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  • Measure Summary
  • NQMC:011142
  • Mar 2015

Hepatopancreatobiliary (HPB) cancer: proportion of patients with hepatocellular carcinoma (HCC) undergoing disease specific treatment with curative intent (liver transplant, resection, or ablation) who die within 90 days of definitive treatment.

NHS Scotland, Scottish Cancer Taskforce. Hepatopancreatobiliary cancer clinical quality performance indicators. Edinburgh (Scotland): Scottish Government, Healthcare Improvement Scotland; 2015 Mar. 35 p. [14 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 hepatocellular carcinoma (HCC) undergoing disease specific treatment with curative intent (liver transplant, resection, or ablation) who die within 90 days of definitive treatment.

This indicator will be reported by principal treatment modality, in the following hierarchy: liver transplant, resection, ablation.

This Cancer Quality Performance Indicator (QPI) measure is separated into two parts. Please refer to the related NQMC measure summary, Hepatopancreatobiliary (HPB) cancer: proportion of patients with hepatocellular carcinoma (HCC) undergoing disease specific treatment (liver transplant, resection, ablation, trans-arterial chemoembolisation [TACE] or systemic anti-cancer therapy [SACT]) who die within 30 days of definitive treatment.

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

Disease specific interventions for hepatocellular carcinoma (HCC) are delivered with either curative (liver transplantation, resection or ablation) or palliative (trans-arterial chemoembolisation [TACE] or systemic anti-cancer therapy [SACT]) intent. In either case treatments should be performed safely with low rates of mortality. Similarly, disease specific treatment should only be undertaken in individuals that may benefit from treatment, that is, disease specific treatments should not be undertaken in futile situations.

Treatment related mortality is a marker of the quality and safety of the whole service provided by the multidisciplinary team (MDT) (NHS Quality Improvement Scotland, 2008).

Evidence for Rationale

NHS Quality Improvement Scotland. Management of bowel cancer services. Edinburgh (Scotland): NHS Quality Improvement Scotland; 2008 Mar. 41 p. [36 references]

NHS Scotland, Scottish Cancer Taskforce. Hepatopancreatobiliary cancer clinical quality performance indicators. Edinburgh (Scotland): Scottish Government, Healthcare Improvement Scotland; 2015 Mar. 35 p. [14 references]

Primary Health Components

Hepatocellular carcinoma (HCC); curative intent; liver transplant; resection; ablation; death

Denominator Description

All patients with hepatocellular carcinoma (HCC) undergoing disease specific treatment with curative intent (liver transplant, resection, or ablation)

Numerator Description

Number of patients with hepatocellular carcinoma (HCC) undergoing disease specific treatment with curative intent (liver transplant, resection, or ablation) that die within 90 days of definitive treatment (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 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

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

Making Care Safer
Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Living with Illness

IOM Domain

Effectiveness

Safety

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 hepatocellular carcinoma (HCC) undergoing disease specific treatment with curative intent (liver transplant, resection, or ablation)

Exclusions
None

Exclusions/Exceptions

None

Numerator Inclusions/Exclusions

Inclusions
Number of patients with hepatocellular carcinoma (HCC) undergoing disease specific treatment with curative intent (liver transplant, resection, or ablation) that die within 90 days of definitive treatment

Note: This indicator will be reported by principal treatment modality, in the following hierarchy: liver transplant, resection, ablation.

Exclusion
None

Numerator Search Strategy

Fixed time period or point in time

Data Source

Electronic health/medical record

Paper medical record

Type of Health State

Death

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Measure is disaggregated into categories based on different definitions of the denominator and/or numerator

Basis for Disaggregation

This indicator will be reported by principal treatment modality, in the following hierarchy: liver transplant, resection, ablation.

Scoring

Rate/Proportion

Interpretation of Score

Desired value is a lower 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: Less than 10%

Evidence for Prescriptive Standard

NHS Scotland, Scottish Cancer Taskforce. Hepatopancreatobiliary cancer clinical quality performance indicators. Edinburgh (Scotland): Scottish Government, Healthcare Improvement Scotland; 2015 Mar. 35 p. [14 references]

Original Title

QPI 5 (ii) – 30 and 90 day mortality after curative or palliative treatment.

Measure Collection Name

Cancer Quality Performance Indicators (QPIs)

Measure Set Name

HepatoPancreatoBiliary Cancer

Measure Subset Name

Hepatocellular Carcinoma (HCC) QPIs

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

HepatoPancreatoBiliary (HPB) 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

2015 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. Hepatopancreatobiliary cancer clinical quality performance indicators. Edinburgh (Scotland): Scottish Government, Healthcare Improvement Scotland; 2015 Mar. 35 p. [14 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 23, 2017.

Copyright Statement

No copyright restrictions apply.

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