Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Can we measure what matters? Feasibility of clinically prioritised colorectal cancer quality indicators with a New South Wales population-based linked dataset (#340)

Candice Donnelly 1 , Puma Sundaresan 2 3 , Gabriel Gabriel 4 5 , James Toh 2 6 , Shalini Vinod 5 7
  1. Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
  2. Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
  3. Radiation Oncology Network, Western Sydney Local Health District, Westmead, NSW, Australia
  4. Collaboration for Cancer Outcomes, Research and Evaluation, Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
  5. South West Sydney Clinical Campuses, UNSW Medicine and Health, Liverpool Hospital, Liverpool, NSW, Australia
  6. Department of Surgery, Westmead Hospital, Westmead, NSW, Australia
  7. Liverpool Cancer Therapy Centre, South Western Sydney Local Health District, Liverpool, NSW, Australia

Aim: To determine the feasibility of utilising an Australian set of 26 multidisciplinary colorectal cancer (CRC) quality indicators (QIs) with population-based linked data.

Methods: Data were obtained on adult patients diagnosed with CRC (ICD-10-AM codes C18-C20) between 01/07/05-31/12/2019 from the New South Wales (NSW) Cancer Registry. The NSW Cancer Registry data were linked to the NSW Clinical Cancer Registry (available for 01/07/05-31/12/2014), NSW Admitted Patient Data Collection, and NSW death records. The feasibility assessment was conducted in four stages; (1) data mapping to match variables required (2) review of publicly available state-wide and site-specific reports using these datasets for routine reporting of the 26 QIs, (3) assess completeness and coverage of data variables using proportional analyses, and (4) pilot calculation of feasible QIs where data exists.

Results: Data mapping found 14 of the 26 QIs were potentially feasible. Linked data of 38,430 CRC patients were available to test eight surgical QIs, and linked data of 8,439 CRC patients were available to test six (neo)adjuvant therapy QIs. The data required to measure the these QIs had significant limitations in data coverage, completeness, and quality rendering the calculations unreliable, and some futile. The data completeness for staging ranged from 74-85% and almost one half of diagnosis dates were illogical. Overall, six of the 26 QIs were feasible and reliable to measure using the linked dataset. These were all surgical and addressed unplanned re-operation/re-admission, colonoscopies, mortality and survival.

Conclusions: This study identified six clinically relevant QIs that were feasible to measure using available NSW population-based data. However, these QIs were restricted to surgical processes and outcomes. A large gap remains in the availability of adequate data to produce clinically meaningful quality measurements for a multidisciplinary CRC team, particularly in diagnostic work-up, (neo)adjuvant therapy and supportive care.