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

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