Abstract
BackgroundIn the scope of the European Commission Initiative on Breast Cancer (ECIBC) the Monitoring and Evaluation (M&E) subgroup was tasked to identify breast cancer screening programme (BCSP) performance indicators, including their acceptable and desirable levels, which are associated with breast cancer (BC) mortality. This paper documents the methodology used for the indicator selection.MethodsThe indicators were identified through a multi-stage process. First, a scoping review was conducted to identify existing performance indicators. Second, building on existing frameworks for making well-informed health care choices, a specific conceptual framework was developed to guide the indicator selection. Third, two group exercises including a rating and ranking survey were conducted for indicator selection using pre-determined criteria, such as: relevance, measurability, accurateness, ethics and understandability. The selected indicators were mapped onto a BC screening pathway developed by the M&E subgroup to illustrate the steps of BC screening common to all EU countries.ResultsA total of 96 indicators were identified from an initial list of 1325 indicators. After removing redundant and irrelevant indicators and adding those missing, 39 candidate indicators underwent the rating and ranking exercise. Based on the results, the M&E subgroup selected 13 indicators: screening coverage, participation rate, recall rate, breast cancer detection rate, invasive breast cancer detection rate, cancers > 20 mm, cancers ≤10 mm, lymph node status, interval cancer rate, episode sensitivity, time interval between screening and first treatment, benign open surgical biopsy rate, and mastectomy rate.ConclusionThis systematic approach led to the identification of 13 BCSP candidate performance indicators to be further evaluated for their association with BC mortality.
Highlights
In the scope of the European Commission Initiative on Breast Cancer (ECIBC) the Monitoring and Evaluation (M&E) subgroup was tasked to identify breast cancer screening programme (BCSP) performance indicators, including their acceptable and desirable levels, which are associated with breast cancer (BC) mortality
Muratov et al BMC Cancer (2020) 20:795 (Continued from previous page). This systematic approach led to the identification of 13 BCSP candidate performance indicators to be further evaluated for their association with BC mortality
The final list of potential performance indicators was identified through a multi-stage process: 1) conduct of a scoping review to identify a list of existing performance indicators; 2) development of a conceptual framework to inform indicator selection; 3) conduct of a survey among the M&E subgroup members to select a list of candidate performance indicators according to pre-agreed criteria; and 4) description of a BC screening and diagnostic pathway to facilitate the mapping of the indicators along the key steps
Summary
In the scope of the European Commission Initiative on Breast Cancer (ECIBC) the Monitoring and Evaluation (M&E) subgroup was tasked to identify breast cancer screening programme (BCSP) performance indicators, including their acceptable and desirable levels, which are associated with breast cancer (BC) mortality. Monitoring and evaluation of BCSPs is necessary to ensure that the programmes are as effective as expected The basis for these activities is described in the European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis [6, 7]. Some evidence exists for both aspects [4, 7,8,9,10], the association between BCSP performance indicators and important patient outcomes, such as BC mortality, quality of life and undesirable effects, is poorly explored. The few studies that have examined the association are limited in their methodologies, in the number of performance indicators evaluated, and report conflicting results [1,2,3,4,5,6,7,8,9,10,11,12,13,14]
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