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Utility of routine data sources for feedback on the quality of cancer care: an assessment based on clinical practice guidelines

机译：利用常规数据源反馈有关癌症护理质量的信息：基于临床实践指南的评估

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Background Not all cancer patients receive state-of-the-art care and providing regular feedback to clinicians might reduce this problem. The purpose of this study was to assess the utility of various data sources in providing feedback on the quality of cancer care. Methods Published clinical practice guidelines were used to obtain a list of processes-of-care of interest to clinicians. These were assigned to one of four data categories according to their availability and the marginal cost of using them for feedback. Results Only 8 (3%) of 243 processes-of-care could be measured using population-based registry or administrative inpatient data (lowest cost). A further 119 (49%) could be measured using a core clinical registry, which contains information on important prognostic factors (e.g., clinical stage, physiological reserve, hormone-receptor status). Another 88 (36%) required an expanded clinical registry or medical record review; mainly because they concerned long-term management of disease progression (recurrences and metastases) and 28 (11.5%) required patient interview or audio-taping of consultations because they involved information sharing between clinician and patient. Conclusion The advantages of population-based cancer registries and administrative inpatient data are wide coverage and low cost. The disadvantage is that they currently contain information on only a few processes-of-care. In most jurisdictions, clinical cancer registries, which can be used to report on many more processes-of-care, do not cover smaller hospitals. If we are to provide feedback about all patients, not just those in larger academic hospitals with the most developed data systems, then we need to develop sustainable population-based data systems that capture information on prognostic factors at the time of initial diagnosis and information on management of disease progression.
机译：背景技术并非所有的癌症患者都能获得最先进的护理，定期向临床医生提供反馈可能会减少此问题。这项研究的目的是评估各种数据源在提供有关癌症治疗质量的反馈方面的效用。方法使用已发布的临床实践指南获取临床医生感兴趣的护理流程清单。根据它们的可用性和使用它们进行反馈的边际成本，将它们分配给四个数据类别之一。结果使用基于人口的登记或住院患者的行政管理数据，只能测量243个护理过程中的8个（3％）（最低费用）。可以使用核心临床注册表对另外119个（49％）进行测量，其中包含有关重要预后因素的信息（例如，临床阶段，生理储备，激素受体状态）。另有88名（36％）需要扩大临床登记或病历审查;主要是因为他们关注疾病进展（复发和转移）的长期管理，而28（11.5％）位患者需要进行患者访谈或录音，因为它们涉及临床医生与患者之间的信息共享。结论基于人群的癌症登记和行政住院数据的优势是覆盖范围广且成本低。缺点是它们当前仅包含有关少数护理过程的信息。在大多数司法管辖区中，可用于报告更多医疗流程的临床癌症登记簿并不覆盖较小的医院。如果我们要提供有关所有患者的反馈，而不仅仅是提供具有最先进数据系统的大型学术医院中的患者的反馈，那么我们需要开发可持续的基于人群的数据系统，以在初诊时获取有关预后因素的信息以及有关患者的信息。疾病进展管理。

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