Table 5. External indicator sets for lung carcinoma from 2016–2018 and national indicator scores in 2016.
| Indicator type | DLCA subset | Indicator description | Part of set in | Nationwide scores 2016** | ||||
|---|---|---|---|---|---|---|---|---|
| 2018 | 2017 | 2016 | Patients in denominator (n) | Indicator score (%) | ||||
| Structure | ||||||||
| L | Registration of at least one patient in the DLCA-L per hospital | √ | NA | NA | ||||
| L | Completeness of data entry^ in DLCA-L | √ | NA | NA | ||||
| L | Volume of new patients registered in the DLCA-L per location | √ | √ | NA | NA | |||
| R | Completeness of data entry^ in DLCA-R | √ | √ | √ | 2,214 | 84.0 | ||
| R | Volume of patients undergoing radical radiation treatment for NSCLC per location | √ | √ | √ | 2,387 | – | ||
| S | Completeness of data entry^ in DLCA-S | √ | √ | √ | 1,979 | 90.7 | ||
| S | Volume of anatomical parenchymal resections* for malignant or benign pathology per hospital location | √ | √ | √ | 2,359 | – | ||
| Process | ||||||||
| L | Percentage of patients discussed in a MDT meeting prior to the start of treatment | √ | √ | NA | NA | |||
| L | Percentage of patients clinical stage III NSCLC and intentional curative treatment in whom cerebral imaging was performed | √ | √ | NA | NA | |||
| L | Percentage of patients with stage IV adenocarcinoma, not eligible for curative treatment, with molecular diagnostics | √ | NA | NA | ||||
| R | Percentage of patients—with radiation treatment with radical intent—discussed in a MDT meeting prior to the start of treatment | √ | 2,214 | 95.1 | ||||
| R | Percentage of patients—with SBRT with radical intent—with a waiting time (between day of referral and first day of radiation) of ≤21 days | √ | 1,162 | 70.7 | ||||
| R | Percentage of stage III NSCLC patients—with radiation treatment with radical intent—undergoing concurrent chemo-radiotherapy | √ | 686 | 55.5 | ||||
| S | Percentage of patients having surgery for a NSCLC discussed in a postoperative MDT meeting | √ | √ | 1,809 | 97.1 | |||
| S | Percentage of patients having surgery for a NSCLC in which the clinical TNM stage is known during the preoperative MDT meeting | √ | √ | 1,790 | 98.3 | |||
| S | Percentage of patients having surgery for a NSCLC in which the pathological TNM stage is known during the preoperative MDT meeting | √ | √ | 1,749 | 99.3 | |||
| S | Percentage of patients having surgery for a NSCLC with a waiting time (between the last MDT meeting and day of surgery) of ≤21 days | √ | √ | 1,660 | 65.0 | |||
| Outcome** | ||||||||
| R | Percentage of patients undergoing a combined chemoradiotherapy treatment that died within 90 days from the last radiation | √ | 1,696 | 6.4 | ||||
| R | Percentage of patients with a grade IV or V toxicity within 90 days from the last radiation treatment with curative intent | √ | √ | √ | 4,469 | 0.9 | ||
| S | Percentage of patients died within 30 days after resection for primary lung carcinoma or during primary admission | √ | √ | √ | 3,573 | 2.3 | ||
| S | Percentage of patients with a complicated course after resection for primary lung carcinoma | √ | √ | √ | 3,573 | 15.6 | ||
| S | Percentage of patients with an irradical resection (R1 or R2) after resection for primary NSCLC | √ | 3,573 | 6.2 | ||||
*, includes: pneumonectomy, (bi)lobectomy or anatomical segment resection (excludes: wedge excisions); **, outcome indicators scores are calculated over a two-year period, thus for 2016: 2015–2016; ^, completeness means that all items required for calculating external indicators are registered per patient. NSCLC, non-small cell lung carcinoma; MDT, multidisciplinary team; NA, not available for 2016; DLCA, Dutch Lung Cancer Audit; L, lung-oncologists; R, radiotherapeutic-oncologists; S, surgical-oncologists; SBRT, stereotactic body radiation therapy.