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  • Measure Summary
  • NQMC:011202
  • Jul 2016

Prostate cancer: number of radical prostatectomy procedures performed by a surgeon over a 1 year period.

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Prostate cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Jul. 38 p. [21 references]

View the original measure documentation External Web Site Policy

This is the current release of the measure.

Primary Measure Domain

Clinical Quality Measures: Structure

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the number of radical prostatectomy procedures performed by a surgeon over a 1 year period.

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

Radical prostatectomy should be performed by surgeons who work in high-volume hospitals, with outcomes audited regularly (Comprehensive Cancer Centre the Netherlands, 2007; Heidenreich et al., 2010).

The European and North American literature supports the view that there is a relationship between increasing surgeon volume and improved patient outcomes, for example, rates of post-operative and late urinary complications and positive surgical margin rates (Heidenreich et al., 2010).

Studies have shown that there is a clear link between surgeon experience and improved clinical outcomes and this continues to increase with the number of cases undertaken (Vickers et al., 2009; Vickers et al., 2007; Vesey et al., 2012).

For robotic assisted radical prostatectomy it has been suggested that individual surgeons should undertake a minimum of 50 to 100 cases per annum (Anderson et al., 2012).

Evidence for Rationale

Anderson JB, Clarke NC, Gillatt D, Dasgupta P, Neal DE, Pickard RS, Prostate Cancer Advisory Group. Advice on the development of robotic assisted radical prostatectomy in England. London (UK): The British Association of Urological Surgeons (BAUS); 2012. 26 p. [17 references]

Comprehensive Cancer Centre the Netherlands. Prostate cancer. [internet]. Amsterdam (The Netherlands): Association of Comprehensive Cancer Centres (ACCC); 2007 [accessed 2013 Aug 01].

Heidenreich A, Bolla M, Joniau S, et al, members of the European Association of Urology (EAU) Guidelines Office. Guidelines on prostate cancer. Arnhem (The Netherlands): European Association of Urology (EAU); 2010.

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Prostate cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Jul. 38 p. [21 references]

Vesey SG, McCabe JE, Hounsome L, Fowler S. UK radical prostatectomy outcomes and surgeon case volume: based on an analysis of the British Association of Urological Surgeons Complex Operations Database. BJU Int. 2012 Feb;109(3):346-54. PubMed External Web Site Policy

Vickers AJ, Bianco FJ, Serio AM, Eastham JA, Schrag D, Klein EA, Reuther AM, Kattan MW, Pontes JE, Scardino PT. The surgical learning curve for prostate cancer control after radical prostatectomy. J Natl Cancer Inst. 2007 Aug 1;99(15):1171-7. PubMed External Web Site Policy

Vickers AJ, Savage CJ, Hruza M, Tuerk I, Koenig P, Martinez-Pineiro L, Janetschek G, Guillonneau B. The surgical learning curve for laparoscopic radical prostatectomy: a retrospective cohort study. Lancet Oncol. 2009 May;10(5):475-80. PubMed External Web Site Policy

Primary Health Components

Prostate cancer; radical prostatectomy; volume of cases per surgeon

Denominator Description

This measure applies to surgeons who perform radical prostatectomy (one surgeon at a time).

Numerator Description

Number of radical prostatectomies performed by each surgeon in a given year

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 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

Does not apply to this measure

Target Population Age

Does not apply to this measure

Target Population Gender

Does not apply to this measure

IOM Care Need

Not within an IOM Care Need

IOM Domain

Not within an IOM Domain

Case Finding Period

Unspecified

Denominator Sampling Frame

Professionals/Staff

Denominator (Index) Event or Characteristic

Health Professional Characteristic

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Surgeons who perform radical prostatectomy (one surgeon at a time)

Exclusions
None

Exclusions/Exceptions

Does not apply to this measure

Numerator Inclusions/Exclusions

Inclusions
Number of radical prostatectomies performed by each surgeon in a given year

Exclusions
None

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

Count

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: Minimum 50 procedures per surgeon in a 1 year period.

This is a minimum target level and is designed to ensure that all surgeons performing radical prostatectomy perform a minimum of 50 procedures per year.

Note: It is recommended that where two consultants operate together on the same patient the case should be counted under the lead surgeon.

Evidence for Prescriptive Standard

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Prostate cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Jul. 38 p. [21 references]

Original Title

QPI 6 – volume of cases per surgeon.

Measure Collection Name

Cancer Quality Performance Indicators (QPIs)

Measure Set Name

Prostate 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

Prostate 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 Jul

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

Unspecified

Measure Status

This is the current release of the measure.

Source(s)

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Prostate cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Jul. 38 p. [21 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 31, 2017.

Copyright Statement

No copyright restrictions apply.

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