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  • Measure Summary
  • NQMC:011081
  • Jun 2016

Bladder cancer: proportion of patients with muscle invasive bladder cancer (MIBC) who have neo-adjuvant chemotherapy who undergo cystectomy or chemoradiation within 8 weeks of treatment.

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Bladder cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Jun. 38 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 muscle invasive bladder cancer (MIBC) who have neo-adjuvant chemotherapy who undergo cystectomy or chemoradiation within 8 weeks of treatment.

This Cancer Quality Performance Indicator (QPI) measure is separated into two parts. Please refer to the related NQMC summary, Bladder cancer: proportion of patients with muscle invasive bladder cancer (MIBC) who undergo radical cystectomy or radiotherapy only within 3 months of diagnosis of MIBC.

Note from the National Quality Measures Clearinghouse: This measure is part of the 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

Patients with bladder cancer should have cystectomy within 3 months of diagnosis as this has optimum survival benefit, if delayed for more than this time it can increase the risk of progression and cancer specific death (Scottish Intercollegiate Guidelines Network [SIGN], 2005; Stenzel et al., 2011).

Neo-adjuvant chemotherapy should be offered to suitable patients prior to definitive radical therapy, this includes radical cystectomy, radical radiation therapy, or preoperative radiotherapy and cystectomy (Scottish Intercollegiate Guidelines Network [SIGN], 2005; Winquist et al., 2005), therefore this treatment should be commenced as soon as possible following diagnosis.

Evidence for Rationale

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Bladder cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Jun. 38 p. [19 references]

Scottish Intercollegiate Guidelines Network (SIGN). Management of transitional cell carcinoma of the bladder. A national clinical guideline. Edinburgh (Scotland): Scottish Intercollegiate Guidelines Network (SIGN); 2005 Dec. 45 p. (SIGN publication; no. 85).  [161 references]

Stenzl A, Cowan NC, De Santis M, Kuczyk MA, Merseburger AS, Ribal MJ, Sherif A, Witjes JA, European Association of Urology (EAU). Treatment of muscle-invasive and metastatic bladder cancer: update of the EAU guidelines. Eur Urol. 2011 Jun;59(6):1009-18. PubMed External Web Site Policy

Winquist E, Waldron T, Segal R, Chin J, Lukka H, Genitourinary Cancer Disease Site Group. Use of neoadjuvant chemotherapy in transitional cell carcinoma of the bladder. Toronto (ON): Cancer Care Ontario (CCO); 2005 May 5. 26 p. (Practice guideline report; no. 3-2-2).  [59 references]

Primary Health Components

Muscle invasive bladder cancer (MIBC); neo-adjuvant chemotherapy; cystectomy; chemoradiation

Denominator Description

All patients with muscle invasive bladder cancer (MIBC) undergoing neo-adjuvant chemotherapy (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Number of patients with muscle invasive bladder cancer (MIBC) who have neoadjuvant chemotherapy who undergo cystectomy or chemoradiation within 8 weeks of treatment

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 Procedure/Imaging Center

Hospital Inpatient

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

Unspecified

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

Timeliness

Case Finding Period

Unspecified

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Clinical Condition

Therapeutic Intervention

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
All patients with muscle invasive bladder cancer (MIBC)* undergoing neo-adjuvant chemotherapy

*Tumour, Node and Metastasis (TNM) Stage: T2 and above

Exclusions
None

Exclusions/Exceptions

None

Numerator Inclusions/Exclusions

Inclusions
Number of patients with muscle invasive bladder cancer (MIBC) who have neo-adjuvant chemotherapy who undergo cystectomy or chemoradiation within 8 weeks of treatment

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: 90%

The tolerance within this target accounts for situations where patients are not fit enough to undergo treatment within the required timescales due to other medical conditions.

Evidence for Prescriptive Standard

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Bladder cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Jun. 38 p. [19 references]

Original Title

QPI 7 (ii) – time to treatment.

Measure Collection Name

Cancer Quality Performance Indicators (QPIs)

Measure Set Name

Bladder Cancer

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

Bladder Cancer 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 Feb

Measure Status

This is the current release of the measure.

Source(s)

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Bladder cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Jun. 38 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 May 3, 2017. The information was verified by the measure developer on May 23, 2017.

Copyright Statement

No copyright restrictions apply.

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