Indicators of guideline-concordant care in lung cancer defined with a modified Delphi method and piloted in a cohort of over 5,800 cases

Table 4 Summary of the evaluation of construct validity, through clinical records evaluation, of a set of indicators to measure guideline-concordant care in lung cancer patients in a subsample of 114 patients from a pilot population of 5746 subjects

	Indicator	No. discordant^a	No. evaluated	% discordant^a
O1	First contact to first therapy ≤60 days	17	97	17.5
O2	From PET to surgery ≤45 days	1	16	6.3
O4	From thorax CT to surgery ≤45 days	1	16	6.3
D1	Thorax CT at diagnosis	12	114	10.5
D2	Thorax CT before biopsy	15	79	19.0
D3	Treatment with curative intent preceded by PET	10	38	26.3^b
D4	Cyto-histologic confirmation	0	114	0.0
D5	NSCLC Stage III patients assessed for metastasis before curative intent treatment	4	22	18.2
D6	SCLC patients fully staged	18	28	64.3^b
S1	No death after first surgery	0	25	0.0
S2	Patients with a thorax CT ≤30 days before surgery	6	25	24.0^b
S4	Stage I-IIIA NSCLC patients undergoing surgery with curative intent	0	56	0.0
S5	Stage I-IIA NSCLC patients undergoing lobectomy	0	24	0.0
S6	No second surgery within 30 days	0	25	0.0
S7	Hospital stay ≤14 days for first surgery	0	20	0.0
M1	Stage II-III NSCLC patients receiving chemo-radiation	0	40	0.0
M2	SCLC patients undergoing medical oncologic therapy or radiotherapy	0	21	0.0
M4	Pain management before death	1	90	1.1

The indicators Follow-up in year 2, 3 and 4 (F1) for surviving patients were not evaluated as full clinical records, including outpatient visit reports, were not available for the follow-up period
^aprocedure performed and in the correct time frame according to clinical record (indicator = 1) and corresponding codes not found in administrative databases in the correct time frame (indicator = 0). ^b indicator with discordance percentage higher than 20%, that was set as the a-priori acceptable threshold value

ISSN: 2049-3258