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  • Measure Summary
  • NQMC:011236
  • Feb 2017

Lung cancer: proportion of patients with stage IIIA non small cell lung cancer (NSCLC), with performance status 0-1, not undergoing surgery who receive chemoradiotherapy (radiotherapy greater than or equal to 54Gy and concurrent or sequential chemotherapy).

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Lung cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2017 Feb. 37 p. [13 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 stage IIIA non small cell lung cancer (NSCLC), with performance status 0-1, not undergoing surgery who receive chemoradiotherapy (radiotherapy greater than or equal to 54Gy and concurrent or sequential chemotherapy).

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

Chemoradiotherapy is an important treatment option for patients with lung cancer (NHS Quality Improvement Scotland, 2008).

Patients with stage III non small cell lung cancer (NSCLC) who are not suitable for surgery should receive chemoradiotherapy, as this has a proven survival benefit. Potential benefit of survival does however have to be balanced with the risk of additional toxicities from this treatment (National Institute for Health and Clinical Excellence [NICE], 2011).

Evidence for Rationale

National Institute for Health and Clinical Excellence (NICE). Lung cancer. The diagnosis and treatment of lung cancer. London (UK): National Institute for Health and Clinical Excellence (NICE); 2011 Apr. 42 p. (Clinical guideline; no. 121). 

NHS Quality Improvement Scotland. Management of lung cancer services. Edinburgh (Scotland): NHS Quality Improvement Scotland; 2008 Jul. 29 p.

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Lung cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2017 Feb. 37 p. [13 references]

Primary Health Components

Stage IIIA non small cell lung cancer (NSCLC); chemoradiotherapy; radical radiotherapy; chemotherapy

Denominator Description

All patients with stage IIIA non small cell lung cancer (NSCLC), with performance status 0-1, not undergoing surgery who receive radical radiotherapy greater than or equal to 54Gy (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Number of patients with stage IIIA non small cell lung cancer (NSCLC), with performance status 0-1, not undergoing surgery who receive chemoradiotherapy (radiotherapy greater than 54Gy and concurrent or sequential chemotherapy) (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/Office-based Care

Ambulatory Procedure/Imaging Center

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 stage IIIA non small cell lung cancer (NSCLC)* with performance status 0-1, not undergoing surgery who receive radical radiotherapy greater than or equal to 54Gy

*Stage IIIA NSCLC: Includes T1a N2; T1b N2; T2a N2; T2b N2; T3 N1; T3 N2; T4 N0; T4 N1

Exclusions

  • Patients who refuse treatment
  • Patients who die before treatment
  • Patients receiving continuous hyperfractionated radiotherapy

Exclusions/Exceptions

Patient factors addressed

Numerator Inclusions/Exclusions

Inclusions
Number of patients with stage IIIA non small cell lung cancer (NSCLC), with performance status 0-1, not undergoing surgery who receive chemoradiotherapy (radiotherapy greater than 54Gy and concurrent or sequential chemotherapy)

Exclusions

  • Patients who refuse treatment
  • Patients who die before treatment
  • Patients receiving continuous hyperfractionated radiotherapy

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: 50%

The tolerance within this target accounts for the fact that due to co-morbidities not all patients will be suitable for chemotherapy. In addition, patients may not have disease that can be encompassed within a radical radiotherapy field without excess toxicity.

Evidence for Prescriptive Standard

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Lung cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2017 Feb. 37 p. [13 references]

Original Title

QPI 9 – chemoradiotherapy in locally advanced non small cell lung cancer.

Measure Collection Name

Cancer Quality Performance Indicators (QPIs)

Measure Set Name

Lung 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

Lung 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

2017 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.

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

Source(s)

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Lung cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2017 Feb. 37 p. [13 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 14, 2017.

Copyright Statement

No copyright restrictions apply.

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