Developing a set of quality indicators for breast cancer care in China

Objective: Large gaps exist between clinical practice and recommended care of breast cancer. Evidence demonstrates that assessment of breast cancer care can help bridge these gaps. However, no valid indicators are currently available for measurement of breast cancer care in China. This study aimed to develop a set of quality indicators to measure and improve the quality of breast cancer care. Design: A modified Delphi process was implemented, and each of the six selection criteria (scientific evidence, utility, interpretability, validity, preventability and data availability) for potential indicators was evaluated on a 5-point scale. Participants: A 16-member expert panel was assembled, including 10 medical oncologists, 5 surgical oncologists and 1 radiation oncologist. Main outcome measure: Quality indicators with mean ratings >= 4, coefficient of variation equal to or <25% and selectivity >= 81.25% in each of the six selection criteria were retained for the face-to-face round. Results: Twenty-six indicators were retained from the rating round and five indicators were retrieved in the face-to-face round. A total of 31 indicators constituted the final set of quality indicators, and the number of indicators pertaining to structure, process, communication and cooperation, management of symptoms or treatment toxicity and outcome was 1, 24, 2, 2 and 2, respectively. Conclusions: Quality indicators for breast cancer care can be systematically developed and will be utilized as a quality measurement tool for breast cancer care.