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Mandato VD, Abrate M, De Iaco P, Pirillo D, Ciarlini G, Leoni M, Comerci G, Ventura A, Lenzi B, Amadori A, Rosati F, Martinello R, De Palma R, Ventura C, Belotti LMB, Formisano D, La Sala GB. Clinical governance network for clinical audit to improve quality in epithelial ovarian cancer management. J Ovarian Res 2013; 6:19. [PMID: 23547941 PMCID: PMC3623733 DOI: 10.1186/1757-2215-6-19] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 03/20/2013] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Epithelial ovarian cancer (EOC) is the most lethal gynecological cancer. Several hospitals throughout the region provide primary treatment for these patients and it is well know that treatment quality is correlated to the hospital that delivers. The aim of this study was to investigate the management and treatment of EOC in a Region of the North Italy (Emilia-Romagna, Italy). METHODS A multidisciplinary group made up of 11 physicians and 3 biostatisticians was formed in 2009 to perform clinical audits in order to identify quality indicators and to develop Region-wide workup in accordance with the principles of evidence-based medicine (EBM). The rationale was that, by setting up an oncogynecology network so as to achieve the best clinical practice, critical points would decrease or even be eliminated. Analysis of cases was based on the review of the medical records. RESULTS 614 EOC patients treated between 2007 and 2008 were identified. We found only 2 high-volume hospitals (≥ 21 patients/year), 3 medium-volume hospitals (11-20 operated patients/year), and 7 low-volume hospitals (≤ 10 operated patients /year). Only 222 patients (76.3%) had a histological diagnosis, FIGO surgical staging was reported only in 206 patients (70.9%) but not all standard surgical procedures were always performed, residual disease were not reported in all patients. No standard number of neoadjuvant chemotherapy cycles was observed. CONCLUSIONS The differences in terms of treatments provided led the multidisciplinary group to identify reference centers, to promote centralization, to ensure uniform and adequate treatment to patients treated in regional centers and to promote a new audit involving all regional hospitals to a complete review of the all the EOC patients.
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Affiliation(s)
- Vincenzo Dario Mandato
- Department of Obstetrics and Gynecology, Arcispedale S. Maria Nuova- IRCCS, Reggio Emilia, Italy
| | - Martino Abrate
- Department of Obstetrics and Gynecology, Arcispedale S. Maria Nuova- IRCCS, Reggio Emilia, Italy
| | - Pierandrea De Iaco
- Department of Obstetrics and Gynecology, University Hospital S. Orsola Malpighi, Bologna, Italy
| | - Debora Pirillo
- Department of Obstetrics and Gynecology, Arcispedale S. Maria Nuova- IRCCS, Reggio Emilia, Italy
| | - Gino Ciarlini
- Department of Obstetrics and Gynecology, Arcispedale S. Maria Nuova- IRCCS, Reggio Emilia, Italy
| | - Maurizio Leoni
- Oncology and Gynecology Unit, Ospedale Civile, Ravenna, Italy
| | | | - Alessandro Ventura
- Department of Obstetrics and Gynecology, Ospedale Civile, Guastalla, Reggio Emilia, Italy
| | - Bruno Lenzi
- Unit of Medicine, Hospital of Argenta, Ferrara, Italy
| | - Andrea Amadori
- Unit of Obstetrics and Gynecology, Ospedale G.B. Morgagni-L.Pierantoni, Forlì, Italy
| | - Federica Rosati
- Unit of Obstetrics and Gynecology, Ospedale degli Infermi, Rimini, Italy
| | - Ruby Martinello
- Unit of Obstetrics and Gynecology, University Hospital S. Anna, Ferrara, Italy
| | - Rossana De Palma
- Clinical Area Government, Health and Social Agency of Emilia-Romagna, Emilia-Romagna, Italy
| | - Chiara Ventura
- Clinical Area Government, Health and Social Agency of Emilia-Romagna, Emilia-Romagna, Italy
| | | | - Debora Formisano
- Statistics and Clinical Epidemiology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Giovanni Battista La Sala
- Department of Obstetrics and Gynecology, Arcispedale S. Maria Nuova- IRCCS; University of Modena and Reggio Emilia, Reggio Emilia, Italy
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