Identifying Breast Cancer Care Quality Measures for a Cancer Facility in Rural Sub-Saharan Africa: Results of a Systematic Literature Review and Modified Delphi Process
Year: 2020
Type: review
Abstract: PURPOSE: The burden of cancer is growing in low- and middle-income countries (LMICs), including sub-Saharan Africa. Ensuring the delivery of high-quality cancer care in such regions is a pressing concern. There is a need for strategies to identify meaningful and relevant quality measures that are applicable to and usable for quality measurement and improvement in resource-constrained settings. METHODS: To identify quality measures for breast cancer care at Butaro Cancer Center of Excellence (BCCOE) in Rwanda, we used a modified Delphi process engaging two panels of experts, one with expertise in breast cancer evidence and measures used in high-income countries and one with expertise in cancer care delivery in Rwanda. RESULTS: Our systematic review of the literature yielded no publications describing breast cancer quality measures developed in a low-income country, but it did provide 40 quality measures, which we adapted for relevance to our setting. After two surveys, one conference call, and one in-person meeting, 17 measures were identified as relevant to pathology, staging and treatment planning, surgery, chemotherapy, endocrine therapy, palliative care, and retention in care. Successes of the process included participation by a diverse set of global experts and engagement of the BCCOE community in quality measurement and improvement. Anticipated challenges include the need to continually refine these measures as resources, protocols, and measurement capacity rapidly evolve in Rwanda. CONCLUSION: A modified Delphi process engaging both global and local expertise was a promising strategy to identify quality measures for breast cancer in Rwanda. The process and resulting measures may also be relevant for other LMIC cancer facilities. Next steps include validation of these measures in a retrospective cohort of patients with breast cancer.
Source: JCO Global Oncology
DOI: 10.1200/go.20.00186
Authors: Lydia E. Pace, Lauren E. Schleimer, Cyprien Shyirambere, André Ilbawi, Jean Marie Vianney Dusengimana, Jean Bosco Bigirimana, Francois Regis Uwizeye, Mary Chamberlin, Yeonsoo Sara Lee, Lawrence N. Shulman, Susan Troyan, Benjamin O. Anderson, Catherine Duggan, Daniel S. O’Neil, Allison Dvaladze, Jane Brock, Cam Nguyen, Deogratias Ruhangaza, Olivier Habimana, Nicaise Nsabimana, John Butonzi, Eugene Nkusi, Tharcisse Mpunga, Nancy L. Keating
Institutions: Brigham and Women's Hospital, Harvard University, Columbia University, Partners In Health, World Health Organization, Dartmouth–Hitchcock Medical Center, Abramson Cancer Center, University of Pennsylvania, EBSCO Industries (United States), University of Washington, Fred Hutch Cancer Center, University of Miami, Sylvester Comprehensive Cancer Center, Ministry of Health
Language: English
Topic: Delphi Technique in Research
Subfield: Sociology and Political Science
Field: Social Sciences
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $2,472
OpenAlex ID: W3091340556