PROCARE registration started in January 2006,follow-up data are only available for a minority of patients at present.Up till now, the default value of variable ‘FU_V139’ was ‘0’ (i.e. no local recurrence;however, missing values also received a value ‘0’), making it impossible to distinguishabsence of local recurrence from missing values. However, in a random sample of 20forms with a value ‘0’ for variable ‘FU_V139’ only 1 missing value (5%) was found.Variable ‘FU_V102’ encodes the date of each follow-up visit, permitting to add a timedimension to this QI. Since this follow-up visit is not at the same time for each patient,it is impossible to calculate an absolute local recurrence rate at 1 year after incidencedate. Therefore, a Kaplan-Meier analysis was used.Measurement in coupled administrative databaseNo administrative code exists for R0 resection or local recurrence.Figure 22. Algorithm for QI 1113 (PROCARE database).All patientsN=1071Follow- updataN=262R0(curative treated)Local recurrenceN=5Pyp-stage0-I-II-IIIN=788Type ofresection?N=233Localrecurrence?No local recurrenceORlocal recurrence=missing indatabaseN=228 98%Local recurrencePypstage?Follow-updata between 0and 12 months?R0 missing(curative treated:not known)N=21Localrecurrence?N=2No local recurrenceORlocal recurrence=missing indatabaseN=19 92%Pyp-cstade=IVorC-stade=IVNo R0(not curative treated)Local recurrenceN=1N=130Pyp-stage=missingN=153No followdataN=526N=8Localrecurrence?No local recurrenceORlocal recurrence=missing indatabaseN=7 45%
KCE Reports 81 PROCARE – phase 2 101PROPORTION OF PATIENTS DISCUSSED AT AMULTIDISCIPLINARY TEAM (MDT) MEETINGMeasurement in prospective PROCARE databaseDiscussion at the MDT is not registered in the PROCARE database.Measurement in coupled administrative database (Figure 23)Specific nomenclature codes for a multidisciplinary oncologic consultation are availablesince February 1 st 2003 (Table 61). Therefore, only RC patients diagnosed afterFebruary 1 st 2003 were taken into account for the pilot testing of this QI. Above this,since the BCR data are incomplete for the year 2004, patients with an incidence dateafter June 30 th 2004 are not considered. Since there is a possibility of more than oneprimary tumour (other than the rectal tumour) and in order to increase the likelihoodthat the MDT was linked to the rectal tumour, a timeframe of 6 months after theincidence date was chosen.Table 61. Nomenclature codes for multidisciplinary oncologic consultation.Nomenclature Description (Dutch)Description (French)code350372 – 350383 Schriftelijk verslag van eenmultidisciplinair oncologisch consultmet deelname van minstens driegeneesheren van verschillendespecialismen onder leiding van eengeneesheer-coördinator, metbeschrijving van de diagnose en vanhet behandelingsplanRapport écrit d'une concertationoncologique multidisciplinaire avec laparticipation d'au moins troismédecins de spécialités différentessous la direction d'un médecincoordinateuret reprenant ladescription du diagnostic et du plande traitement350394 – 350405 Deelname aan multidisciplinair Participation à la concertationoncologisch consult350416 – 350420 Deelname aan multidisciplinaironcologisch consult door debehandelende arts die geen deeluitmaakt van de ziekenhuisstafoncologique multidisciplinaireParticipation à la concertationoncologique multidisciplinaire par lemédecin traitant qui n'est pasmembre de l'équipe hospitalière
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35. Etude relative aux coûts poten
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