Quality Indicators and Benchmarks for Radiotherapy in Lung Cancer: A Modified Delphi Approach

Abstract

Aims

While there are many published quality indicators (QIs) for assessing clinical care in lung cancer, few specifically measure the quality of radiotherapy (RT). To address this gap, we used a structured modified Delphi technique to develop a core set of QIs and benchmarks to evaluate RT processes for lung cancer treatment.

Materials and methods

Candidate QIs identified from the systematic review were evaluated through survey consensus and deliberation by a multidisciplinary reference committee for inclusion in the initial survey and then after each round. A modified Delphi technique was employed across two rounds to reach consensus for QI development. The international expert survey panel consisting of radiation oncologists treating lung cancer rated QI importance, feasibility, and benchmarks, with consensus predefined as at least 70% of respondents reaching a threshold rating on a Likert scale.

Results

There were 70 respondents over two surveys, with 30 of the 47 QIs reaching the threshold for importance in the first Delphi round and 29 after the final Delphi round. Agreement ranged from 71% to 97% with 12 QIs reaching a consensus of 90% or more. Final consensus was reached as all 29 QIs were identified as feasible, and 27 of the suggested benchmarks were deemed acceptable.

Conclusion

This core set of QIs provides a well-defined framework for evaluating RT processes in lung cancer treatment. They have the potential to establish a foundation for standardised quality measurement and benchmarking for guiding quality improvement efforts and improving patient outcomes.