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  • Measure Summary
  • NQMC:011255
  • Mar 2016

Colorectal cancer: proportion of patients with rectal cancer who undergo elective primary surgical resection or surgical resection following short course neo-adjuvant radiotherapy in which the circumferential margin is clear of tumour.

NHS Scotland, Scottish Cancer Taskforce. Colorectal cancer clinical quality performance indicators. Edinburgh (Scotland): Scottish Government, Healthcare Improvement Scotland; 2015 Mar. 32 p. [11 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 rectal cancer who undergo elective primary surgical resection or surgical resection following short course neo-adjuvant radiotherapy in which the circumferential margin is clear of tumour.

This Cancer Quality Performance Indicator (QPI) is separated into two parts. Please refer to the related NQMC measure summary, Colorectal cancer: proportion of patients with rectal cancer who undergo elective surgical resection following neo-adjuvant long course radiotherapy or chemoradiotherapy in which the circumferential margin is clear of tumour.

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

The circumferential margin is an independent risk factor for the development of distant metastases and mortality. It is recognised that local recurrence of rectal cancer can be accurately predicted by pathological assessment of circumferential margin involvement in these tumours (Scottish Intercollegiate Guidelines Network [SIGN], 2011).

This indicator is a measure of the quality of both pre-operative assessment and resection.

Evidence for Rationale

NHS Scotland, Scottish Cancer Taskforce. Colorectal cancer clinical quality performance indicators. Edinburgh (Scotland): Scottish Government, Healthcare Improvement Scotland; 2015 Mar. 32 p. [11 references]

Scottish Intercollegiate Guidelines Network (SIGN). Diagnosis and management of colorectal cancer. A national clinical guideline. Edinburgh (Scotland): Scottish Intercollegiate Guidelines Network (SIGN); 2011 Dec. 56 p. (SIGN publication; no. 126).  [211 references]

Primary Health Components

Rectal cancer; elective primary surgical resection; surgical resection following short course neo-adjuvant radiotherapy; circumferential margin; tumour

Denominator Description

All patients with rectal cancer who undergo elective primary surgical resection or surgical resection following short course neo-adjuvant radiotherapy (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Number of patients with rectal cancer who undergo elective primary surgical resection or surgical resection following short course neo-adjuvant radiotherapy in which the circumferential margin is clear of tumour (see the related "Numerator Inclusions/Exclusions" field)

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 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

Hospital Inpatient

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

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 rectal cancer who undergo elective primary surgical resection or surgical resection following short course neo-adjuvant radiotherapy

Exclusions
Patients who undergo transanal endoscopic microsurgery or transanal resection of tumour

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
Number of patients with rectal cancer who undergo elective primary surgical resection or surgical resection following short course neo-adjuvant radiotherapy in which the circumferential margin is clear of tumour

Exclusions
Patients who undergo transanal endoscopic microsurgery or transanal resection of tumour

Numerator Search Strategy

Fixed time period or point in time

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%

Evidence for Prescriptive Standard

NHS Scotland, Scottish Cancer Taskforce. Colorectal cancer clinical quality performance indicators. Edinburgh (Scotland): Scottish Government, Healthcare Improvement Scotland; 2015 Mar. 32 p. [11 references]

Original Title

QPI 7 (i) – surgical margins.

Measure Collection Name

Cancer Quality Performance Indicators (QPIs)

Measure Set Name

Colorectal 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

Colorectal 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 Mar

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. Colorectal cancer clinical quality performance indicators. Edinburgh (Scotland): Scottish Government, Healthcare Improvement Scotland; 2015 Mar. 32 p. [11 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 June 21, 2017.

Copyright Statement

No copyright restrictions apply.

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