Quality indicators for the diagnosis and surgical management of breast cancer in South Africa

Breast

Wenlong Carl Chen¹  Shane A. Norris²  Paul Ruff³  Sarah Nietz⁴  Daniel S. O’Neil⁵ 

[1] Corresponding author. Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown, 2193, South Africa.;Division of Medical Oncology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;Noncommunicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Johannesburg, South Africa;Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;Noncommunicable Diseases Research Division, Wits Health Consortium (PTY) Ltd, Johannesburg, South Africa;

关键词: Breast cancer surgery;    Quality indicators;    Low-to middle-income countries;   

DOI  :  

来源: DOAJ

【 摘 要 】

Introduction: Quality indicators (QIs) for breast cancer care have been developed and applied in high-income countries and contributed to improved quality of care and patient outcomes over time. Materials and methods: A modified Delphi process was used to derive expert consensus. Potential QIs were rated by a panel of 17 breast cancer experts from various subspecialties and across South African provinces. Each QI was rated according to importance to measure, scientific acceptability and feasibility. Scoring ranged from 1 (no agreement) to 5 (strong agreement). Inclusion thresholds were set a priori at mean ratings ≥4 with a coefficient variation of ≥25%. Levels of evidence were determined for each indicator. Results: The literature review identified 790 potential QIs. After categorisation and removal of duplicates, 52 remained for panel review. There was strong consensus for 47 which were merged to 30 QIs by exclusion of similar indicators and indicator grouping. The final set included eight QIs with level I or II evidence and two QIs with level III evidence which were deemed “mandatory” due to clinical priority and impact on care. The remaining QIs with lower-level evidence were grouped as eight “recommended” QIs (regarded as standard of care) and twelve “optional” QIs (not regarded as standard of care). Conclusion: A regional set of QIs was developed to facilitate standardised treatment and auditing of surgical care for breast cancer patients in South Africa. Routine monitoring of the ten mandatory QIs, which were selected to have the most substantial impact on patient outcome, is proposed.

【 授权许可】

Unknown