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Table 2 Changes over time in the quality indicators used for benchmarking in 2007

From: Benchmarking the quality of breast cancer care in a nationwide voluntary system: the first five-year results (2003–2007) from Germany as a proof of concept

        

DKG/DGS requirement

QI No.

Quality indicator (QI)

Year of introduction

2003

2004

2005

2006

2007

1st year

3rd year

1

Preoperative histological confirmation of diagnosis

2003

58%

71%

78%

84%

88%

90%a

90%a

2

Appropriate axillary dissection

2003

85%

85%

80%

83%

88%

85%

95%

   [ex-3] b

Complete tumour staging data

2003

85%

96%

98%

95%

 

> 95%

> 95%

3

Data on safety distance between tumour and resection margin

2007

    

91%

100%

100%

   [ex-4] b

HER-2/neu assessment

2005

  

94%

98%

 

> 95%

> 95%

4

Specimen radiography

2007

    

83%

> 95%

> 95%

5

Hormone receptor assessment

2003

92%

96%

96%

97%

98%

100%

100%

6

Appropriate endocrine therapy in hormone receptor-positive patients

2003

27%

82%

92%

94%

93%

70%

95%

7.1

Appropriate adjuvant and neoadjuvant chemotherapy

2003

       

   7.1a

during the current analysis period; age ≤ 70 years

2005

  

65%

75%

81%

70%

80%

   7.1b

during the current analysis period; no age limit

2003

32%

45%

55%

63%

80%

--

--

7.2

Use of appropriate standard regimens in chemotherapy

2005

       

   7.2a

during the current analysis period; age ≤ 70 years

2006

   

65%

72%

--

--

   7.2b

during the current analysis period; no age limit

2005

  

57%

60%

69%

--

--

8

Percentage of patients in clinical trials

2005

  

8%

7%

7%

10%

20%

9

Appropriate radiotherapy after breast-conserving therapy

2003

20%

46%

60%

70%

79%

100%c

100%c

10

Appropriate radiotherapy after mastectomy

2003

8%

26%

35%

47%

65%

100%c

100%c

11

Indication for breast-conserving therapy

2003

       

   11a

at any tumour stage

2003

64%

66%

64%

68%

70%

--

--

   11b

at T1

2005

  

79%

83%

85%

50%

70%

   11c

at T2

2006

   

60%

63%

--

--

   11d

at T3

2006

   

15%

13%

--

--

   11e

at T4

2006

   

15%

12%

--

--

  1. a requirement for palpable tumours, 70% for nonpalpable tumours
  2. b Square brackets and italics indicate QIs which were discontinued at the end of 2006
  3. c number of radiation treatments to be recorded; exceptions require justification
  4. -- no specified requirement.
  5. Numbering and names, year of introduction, QI values for the 2003–2007 period (mean percentages across all participating institutions) and the required percentages for years 1 and 3 of DKG/DGS certification.