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  • Measure Summary
  • NQMC:011106
  • Oct 2016

Renal cancer: proportion of patients who die within 30 or 90 days of treatment for renal cell carcinoma (RCC).

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Renal cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Oct. 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: Outcome

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the proportion of patients who die within 30 or 90 days of treatment for renal cell carcinoma (RCC).

This cancer quality performance indicator (QPI) will be reported separately as 30-day mortality and 90-day mortality as opposed to a single figure.

In addition, this QPI will be reported by treatment type as opposed to a single figure for all treatment options covered by the indicator (i.e., radiofrequency ablation [RFA], cryotherapy, systemic anti-cancer therapy [SACT] or surgery).

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

Treatment related mortality is a marker of the quality and safety of the whole service provided by the multidisciplinary team (MDT). However, all causes of death have been used in this indicator as the recording of cause of death by the certifying medical practitioner is not always as specific as the recording of a cancer diagnosis.

"For clinicians to restore and retain public confidence, they need to show that effective mechanisms exist for assessing events such as death and to justify patients' faith in the delivery of care" (Thompson & Stonebridge, 2005).

Evidence for Rationale

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Renal cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Oct. 33 p. [20 references]

Thompson AM, Stonebridge PA. Building a framework for trust: critical event analysis of deaths in surgical care. BMJ. 2005 May;330(7500):1139-42. PubMed External Web Site Policy

Primary Health Components

Renal cell carcinoma (RCC); minimally invasive treatment; radiofrequency ablation (RFA); cryotherapy; systemic anti-cancer therapy (SACT); operative treatment; death

Denominator Description

All patients with renal cell carcinoma (RCC) who undergo minimally invasive (radiofrequency ablation [RFA], cryotherapy, systemic anti-cancer therapy [SACT]) or operative treatment (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Number of patients with renal cell carcinoma (RCC) who undergo minimally invasive (radiofrequency ablation [RFA], cryotherapy, systemic anti-cancer therapy [SACT]) or operative treatment who die within 30 or 90 days of 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
  • 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 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

Ambulatory/Office-based Care

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

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 renal cell carcinoma (RCC) who undergo minimally invasive (radiofrequency ablation [RFA], cryotherapy, systemic anti-cancer therapy [SACT]) or operative treatment

Exclusions
Patients who undergo emergency surgery (nephrectomy)

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
Number of patients with renal cell carcinoma (RCC) who undergo minimally invasive (radiofrequency ablation [RFA], cryotherapy, systemic anti-cancer therapy [SACT]) or operative treatment who die within 30 or 90 days of treatment

Note: This Cancer Quality Performance Indicator (QPI) will be reported separately as 30-day mortality and 90-day mortality as opposed to a single figure.

In addition, this QPI will be reported by treatment type as opposed to a single figure for all treatment options covered by the indicator (i.e., RFA, cryotherapy, SACT or surgery).

Exclusions
Patients who undergo emergency surgery (nephrectomy)

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 Cancer Quality Performance Indicator (QPI) will be reported separately as 30-day mortality and 90-day mortality as opposed to a single figure.

In addition, this QPI will be reported by treatment type as opposed to a single figure for all treatment options covered by the indicator (i.e., radiofrequency ablation [RFA], cryotherapy, systemic anti-cancer therapy [SACT] or surgery).

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 5% for patients receiving systemic anti-cancer therapy (SACT)
  • Less than 2% for patients receiving operative treatment, radiofrequency ablation (RFA) and cryotherapy

This target reflects the fact that death from any cause, rather than death from renal cancer is being measured by this indicator.

Evidence for Prescriptive Standard

NHS Scotland, Scottish Cancer Taskforce, National Cancer Quality Steering Group. Renal cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Oct. 33 p. [20 references]

Original Title

QPI 8 – 30/90 day mortality.

Measure Collection Name

Cancer Quality Performance Indicators (QPIs)

Measure Set Name

Renal 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

Renal 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 Oct

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. Renal cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Oct. 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 16, 2017.

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No copyright restrictions apply.

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