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

144 PROCARE – phase 2 KCE reports 81LATE GRADE 4 COMPLICATIONS OF RADIOTHERAPY ORCHEMORADIATIONMeasurement in prospective PROCARE database (Figure 54)Patients receiving radio(chemo)therapy are selected with variables ‘AD_V113’,‘AD_V114’, ‘AD_V117’, ‘AD_V118’, ‘AD_V121’ and ‘AD_V122’. Late complications ofradio(chemo)therapy are registered with variables ‘FU_V106’ – ‘FU_V110’.Measurement in coupled administrative databaseNo specific administrative codes are available for late (C)RT-related complications. Inthe ICD-9-CM coding system some aspecific codes are available (990 effects ofradiation, unspecified; 963.1 poisoning by primarily systemic agents: antineoplastic andimmunosuppressive drugs; 558.1 gastroenteritis and colitis due to radiation; etc.), butthere is no mentioning of grade. Therefore, these codes cannot be used. The QI is notmeasurable.Figure 54. Algorithm for QI 1263 (prospective database).All patientsN=1071Radio and/orchemotherapyFollow-updata after 1 yearGRADE 4 OR 5N=771 N=112N=10,97%GRADE 0-1-2-3Radioand/orchemotherapy?Follow-up dataavailable?Gradecomplications?N=17Gradecomplications= MISSINGN=9No follow up dataafter 1 yearN=633No radio and/orchemotherapyN=300Follow-updata after 1 yearN=26No complicationsN=85USE OF THE PATHOLOGY REPORT SHEETMeasurement in prospective PROCARE databaseIn the hospital data section of the PROCARE data entry form, the variable ‘AD_V111’ ischecked if the patient underwent rectal surgery. Those patients undergoing resectionalsurgery (including local excision or TEMS) are selected using variables ‘SG_V168’,‘SG_V210’, ‘SG_V216’ and ‘SG_V234’. However, no code is available that registers theuse of a pathology report sheet by the pathologist. Also, the suggested pathology reportsheet is only in use since November 2006.Measurement in coupled administrative databaseNo administrative code exists for the use of a pathology report sheet.