Svenska lungcancerregistret och Socialstyrelsens Nationella riktlinjer för lungcancervård anger målnivåer för de olika kvalitetsindikatorerna. De är framtagna på lite olika sätt.
Svenska lungcancerregistret har två målnivåer: en lägre nivå som motsvarar den nationella nivån för kvalitetsindikatorn år 2014, och en högre nivå som ska motsvara en ”ideal” nivå.
Nationella riktlinjer från 2011 och tidigare versioner av vårdprogrammet för lungcancer har målnivåer för samma kvalitetsindikatorer, och målnivåerna i tidigare vårdprogrammet har
anpassats till de nationella riktlinjerna. Målnivåerna är framtagna med en matematisk modell som i stora drag motsvarar 90-percentilen av resultaten nationellt. Detta innebär att målnivån baseras på de tre bästa länen i Sverige vid tiden då de nationella riktlinjerna togs fram.
Arbetet med kvalitetsindikatorer och målnivåer måste ses som en process i förändring och måste kontinuerlig utvärderas.
Nedan redovisas ett förslag på nya kvalitetsindikatorer som är möjliga att följa upp med data från Svenska lungcancerregistret. I denna version av vårdprogrammet anges inga målnivåer. För målnivåer hänvisas till Svenska lungcancerregistrets rapporter respektive Socialstyrelsens nationella riktlinjer för lungcancervård från 2011.
Nr Indikator Process-/resultatmått
1. PET-DT Andel patienter med lungcancer som genomgår PET-DT inför start av kurativt syftande terapi 2. Molekylärpatologisk
testning
Andel patienter i stadium IV NSCLC, där aktiv behandling planeras
3. MDK Andel av alla patienter som är bedömda på multi-disciplinär konferens (MDT) inför primär behandling
4. Lokaliserad sjukdom Kurativt syftande behandling
Andel patienter med icke-småcellig lungcancer, stadium I–II, PS 0–2, som får kurativt syftande kirurgi eller SBRT relaterat till stadium
5. Lokalt avancerad sjukdom NSCLC
Kurativt syftande behandling
Andel patienter med NSCLC, stadium III, PS 0–2, som får kurativt syftande radiokemoterapi
6. Lokalt avancerad sjukdom SCLC
Kurativt syftande behandling
Andel patienter med SCLC, stadium III, PS 0–2 som får kurativt syftande radiokemoterapi
7. Deltagande i behandlingsstudier
Andel patienter med lungcancerdiagnos som deltagit i någon form av strukturerad behandlingsstudie.
8. EBUS Andel patienter som genomgår mediastinal staging 9. DT/MR hjärna inför kurativt
syftande behandling
Andel patienter med lungcancerstadium III där kurativt syftande behandling planeras som genomgår DT/MR hjärna
10. 1-årsöverlevnad efter lungcancerdiagnos
Andel patienter som är i livet ett år efter datum för lungcancerdiagnos, uppdelat på stadium vid upptäckt.
11. 3-årsöverlevnad efter lungcancerdiagnos
Andel patienter som är i livet tre år efter datum för lungcancerdiagnos, uppdelad på stadium vid upptäckt.
12. 5-årsöverlevnad efter lungcancerdiagnos
Andel patienter som är i livet fem år efter datum för lungcancerdiagnos, uppdelat på stadium vid upptäckt
KAPITEL 22
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