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  • Measure Summary
  • NQMC:011119
  • May 2016

Sarcoma: proportion of patients with extremity sarcoma who undergo successful primary flap reconstruction.

NHS Scotland, Scottish Cancer Taskforce. Sarcoma clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 May 20. 33 p. [30 references]

View the original measure documentation External Web Site Policy

This is the current release of the measure.

Measure Hierarchy

Cancer Quality Performance Indicators (QPIs) > Sarcoma

Age Group

UMLS Concepts (what is this?)

SNOMEDCT_US
Flap (246343008), Flap (256683004), Reconstruction with distant flap (240984009), Reconstruction with local flap (240983003), Sarcoma (2424003), Sarcoma (269469005), Sarcoma (424413001), Sarcoma (424952003)

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 extremity sarcoma who undergo successful primary flap reconstruction.

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

After surgical resection, reconstructive surgery may be needed to cover wounds, preserve function and/or improve the cosmetic outcome (Moreira-Gonzalez, Djohan, & Lohman, 2010).

When conducting reconstructive surgery, surgeons should consider the flap success rate as one factor in choosing the best construction for any individual patient (Kroll et al., 1996).

Evidence for Rationale

Kroll SS, Schusterman MA, Reece GP, Miller MJ, Evans GR, Robb GL, Baldwin BJ. Choice of flap and incidence of free flap success. Plast Reconstr Surg. 1996 Sep;98(3):459-63. PubMed External Web Site Policy

Moreira-Gonzalez A, Djohan R, Lohman R. Considerations surrounding reconstruction after resection of musculoskeletal sarcomas. Cleve Clin J Med. 2010 Mar;77 Suppl 1 :S18-22. PubMed External Web Site Policy

NHS Scotland, Scottish Cancer Taskforce. Sarcoma clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 May 20. 33 p. [30 references]

Primary Health Components

Extremity sarcoma; primary flap reconstruction

Denominator Description

All patients with extremity sarcoma who undergo primary flap reconstruction (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Number of patients with extremity sarcoma who undergo successful primary flap reconstruction (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 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

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 extremity sarcoma who undergo primary flap reconstruction

Exclusions
Patients with cutaneous sarcomas

Exclusions/Exceptions

Medical factors addressed

Numerator Inclusions/Exclusions

Inclusions
Number of patients with extremity sarcoma who undergo successful* primary flap reconstruction.

*Successful has been defined as patients who do not need to return to theatre for unplanned surgical debridement of a sufficient volume of the flap reconstruction such that secondary reconstruction is required.

Exclusions
Patients with cutaneous sarcomas

Numerator Search Strategy

Fixed time period or point in time

Data Source

Electronic health/medical record

Paper medical record

Type of Health State

Physiologic Health State (Intermediate Outcome)

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: 85%

The tolerance within this target is designed to account for situations where re-exploration of flaps is undertaken due to vascular insufficiency.

Evidence for Prescriptive Standard

NHS Scotland, Scottish Cancer Taskforce. Sarcoma clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 May 20. 33 p. [30 references]

Original Title

QPI 7 – primary flap reconstruction.

Measure Collection Name

Cancer Quality Performance Indicators (QPIs)

Measure Set Name

Sarcoma

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

Sarcoma 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 May

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 Dec

Measure Status

This is the current release of the measure.

Source(s)

NHS Scotland, Scottish Cancer Taskforce. Sarcoma clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 May 20. 33 p. [30 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.

Copyright Statement

No copyright restrictions apply.

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