Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Assessing the Quality of Care in Breast Cancer Radiotherapy (#346)

Sara SP Pyun , Kim-Lin KLC Chiew 1 2 , Jesmin JS Shafiq 2 3 , Shalini SV Vinod 1 2 , Andrej AB Bece 4 , Rowena RM Martin 5 , Jeremiah De Leon 6
  1. Liverpool and Macarthur Cancer Therapy Centre, Liverpool and Macarthur, Sydney, NSW, Australia
  2. South Western Sydney Clinical School UNSW , Sydney, NSW, Australia
  3. Ignham Institute of Applied Medical Research, Liverpool, NEW SOUTH WALES, Australia
  4. St George Cancer Care Centre, St George Hospital, Sydney, NSW, Australia
  5. Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia
  6. Illawarra Cancer Care Centre, Wollongong Hospital, Sydney, NSW, Australia

Background:

Quality indicators (QIs) are an important tool for measuring quality of care in oncology. Breast cancer is the second most prevalent cancer in Australia and radiotherapy (RT) is an important component of treatment indicated in 87% of patients. With the rapid evolution of radiotherapy technology, assessing quality of RT care is essential.   

Aims:

The aims of this study were to identify published QIs relevant to breast cancer RT, assess the feasibility of measuring these from routine clinical information and evaluate the proportion of patients whose care was compliant with the identified QIs.

Methods:

A literature review was conducted for studies published from 2000-2019 to identify QIs relevant to breast cancer RT. Clinical data were automatically extracted and manually curated from four NSW oncology centres to record variables enabling QI measurement. The study population included all patients with invasive breast cancer seen in a radiation oncology clinic between 1/1/2018-30/6/2018. Descriptive analyses were performed to measure breast cancer RT QIs.

Results:

We identified 27 breast cancer QIs from the literature review of which 22 were relevant to radiotherapy and 15 QIs have been measured to date. Data was extracted from 430 patients to assess feasibility of measurement. All QIs were measurable across all centres except one measurable at only one centre. Compliance exceeded published benchmarks for three QIs and was within 10% of benchmarks for four QIs. The remaining eight QIs fell below 10% of the published benchmarks with the majority of these measuring the appropriate use of RT and involving multiple criteria in their definition.  

Conclusion:

It is feasible to measure breast cancer RT QIs using routine clinical data, however, only half of the indicators showed acceptable compliance with published benchmarks. The varying rates of adherence may be related to the complexity of the QI.

  1. Barton, M. et al. Estimating the demand for radiotherapy from the evidence: a review of changes from 2003 to 2012. Radiotherapy and Oncology 112, 140-144 (2014).