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

More documents

Recommendations

Info

56 PROCARE – phase 2 KCE reports 81This information is already available from the PROCARE database. For QI 1252 the useof a variable with default value ‘0’ should be avoided (which is in fact a general remark).For both QI, it is important to increase the effort to identify the exact cStage.Table 48. Measurability of selected QI on palliative treatment.QI Prospective Db Administrative DbMeasurable? If not: reason? Measurable? If not: reason?1251 Yes - Yes -1252 Yes - No No code3.2.2.7 Quality indicators related to follow-upRate of curatively treated patients that received a colonoscopywithin 1 year after resectionDEFINITIONNumerator: all RC patients with R0 resection receiving a colonoscopy within 1 year afterresection.Denominator: all RC patients with R0 resection.Exclusion:• patients not treated with R0 resectionRESULTSThis QI is not measurable for the prospective cohort, since no code is available for acolonoscopy in the follow-up section of the PROCARE registration. Above this, followupdates are variable, making a calculation at 1 year impossible.Again, since no administrative code is available for R0 resection, this QI is notmeasurable for the administrative cohort.Rate of patients undergoing regular follow-up (according to thePROCARE recommendations)Numerator: all RC patients with R0 resection undergoing regular follow-up according tothe PROCARE recommendations.Denominator: all RC patients with R0 resection.Exclusion:• patients not treated with R0 resectionRESULTSThis QI is not measurable for the prospective cohort, since no code is available fordiagnostic techniques in the follow-up section of the PROCARE registration.Again, since no administrative code is available for R0 resection, this QI is notmeasurable for the administrative cohort.Late grade 4 complications of radiotherapy or chemoradiationNumerator: all RC patients that received radiotherapy with or without chemotherapyand having late grade 4 complications.Denominator: all RC patients that received radiotherapy with or without chemotherapy.Exclusion:• patients not treated with (chemo)radiotherapy• patients dying within 1 year after incidence dateRESULTSOne percent of the PROCARE patients treated with (chemo)radiotherapy experiencedlate grade 4 complications (Table 49). This result needs to be interpreted with caution,since in 633 patients no follow-up data were available. Above this, for 9 of the 112patients with follow-up data, no information was available on late complications.
KCE Reports 81 PROCARE – phase 2 57Since the variable on late complications has a default value ‘0’, the exact number ofmissing values cannot be determined.Since only one patient with a grade 4 complication was identified, a per-centre-analysisis irrelevant.This QI cannot be calculated for the administrative cohort, since no code is available forlate grade 4 complications.Table 49. Rate of late grade 4 complications of (chemo)radiotherapy,measured with prospective PROCARE data.NPatients with rectal cancer 1071Patients with (chemo)radiotherapy 771Proportion with follow-up data and information on late complications (denominator) 103Proportion with grade 4 complications (numerator) 1 (1%)DiscussionOnly 1 QI is measurable using the prospective database, while no QI are measurableusing the administrative database (Table 50). To render QI 1261 and 1262 measurable,the follow-up section of the PROCARE data entry form needs revision, specificallyasking which follow-up study was done at what moment.At this moment, all data related to medium- and long-term follow-up need to beinterpreted with caution, since only a minority of PROCARE patients already enteredthe follow-up stage of their disease.Table 50. Measurability of selected QI on follow-up.QI Prospective Db Administrative DbMeasurable? If not: reason? Measurable? If not: reason?1261 No No code No No code1262 No No code No No code1263 Yes - No No code3.2.2.8 Quality indicators related to histopathologic examinationUse of the pathology report sheetDEFINITIONNumerator: all patients with RC that underwent local or radical resective surgery andhave a pathology report sheet.Denominator: all patients with RC that underwent local or radical resective surgery.Exclusion:• patients not treated with local or radical surgeryRESULTSIn the PROCARE database, no code is available that registers the use of a pathologyreport sheet by the pathologist. Also, the suggested pathology report sheet was onlydistributed by surface mail to all Belgian pathologists in November 2006 and has beenonly gradually in use since then. Therefore, this QI is not measurable for theprospective cohort at present.Also, no administrative code exists for the use of a pathology report sheet.Quality of TME assessed according to Quirke and mentioned in thepathology reportDEFINITIONNumerator: all patients with RC that underwent TME and had the quality of TMEassessed according to Quirke and mentioned in the pathology report.Denominator: all patients with RC that underwent TME.
Page 1 and 2:
Assurance de qualitépour le cancer
Page 3 and 4:
Assurance de qualité pour lecancer
Page 5 and 6:
KCE Reports 81B Cancer rectal - pha
Page 7:
KCE Reports 81B Cancer rectal - pha
Page 10 and 11:
vi Cancer rectal - phase 2 KCE Repo
Page 12 and 13:
2 PROCARE - phase 2 KCE reports 81A
Page 14 and 15:
4 PROCARE - phase 2 KCE reports 811
Page 16 and 17: 6 PROCARE - phase 2 KCE reports 81F
Page 19 and 20: KCE Reports 81 PROCARE - phase 2 92
Page 65: KCE Reports 81 PROCARE - phase 2 55
Page 87 and 88: KCE Reports 81 PROCARE - Phase 2 77
Page 117 and 118:
KCE Reports 81 PROCARE - phase 2 10
Page 119 and 120:
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
Page 127 and 128:
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
Page 151 and 152:
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
Page 169:
Page 172 and 173:
Dépôt légal : D/2008/10.273/39
Page 174 and 175:
35. Etude relative aux coûts poten
show all

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

Create successful ePaper yourself

Delete template?

Save as template?