Quality indicators (QIs) are increasingly being used to evaluate quality in healthcare. They are quantitative measures of quality that can be used to set benchmarks, identify variations in care, focus on areas for performance improvement or assess changes over time. The management of lung cancer requires a multidisciplinary approach that often involves complex and multimodality management, which has evolved rapidly as new evidence emerges. Monitoring the quality of care received by patients is therefore particularly important to optimise their outcomes. We aim to identify and analyse QIs used in lung cancer.
A literature search was conducted using the Medline database and the search terms “quality indicators” and “lung neoplasms”, limited from January 2001 up to September 2016 and to English language. Abstracts were excluded that were duplicates and full-text review performed to include only articles that were original research that developed or applied quality indicators related to the care of lung cancer patients.
59 abstracts were screened and 34 articles were included. These included a total of 222 distinct QIs, of which 2 were related to prevention and screening, 22 diagnosis and staging, 19 pre-treatment assessment, 64 surgery, 18 chemotherapy, 5 radiotherapy, 8 combined therapy, 9 palliative care, 42 symptom assessment or management, 6 supportive care, 3 follow-up and 24 were non-specific. The most frequently reported indicators were related to surgery (n=108), then symptom assessment and management (n=52) and diagnosis and staging (n=51).
There are numerous but varied quality indicators that have been used in lung cancer, of which the majority are focused on surgical management. There are many areas in the management of lung cancer which are under-represented in quality measurement. Further research will focus on assessing the technical characteristics of existing indicators and developing QIs in domains that are not adequately being measured.