Trends in Attaining Mammography Quality Benchmarks With Repeated Participation in a Quality Measurement Program: Going Beyond the Mammography Quality Standards Act to Address Breast Cancer Disparities.
Trends in Attaining Mammography Quality Benchmarks With Repeated Participation in a Quality Measurement Program: Going Beyond the Mammography Quality Standards Act to Address Breast Cancer Disparities.
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DOI：
10.1016/j.jacr.2020.07.019
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Murphy AM
中科院分区：
文献类型：
--
作者：
Rauscher GH;Tossas-Milligan K;Macarol T;Grabler PM;Murphy AM
《乳房X线摄影质量标准法》（MQSA）要求乳房X线摄影设施进行审计，但没有规定要测量的指标。在以前的乳房X线摄影质量改进项目中，我们检查了乳腺癌筛查设施是否可以收集必要的数据，以表明它们符合某些质量基准。在这里，我们提出的趋势，从第一个五年的数据收集，以检查是否继续参与这一质量改进计划与乳腺癌筛查达到的基准数量的增加。纳入了伊利诺伊州的参与机构（N=114），至少在两个时间点（2006年、2009年、2010年、2011年和/或2013年）收集了数据。各设施提供了关于筛查乳房X线照片和相应的诊断后续信息的汇总数据，这些数据用于估计13项措施和患者跟踪、回诊、癌症检测、失访和及时护理的相应基准。对于许多但不是所有措施，能够表明它们达到具体基准的设施数量随着参与时间的延长而增加。达到更多基准的趋势在癌症检测、及时成像、活检时未丢失、已知最小状态（所有p<0.01）以及筛查检测到的最小和早期癌症的比例（两者均p<0.001）方面是明显的。参与质量改进计划似乎导致患者跟踪，回叫/检测和及时性基准的改善。
The Mammography Quality Standards Act (MQSA) requires that mammography facilities conduct an audit but there are no specifications on the metrics to be measured. In a previous mammography quality improvement project, we examined whether breast cancer screening facilities could collect the data necessary to show that they met certain quality benchmarks. Here we present trends from the first five years of data collection, to examine whether continued participation in this quality improvement program was associated with an increase in the number of benchmarks met for breast cancer screening. Participating facilities across the state of Illinois (N=114) with at least two time points of data collected in (years 2006, 2009, 2010, 2011 and/or 2013) were included. Facilities provided aggregate data on screening mammograms and corresponding diagnostic follow-up information, which was used to estimate 13 measures and corresponding benchmarks for patient tracking, callback, cancer detection, loss to follow-up and timeliness of care. The number of facilities able to show that they met specific benchmarks increased with length of participation for many but not all measures. Trends towards meeting more benchmarks were apparent for cancer detection, timely imaging, not lost at biopsy, known minimal status (p<0.01 for all), and proportion of screen-detected cancers that were minimal and early stage (p<0.001 for both). Participation in the quality improvement program appeared to lead to improvements in patient tracking, callback/detection, and timeliness benchmarks.
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