Table 3.
List of PACAP-1 interventions per medical specialty
| Medical oncology | ||||
| Intervention | Definition | Outcome | Measurement | |
| 1 | Standard information and decision support tool | Use of standard information and decision support tool for all pancreatic cancer patient subgroups (e.g., via https://bit.do/beslisboom) | Survival | NCR |
| 2 | Discussion on chemotherapy (resectable patients) | Percentage of resectable pancreatic cancer patients with whom Chemotherapy options are discussed in DPCG center |
Survival Quality of life |
NCR PROMs DPCA |
| 3 | Diagnostics LAPC patient established in DPCG center | Percentage of LAPC patients in the diagnostic phase that are discussed in DPCG MDT meeting |
Survival Quality of life |
NCR PROMs DPCA |
| 4 | Post-induction chemotherapy discussion of LAPC patient in DPCG center | Percentage of LAPC patients treated with chemotherapy that are discussed in DPCG MDT meeting after 2 months of therapy |
Survival Quality of life |
NCR PROMs DPCA |
| 5 | PERT | Percentage of patients with EPI who receive PERT |
Survival Quality of life |
NCR PROMs |
| 6 | Key parameter WHO performance status reporting | Percentage of patients with a (suspected) pancreatic malignancy, in whom the WHO performance status is reported at first presentation. | – |
NCR DPCA |
| 7 | Pre-treatment pathology confirmation | Percentage of patients with (suspected) locally advanced and metastatic pancreatic cancer, with histological or cytological proof of pancreatic adenocarcinoma | – | NCR |
| 8 | PROMs | Percentage of patients with a (suspected) pancreatic malignancy who are registered for the PACAP PROMs | – | PROMs |
| 9 | Biobanking | Percentage of patients receiving pancreatic resection for suspected malignancy who are registered for the PancreasParel | – | PancreasParel |
| Surgery | ||||
| Intervention | Definition | Outcome | Measurement | |
| 1 | Medical oncology referral | Percentage of patients with pancreatic cancer referred to medical oncologist for consultation on adjuvant chemotherapy |
Survival Quality of life |
NCR PROMs |
| 2 | PERT | Percentage of patients with EPI who receive PERT |
Survival Quality of life |
NCR PROMs |
| 3 | Synoptic discharge letter | Percentage of patients receiving pancreatic resection for a (suspected) malignancy in whom the synoptic complication table is used in the discharge letter | – | DPCA |
| 4 | Synoptic POC | Percentage of patients undergoing pancreatic resection in whom the synoptic POC is used in the operation report | – | DPCA |
| 5 | PROMs | Percentage of patients receiving pancreatic resection for (suspected) malignancy who are registered for the PACAP PROMs | – | PROMs |
| 6 | Biobanking | Percentage of patients receiving pancreatic resection for (suspected) malignancy who are registered for the PancreasParel | – | PancreasParel |
| 7 | Standardized complication management | Standardized approach to early detection and treatment of pancreatic fistula (PORSCH trial) | Postoperative complications |
DPCA PROMs PORSCH |
| Gastroenterology | ||||
| Intervention | Intervention | Outcome | Measurement | |
| 1 | Metal stent | Percentage of patients with a (suspected) pancreatic malignancy requiring biliary drainage receiving a metal (rather than a plastic) stent | Complications |
NCR DPCA |
| 2 | PERT | Percentage of patients with EPI who receive PERT |
Survival Quality of life |
NCR PROMs |
| 3 | Pre-treatment pathology confirmation | Percentage of patients with (suspected) locally advanced and metastatic pancreatic cancer with histological or cytological proof of pancreatic adenocarcinoma | – | NCR |
| Pathology | ||||
| Intervention | Definition | Outcome | Measurement | |
| 1 | Synoptic reporting | Percentage of patients receiving pancreatic resection for a suspected malignancy in whom the resection specimen is recorded according to the PALGA/Dutch Society of Pathology nationwide synoptic report | Number of R1 resections | DPCA |
| Radiology | ||||
| Intervention | Definition | Outcome | Measurement | |
| 1 | Synoptic reporting | Percentage of patients with a (suspected) pancreatic in whom the computed tomography (CT) is recorded according to the Dutch Society of Radiology CT-checklist | – | DPCA |
Abbreviations: NCR Netherlands Cancer Registry, PROMS patient reported outcome measures, DPCA Dutch Pancreatic Cancer Audit, DPCG Dutch Pancreatic Cancer Group, LAPC locally advanced pancreatic cancer, MDT multidisciplinary team, PERT pancreatic enzyme replacement therapy, EPI exocrine pancreatic insufficiency, WHO World Health Organization, PACAP Dutch Pancreatic Cancer Project, POC postoperative conclusion, PALGA nationwide network and registry of histo- and cytopathology of the Netherlands