Consensus-based validation of key quality indicators in pancreatic cancer surgery in Catalonia: a modified Delphi study

Abstract

Introduction: Pancreatic cancer surgery is highly complex and associated with significant perioperative risk, high mortality and morbidity, low quality of life, and increased healthcare costs. Establishing quality indicators to monitor these procedures may improve care quality and outcomes. This study aims to define a set of quality indicators to evaluate pancreatic cancer surgery in Catalonia. Methods: A preliminary list of quality indicators was developed based on a literature review. Subsequently, a modified Delphi study was undertaken, involving 11 expert pancreatic surgeons, one from each center where these complex surgeries are authorized in Catalonia, to achieve consensus on quality indicators for pancreatic cancer surgery. Results: The literature review yielded 21 potential quality indicators. After 4 rounds of voting, the expert panel accepted 17 indicators and rejected 4. The final set of quality indicators encompasses critical aspects including positive tumor resection margin, lymph nodes retrieved, postoperative complications, hospital readmission, reoperation, 90-day mortality and one-year survival. Conclusion: The outcome of this study is a set of agreed quality indicators to measure, describe and monitor the quality and outcomes of pancreatic cancer surgery. These quality indicators can be used as a foundation for benchmarking studies and systematic evaluations of quality of care and enhanced surgical performance in pancreatic cancer.