Table 5

Achievement of Piedmont Region clinical practice guidelines quality-of-care standards in 2002 and 2004, and effects of year, Piedmont Region, Italy
Results Effect of year (adjusted* OR and 95%CI) 2002 vs 2004
2002 2004
N and % Missing N and % Missing
% of malignant lesions with cytological or histological pre-operative diagnosis 297/513 48 329/495 65 0.64 (0.49-0.85)
(57.9%) (8.6%) (66.5%) (11.6%)
% BCS in pT1, unifocal 231/268 0 253/272 0 0.41 (0.22-0.75)
(86.2%) (93.0%)
% BCS with free margins (> 1 mm) 312/368 33 348/387 33 0.65 (0.41-1.01)
(84.8%) (8.2%) (89.9%) (7.9%)
% single surgery after diagnosis 332/369 4 342/376 8 1.02 (0.24-5.91)
(90.0%) (1.1%) (91.0%) (2.1%)
% frozen section in lesions ≤ 10 mm 55/97 1 85/113 0 0.32 (0.16-0.65)
(56.7%) (1.0%) (75.2%)
% of patients with invasive lesion treated with axillary clearance or SLN technique 433/468 0 460/478 1 0.28 (0.10-0.85)
(92.5%) (96.2%) (0.2%)
% of patients treated with axillary clearance with > 9 lymph nodes 317/336 4 245/268 4 1.71 (0.89-3.31)
(94.3%) (1.2%) (91.4%) (1.5%)
% with NO dissection among CIS patients** 115/123 0 98/104 0 0.60 (0.14-2.50)
(93.5) (94.2%)
% correct identification of SLN 118/126 30 215/219 54 0.46 (0.18-1.05)
(93.6%) (19.2%) (98.2%) (19.8%)
% histopathological grading available 455/462 18 466/469 17 0.34 (0.08-1.42)
(98.5%) (3.7%) (99.4%) (3.5%)
% hormonal receptor availability 455/471 9 446/473 13 1.80 (0.94-3.48)
(96.6%) (1.8%) (94.3%) (2.7%)
% immediate reconstruction after mastectomy 41/154 4 30/137 2 1.16 (0.63-2.16)
(26.6%) (2.5%) (21.9%) (1.4%)
% radiotherapy in patients treated with BCS 341/389 0 362/412 0 1.01 (0.60-1.5)
(87.7%) (87.9%)
% of eligible patients that receive hormonal therapy 319/338 0 332/354 0 1.01 (0.69-1.42)
(94.3%) (93.8%)

The 2004 period is the reference category for the estimation of ORs.

*Adjusted for age, educational level, clinical stage, screening provenience and surgical unit annual case load.

**Calculated on CIS lesions over-sampled group.

OR: odds ratio, BCS: breast conservative surgery, pT1: small primary tumor, CIS: carcinoma in situ, SLN: sentinel lymph node.

Sacerdote et al.

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

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