Pancreatic cancer: does the institution that performs pancreatic cancer surgery perform greater than or equal to 12 cases per year?

This measure is used to assess whether the institution that performs pancreatic cancer surgery performs greater than or equal to 12 cases per year.

There is considerable variability in outcomes among hospitals in the United States for many procedures and medical conditions, particularly for complex surgeries such as pancreatectomy for malignancy. Short-term and long-term outcomes of patients at some hospitals are considerably worse than at other hospitals; however, it has been difficult to identify the factors responsible for this variability. Hospitals with poor outcomes are left with little guidance on where to focus quality improvement efforts. Thus, efforts have focused on identifying quality indicators or measures that can be used to standardize care and ensure that patients are managed in accordance with established recommendations.

Pancreatic cancer outcomes vary considerably among hospitals. Assessing pancreatic cancer care by using quality indicators could help reduce this variability.

Pancreatic cancer surgery; case volume

This measure applies to institutions that perform pancreatic cancer surgery (one institution at a time).

The institution that performs pancreatic cancer surgery performs greater than or equal to 12 cases per year.

Unspecified

Potential quality indicators were identified from the literature, consensus guidelines, and interviews with experts. A panel of 20 pancreatic cancer experts ranked potential quality indicators for validity based on the RAND/UCLA Appropriateness Methodology. The rankings were rated as valid (high or moderate validity) or not valid. Adherence with valid indicators at both the patient and the hospital levels and a composite measure of adherence at the hospital level were assessed using data from the National Cancer Data Base (2004-2005) for 49,065 patients treated at 1,134 hospitals. Summary statistics were calculated for each individual candidate quality indicator to assess the median ranking and distribution. Of the 50 potential quality indicators identified, 43 were rated as valid (29 as high and 14 as moderate validity).

Refer to the reference listed below for further details.

Does not apply to this measure

Annual

Inclusions
This measure applies to institutions that perform pancreatic cancer surgery (one institution at a time).

Exclusions
None

Inclusions
The institution that performs pancreatic cancer surgery performs greater than or equal to 12 cases per year.

Exclusions
None

Unspecified

Greater than or equal to 12 cases per year

If an institution performs pancreatic cancer surgery, then the institution should perform ≥12 cases per year.

The American College of Surgeons' Pancreatic Cancer Quality Indicator Development Expert Panel included surgeons (Peter J. Allen, MD, Memorial Sloan-Kettering Cancer Center; Gerard V. Aranha, MD, Stritch School of Medicine, Loyola University Chicago; David J. Bentrem, MD, Feinberg School of Medicine, Northwestern University; Douglas B. Evans, MD, M.D. Medical College of Wisconsin; Keith D. Lillemoe, MD, Indiana University School of Medicine; Peter W. T. Pisters, MD, M.D. Anderson Cancer Center; Richard D. Schulick, MD, Johns Hopkins University School of Medicine; Stephen F. Sener, MD, NorthShore University HealthSystem; Mark S. Talamonti, MD, NorthShore University HealthSystem; Selwyn M. Vickers, MD, University of Minnesota; Andrew L. Warshaw, MD, Massachusetts General Hospital, Harvard Medical School; Charles J. Yeo, MD, Jefferson Medical College, Thomas Jefferson University), medical oncologists (David P. Kelsen, MD, Memorial Sloan-Kettering Cancer Center; Vincent J. Picozzi, MD, Virginia Mason Medical Center; Margaret A. Tempero, MD, University of California at San Francisco Medical Center), radiation oncologists (Ross A. Abrams, MD, Rush University Medical Center; Christopher G. Willett, MD, Duke University School of Medicine), a pathologist (N. Volkan Adsay, MD, Emory University School of Medicine), a radiologist (Alec J. Megibow, MD, MPH, New York University Medical Center), and a gastroenterologist (Stuart Sherman, MD, Indiana University School of Medicine).

Unspecified

This measure was not adapted from another source.

Unspecified

This is the current release of the measure.

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in January 2017.

Source available from the Journal of the National Cancer Institute Web site .

For more information, contact Karl Bilimoria, MD, MS, Division of Research and Optimal Patient Care, American College of Surgeons, Department of Surgery, Feinberg School of Medicine, Northwestern University, 633 Clark Street, Evanston, IL 60208; Email: k-bilimoria@northwestern.edu.

This NQMC summary was completed by ECRI Institute on February 22, 2012. The information was verified by the measure developer on March 16, 2012.

The information was reaffirmed by the measure developer on January 31, 2017.

This quality indicator has been published publicly. Copyright American College of Surgeons 2009.