Table 1 Indicators (No. 22) to measure guideline-concordant care in lung cancer patients selected with a modified Delphi process
| Â | Short name | Numeratora | Denominator | No.of respondents | Validity | Modifiability | Utility |
|---|---|---|---|---|---|---|---|
M (Iq-IIIq) | M (Iq-IIIq) | M (Iq-IIIq) | |||||
O1 | First contact to first therapy ≤60 days | With an interval between first contact and first therapy ≤60 days | All patients with any recorded treatment and a contact§ ≤ 180 days | 95 | 6 (5–6) | 4 (3–5) | 6 (5–6) |
O2 | From PET to surgery ≤45 days | With an interval between PET and surgery ≤45 days | All patients receiving lung surgery and having a PET within 3 months before | 95 | 6 (5–7) | 4 (3–5) | 5 (4–6) |
O3 | Multidisciplinary evaluation | With multidisciplinary evaluation within 30 days before first treatment | All patients with any recorded treatment | 95 | 6 (5–7) | 5 (4–6) | 6 (5–7) |
O4b | From thorax CT to surgery ≤45 days | With an interval between thorax CT and surgery ≤45 days | All patients receiving lung surgery and having a thorax CT within 3 months before |  | na | na | na |
D1 | Thorax CT at diagnosis | Thorax CT within 2 months from diagnosis | All patients | 92 | 6 (5–7) | 4 (2–6) | 5 (3–6.5) |
D2 | Thorax CT before biopsy | With a thorax CT in the 30 days preceding broncoscopy or other biopsy procedure | All patients receiving a biopsy within 3 months before and one month after diagnosis | 92 | 6 (5–7) | 4.5 (3–6) | 6 (4–7) |
D3 | Treatment with curative intent preceded by PET | With a PET record in the 3 months preceding surgery or chemoradiation | NSCLC patients in stage I-III receiving either surgery or concomitant/sequential chemo-radiation | 92 | 6 (5–7) | 4 (3–6) | 6 (4–7) |
D4 | Cyto-histologic confirmation | With cyto-histologic confirmation in the cancer register | All patients | 92 | 6.5 (5–7) | 4 (3–6) | 6 (5–7) |
D5 | NSCLC Stage III patients assessed for metastasis before curative intent treatment | With a head CT/MR and PET/bone scan in the month preceding first therapy | NSCLC in stage III and receiving concomitant/sequential chemo-radiation | 92 | 6 (5–7) | 5 (3–6) | 6 (4–7) |
D6 | SCLC patients fully staged | With a thorax CT and abdominal CT/sonography and head CT/MR and PET/bone scan in the 3 months before diagnosis | All SCLC patients | 92 | 6 (5–7) | 5 (3–6) | 6 (5–7) |
S1 | Survival after first surgery | Not deaceased within 30 days from first surgery | All patients receiving lung surgery | 90 | 6 (6–7) | 4.5 (2–6) | 6 (5–7) |
S2 | Patients with a thorax CT ≤30 days before surgery | thorax CT in the 30 days before first surgery | All patients receiving lung surgery | 90 | 6 (5–7) | 4 (3–6) | 6 (5–7) |
S3 | Functional evaluation before surgery | Lung functionality evaluation in the month before first surgery | All patients receiving lung surgery in stage I-IIIa | 90 | 7 (6–7) | 5 (3–6) | 6 (5–7) |
S4 | Stage I-IIIA NSCLC patients undergoing curative intent surgery | Receiving surgery with presumed curative intent | NSCLC patients in stage I-IIIa | 90 | 6 (5–7) | 5 (3–6) | 6 (5–7) |
S5 | Stage I-IIA NSCLC patients undergoing lobectomy | Receiving lobectomy as first surgery | NSCLC patients in stage I-IIa and receiving lung surgery | 90 | 6 (5–7) | 4 (3–6) | 6 (5–6) |
S6 | No second surgery within 30 days | Not undergoing a second lung intervention within 30 days | All patients receiving lung surgery | 90 | 6 (6–7) | 4 (2–6) | 6 (5–7) |
S7 | Hospital stay ≤14 days for first surgery | With an hospital stay ≤14 days and with no hospital access in the 30 days after discharge | All patients undergoing segmentectomy, lobectomy or pneumonectomy as their first lung surgery | 90 | 6 (5–7) | 4 (3–6) | 6 (5–7) |
M1 | Stage II-III NSCLC patients receiving chemo-radiation | Receiving concomitant or sequential chemo-radiation | NSCLC patients in stage II-III that did not receive surgery | 87 | 5 (5–6) | 4 (3–5) | 5 (4–6) |
M2 | SCLC patients undergoing medical oncologic therapy or radiotherapy | Receiving medical oncologic treatment and/or radiotherapy | SCLC patients not in stage IV | 87 | 6 (5–7) | 4 (3–5) | 5 (4–6) |
M3 | Palliative care before death | Home-care, hospice or hospital admission for palliative care in the 3 months before death | All patients deceased at 31/12/2016 | 85 | 6 (6–7) | 5 (3–6) | 6 (5–7) |
M4 | Pain management before death | With an opioids prescription in the 3 months before death | All patients deceased at 31/12/2016 | 85 | 6 (5–7) | 5 (3–6) | 6 (4–7) |
F1 | Follow-up in year 2, 3, and 4 for surviving patients | With at least one follow-up visit or hospital admission in the year (excluding urgent admission and admission for medical oncologic treatment, radiotherapy or lung surgery) | Patients alive after 2, 3, and 4 years | 85 | 6 (5–7) | 5 (3–6) | 6 (5–7) |