Evidence map›Paper›PMID 33943026›Full record

ArticleCancer medicine2021

Hospital-level compliance with the commission on cancer's quality of care measures and the association with patient survival.

Daniel P Nussbaum, Christel N Rushing, Zhifei Sun, Babatunde A Yerokun, Mathias Worni, Robert S Saunders, Mark B McClellan, Donna Niedzwiecki, Rachel A Greenup, Dan G Blazer

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Article in Cancer medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Daniel P NussbaumDepartment of Surgery, Duke University, Durham, NC, USA.ORCID 0000-0003-3070-6605
Christel N RushingDepartment of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA.
Zhifei SunDepartment of Surgery, Duke University, Durham, NC, USA.
Babatunde A YerokunDepartment of Surgery, Duke University, Durham, NC, USA.
Mathias WorniDepartment of Visceral Surgery, Clarunis, University Centre for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital, Basel, Switzerland.
Robert S SaundersDuke University, Robert J. Margolis Center for Health Policy, Durham, NC, USA.
Mark B McClellanDuke University, Robert J. Margolis Center for Health Policy, Durham, NC, USA.
Donna NiedzwieckiDepartment of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA.
Rachel A GreenupDepartment of Surgery and Population Health Sciences, Duke University, Duke Cancer Institute, Durham, NC, USA.
Dan G BlazerDepartment of Surgery, Duke University, Duke Cancer Institute, Durham, NC, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundQuality measurement has become a priority for national healthcare reform, and valid measures are necessary to discriminate hospital performance and support value-based healthcare delivery. The Commission on Cancer (CoC) is the largest cancer-specific accreditor of hospital quality in the United States and has implemented Quality of Care Measures to evaluate cancer care delivery. However, none has been formally tested as a valid metric for assessing hospital performance based on actual patient outcomes.

methodsEligibility and compliance with the Quality of Care Measures are reported within the National Cancer Database, which also captures data for robust patient-level risk adjustment. Hospital-level compliance was calculated for the core measures, and the association with patient survival was tested using Cox regression.

resultsSeven hundred sixty-eight thousand nine hundred sixty-nine unique cancer cases were included from 1323 facilities. Increasing hospital-level compliance was associated with improved survival for only two measures, including a 35% reduced risk of mortality for the gastric cancer measure G15RLN (HR 0.65, 95% CI 0.58-0.72) and a 19% reduced risk of mortality for the colon cancer measure 12RLN (HR 0.81, 95% CI 0.77-0.85). For the lung cancer measure LNoSurg, increasing compliance was paradoxically associated with an increased risk of mortality (HR 1.14, 95% CI 1.08-1.20). For the remaining measures, hospital-level compliance demonstrated no consistent association with patient survival.

conclusionHospital-level compliance with the CoC's Quality of Care Measures is not uniformly aligned with patient survival. In their current form, these measures do not reliably discriminate hospital performance and are limited as a tool for value-based healthcare delivery.

Indexed as

Quality of Health CareAccreditationCarcinoma, Non-Small-Cell LungColonic NeoplasmsDatabases, FactualFemaleHospitalsHumansKaplan-Meier EstimateLung NeoplasmsMaleNeoplasmsProportional Hazards ModelsQuality ImprovementRectal NeoplasmsStomach Neoplasmscancerhospitalsprocess measuresquality of care

Identifiers

PMID33943026
PMCPMC8178497

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.