Clinical governance network for clinical audit to improve quality in epithelial ovarian cancer management

Vincenzo Dario Mandato, Martino Abrate, Pierandrea De Iaco, Debora Pirillo, Gino Ciarlini, Maurizio Leoni, Giuseppe Comerci, Alessandro Ventura, Bruno Lenzi, Andrea Amadori, Federica Rosati, Ruby Martinello, Rossana De Palma, Chiara Ventura, Laura Maria Beatrice Belotti, Debora Formisano, Giovanni Battista La Sala

Research output: Contribution to journalArticle

Abstract

Background: Epithelial ovarian cancer (EOC) is the most lethal gynecological cancer. Several hospitals throughout the region provide primary treatment for these patients and it is well know that treatment quality is correlated to the hospital that delivers. The aim of this study was to investigate the management and treatment of EOC in a Region of the North Italy (Emilia-Romagna, Italy). Methods. A multidisciplinary group made up of 11 physicians and 3 biostatisticians was formed in 2009 to perform clinical audits in order to identify quality indicators and to develop Region-wide workup in accordance with the principles of evidence-based medicine (EBM). The rationale was that, by setting up an oncogynecology network so as to achieve the best clinical practice, critical points would decrease or even be eliminated. Analysis of cases was based on the review of the medical records. Results: 614 EOC patients treated between 2007 and 2008 were identified. We found only 2 high-volume hospitals (≥ 21 patients/year), 3 medium-volume hospitals (11-20 operated patients/year), and 7 low-volume hospitals (≤ 10 operated patients /year). Only 222 patients (76.3%) had a histological diagnosis, FIGO surgical staging was reported only in 206 patients (70.9%) but not all standard surgical procedures were always performed, residual disease were not reported in all patients. No standard number of neoadjuvant chemotherapy cycles was observed. Conclusions: The differences in terms of treatments provided led the multidisciplinary group to identify reference centers, to promote centralization, to ensure uniform and adequate treatment to patients treated in regional centers and to promote a new audit involving all regional hospitals to a complete review of the all the EOC patients.

Original languageEnglish
Article number19
JournalJournal of Ovarian Research
Volume6
Issue number1
DOIs
Publication statusPublished - 2013

Keywords

  • Centralized care
  • Clinical audit
  • Epithelial ovarian cancer
  • Guide line
  • Quality of care

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

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    Mandato, V. D., Abrate, M., De Iaco, P., Pirillo, D., Ciarlini, G., Leoni, M., Comerci, G., Ventura, A., Lenzi, B., Amadori, A., Rosati, F., Martinello, R., De Palma, R., Ventura, C., Belotti, L. M. B., Formisano, D., & La Sala, G. B. (2013). Clinical governance network for clinical audit to improve quality in epithelial ovarian cancer management. Journal of Ovarian Research, 6(1), [19]. https://doi.org/10.1186/1757-2215-6-19