Cancer Quality-ASSIST Supportive Oncology Quality Indicator Set Feasibility, Reliability, and Validity Testing

被引:59
作者
Dy, Sydney M. [1 ,2 ,3 ]
Lorenz, Karl A. [4 ]
ONeill, Sean M. [5 ]
Asch, Steven M. [4 ]
Walling, Anne M. [6 ]
Tisnado, Diana [6 ]
Antonio, Anna Liza [7 ]
Malin, Jennifer L. [4 ]
机构
[1] Johns Hopkins Sch Med, Dept Hlth Policy & Management, Baltimore, MD 21205 USA
[2] Johns Hopkins Sch Med, Dept Oncol, Baltimore, MD 21205 USA
[3] Johns Hopkins Sch Med, Dept Med, Baltimore, MD 21205 USA
[4] Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, RAND Hlth, Los Angeles, CA 90095 USA
[5] Univ Calif Los Angeles, David Geffen Sch Med, RAND Pardee Grad Sch, Los Angeles, CA 90095 USA
[6] Univ Calif Los Angeles, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA USA
[7] Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA
基金
美国医疗保健研究与质量局;
关键词
supportive oncology; quality indicators; pain; dysprea; care planning; EVIDENCE-BASED RECOMMENDATIONS; HOSPICE CARE; PERFORMANCE; LIFE; END;
D O I
10.1002/cncr.25109
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND: Although measuring the quality of symptom management and end-of-life care could help provide a basis for improving supportive care for advanced cancer, few quality indicators in this area have been rigorously developed or evaluated. METHODS: The authors conducted a pilot evaluation of a comprehensive set of 92 supportive oncology quality indicators, Cancer Quality-ASSIST, including outpatient and hospital indicators for symptoms commonly related to cancer and its treatment and information and care planning. They operationalized the indicators and developed an electronic abstraction tool and extensive guidelines and training materials. Quality assurance nurses abstracted the medical records for 356 advanced cancer patients in 2 settings: a Veterans Administration hospital and an academic hospital and cancer center. The authors evaluated the indicators' feasibility, inter-rater reliability, and validity. RESULTS: The authors successfully evaluated 78 indicators across the domains; results were similar in the 2 settings. They could not feasibly evaluate 3 indicators because of low prevalence; 22 indicators had significant inter-rater reliability issues, 9 had significant validity issues, and 3 had both reliability and validity issues, leaving a set of 41 indicators most promising for further testing and use in this population, with an overall kappa score of 0.85 for specified care. CONCLUSIONS: Of 92 Cancer Quality-ASSIST quality indicators for symptoms, treatment toxicity, and information and care planning, 41 were sufficiently feasible, reliable, and valid to be used for patients with advanced cancer in these settings. This set of indicators shows promise for describing key supportive care processes in advanced cancer. Cancer 2010;116:3267-75. (C) 2010 American Cancer Society.
引用
收藏
页码:3267 / 3275
页数:9
相关论文
共 23 条
[1]  
[Anonymous], MEAS EV CRIT
[2]  
*CAR CTR MED EXC, PALL CAR QUAL MEAS P
[3]   Measuring hospice care: The national hospice and palliative care organization national hospice data set [J].
Connor, SR ;
Tecca, M ;
LundPerson, J ;
Teno, J .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 2004, 28 (04) :316-328
[4]  
*CTR MED MED SERV, 2010, PHYS QUAL REP IN PQR
[5]   Evidence-based standards for cancer pain management [J].
Dy, Sydney M. ;
Asch, Steven M. ;
Naeim, Arash ;
Sanati, Homayoon ;
Walling, Anne ;
Lorenz, Karl A. .
JOURNAL OF CLINICAL ONCOLOGY, 2008, 26 (23) :3879-3885
[6]   Evidence-based recommendations for cancer fatigue, anorexia, depression, and dyspnea [J].
Dy, Sydney M. ;
Lorenz, Karl A. ;
Naeim, Arash ;
Sanati, Homayoon ;
Walling, Anne ;
Asch, Steven M. .
JOURNAL OF CLINICAL ONCOLOGY, 2008, 26 (23) :3886-3895
[7]   Aggressiveness of cancer care near the end of life: Is it a quality-of-care issue? [J].
Earle, Craig C. ;
Landrum, Mary Beth ;
Souza, Jeffrey M. ;
Neville, Bridget A. ;
Weeks, Jane C. ;
Ayanian, John Z. .
JOURNAL OF CLINICAL ONCOLOGY, 2008, 26 (23) :3860-3866
[8]   Nationwide veterans affairs quality measure for cancer: The family assessment of treatment at end of life [J].
Finlay, Esme ;
Shreve, Scott ;
Casarett, David .
JOURNAL OF CLINICAL ONCOLOGY, 2008, 26 (23) :3838-3844
[9]   Improvement in oncology practice performance through voluntary participation in the quality oncology practice initiative [J].
Jacobson, Joseph O. ;
Neuss, Michael N. ;
McNiff, Kristen K. ;
Kadlubek, Pamela ;
Thacker, Leroy R., II ;
Song, Frank ;
Eisenberg, Peter D. ;
Simone, Joseph V. .
JOURNAL OF CLINICAL ONCOLOGY, 2008, 26 (11) :1893-1898
[10]   MEASUREMENT OF OBSERVER AGREEMENT FOR CATEGORICAL DATA [J].
LANDIS, JR ;
KOCH, GG .
BIOMETRICS, 1977, 33 (01) :159-174