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  • Measure Summary
  • NQMC:011134
  • Feb 2016

Head and neck cancer: proportion of patients with head and neck cancer undergoing radiotherapy who receive intensity modulated radiotherapy (IMRT).

NHS Scotland, Scottish Cancer Taskforce. Head and neck cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Feb. 33 p. [20 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 head and neck cancer undergoing radiotherapy who receive intensity modulated radiotherapy (IMRT).

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

Intensity modulated radiotherapy (IMRT) allows for the radiation dose to conform more precisely to the three-dimensional (3-D) shape of the tumour. This allows higher radiation doses to be focused to regions within the tumour while minimising the dose to surrounding normal critical structures (American Society of Clinical Oncology et al., 2006).

IMRT is the recommended treatment for all nasopharyngeal, oropharyngeal, hypopharyngeal, laryngeal, oral cavity, and unknown primary cancers where lymph node regions requiring inclusion in the treatment volume would result in irreparable damage to salivary function if two-dimensional (2-D) external beam radiotherapy (EBRT) or 3-D EBRT were used (American Society of Clinical Oncology et al., 2006).

Evidence for Rationale

American Society of Clinical Oncology, Pfister DG, Laurie SA, Weinstein GS, Mendenhall WM, Adelstein DJ, Ang KK, Clayman GL, Fisher SG, Forastiere AA, Harrison LB, Lefebvre JL, Leupold N, List MA, O'Malley BO, Patel S, Posner MR, Schwartz MA, Wolf GT. American Society of Clinical Oncology clinical practice guideline for the use of larynx-preservation strategies in the treatment of laryngeal cancer. J Clin Oncol. 2006 Aug 1;24(22):3693-704. [179 references] PubMed External Web Site Policy

NHS Scotland, Scottish Cancer Taskforce. Head and neck cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Feb. 33 p. [20 references]

Primary Health Components

Head and neck cancer; intensity modulated radiotherapy (IMRT)

Denominator Description

All patients with head and neck cancer undergoing radiotherapy (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Number of patients with head and neck cancer undergoing radiotherapy who receive intensity modulated radiotherapy (IMRT) (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

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

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 head and neck cancer undergoing radiotherapy

Exclusions

  • Patients undergoing palliative radiotherapy care
  • Patients with T1/T2/N0 larynx cancer

Exclusions/Exceptions

Medical factors addressed

Numerator Inclusions/Exclusions

Inclusions
Number of patients with head and neck cancer undergoing radiotherapy who receive intensity modulated radiotherapy (IMRT)

Exclusions

  • Patients undergoing palliative radiotherapy care
  • Patients with T1/T2/N0 larynx cancer

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: 80%

The tolerance within this target accounts for the fact that due to co-morbidities not all patients will be suitable for intensity modulated radiotherapy (IMRT) and patients with unilateral disease where IMRT may not be clinically appropriate

Evidence for Prescriptive Standard

NHS Scotland, Scottish Cancer Taskforce. Head and neck cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Feb. 33 p. [20 references]

Original Title

QPI 9 – intensity modulated radiotherapy (IMRT).

Measure Collection Name

Cancer Quality Performance Indicators (QPIs)

Measure Set Name

Head and Neck 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

Head and Neck 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 Feb

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. Formal reviews are conducted every 3 years and baseline checks each year.

Date of Next Anticipated Revision

2017 Nov

Measure Status

This is the current release of the measure.

Source(s)

NHS Scotland, Scottish Cancer Taskforce. Head and neck cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Feb. 33 p. [20 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 18, 2017.

Copyright Statement

No copyright restrictions apply.

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