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Table 3 Indicator scores and determinants for guideline adherence concerning NHL care

From: Variation in guideline adherence in non-Hodgkin’s lymphoma care: impact of patient and hospital characteristics

Quality Indicator N Indicator score (%) Range in 19 hospitals(%) OR (95 % CI) P-value Explained variance (%)
Diagnosis and staging
QI1 Diagnosis based on histological examination or an excision or wide incision biopsy 369 79 53–100    5
 Older age     0.97 (0.95–0.99) <0.01  
QI2 Patients staged according to Ann Arbor classification 390 81 59–100    35
 Older age     0.93 (0.90–0.95) <0.01  
 Therapy used     7.55 (4.04–14.00) <0.01  
QI3 Diagnosis based on morphology and immune phenotype 376 96 74–100    n.a.
QI4 Staging techniques include CT-scans, bone marrow aspirate, and bone biopsy 421 48 0–74    14
 Older age     0.98 (0.96–0.99) 0.02  
 Extranodal involvement     0.52 (0.33–0.84) <0.01  
 Discussed in MTC     1.88 (1.10–3.20) 0.02  
 Aberrant Hb level     0.54 (0.34–0.86) 0.01  
 Therapy used     3.08 (1.76–5.39) <0.01  
QI5 Assessment of International Prognostic Index for patients with aggressive NHL 250 43 0–81    17
 Older age     0.97 (0.95–0.99) 0.01  
 DLBCL tumor type     2.85 (1.07–4.82) 0.03  
 Therapy used     8.70 (1.82–41.50) <0.01  
QI6 Assessment of LDH level 423 92 70–100    9
 Discussed in MTC     0.42 (0.19–0.94) 0.03  
 Therapy used     2.92 (1.36–6.27) <0.01  
QI7 Examination of blood counts 422 82 14–100    n.a.
Treatment and follow-up       
QI8 Reporting of response to therapy using predefined terminology 304 73 53–100    2
 High LDH level     1.79 (1.03–3.11) 0.04  
QI9 Lesions documented in radiology report before therapy 344 67 22–90    n.a.
QI10 Lesions documented in radiology report after therapy 114 58 0–100    24
 DLBCL tumor type     0.34 (0.15–0.79) 0.01  
 Co-morbidities (≥1)     0.34 (0.15–0.81) 0.02  
Hospital region 1     1.08 (0.38–3.07)   
       2     4.10 (1.48–11.40)   
       3     Ref. 0.02  
QI11 Evaluation after chemotherapy with (PET)CT-scans, bone marrow aspirate, and bone biopsy 246 62 29–100    30
Extranodal involvement     0.18 (0.09–0.34) <0.01  
Hospital region 1     0.93 (0.47–1.84)   
        2     4.54 (1.88–10.96)   
        3     Ref. <0.01  
QI12 Patients with DLBCL received RCHOP chemotherapy 194 78 44–100    26
Older age     0.92 (0.88–0.95) <0.01  
QI13 Dose of RCHOP was not reduced or reason for reduction was reported 111 82 40–100    8
Extranodal involvement     0.31 (0.10–0.99) 0.05  
Quality Indicator N Indicator score (%) Range in 19 hospitals (%) OR (95 % CI) P-value Explained variance (%)
Organization and coordination of care
QI14 Sending of unfixed biopsy material 321 41 0–91    n.a.
QI15 Integrated reporting of pathology techniques 365 89 35–100    11
Extranodal involvement     2.46 (1.10–5.50) 0.03  
Discussed in pathology panel     5.25 (1.75–15.74) <0.01  
QI16 Pathology report describes all necessary, predefined characteristics 378 14 0–47    23
Discussed in MTC     2.46 (1.10–5.51) 0.03  
Hospital region 1     2.73 (0.62–12.04)   
        2     0.17 (0.02–1.31)   
        3     Ref. 0.04  
QI17 Patients discussed in multidisciplinary consultations 422 41 4–96    9
Availability of PET-scanner     4.22 (1.01–17.56) 0.05  
QI18 Results of bone marrow pathology known before start of treatment 317 83 43–100    11
Aggressive tumor     0.30 (0.13–0.70) <0.01  
Aberrant Hb level     0.38 (0.20–0.72) <0.01  
QI19 Diagnostic period of 4 weeks after first visit to the hospital 420 47 22–70    10
Previous malignancies     0.52 (0.29–0.95) 0.03  
Extranodal involvement     1.72 (1.11–2.66) 0.02  
In-hospital referral     0.52 (0.34–0.81) <0.01  
High LDH level     1.9 2 (1.27–3.03) <0.01  
QI20 Start of therapy within 2 weeks after diagnostic period 313 58 37–79    9
Male gender     1.69 (1.03–2.76) 0.04  
Aggressive tumor     1.99 (1.17–3.41) 0.01  
High LDH level     1.92 (1.16–3.19) 0.01  
  1. Abbreviations: MTC, multidisciplinary team consultation; DLBCL, diffuse large B-cell lymphoma; LDH, lactate-dehydrogenase; Hb, Hemoglobin; RCHOP, ritixumab-involved chemotherapy