The Opportunity

As the second leading cause of death in the U.S., cancer will touch nearly half of men and one-third of women in their lifetime. The physical, emotional, and economic impact of cancer is well-documented. Screening and treatment advances are showing progress in improving outcomes, extending survival rates, and reducing the side effects of treatment. Outcome-based performance measures on quantity (survival) and patient-reported quality of life will address gaps in oncology measurement and may lead to improved quality of care for patients living with or at risk for cancer.

Most oncology measures focus on screening and are limited to breast, colorectal, and prostate cancers. Lung cancer, the leading cause of cancer deaths among men and women, and melanoma, the deadliest of skin cancers, receive less attention. Developing measures for high-priority cancers (such as NSCLC, SCLC, and melanoma) that focus on survival, irrespective of therapy, is a persistent measurement gap and critical topic in oncology-focused quality measurement.

About the Project

As a first step, NQF convened three Measure Incubator® strategy sessions focused on oncology with multistakeholder Expert Panels in 2017 and 2018. At these meeting, panelists considered strategies to improve care for lung cancer and melonmia patients. NQF engaged a broad-based stakeholder group in this Measure Incubator project, including patients and caregivers, patient advocates, specialty society representatives, measure developers, health services researchers, and oncologists.

Building on the recommendations from the NQF convened strategy sessions, NQF prioritized four measure concepts for initial development: three overall survival rates measures for non-small-cell lung cancer, small-cell lung cancer, and melanoma and one PRO-PM (patient-reported symptom burden measure among NSCLC patients receiving chemotherapy). KM Healthcare Consulting led initial development of these measure concepts into fully specified performance measures, gathering input from expert panelists and other clinical experts to develop pre-testing specifications. Now in the testing phase, Mathematica is testing the measures through the National Quality Forum (NQF) Measure Incubator®. Initial development and testing of the four measures began in 2019.

The use of survival in oncology performance measures presents a number of challenges, including limited data availability, small sample sizes, and lack of consensus around attribution approaches. To help identify and address such challenges, Mathematica is providing draft specifications for SCLC, NSCLC, and melanoma survival measures to the public in order to obtain feedback and responses to questions about specifying and implementing these measures.

Public Feedback Opportunity

NQF is soliciting public comments on two lung cancer (PDF) and one melanoma (PDF) survival rates quality measures listed above, including:

• General comments on measures under development;
• Input on critical components of the proposed measures, such as numerator, denominator criteria, stratification, risk-adjustment, accountability and performance improvement, usability and attribution; Measure-specific feedback, such as measure importance (see public comment page for more details); and,
• Feedback on potential data availability and implementation barriers and proposed solutions.

Comments are due by November 18, 2020 at 11:59pm ET. Please see measure background (PDF) for more details.

Funding

NQF is delivering this project through the Measure Incubator® with financial support from Bristol-Myers Squibb (BMS).

Contact Information

For more information, contact the Mathematica project team at kbarrett@mathematica-mpr.com.