Open AccessMonitoring quality of care in hepatocellular carcinoma: A modified Delphi consensus
Author(s) -
Maharaj Ashika D.,
Lubel John,
Lam Eileen,
Clark Paul J.,
Duncan Oliver,
George Jacob,
Jeffrey Gary P.,
Lipton Lara,
Liu Howard,
McCaughan Geoffrey,
Neo EuLing,
Philip Jennifer,
Strasser Simone I.,
Stuart Katherine,
Thompson Alexander,
Tibballs Jonathan,
Tu Thomas,
Wallace Michael C.,
Wigg Alan,
Wood Marnie,
Zekry Amany,
Greenhill Elysia,
Ioannou Liane J.,
Ahlenstiel Golo,
Bowers Kaye,
Clarke Stephen J.,
Dev Anouk,
Fink Michael,
Goodwin Mark,
Karapetis Christos S.,
Levy Miriam T.,
Muller Kate,
O'Beirne James,
Pryor David,
Seow James,
Shackel Nicholas,
Tallis Caroline,
Butler Nick,
Olynyk John K.,
ReedCox Kate,
Zalcberg John R.,
Roberts Stuart K.
Publication year - 2022
Publication title -
hepatology communications
Language(s) - English
Resource type - Journals
ISSN - 2471-254X
DOI - 10.1002/hep4.2089
Subject(s) - medicine , delphi method , quality management , hepatocellular carcinoma , intensive care medicine , best practice , multidisciplinary approach , medline , quality of life (healthcare) , medical physics , nursing , operations management , management system , social science , statistics , mathematics , management , sociology , political science , law , economics
Although there are several established international guidelines on the management of hepatocellular carcinoma (HCC), there is limited information detailing specific indicators of good quality care. The aim of this study was to develop a core set of quality indicators (QIs) to underpin the management of HCC. We undertook a modified, two‐round, Delphi consensus study comprising a working group and experts involved in the management of HCC as well as consumer representatives. QIs were derived from an extensive review of the literature. The role of the participants was to identify the most important and measurable QIs for inclusion in an HCC clinical quality registry. From an initial 94 QIs, 40 were proposed to the participants. Of these, 23 QIs ultimately met the inclusion criteria and were included in the final set. This included (a) nine related to the initial diagnosis and staging, including timing to diagnosis, required baseline clinical and laboratory assessments, prior surveillance for HCC, diagnostic imaging and pathology, tumor staging, and multidisciplinary care; (b) thirteen related to treatment and management, including role of antiviral therapy, timing to treatment, localized ablation and locoregional therapy, surgery, transplantation, systemic therapy, method of response assessment, and supportive care; and (c) one outcome assessment related to surgical mortality. Conclusion : We identified a core set of nationally agreed measurable QIs for the diagnosis, staging, and management of HCC. The adherence to these best practice QIs may lead to system‐level improvement in quality of care and, ultimately, improvement in patient outcomes, including survival.