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Title: Monitoring quality of care in hepatocellular carcinoma: A modified Delphi consensus.
Austin Authors: Maharaj, Ashika D;Lubel, John;Lam, Eileen;Clark, Paul J;Duncan, Oliver;George, Jacob;Jeffrey, Gary P;Lipton, Lara;Liu, Howard;McCaughan, Geoffrey;Neo, Eu-Ling;Philip, Jennifer;Strasser, Simone I;Stuart, Katherine;Thompson, Alexander;Tibballs, Jonathan;Tu, Thomas;Wallace, Michael C;Wigg, Alan;Wood, Marnie;Zekry, Amany;Greenhill, Elysia;Ioannou, Liane J;Ahlenstiel, Golo;Bowers, Kaye;Clarke, Stephen J;Dev, Anouk;Fink, Michael A ;Goodwin, Mark D ;Karapetis, Christos S;Levy, Miriam T;Muller, Kate;O'Beirne, James;Pryor, David;Seow, James;Shackel, Nicholas;Tallis, Caroline;Butler, Nick;Olynyk, John K;Reed-Cox, Kate;Zalcberg, John R;Roberts, Stuart K
Affiliation: Public Health and Preventative Medicine, Monash University, Melbourne, Australia.
Alfred Health and Central Clinical School, Monash University, Melbourne, Australia.
Mater Hospital, Brisbane, Australia.
Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, Australia.
Sir Charles Gairdner Hospital, Perth, Australia.
Royal Melbourne Hospital, Western Health, Parkville, Australia.
Princess Alexandra Hospital, Woolloongabba, Australia.
Royal Prince Alfred Hospital and Centenary Institute for Medical Research, Newtown, Australia.
Royal Adelaide Hospital, Adelaide, Australia.
St. Vincent's Hospital and University of Melbourne, Melbourne, Australia.
Royal Prince Alfred Hospital and University of Sydney, Camperdown, Australia.
Sydney Institute for Infectious Diseases and Storr Liver Centre, Westmead Hospital, and University of Sydney, Sydney, Australia.
Flinders Medical Centre and Flinders University, Adelaide, Australia.
Royal Brisbane and Women's Hospital, Herston, Australia.
St. George and Sutherland Clinical Campus, St. George Hospital, Sydney, Australia.
Blacktown Clinical School and Hospital, Western Sydney University, Penrith, Australia.
Alfred Health and Department of Surgery, Monash University, Melbourne, Australia.
Royal North Shore Hospital and University of Sydney, St Leonards, Australia.
Monash Health, Melbourne, Australia.
Austin Health
Department of Gastroenterology, Liverpool Hospital, University of New South Wales, Liverpool, Australia.
Sunshine Coast University Hospital, Birtinya, Australia.
Royal Perth Hospital, Perth, Australia.
Gastroenterology Services Tasmania, Launceston, Australia.
Princess Alexandra Hospital and University of Queensland, Woolloongabba, Australia.
Fiona Stanley Hospital and Edith Cowan University, Murdoch, Australia.
Canberra Health Services, Canberra, Australia.
Alfred Health, Gastroenterology Department, and Central Clinical School, Monash University, Melbourne, Australia.
Issue Date: Sep-2022
Date: 2022
Publication information: Hepatology Communications 2022
Abstract: Although there are several established international guidelines on the management of hepatocellular carcinoma (HCC), there is limited information detailing specific indicators of good quality care. The aim of this study was to develop a core set of quality indicators (QIs) to underpin the management of HCC. We undertook a modified, two-round, Delphi consensus study comprising a working group and experts involved in the management of HCC as well as consumer representatives. QIs were derived from an extensive review of the literature. The role of the participants was to identify the most important and measurable QIs for inclusion in an HCC clinical quality registry. From an initial 94 QIs, 40 were proposed to the participants. Of these, 23 QIs ultimately met the inclusion criteria and were included in the final set. This included (a) nine related to the initial diagnosis and staging, including timing to diagnosis, required baseline clinical and laboratory assessments, prior surveillance for HCC, diagnostic imaging and pathology, tumor staging, and multidisciplinary care; (b) thirteen related to treatment and management, including role of antiviral therapy, timing to treatment, localized ablation and locoregional therapy, surgery, transplantation, systemic therapy, method of response assessment, and supportive care; and (c) one outcome assessment related to surgical mortality. Conclusion: We identified a core set of nationally agreed measurable QIs for the diagnosis, staging, and management of HCC. The adherence to these best practice QIs may lead to system-level improvement in quality of care and, ultimately, improvement in patient outcomes, including survival.
DOI: 10.1002/hep4.2089
ORCID: 0000-0002-2024-9677
Journal: Hepatology Communications
Start page: 3260
End page: 3271
PubMed URL: 36153817
ISSN: 2471-254X
Type: Journal Article
Subjects: hepatocellular carcinoma
Carcinoma, Hepatocellular/diagnosis
Liver Neoplasms/diagnosis
Appears in Collections:Journal articles

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