Evidence Table 11 - Question 3 (Grey Literature): What quality-of-care measures are available and what evidence is available for measures of colonoscopic surveillance for colorectal cancer?

StudyCharacteristics of Quality MeasureComments/Quality Scoring
Institute of Medicine report, 2005 Quality measure (QM): Followup colonoscopy after treatment for Stage I to Stage III colorectal cancer General comments:
#36680 Basis of QM: Clinical practice guideline (National Comprehensive Cancer Network [NCCN] guidelines)Local practice patterns and patient-related factors affect the use of endoscopic procedures.
Type of QM: Key references cited:
(a) ProcessCooper et al., 2000
(b) GeneralFisher et al., 2003
Outcome to which the QM is linked: reduction in CRC mortality rateNCCN, 2004
Intent of QM: Quality improvementRulyak et al., 2004
Definition of denominator/numerator: Winawer et al., 2003
Denominator:Rating of quality measure as presented (scale of 1–5, where 1 = poor, 3 = moderate, 5 = ideal):
Number of stage I to stage III colorectal cancer cases.
  • Importance: 5
  • Usability: 5
  • Scientific acceptability (two criteria):
    • Precise specifications: 4
    • Adaptability: 4
Numerator:
Number of above cases with a colonoscopy within 1 year of surgery.
Data sources: Surveillance, Epidemiology, and End Results Program (SEER)-Medicare dataset, special studies of medical records
Recommended frequency of data collection: No recommendation
National Committee for Quality Assurance, 2005 Quality measure (QM): Percent of colon cancer cases (all stages) that received a followup colonoscopy within 36 months of surgical treatmentGeneral comments: None
#36580 Basis of QM: Clinical practice guideline (National Comprehensive Cancer Network [NCCN] guidelines)Rating of quality measure as presented (scale of 1–5, where 1 = poor, 3 = moderate, 5 = ideal):
Type of QM:
  • Importance: 5
  • Usability: 5
  • Scientific acceptability (two criteria):
    • Precise specifications: 4
    • Adaptability: 4
(a) Process
(b) General
Outcome to which the QM is linked: Improved health status
Intent of QM: Quality improvement
Definition of denominator/numerator:
Denominator:
Number of patients with colon cancer surgery in a 12-month period.
Numerator:
Number of above patients who received a colonoscopy exam within 36 months of surgical treatment.
Data sources: Cancer registry, claims data
Recommended frequency of data collection: No recommendation
National Committee for Quality Assurance, 2005 Quality measure (QM): Percentage of rectal cancer cases (all stages) that received a postsurgical endoscopic exam within 12 months postsurgery General comments:
#36580 Basis of QM: Clinical practice guideline (National Comprehensive Cancer Network [NCCN] guidelines)Long-term followup may not be feasible.
Type of QM: Rating of quality measure as presented (scale of 1–5, where 1 = poor, 3 = moderate, 5 = ideal):
(a) Process
  • Importance: 5
  • Usability: 5
  • Scientific acceptability (two criteria):
    • Precise specifications: 4
    • Adaptability: 4
(b) General
Outcome to which the QM is linked: Improved health status
Intent of QM: Quality improvement
Definition of denominator/numerator:
Denominator:
Number of patients with rectal cancer surgery (all stages) over a 12-month period.
Numerator:
Number of above who received an endoscopic exam within 12 months postsurgical treatment.
Data sources: Cancer registry, claims data
Recommended frequency of data collection: No recommendation

From: Appendix E: Evidence Tables

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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