Abstract
PurposesThe aim of this study was to clarify the impact of a board certification system and the implementation of clinical practice guidelines for pancreatic cancer (PC) on the mortality of pancreaticoduodenectomy in Japan.MethodsBy a web questionnaire survey via the National Clinical Database (NCD) for departments participating in the NCD, quality indicators (QIs) related to the treatment for PC, namely the board certification systems of various societies and the adherence to clinical practice guidelines for PC, were investigated between October 2014 and January 2015. A multivariable logistic regression analysis was performed to evaluate the relationship between the QIs and mortality of pancreaticoduodenectomy.ResultsOf 1415 departments that registered at least 1 pancreaticoduodenectomy between 2013 and 2014 in NCD, 631 departments (44.6%), which performed pancreaticoduodenectomy for a total of 11,684 cases, answered the questionnaire. The mortality of pancreaticoduodenectomy was positively affected by the board certification systems of the Japanese Society of Gastroenterological Surgery, Japanese Society of Hepato-Biliary-Pancreatic Surgery, Japanese Society of Gastroenterology, and Japanese Society of Medical Oncology as well as by institutions that used magnetic resonance imaging of ≥ 3 T for the diagnosis of PC in principle.ConclusionsThe measurement of the appropriate QIs is suggested to help improve the mortality in pancreaticoduodenectomy. Masamichi Mizuma and Hiroyuki Yamamoto equally contributed
Highlights
MethodsQuality indicators (QIs) are utilized to measure the quality of care, which can be defined as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” [1]
CA celiac artery, CT computed tomography, JSGE Japanese Society of Gastroenterology, JSGS Japanese Society of Gastroenterological Surgery, Japanese Society of HepatoBiliary-Pancreatic Surgery (JSHBPS) Japanese Society of Hepato-Biliary-Pancreatic Surgery, JSMO Japanese Society of Medical Oncology, JSS Japan Surgical Society, MRI magnetic resonance imaging, NCD National Clinical Database, SMA superior mesenteric artery regression models fitted with a generalized estimating equation, considering the clustering of patients by the hospital level
The present study revealed the following three points using questionnaires and the data of the NCD: (1) Mortality of PD was positively affected by the institution certification systems of the JSGS, JSHBPS, JSGE and JSMO. (2) Institutions with an expert or instructor board-certified by the JSHBPS, JSGE or JSMO showed a low PD mortality
Summary
MethodsQuality indicators (QIs) are utilized to measure the quality of care, which can be defined as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” [1]. CA celiac artery, CT computed tomography, JSGE Japanese Society of Gastroenterology, JSGS Japanese Society of Gastroenterological Surgery, JSHBPS Japanese Society of Hepato-Biliary-Pancreatic Surgery, JSMO Japanese Society of Medical Oncology, JSS Japan Surgical Society, MRI magnetic resonance imaging, NCD National Clinical Database, SMA superior mesenteric artery regression models fitted with a generalized estimating equation, considering the clustering of patients by the hospital level.
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