Table 1

Piedmont Region clinical practice guidelines quality-of-care indicators
Level of evidence (AHRQ grade of underlying recommendation) Quality-of-care indicators Function Quality-of-care standards
B % of malignant lesions with cytological or histological pre-operative diagnosis Calculates the proportion of patients with invasive or in situ lesions with a pre-operative cytological or histological diagnosis (C5 or B5), out of the total number of patients with invasive or in situ lesions who underwent surgical treatment. ≥ 70%
A % BCS in pT1, unifocal Calculates the proportion of patients diagnosed with invasive lesions of a pathological size of ≤20 mm (pT1, microinvasive included), not clinically multicentric or multifocal, who were treated with BCS. ≥ 80%
B % BCS with free margins (>1 mm) Calculates the proportion of BCS (last BCS if more than one) for invasive or in situ lesions which ensured clear margins (distance >1 mm from the lesion), out of the total number of BCS performed. /
/ % single surgery after diagnosis Calculates the proportion of patients whose first surgical treatment was not followed by further local operations that were required due to incomplete excision (excluding failed biopsies), out of the total number of patients who were surgically treated for localized invasive or in situ lesions with a positive or suspicious cytological or histological pre-operative diagnosis. /
C % frozen section in lesions ≤10 mm Calculates the proportion of patients surgically treated for invasive lesions (excluding microinvasive lesions) of a maximum pathological size ≤10 mm for which there was no frozen section, out of the total number of patients with the same diagnosis. ≥ 95%
A % of patients with invasive lesions treated with axillary clearance or SLN technique Calculates the proportion of patients with invasive lesions who were treated with axillary dissection or SLN technique, out of the total number of patients with invasive lesions. /
C % of patients treated with axillary clearance with >9 lymph nodes Calculates the proportion of patients with invasive lesions who were treated with axillary clearance (level I-III), excluding sampling, and from whom at least 10 lymph nodes were excised, out of the total number of patients with invasive lesions who were treated with axillary clearance. ≥ 95%
C % with NO dissection among CIS patients Calculates the proportion of patients diagnosed with CIS or not otherwise specified in situ lesions (microinvasive cancer excluded) on whom no axillary dissection was performed (not even level I) out of the total number of patients with this diagnosis who were surgically treated. ≥ 95%
C % correct SLN identification Calculates the% of SLN identified out of the total of identified SLN in patients with invasive lesions, who were treated with SLN technique. ≥ 90%
C % histopathological grading available Calculates the proportion of patients with invasive lesions (excluding microinvasive cancer) who were surgically treated and for whom measuring was provided, out of the total number of patients with invasive lesions who underwent surgical treatment. ≥ 95%
C % hormonal receptor availability Calculates the proportion of patients with invasive lesions (excluding microinvasive cancer) who were surgically treated and for whom measuring was provided, out of the total number of patients with invasive lesions who underwent surgical treatment. ≥ 95%
/ % immediate reconstruction after mastectomy Calculates the proportion of patients with invasive or in situ lesions who had mastectomies and immediate reconstruction, out of the total number of patients treated with mastectomy. /
A % radiotherapy in patients treated with BCS Calculates the proportion of patients who were treated with BCS for invasive or in situ lesions, and for whom radiotherapy followed, out of the total number of patients with the same diagnosis who were treated with BCS. ≥ 95%
A % of eligible patients that receive hormonal therapy Calculates the proportion of patients with invasive lesions and positive estrogen receptors who received hormonal therapy. /

AHRQ grade of underlying recommendation (reference http://archive.ahrq.gov/clinic/epcarch.htm webcite), BCS: breast conservative surgery, pT1: small primary tumor, SLN: sentinel lymph node, CIS: carcinoma in situ.

Sacerdote et al.

Sacerdote et al. BMC Health Services Research 2013 13:28   doi:10.1186/1472-6963-13-28

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