Clinical auditing as an instrument to improve care for patients with ovarian cancer: The Dutch Gynecological Oncology Audit (DGOA)

Nishita Baldewpersad Tewarie ,M.B Verbruggen,J.A Louwers,H.T.C Nagel,J.W Mens,E.B.L Van Dorst,H.P.M Smedts,E.J.M Robbe,M Van Der Aa,C.G Gerestein,Y.W.C.M Van Der Plas – Koning,A Van Der Kolk,A.D Ten Cate,A.M.L.D Van Haaften-De Jong,J.E.W Van Dijk,M.J.A Engelen,S.F.P.J Coppus,R.A Smit,W.J Van Driel,I.M.W Ebisch,A.M.G Van De Swaluw,B.A.J.T Visschers,P.M.L.H Vencken,C.M.W.H Smeets,H.H Keizer,N Reesink,E.A Ooms,P Kolk,K.N Gaarenstroom,W.M Van Baal,T.K Schikken,K Overmars,J Lange ,Astrid Baalbergen ,Brigitte Slangen ,Guus Fons ,Morgan Delarue ,Eva Maria Roes ,Dorry Boll ,Margriet A Huisman ,Frances Cate ,Petra Timmers ,Justine M Briët ,Lidewij R Bartelink ,Gunther Jansen ,Rafli Van De Laar ,Mc Vos ,Refika Yigit ,Dat Ngo ,Judith De Waard ,Arnold‐Jan Kruse ,Harold R Verhoeve ,Laura Hofman ,Euctr Es ,Martin Glas ,Dieuwke Boskamp ,Elvira M Davelaar ,Fidelma Dunne ,Steven M Westenberg ,Miriam Wüst ,Muriel Van Den Hende ,Rfpm Kruitwagen ,Marjolein Kleppe ,Jos H.a Vollebergh ,Leonie C De Vries ,Ninke Leffers ,Messina Baas ,Anette L Aalders ,T Stam ,Jeroen Diepstraten ,Willy Minderhoud-Bassie ,Michel W.j.m Wouters ,Jeroen Kaijser ,Fleur E.m Rijcken ,Ming Y Tjiong ,Maaike Van Ham ,C Buis

doi:10.1016/j.ejso.2021.01.019

Abstract

IntroductionThe Dutch Gynecological Oncology Audit (DGOA) was initiated in 2014 to serve as a nationwide audit, which registers the four most prevalent gynecological malignancies. This study presents the first results of clinical auditing for ovarian cancer in the Netherlands. MethodsThe Dutch Gynecological Oncology Audit is facilitated by the Dutch Institute of Clinical Auditing (DICA) and run by a scientific committee. Items are collected through a web-based registration based on a set of predefined quality indicators. Results of quality indicators are shown, and benchmarked information is given back to the user. Data verification was done in 2016. ResultsBetween January 01, 2014 and December 31, 2018, 6535 patients with ovarian cancer were registered. The case ascertainment was 98.3% in 2016. The number of patients with ovarian cancer who start therapy within 28 days decreased over time from 68.7% in 2014 to 62.7% in 2018 (p < 0.001). The percentage of patients with primary cytoreductive surgery decreased over time (57.8%–39.7%, P < 0.001). However, patients with complete primary cytoreductive surgery improved over time (53.5%–69.1%, P < 0.001). Other quality indicators did not significantly change over time. ConclusionThe Dutch Gynecological Oncology Audit provides valuable data on the quality of care on patients with ovarian cancer in the Netherlands. Data show variation between hospitals with regard to pre-determined quality indicators. Results of ‘best practices’ will be shared with all participants of the clinical audit with the aim of improving quality of care nationwide.

Highlights

The Dutch Gynecological Oncology Audit (DGOA) was initiated in 2014 to serve as a nationwide audit, which registers the four most prevalent gynecological malignancies
This registry includes patients with ovarian, cervical, endometrial, and vulvar cancer [4]. Such registries use a set of quality indicators concerning quality aspects of the diagnosis and treatment of patients with gynecologic cancers
The Dutch Gynecological Oncology Audit scientific committee consists of four gynecologic oncologists, two radiation oncologists, one representative of the Netherlands Comprehensive Cancer Organization, the Netherlands (NCCN), and two members from the gynecological oncology patient advocate organization "Stichting Olijf"

Summary

Introduction

The Dutch Gynecological Oncology Audit (DGOA) was initiated in 2014 to serve as a nationwide audit, which registers the four most prevalent gynecological malignancies. This study presents the first results of clinical auditing for ovarian cancer in the Netherlands. Conclusion: The Dutch Gynecological Oncology Audit provides valuable data on the quality of care on patients with ovarian cancer in the Netherlands. A European example is the Swedish Quality Registry for Gynecologic Cancer; this population-based registry covers about 95% of all gynecological malignant tumors and was initiated in 2010. This registry includes patients with ovarian, cervical, endometrial, and vulvar cancer [4]. Such registries use a set of quality indicators concerning quality aspects of the diagnosis and treatment of patients with gynecologic cancers. Clinical registries have been acknowledged as an essential tool for quality assessment and provide feedback to participating hospitals, leading to improved patient outcomes [5]

Methods

Results

Conclusion