Cancer care - ovarian cancer quality performance indicators review: consultation

Appendix 1: QPI Development Process

Preparatory Work and Scoping

The preparatory work involved the development of a structured briefing paper by Healthcare Improvement Scotland. This paper took account of existing, high quality, clinical guidance and provided a basis for the development of QPIs.

The scope for development of ovarian cancer QPIs and a search narrative were defined and agreed by the Ovarian Cancer QPI Development Group. The table below shows the final search criteria used in the literature search.

Inclusion:

• Topics (population/patient): epithelial ovarian, fallopian tube, and primary peritoneal carcinomas
• Topics (intervention): Diagnosis, staging, surgery, non-surgical management, treatment, chemotherapy, radiotherapy, intraperitoneal therapy, and hormone therapy.
• Adults only
• Date: 2005 to present day
• Language: English only

Exclusion:

Topics:

• Related cancers, including:
  • Borderline ovarian carcinoma
  • Pseudomyxoma peritonei
  • Germ cell tumours of the ovary
  • Sex cord stromal tumours
  • Neuroendocrine tumours
  • Secondary ovarian cancers
• Communication/information, end of life care, pain management, prevention, and screening.
• Guidelines for the conduct of clinical trials (topic for generic QPI development).

A systematic search was carried out by Healthcare Improvement Scotland using selected websites and two primary medical databases to identify national and international guidelines.

Seventeen guidelines were appraised for quality using the AGREE II instrument. This instrument assesses the methodological rigour and precision used when developing a guideline. Twelve were recommended for use, three were not recommended, and two were consensus guidelines on management of ovarian cancer in pregnancy.

Indicator Development

The Group developed QPIs using the clinical recommendations set out in the briefing papar as a base, ensuring all indicators met the following criteria:

• Overall importance – does the indicator address an area of clinical importance that would significantly impact on the quality and outcome of care delivered?
• Evidence based – is the indicator based on high quality clinical evidence?
• Measurability - is the indicator measurable i.e. are there explicit requirements for data measurement and are the required data items accessible and available for collection?

Engagement Process

A wide clinical and public engagement exercise was undertaken as part of development in February 2013 where the Ovarian Cancer QPIs, along with accompanying draft minimum core dataset and measurability specifications, were made available on the Scottish Government website. During the engagement period clinical and management colleagues from across NHSScotland, patients affected by ovarian cancer and the wider public were given the opportunity to influence the development of Ovarian Cancer QPIs.

Draft documentation was circulated widely to professional groups, health service staff, voluntary organisations and individuals for comment and feedback.

Following the engagement period all comments and responses received were reviewed by the Ovarian Cancer QPI Development Group and used to produce and refine the final indicators.

Ovarian Cancer QPI Development Group Membership (2013)

Name, Designation, Cancer Network/NHS Board

• John Dewar, Consultant Clinical Oncologist, (CHAIR)
• Elsa Armstrong, Data Manager, NOSCAN/NHS Grampian
• Kevin Burton, Consultant Gynae Oncologist, WoSCAN/NHSGGC
• Nancy Burns, Ward Manager, SCAN/NHS Lothian
• John Burton, Consultant Radiologist, NOSCAN/NHS Tayside
• Kevin Campbell, Project Manager, WoSCAN
• Barbara Flont, Consultant Radiologist, NOSCAN/NHS Highland
• Ros Glasspool, Consultant Medical Oncologist, WoSCAN/NHSGGC
• Charley Gourley, Consultant Medical Oncologist, SCAN/NHS Lothian
• Simon Herrington, Consultant Pathologist, NOSCAN/NHS Tayside
• Michelle Hilton-Boon, Programme Manager, Health Improvement Scotland
• Sue Lassman, Consultant Radiologist, WoSCAN/NHSGGC
• Claire Mckenzie, Audit Facilitator, SCAN/NHS Lanarkshire
• Ethel McLean, Audit Facilitator , WoSCAN/NHSAA
• Wendy McMullan, Consultant Gynaecologist, NOSCAN/NHS Tayside
• Cameron Martin, Consultant Gynaecologist, SCAN/NHS Lothian
• Lorna Maule, Macmillan Gynaecology CNS, WoSCAN/NHS Tayside
• David Millan, Consultant Pathologist, WoSCAN/NHSGGC
• Kathryn Morton, Consultant Pathologist, WoSCAN/NHSGGC
• Brian Murray, Principal Information, Information Services Development Manager Division
• David Parkin, Consultant Gynae Oncologist, NOSCAN/NHS Grampian
• Nick Reed, Consultant Clinical Oncologist, WoSCAN/NHSGGC
• Rae Roan, Gynaecological CNS, WoSCAN/NHSGGC
• Nadeem Siddiqui, Consultant Gynae Oncologist, WoSCAN/NHSGGC
• Evelyn Thomson, Regional Manager (Cancer) , WoSCAN/NHSGGC
• Radha Todd, Consultant Medical Oncologist, NOSCAN/NHS Grampian
• Ewen Walker, Consultant Gynaecologist, WoSCAN/NHSGGC
• Alistair Williams, Consultant Pathologist, SCAN/NHS Lothian