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  • Measure Summary
  • NQMC:011065
  • Jun 2016

Acute leukaemia: proportion of patients with acute leukaemia 60 years of age and over with performance status (PS) 0-1 who receive intensive chemotherapy.

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Acute leukaemia clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Jun. 30 p. [19 references]

View the original measure documentation External Web Site Policy

This is the current release of the measure.

Primary Measure Domain

Clinical Quality Measures: Process

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the proportion of patients with acute leukaemia 60 years of age and over with performance status (PS) 0-1 who receive intensive chemotherapy.

This Cancer Quality Performance Indicator (QPI) measure is separated into two parts. Please refer to the related NQMC summary, Acute leukaemia: proportion of patients with acute leukaemia 60 years of age and over receiving intensive chemotherapy who are enrolled in a clinical trial.

Note from the National Quality Measures Clearinghouse: This measure is part of the Cancer Quality Performance Indicators (QPIs) collection. For more information, including a complete list of QPI measure sets, please visit the Healthcare Improvement Scotland Web site External Web Site Policy.

Rationale

Older age should not be a reason to withhold intensive therapy. Evidence suggests that intensive chemotherapy provides better quality of life and longer survival than supportive care only regardless of chronologic age (British Committee for Standards in Haematology et al., 2006; Döhner et al., 2010; O'Donnell et al., 2012).

Performance status, adverse features (e.g., unfavourable cytogenetics) and co-morbidities should be utilised to select treatment options rather than relying on chronological age alone (O'Donnell et al., 2012; Zaretsky et al., 2008).

Patients with acute leukaemia should be treated on a clinical trials wherever possible (British Committee for Standards in Haematology et al., 2006; Döhner et al., 2010; Alvarnas et al., 2012).

Evidence for Rationale

Alvarnas JC, Brown PA, Aoun P, Ballen KK, Bellam N, Blum W, Boyer MW, Carraway HE, Coccia PF, Coutre SE, Cultrera J, Durrant J, DeAngelo DJ, Douer D, Frangoul H, Frankfurt O, Goorha S, Millenson MM, O'Brien S, Petersdorf SH, Rao AV, Terezakis S, Uy G, Wetzler M, Zelenetz AD, Naganuma M, Gregory KM, National Comprehensive Cancer Network. Acute lymphoblastic leukemia. J Natl Compr Canc Netw. 2012 Jul 1;10(7):858-914. PubMed External Web Site Policy

British Committee for Standards in Haematology, Milligan DW, Grimwade D, Cullis JO, Bond L, Swirsky D, Craddock C, Kell J, Homewood J, Campbell K, McGinley S, Wheatley K, Jackson G. Guidelines on the management of acute myeloid leukaemia in adults. Br J Haematol. 2006 Nov;135(4):450-74. [181 references] PubMed External Web Site Policy

Döhner H, Estey EH, Amadori S, Appelbaum FR, Büchner T, Burnett AK, Dombret H, Fenaux P, Grimwade D, Larson RA, Lo-Coco F, Naoe T, Niederwieser D, Ossenkoppele GJ, Sanz MA, Sierra J, Tallman MS, Löwenberg B, Bloomfield CD, European LeukemiaNet. Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European LeukemiaNet. Blood. 2010 Jan 21;115(3):453-74. PubMed External Web Site Policy

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Acute leukaemia clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Jun. 30 p. [19 references]

O'Donnell MR, Abboud CN, Altman J, Appelbaum FR, Arber DA, Attar E, Borate U, Coutre SE, Damon LE, Goorha S, Lancet J, Maness LJ, Marcucci G, Millenson MM, Moore JO, Ravandi F, Shami PJ, Smith BD, Stone RM, Strickland SA, Tallman MS, Wang ES, Naganuma M, Gregory KM. NCCN clinical practice guidelines acute myeloid leukemia. J Natl Compr Canc Netw. 2012 Aug;10(8):984-1021. PubMed External Web Site Policy

Zaretsky Y, Crump M, Haynes AE, Imrie K, Stevens A, Imrie K, Meyer RM, Hematology Disease Site Group. Treatment of acute myeloid leukemia in older patients: guideline recommendations. Toronto (ON): Cancer Care Ontario (CCO); 2008 Dec 18. 65 p. (Evidence-based series; no. 6-14).  [68 references]

Primary Health Components

Acute leukaemia; performance status (PS); intensive chemotherapy; elderly

Denominator Description

All patients with acute leukaemia 60 years of age and over with performance status (PS) 0-1

Numerator Description

Number of patients with acute leukaemia 60 years of age and over with performance status (PS) 0-1 who receive intensive chemotherapy

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A clinical practice guideline or other peer-reviewed synthesis of the clinical research evidence
  • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences

Additional Information Supporting Need for the Measure

Unspecified

Extent of Measure Testing

The collection of data is piloted on a small number of patient records using a paper data collection form produced by the Information Services Division (ISD). The aim is to identify any anomalies or difficulties with data collection prior to full implementation. At least one NHS board in each Regional Cancer Network participates in the pilot.

Evidence for Extent of Measure Testing

NHS Scotland. National cancer quality performance indicators: overview of development process. Edinburgh (Scotland): NHS Scotland; 2012 Dec. 7 p.

State of Use

Current routine use

Current Use

Internal quality improvement

National reporting

Public reporting

Measurement Setting

Ambulatory/Office-based Care

Ambulatory Procedure/Imaging Center

Hospital Outpatient

Professionals Involved in Delivery of Health Services

Physicians

Least Aggregated Level of Services Delivery Addressed

Single Health Care Delivery or Public Health Organizations

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

Age greater than 60 years

Target Population Gender

Either male or female

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Getting Better

Living with Illness

IOM Domain

Effectiveness

Case Finding Period

Unspecified

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Clinical Condition

Patient/Individual (Consumer) Characteristic

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
All patients with acute leukaemia 60 years of age and over with performance status (PS) 0-1

Exclusions
None

Exclusions/Exceptions

None

Numerator Inclusions/Exclusions

Inclusions
Number of patients with acute leukaemia 60 years of age and over with performance status (PS) 0-1 who receive intensive chemotherapy

Exclusions
None

Numerator Search Strategy

Fixed time period or point in time

Data Source

Electronic health/medical record

Paper medical record

Type of Health State

Does not apply to this measure

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Desired value is a higher score

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

External comparison at a point in, or interval of, time

External comparison of time trends

Internal time comparison

Prescriptive standard

Prescriptive Standard

Target: 20%

The tolerance within the target is designed to account for situations where patient's co-morbidities preclude treatment with intensive chemotherapy and for factors of patient choice.

Evidence for Prescriptive Standard

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Acute leukaemia clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Jun. 30 p. [19 references]

Original Title

QPI 10 – intensive chemotherapy in older adults.

Measure Collection Name

Cancer Quality Performance Indicators (QPIs)

Measure Set Name

Acute Leukaemia

Submitter

NHS Scotland - National Government Agency [Non-U.S.]

Scottish Cancer Taskforce - National Government Agency [Non-U.S.]

Developer

NHS Scotland - National Government Agency [Non-U.S.]

Scottish Cancer Taskforce - National Government Agency [Non-U.S.]

Funding Source(s)

Scottish Government

Composition of the Group that Developed the Measure

Acute Leukaemia QPI Development Group

Financial Disclosures/Other Potential Conflicts of Interest

Unspecified

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2016 Jun

Measure Maintenance

The Cancer Quality Performance Indicators (QPIs) will be kept under regular review and be responsive to changes in clinical practice and emerging evidence.

Date of Next Anticipated Revision

2018 Mar

Measure Status

This is the current release of the measure.

Source(s)

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Acute leukaemia clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Jun. 30 p. [19 references]

Measure Availability

Source document available from the Healthcare Improvement Scotland Web site External Web Site Policy.

For more information, contact the Healthcare Improvement Scotland at Gyle Square, 1 South Gyle Crescent, Edinburgh, Scotland EH12 9EB; Phone: 0131 623 4300; E-mail: comments.his@nhs.net; Web site: www.healthcareimprovementscotland.org/ External Web Site Policy.

Companion Documents

The following is available:

  • NHS Scotland. National cancer quality performance indicators: overview of development process. Edinburgh (Scotland): NHS Scotland; 2012 Dec. 7 p. This document is available from the Healthcare Improvement Scotland Web site External Web Site Policy.

NQMC Status

This NQMC summary was completed by ECRI Institute on April 25, 2017. The information was verified by the measure developer on May 23, 2017.

Copyright Statement

No copyright restrictions apply.

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