American society of clinical oncology/national comprehensive cancer network quality measures
American society of clinical oncology/national comprehensive cancer network quality measures
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DOI：
10.1200/jco.2008.16.5068
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发表时间：
2008-07-20
影响因子：
45.3
通讯作者：
Edge, Stephen B.
中科院分区：
文献类型：
--
作者：
Desch, Christopher E.;McNiff, Kristen K.;Edge, Stephen B.
目的 国家癌症政策委员会于 1999 年建议建立质量衡量标准和国家报告系统。美国临床肿瘤学会 (ASCO) 和国家综合癌症网络 (NCCN) 的代表合作创建适合国家绩效衡量的指标。方法 ASCO 和 NCCN 提名的内容和方法专家会面，根据国家癌症护理质量倡议和 NCCN 措施以及 NCCN 和 ASCO 指南，选择和完善乳腺癌、结肠癌和直肠癌的指标。根据对无病生存率和总生存率的影响、存在改善机会的程度以及数据收集的可行性来选择措施。结果选择了三种乳腺癌措施和四种结直肠癌措施。乳腺癌的治疗措施包括针对激素受体阳性肿瘤的辅助激素治疗、针对激素受体阴性癌症的化疗以及肿瘤切除术后的放疗。结直肠治疗措施包括直肠癌的辅助放疗和化疗以及结肠癌的辅助化疗。除一项外，所有其他措施均被建议作为问责措施，一项则用于质量改进（切除并检查结肠癌中的 12 个或更多淋巴结）。使用肿瘤登记处作为数据源为每项措施制定了规范。 结论 卫生系统、提供者团体或付款人可以使用当地肿瘤登记处提供分期和治疗数据来实施 ASCO/NCCN 措施，以进行改进或问责。
Purpose The National Cancer Policy Board recommended the creation of quality measures and a national reporting system in 1999. Representatives from the American Society of Clinical Oncology ( ASCO) and the National Comprehensive Cancer Network ( NCCN) collaborated to create metrics suitable for national performance measurement.Methods Content and methodology experts nominated by ASCO and NCCN met to select and refine metrics for breast, colon, and rectal cancer based on National Initiative for Cancer Care Quality and NCCN measures and NCCN and ASCO guidelines. Measures were selected based on their impact on disease free and overall survival, the degree to which opportunities for improvement exist, and the feasibility of data collection.Results Three breast cancer measures and four colorectal cancer measures were chosen. Measures for breast cancer included adjuvant hormone therapy for hormone receptor - positive tumors, chemotherapy for hormone receptor - negative cancer, and radiation after lumpectomy. Colorectal measures included adjuvant radiation and chemotherapy for rectal cancer, and adjuvant chemotherapy for colon cancer. All but one were recommended as accountability measures and one for quality improvement ( removal and examination of 12 or more lymph nodes in colon cancer). Specifications were developed for each measure using tumor registries as the data source.Conclusion ASCO/ NCCN measures can be implemented by health systems, provider groups or payors for improvement or accountability using local tumor registries to furnish data on staging and treatment.