Evaluation of Reliability and Correlations of Quality Measures in Cancer Care

• DOI: 10.1001/jamanetworkopen.2021.2474
• Publication Date: 2021-03-22T15:31:12Z
• Authors: Nancy L. Keating; Jessica L. F. Cle...; Alexi A. Wright; Gabriel A. Brooks; Laurie Meneades; Lauren Riedel; Jose R. Zubizarreta; Mary Beth Landrum
• Keywords: Guideline

<h3>Importance</h3> Measurement of the quality care is important for alternative payment models in oncology, yet ability to distinguish high-quality from low-quality across oncology practices remains uncertain. <h3>Objective</h3> To assess reliability cancer measures using registry and claims-based process, utilization, end-of-life (EOL) care, survival, correlations practice-level performance measure types. <h3>Design, Setting, Participants</h3> This cross-sectional study used Surveillance, Epidemiology, End Results (SEER) Program linked Medicare administrative data identify individuals with lung cancer, breast or colorectal (CRC) that was newly diagnosed between January 1, 2011, December 31, 2015, who were treated 20 more patients. Data analyzed 2018 2020. <h3>Main Outcomes Measures</h3> Receipt guideline-recommended treatment surveillance, hospitalizations emergency department visits during 6-month chemotherapy episodes, intensity last month life, 12-month survival measured. Summary each domain cohort calculated. Practice-level rates estimated hierarchical linear random effects; (reproducibility) based on between-measure variance, within-measure distribution patients practice; <h3>Results</h3> In this SEER 49 715 502 practices, 21 692 CRC 347 52 901 492 few had eligible most process 5-year period. Patients 65 years older; approximately 50% all women. Most limited variability practices. Among measures, 0 6 CRC, 3 11 a 0.75 higher median-sized practice. No EOL higher. Correlations types low (<i>r</i> ≤ 0.20 all) except correlation 1-year summary = 0.35;<i>P</i> &lt; .001). no 0.16 all). <h3>Conclusions Relevance</h3> found by small numbers even after pooling 5 data. Measures types, suggesting need research reliable assessments.