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  • Measure Summary
  • NQMC:011179
  • Aug 2016

Cervical cancer: proportion of patients with cervical cancer who undergo surgery where surgical margins are clear of tumour.

NHS Scotland, Scottish Cancer Taskforce. Cervical cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Aug. 29 p. [12 references]

View the original measure documentation External Web Site Policy

This is the current release of the measure.

Primary Measure Domain

Clinical Quality Measures: Outcome

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the proportion of patients with cervical cancer who undergo surgery where surgical margins are clear of tumour.

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

The quality of radical surgery for cervical cancer has an important influence on local control of the tumour and ultimately survival. Therefore, it is important to optimise and ensure the quality of surgical care for cervical cancer patients. Positive surgical margins increase the risk of reoccurrence, necessitating adjuvant treatment (Greer et al., 2010; McCann et al., 2013; Verleye et al., 2009).

Evidence for Rationale

Greer BE, Koh WJ, Abu-Rustum NR, Apte SM, Campos SM, Chan J, Cho KR, Copeland L, Crispens MA, Dupont N, Eifel PJ, Gaffney DK, Huh WK, Kapp DS, Lurain JR 3rd, Martin L, Morgan MA, Morgan RJ Jr, Mutch D, Remmenga SW, Reynolds RK, Small W Jr, Teng N, Valea FA, National Comprehensive Cancer Networks. Cervical cancer. J Natl Compr Canc Netw. 2010 Dec;8(12):1388-416. PubMed External Web Site Policy

McCann GA, Taege SK, Boutsicaris CE, Phillips GS, Eisenhauer EL, Fowler JM, O'Malley DM, Copeland LJ, Cohn DE, Salani R. The impact of close surgical margins after radical hysterectomy for early-stage cervical cancer. Gynecol Oncol. 2013 Jan;128(1):44-8. PubMed External Web Site Policy

NHS Scotland, Scottish Cancer Taskforce. Cervical cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Aug. 29 p. [12 references]

Verleye L, Vergote I, Reed N, Ottevanger PB. Quality assurance for radical hysterectomy for cervical cancer: the view of the European Organization for Research and Treatment of Cancer--Gynecological Cancer Group (EORTC-GCG). Ann Oncol. 2009 Oct;20(10):1631-8. PubMed External Web Site Policy

Primary Health Components

Cervical cancer; surgery; surgical margins; tumour

Denominator Description

All patients with cervical cancer who undergo surgery

Numerator Description

Number of patients with cervical cancer who undergo surgery where surgical margins are clear of tumour

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
  • One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal

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

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

Therapeutic Intervention

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
All patients with cervical cancer who undergo surgery

Exclusions
None

Exclusions/Exceptions

None

Numerator Inclusions/Exclusions

Inclusions
Number of patients with cervical cancer who undergo surgery where surgical margins are clear of tumour

Exclusions
None

Numerator Search Strategy

Institutionalization

Data Source

Electronic health/medical record

Paper medical record

Type of Health State

Physiologic Health State (Intermediate Outcome)

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: 95%

The tolerance within this target allows for cases in which it is not clinically possible to achieve a clear surgical margin despite full radiological staging.

Evidence for Prescriptive Standard

NHS Scotland, Scottish Cancer Taskforce. Cervical cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Aug. 29 p. [12 references]

Original Title

QPI 5 – surgical margins.

Measure Collection Name

Cancer Quality Performance Indicators (QPIs)

Measure Set Name

Cervical 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

Cervical and Endometrial 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 Aug

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

Unspecified

Measure Status

This is the current release of the measure.

Source(s)

NHS Scotland, Scottish Cancer Taskforce. Cervical cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Aug. 29 p. [12 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 16, 2017.

Copyright Statement

No copyright restrictions apply.

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