Area Editoriale
BACKGROUND:Colorectal cancer is the second most common cancer type among new cancerdiagnoses in the United States. Attention to the quality of surgicalcare for colorectal cancer is of particular importance given the increasingnumbers of colorectal cancer resections performed in the aging population. ANational Cancer Institute-sponsored consensus panel produced guidelines forcolorectal cancer surgery in 2000. We have updated and extended that work byusing a formal process to identify and rate quality indicators as valid forcare during the preoperative, intraoperative, and postoperative periods.METHODS: Using a modification of the RAND/UCLA Appropriateness Methodology, wecarried out structured interviews with leaders in the field of colorectalcancer surgery and systematic reviews of the literature to identify candidatequality indicators addressing perioperative care for patients undergoingsurgery for colorectal cancer. A panel of 14 colorectal surgeons, generalsurgeons, and surgical oncologists then evaluated and formally rated theindicators using the modified Delphi method toidentify valid indicators. RESULTS: A total of 142 candidate indicators wereidentified in six broad domains: privileging (which addresses surgicalcredentials), preoperative evaluation, patient-provider discussions, medicationuse, intraoperative care, and postoperative management. The expert panel rated92 indicators as valid. These indicators address all domains of perioperativecare for patients undergoing surgery for colorectal cancer. CONCLUSIONS: TheRAND/UCLA Appropriateness Methodology can be used to identify and rateindicators of high-quality perioperative care for patients undergoing surgeryfor colorectal cancer. The indicators can be used as quality performance measuresand for quality-improvement programs. Leggil'articolo