Quality indicators in the management of bladder cancer: A modified Delphi study

Satya R Khare; Armen Aprikian; Peter Black; Normand Blais; Chris Booth; Fadi Brimo; Joseph Chin; Peter Chung; Darrel Drachenberg; Libni Eapen; Adrian Fairey; Neil Fleshner; Yves Fradet; Geoffrey Gotto; Jonathan Izawa; Michael Jewett; Girish Kulkarni; Louis Lacombe; Ron Moore; Chris Morash; Scott North; Ricardo Rendon; Fred Saad; Bobby Shayegan; Robert Siemens; Alan So; Srikala S Sridhar; Samer L Traboulsi; Wassim Kassouf

doi:10.1016/j.urolonc.2016.12.003

Quality indicators in the management of bladder cancer: A modified Delphi study

Urol Oncol. 2017 Jun;35(6):328-334. doi: 10.1016/j.urolonc.2016.12.003. Epub 2017 Jan 3.

Authors

Satya R Khare¹, Armen Aprikian², Peter Black³, Normand Blais⁴, Chris Booth⁵, Fadi Brimo⁶, Joseph Chin⁷, Peter Chung⁸, Darrel Drachenberg⁹, Libni Eapen¹⁰, Adrian Fairey¹¹, Neil Fleshner¹², Yves Fradet¹³, Geoffrey Gotto¹⁴, Jonathan Izawa⁷, Michael Jewett¹², Girish Kulkarni¹², Louis Lacombe¹³, Ron Moore¹¹, Chris Morash¹⁵, Scott North¹⁶, Ricardo Rendon¹⁷, Fred Saad¹⁸, Bobby Shayegan¹⁹, Robert Siemens²⁰, Alan So³, Srikala S Sridhar²¹, Samer L Traboulsi², Wassim Kassouf²²

Affiliations

¹ Department of Family Medicine, McGill University, Montreal, QC, Canada.
² Department of Urology, McGill University Health Centre, Montreal, QC, Canada.
³ Department of Urology, University of British Columbia, Vancouver, BC, Canada.
⁴ Division of Medical Oncology, University of Montreal, Montreal, QC, Canada.
⁵ Department of Oncology, Queen's University, Kingston, ON, Canada.
⁶ Department of Pathology, McGill University Health Centre, Montreal, QC, Canada.
⁷ Division of Urology, Western University, London, ON, Canada.
⁸ Department of Radiation Oncology, Princess Margaret Cancer Centre and the University Health Network, University of Toronto, Toronto, ON, Canada.
⁹ Division of Urology, University of Manitoba, Winnipeg, MB, Canada.
¹⁰ Division of Radiation Oncology, University of Ottawa, Ottawa, ON, Canada.
¹¹ Division of Urology, University of Alberta, Edmonton, AB, Canada.
¹² Departments of Surgery (Urology), Princess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada; Department of Surgical Oncology, Princess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada.
¹³ Division of Urology, Laval University, Quebec City, QC, Canada.
¹⁴ Division of Urology, University of Calgary, Calgary, AB, Canada.
¹⁵ Division of Urology, University of Ottawa, Ottawa, ON, Canada.
¹⁶ Division of Medical Oncology, University of Alberta, Edmonton, AB, Canada.
¹⁷ Division of Urology, Dalhousie University, Halifax, NS, Canada.
¹⁸ Division of Urology, University of Montreal, QC, Canada.
¹⁹ Division of Urology, McMaster University, Hamilton, ON, Canada.
²⁰ Department of Oncology, Queen's University, Kingston, ON, Canada; Department of Urology, Queen's University, Kingston, ON, Canada.
²¹ Department of Medical Oncology, Princess Margaret Cancer Centre and the University Health Network, University of Toronto, Toronto, ON, Canada.
²² Department of Urology, McGill University Health Centre, Montreal, QC, Canada. Electronic address: wassim.kassouf@muhc.mcgill.ca.

PMID: 28065393
DOI: 10.1016/j.urolonc.2016.12.003

Abstract

Background: Survival in patients with bladder cancer has only moderately improved over the past 2 decades. A potential reason for this is nonadherence to clinical guidelines and best practice, leading to wide variations in care. Common quality indicators (QIs) are needed to quantify adherence to best practice and provide data for benchmarking and quality improvement.

Objective: To produce an evidence- and consensus-based list of QIs for the management of bladder cancer.

Methods: A modified Delphi method was used to develop the indicator list. Candidate indicators were extracted from the literature and rated by a 27-member Canadian expert panel in several rounds until consensus was reached on the final list of indicators. In rounds with numeric ratings, a frequency analysis was performed.

Results: A total of 86 indicators were rated, 52 extracted from the literature and 34 suggested by the panel. After iterative rounds of ratings and discussion, a final list of 60 QIs spanning several disciplines and phases of the cancer care continuum was developed.

Conclusions: This is the first study to comprehensively produce common QIs representing structure, process, and outcome measures in bladder cancer management. Though developed in Canada, these indicators can be used in other countries with slight modifications to track performance and improve care.

Keywords: Bladder cancer; Outcome; Quality improvement; Quality indicators.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Delphi Technique*
Female
Humans
Male
Survival Analysis
Urinary Bladder Neoplasms / mortality
Urinary Bladder Neoplasms / pathology
Urinary Bladder Neoplasms / therapy*