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Evaluation and Selection of Quality Indicators for the Management of Endometrial Cancer
Laure Chenoz1, Juliette Phelippeau, Emmanuel Barranger
1*Service de Gynécologie Obstétrique; †Sce Gynécologie Hôpital Bichat Claude Bernard, Paris; ‡Sce Gynécologie Centre Antoine Lacassagne, Nice; §Sce Gynécologie, CHU Estaing, Clermont-Ferrand; ∥Pôle d'Obstétrique Gynécologie Reproduction, Hôpital Pellegrin, Centre Aliénor d'Aquitaine, CHU Bordeaux, Bordeaux; ¶Sce de Chirurgie Oncologique 2, Institut Paoli Calmettes, Marseille; #Clinique de Chirurgie Gynécologique Hôpital Jeanne de Flandre, CHRU de Lille, Université Lille Nord de France, Lille; **Sce Gynécologie, Hôpital Le Bocage CHU Dijon, Dijon; ††Sce Gynécologie, Hôpital Tenon Paris, Paris; ‡‡Sce Gynécologie, CHU Antoine Béclére, Clamart; §§Sce Gynécologie CHU Limoges, Limoges; ∥∥Sce Gynécologie, CH Lyon Sud, Lyon; ¶¶Sce Gynécologie, CH Poissy, Poissy; ##Sce Gynécologie, CHRU Bretonneau, Tours; ***Sce Gynécologie Institut Curie; and †††Sce Gynécologie Hôpital Bichat Claude Bernard, Paris, France.
Objective:
The aim of this study was to evaluate 36 quality indicators (QIs) for monitoring the quality of care of uterine cancer to be implemented in the EFFECT (effectiveness of endometrial cancer treatment) project.
Methods:
The 36 QIs were evaluated in the first 10 patients diagnosed with endometrial cancer and managed in 14 French hospitals in 2011. To assess the status of each QI, a questionnaire detailing the 36 QIs was sent to each hospital, and the information was cross-checked with information from the multidisciplinary staff meeting, surgical reports, and pathological reports. The QIs were evaluated in terms of measurability and improvability. The remaining QIs were evaluated with a multiple correspondence analysis to highlight the interrelationships between qualitative variables describing a population.
Results:
Thirteen of the 14 institutions responded to the survey for a total of 130 patients. Twenty-five of the 36 QIs affected less than 80% of the patients. Thirteen QIs were found not to be improvable because they reached more than 95% of the theoretical target. Finally, 5 QIs concerning more than 80% of the patients were found to be improvable. The multiple correspondence analysis finally identified 3 dimensions-outcome, safety, and perioperative management-that included the 5 QIs.
Conclusions:
In the present study, 5 of the 36 QIs suggested by the EFFECT project seem to be sufficient to report on the quality of endometrial cancer management. Further studies are needed to correlate the information provided by those 5 questions and the relevant outcomes reflecting quality of care in endometrial cancer.
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