Table 7Quality measure ratings - Question 2c

Quality measureQuality measure rating (range 1–5, where 1 = poor and 5 = ideal)Recommendations for the measure
Important and usable (I)Scientifically acceptable (S)Well tested (T)
General measures
Percentage of patients with stage III colon cancer receiving adjuvant chemotherapy13,54,71,103,112,126,128,129,131,134,135545Quality of the data needs to be ensured. The importance of patient preferences is elucidated in the studies.
Percentage of patients with stage II or III rectal cancer receiving chemoradiotherapy132532Guidelines for adjuvant therapy for colon and rectum cancers are distinct; measures need to be distinct, too. Needs to account for possible reasons for non-receipt of therapy (e.g., insurance coverage or patient preference).
Percentage of patients with stage IV colon cancer or stage IV rectal cancer receiving palliative chemotherapy95,136532Additional testing of quality measure required; risk-adjustment is especially important. Further development and testing needed.
Percentage of patients referred to medical oncologist for consideration of adjuvant chemotherapy137532Testing needed with more studies.
Percentage of patients with stage III colon and stage II and III rectal cancer receiving adjuvant chemotherapy48,90,99,125,127,130544Quality of the data needs to be addressed. Studies address the need for validation of registry data with office records. Risk-adjustment is important, and patient preference should be accounted for.
Rate of adjuvant chemotherapy for CRC86,88,94,100102533Measures for colon and rectal cancer need to be distinct.
Percentage of patients receiving adjuvant radiotherapy who also received adjuvant chemotherapy for cancer of the sigmoid colon or rectum124432More extensive testing is required (in conjunction with measures for radiation therapy).
Adjuvant therapy rates110532More testing to be conducted from more recent data.
Use of chemotherapy in Stage II and III rectal patients131,133,134533Quality measure to be tested with more studies, with patient preference taken into account, and with risk-adjustment for comorbidities.
Percentage of late stage rectal cancer (stage ≥ III) that received one or more courses of adjuvant chemotherapy within 1 year of initial cancer surgery6154-Testing needed on whether specifying “late stage (stage ≥ III)” produces similar results as specifying “stage III” because there is no agreement on use of adjuvant chemotherapy for stage IV.

Note: Investigators used their judgment to determine the quality measure rating for each measure across all studies that utilized the measure. See Appendix F* for details.

From: 3, Results

Cover of Cancer Care Quality Measures
Cancer Care Quality Measures: Diagnosis and Treatment of Colorectal Cancer.
Evidence Reports/Technology Assessments, No. 138.
Patwardhan MB, Samsa GP, McCrory DC, et al.

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