BACKGROUND: The National Comprehensive Cancer Network (NCCN) Outcomes Database was created to assess concordance to evidence- and consensus-based guidelines and to measure adherence to quality measures on an ongoing basis. The Colorectal Cancer Database began in 2005 as a collaboration among 8 NCCN centers. METHODS: Newly diagnosed colon and rectal cancer patients presenting to 1 of 8 NCCN centers between September 1, 2005, and May 21, 2008, were eligible for analysis of concordance with NCCN treatment guidelines for colorectal cancer and with a set of quality metrics jointly developed by ASCO and NCCN in 2007. Adherence rates were determined for each metric. Center-specific rates were benchmarked against mean concordance rates for all participating centers. RESULTS: A total of 3443 patients were evaluable. Mean concordance rates with NCCN colorectal cancer guidelines and ASCO/NCCN quality measures were generally high ( >or= 90%). However, relatively low mean concordance rates were noted for adjuvant chemotherapy treatment recommendations within 9 months of diagnosis of stage II to III rectal cancer (81%), and neoadjuvant chemoradiation in clinical T4 rectal primaries (83%). These low rates of concordance seemed to be consistent across centers. CONCLUSIONS: Adherence to guidelines and quality measures is generally high at institutions participating in the NCCN colorectal cancer database. Lack of documentation, patient refusal, delayed treatment initiation, and lack of consensus about whether treatment was essential were the primary reasons for nonconcordance. Measurement of concordance and the reasons for nonconcordance enable participating centers to understand and improve their care delivery systems.
BACKGROUND: The National Comprehensive Cancer Network (NCCN) Outcomes Database was created to assess concordance to evidence- and consensus-based guidelines and to measure adherence to quality measures on an ongoing basis. The Colorectal Cancer Database began in 2005 as a collaboration among 8 NCCN centers. METHODS: Newly diagnosed colon and rectal cancerpatients presenting to 1 of 8 NCCN centers between September 1, 2005, and May 21, 2008, were eligible for analysis of concordance with NCCN treatment guidelines for colorectal cancer and with a set of quality metrics jointly developed by ASCO and NCCN in 2007. Adherence rates were determined for each metric. Center-specific rates were benchmarked against mean concordance rates for all participating centers. RESULTS: A total of 3443 patients were evaluable. Mean concordance rates with NCCN colorectal cancer guidelines and ASCO/NCCN quality measures were generally high ( >or= 90%). However, relatively low mean concordance rates were noted for adjuvant chemotherapy treatment recommendations within 9 months of diagnosis of stage II to III rectal cancer (81%), and neoadjuvant chemoradiation in clinical T4 rectal primaries (83%). These low rates of concordance seemed to be consistent across centers. CONCLUSIONS: Adherence to guidelines and quality measures is generally high at institutions participating in the NCCN colorectal cancer database. Lack of documentation, patient refusal, delayed treatment initiation, and lack of consensus about whether treatment was essential were the primary reasons for nonconcordance. Measurement of concordance and the reasons for nonconcordance enable participating centers to understand and improve their care delivery systems.
Authors: Hanna K Sanoff; William R Carpenter; Til Stürmer; Richard M Goldberg; Christopher F Martin; Jason P Fine; Nadine Jackson McCleary; Jeffrey A Meyerhardt; Joyce Niland; Katherine L Kahn; Maria J Schymura; Deborah Schrag Journal: J Clin Oncol Date: 2012-06-04 Impact factor: 44.544
Authors: Karl Y Bilimoria; David J Bentrem; Andrew K Stewart; Mark S Talamonti; David P Winchester; Thomas R Russell; Clifford Y Ko Journal: J Natl Cancer Inst Date: 2008-09-09 Impact factor: 13.506
Authors: Hanna K Sanoff; William R Carpenter; Christopher F Martin; Daniel J Sargent; Jeffrey A Meyerhardt; Til Stürmer; Jason P Fine; Jane Weeks; Joyce Niland; Katherine L Kahn; Maria J Schymura; Deborah Schrag Journal: J Natl Cancer Inst Date: 2012-01-20 Impact factor: 13.506
Authors: George L Jackson; Leah L Zullig; Sean M Phelan; Dawn Provenzale; Joan M Griffin; Steven B Clauser; David A Haggstrom; Rahul M Jindal; Michelle van Ryn Journal: Cancer Date: 2015-03-17 Impact factor: 6.860
Authors: Steven T Fleming; Heath B Mackley; Fabian Camacho; Eric E Seiber; Niraj J Gusani; Stephen A Matthews; Jason Liao; Tse-Chuan Yang; Wenke Hwang; Nengliang Yao Journal: J Rural Health Date: 2013-06-26 Impact factor: 4.333
Authors: Knut M Augestad; Rolv-Ole Lindsetmo; Jonah Stulberg; Harry Reynolds; Anthony Senagore; Brad Champagne; Alexander G Heriot; Fabien Leblanc; Conor P Delaney Journal: World J Surg Date: 2010-11 Impact factor: 3.352