Aim
This study, the first part of the BETTER-TRACC (Benchmarking and Tracking TrEatment and Response in Advanced Colon Cancer) project, aimed to develop quality indicators (QIs) that can be extracted from existing comprehensive clinical registry data.
Methods
After an initial literature review, we defined a proposed set of 12 QIs that could be extracted from data collected in the TRACC (Treatment of Recurrent and Advanced Colorectal Cancer) clinical registry. A two-step modified Delphi method is being used to establish consensus. An expert panel comprising eight colorectal oncologists , representing different treatment sites, including public and private hospitals and a regional site, participated in round 1. Panel members were asked to review the definition, feasibility and utility of each QI, and propose additional QIs. The results of round one will be collated to refine, retain and/or exclude QIs before the second and final round.
Results
All invited participants responded promptly and completely to the surveys for their site. In round 1, all 12 proposed QIs were retained, with suggestions for refining the inclusion/exclusion criteria. 5 further QIs were proposed for review, including use of next-generation sequencing, administration of additional biomarker-directed therapies, clinical trial participation and the uptake of Voluntary Assisted Dying. Outcomes from the full modified Delphi study and the final QI set will be presented at the meeting.
Conclusion
Clinicians were enthusiastic to engage in and supportive of this effort. This modified Delphi study will establish a set of QIs using clinical data from the TRACC registry. As part of the future plans for BETTER-TRACC pilot trial, Quality Appraisals will be circulated to participating sites, each site receiving summary data in comparison to other de-identified sites. The ultimate goal is continued measurement and reporting, with the plan to add new QIs with any new developments in the management of mCRC.