Demonstration of quality of care measurement using the Japanese liver cancer registry

Abstract

Despite advances in medical therapy, studies have reported gaps between current evidence and actual practice in many areas of medicine. Process-of-care quality indicators (QIs) are tools to measure the evidence-practice gap. This study aims to examine the feasibility of applying QIs for liver cancer care to the national registry database operated by the Liver Cancer Study Group of Japan. Prior research developed a set of process-of-care QIs developed on the basis of the Japanese Clinical Practice Guidelines for hepatocellular carcinoma. Each QI describes target patients and care processes indicated for such patients. Among the 25 developed QIs, six appeared scorable using the information contained in the dataset from the 17(th) Nationwide Survey of Primary Liver Cancer. In total, 16 187 patients were eligible for the six QIs for 34 599 times, among which the indicated care was provided 83.9% times. The scores ranged from 64.4% (surgical therapy in patients with HCC 3-5 cm in diameter) to 91.1% (indocyanine green checkup before surgical resection). The information was generally available to determine eligibility (78.3%-100%) and pass/fail (91.9%-99.9%) for the QIs. Applying QIs to the liver cancer registry, the quality of hepatocellular carcinoma care can be measured. In future, providing feedback regarding the results to the participating society may improve the quality of liver cancer care nationwide.