1
|
Rego IB, Coelho S, Semedo PM, Cavaco-Silva J, Teixeira L, Sousa S, Reis J, Dinis R, Schmitt F, Afonso N, Fougo JL, Pavão F, Baptista Leite R, Costa L. 360 Health Analysis (H360)-A Comparison of Key Performance Indicators in Breast Cancer Management across Health Institution Settings in Portugal. Curr Oncol 2023; 30:6041-6065. [PMID: 37504311 PMCID: PMC10378695 DOI: 10.3390/curroncol30070451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/02/2023] [Accepted: 06/14/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND The increased focus on quality indicators (QIs) and the use of clinical registries in real-world cancer studies have increased compliance with therapeutic standards and patient survival. The European Society of Breast Cancer Specialists (EUSOMA) established QIs to assess compliance with current standards in breast cancer care. METHODS This retrospective study is part of H360 Health Analysis and aims to describe compliance with EUSOMA QIs in breast cancer management in different hospital settings (public vs. private; general hospitals vs. oncology centers). A set of key performance indicators (KPIs) was selected based on EUSOMA and previously identified QIs. Secondary data were retrieved from patients' clinical records. Compliance with target KPIs in different disease stages was compared with minimum and target EUSOMA standards. RESULTS A total of 259 patient records were assessed. In stages I, II, and III, 18 KPIs met target EUSOMA standards, 5 met minimum standards, and 8 failed to meet minimum standards. Compliance with KPIs varied according to the type of hospital (particularly regarding diagnosis) and disease stage. Although small differences were found in KPI compliance among institutions, several statistical differences were found among treatment KPIs according to disease stage, particularly in stage III. CONCLUSIONS This study represents the first assessment of the quality of breast cancer care in different hospital settings in Portugal and shows that, although most QIs meet EUSOMA standards, there is room for improvement. Differences have been found across institutions, particularly between oncology centers and general hospitals, in diagnosis and compliance with KPIs among disease stages. Stage III showed the greatest variability in compliance with treatment KPIs, probably related to the lower specificity of the guidelines in this disease stage.
Collapse
Affiliation(s)
- Inês Brandão Rego
- Institute of Health Sciences, Universidade Católica Portuguesa, Palma de Cima, 1649-023 Lisboa, Portugal
- Hospital de São João, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal
| | - Sara Coelho
- Institute of Health Sciences, Universidade Católica Portuguesa, Palma de Cima, 1649-023 Lisboa, Portugal
- Instituto Português de Oncologia do Porto Francisco Gentil EPE, 4200-072 Porto, Portugal
| | - Patrícia Miguel Semedo
- Institute of Health Sciences, Universidade Católica Portuguesa, Palma de Cima, 1649-023 Lisboa, Portugal
- Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal
- Instituto de Medicina Molecular-João Lobo Antunes, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Joana Cavaco-Silva
- Institute of Health Sciences, Universidade Católica Portuguesa, Palma de Cima, 1649-023 Lisboa, Portugal
- ScienceCircle-Scientific and Biomedical Consulting, 1600-369 Lisboa, Portugal
| | - Laetitia Teixeira
- Institute of Health Sciences, Universidade Católica Portuguesa, Palma de Cima, 1649-023 Lisboa, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, 4050-313 Porto, Portugal
| | - Susana Sousa
- Institute of Health Sciences, Universidade Católica Portuguesa, Palma de Cima, 1649-023 Lisboa, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, 4050-313 Porto, Portugal
| | - Joana Reis
- Hospital de São João, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal
| | - Rui Dinis
- Hospital do Espírito Santo de Évora, 7000-811 Évora, Portugal
| | - Fernando Schmitt
- Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal
| | - Noémia Afonso
- Centro Hospitalar de Vila Nova de Gaia e Espinho, 4400-129 Vila Nova de Gaia, Portugal
| | - José Luís Fougo
- Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal
- Centro de Mama, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal
| | - Francisco Pavão
- Institute of Health Sciences, Universidade Católica Portuguesa, Palma de Cima, 1649-023 Lisboa, Portugal
| | - Ricardo Baptista Leite
- Institute of Health Sciences, Universidade Católica Portuguesa, Palma de Cima, 1649-023 Lisboa, Portugal
- Faculty of Health, Medicine and Life Sciences, Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Luís Costa
- Institute of Health Sciences, Universidade Católica Portuguesa, Palma de Cima, 1649-023 Lisboa, Portugal
- Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal
- Instituto de Medicina Molecular-João Lobo Antunes, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal
| |
Collapse
|
2
|
Coelho S, Rego IB, Dionísio MR, Cavaco-Silva J, Semedo PM, Pavão F, Leite RB, Costa L. 360 Health Analysis (H360) - A Proposal for an Integrated Vision of Breast Cancer in Portugal. Eur J Breast Health 2020; 16:91-98. [PMID: 32285029 PMCID: PMC7138355 DOI: 10.5152/ejbh.2020.5144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 12/22/2019] [Indexed: 12/31/2022]
Abstract
H360 aims to provide a comprehensive picture of breast cancer management in Portugal by retrieving real-world data from 10 Portuguese hospitals and deriving a snapshot from the medical interpretation of evidence-based data to patient perspective on the quality and effectiveness of medical care provided. This article reviews evidence on breast cancer clinical practice and quality of care and disease management in Portugal. A review of evidence on breast cancer clinical practice and quality of care over the last 10 years was performed in PubMed using the query "Organization and Administration"[Mesh] AND "breast cancer"[All Fields] NOT "Review" [ptyp]. National cancer initiatives relevant for quality of care and national and international guidelines and consensus were analyzed. Retrieved results showed that breast cancer incidence is still increasing, including in Portugal. Studies investigating disease outcomes seek to derive improvements to clinical practice and better financial resource allocation. Setting performance measures (KPIs) in institutions treating cancer is not a reality in Portugal yet, but has potential to leverage the quality of clinical performance. A multidisciplinary approach within one health structure is also desirable. More investment in clinical (including academic) research is key to optimize the quality of care. Implementation of clinical practice guidelines (largely based on ESMO guidelines in Portugal) is crucial to improve patient outcomes. Not less importantly, quality of life is a treatment goal on its own in breast cancer care. Breast cancer remains a health challenge and a multidimensional, 360-degree appraisal, beyond the exclusively clinical perspective, may provide new insights towards an optimal patient-centered approach.
Collapse
Affiliation(s)
- Sara Coelho
- Instituto Português de Oncologia do Porto Francisco Gentil EPE, Porto, Portugal
| | - Inês Brandão Rego
- Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal
| | | | | | | | - Francisco Pavão
- Universidade Católica Portuguesa, Institute of Health Sciences, Lisbon, Portugal
| | - Ricardo Baptista Leite
- Maastricht University, Faculty of Health, Medicine and Life Sciences, Maastricht, Netherlands
| | - Luís Costa
- Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Luis Costa Lab, Lisbon, Portugal
| |
Collapse
|
4
|
Libin P, Beheydt G, Deforche K, Imbrechts S, Ferreira F, Van Laethem K, Theys K, Carvalho AP, Cavaco-Silva J, Lapadula G, Torti C, Assel M, Wesner S, Snoeck J, Ruelle J, De Bel A, Lacor P, De Munter P, Van Wijngaerden E, Zazzi M, Kaiser R, Ayouba A, Peeters M, de Oliveira T, Alcantara LCJ, Grossman Z, Sloot P, Otelea D, Paraschiv S, Boucher C, Camacho RJ, Vandamme AM. RegaDB: community-driven data management and analysis for infectious diseases. Bioinformatics 2013; 29:1477-80. [PMID: 23645815 PMCID: PMC3661054 DOI: 10.1093/bioinformatics/btt162] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Summary: RegaDB is a free and open source data management and analysis environment for infectious diseases. RegaDB allows clinicians to store, manage and analyse patient data, including viral genetic sequences. Moreover, RegaDB provides researchers with a mechanism to collect data in a uniform format and offers them a canvas to make newly developed bioinformatics tools available to clinicians and virologists through a user friendly interface. Availability and implementation: Source code, binaries and documentation are available on http://rega.kuleuven.be/cev/regadb. RegaDB is written in the Java programming language, using a web-service-oriented architecture. Contact:pieter.libin@rega.kuleuven.be
Collapse
Affiliation(s)
- Pieter Libin
- Department of Microbiology and Immunology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|