ORLANDO-The National Initiative on Cancer Care Quality (NICCQ) has presented preliminary results from its ongoing survey of breast and colorectal cancer patients in five cities. The study, now in its second year, was prompted by a 1999 Institute of Medicine report that found serious gaps in the quality of care for many people.
ORLANDOThe National Initiative on Cancer Care Quality (NICCQ) has presented preliminary results from its ongoing survey of breast and colorectal cancer patients in five cities. The study, now in its second year, was prompted by a 1999 Institute of Medicine report that found serious gaps in the quality of care for many people.
"Today, we cannot guarantee that all patients with cancer will get the quality of care known to be associated with optimal outcomes," said Ezekiel J. Emanuel, MD, PhD, of the National Institutes of Health. Dr. Emanuel is the head of the NICCQ task force, which presented the data at the 38th Annual Meeting of the American Society of Clinical Oncology (ASCO).
The good news for cancer care, said task force member Eric Schneider, MD, of the Harvard School of Public Health, is that cancer patients generally rate their care higher than do other adults assessing their overall care. The panel stressed that the NICCQ patient survey information and quality of care would be verified through an assessment of medical records.
According to Dr. Emanuel, one of the reasons for choosing the five cities for the studyHouston, Cleveland, Los Angeles, Kansas City, and Atlantais their high rate of minorities and mixed rates of managed care. "We’re also interested in how people with low education and low socioeconomic status are navigating the system," he said. NICCQ researchers hope to identify 5,500 patients and expect that about 2,800 will be interviewed and have their records reviewed. The current report included 629 patients ranging in age from 21 to 80; all had been diagnosed in 1998 with either breast cancer (stages I, II, or III) or colorectal cancer (stages II and III) and treated in a variety of in- and outpatient settings.
After a year in which study instruments were developed, the researchers began patient surveys (still ongoing) in mid-2001. According to Dr. Schneider, more than 85% of patients agreed to have their records reviewed. Among the survey questions reported at ASCO were:
The patient survey should be completed by the fall, Dr. Schneider said. He appealed to physicians for help in obtaining the medical records. "It’s an important initiative, and we’ve taken great pains to make sure that privacy will be protected," he said.
NICCQ is working closely with the National Cancer Institute and their ongoing quality of care study "so we don’t have to reinvent measures," said Joseph S. Bailes, MD, of US Oncology, Inc. "We are committed to following up," he said. "The data won’t just sit there."
Said Dr. Emanuel: "One of our commitments is to identify problems with quality so we can fix them. We were committed to assessing quality objectively. That is one of the reasons we got Harvard and Rand involved. We didn’t want people to think this was just oncologists evaluating themselves."