The impact of organisational external peer review on colorectal cancer treatment and survival in the Netherlands

M. J. Kilsdonk, B. A. C. van Dijk, R. Otter, S. Siesling, W. H. van Harten*

*Corresponding author for this work

    Research output: Contribution to journalReview articleAcademicpeer-review

    10 Citations (Scopus)
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    Abstract

    Background: Organisational external peer review was introduced in 1994 in the Netherlands to improve multidisciplinary cancer care. We examined the clinical impact of this programme on colorectal cancer care.

    Methods: Patients with primary colorectal cancer were included from 23 participating hospitals and 7 controls. Hospitals from the intervention group were dichotomised by their implementation proportion (IP) of the recommendations from each peer review (high IP vs low IP). Outcome measures were the introduction of new multidisciplinary therapies and survival.

    Results: In total, 45 705 patients were included (1990-2010). Patients from intervention hospitals more frequently received adjuvant chemotherapy for stage III colon cancer. T2-3/M0 rectal cancer patients from hospitals with a high IP had a higher chance of receiving preoperative radiotherapy (OR 1.31, 95% CI 1.11-1.55) compared with the controls and low IP group (OR 0.75, 95% CI 0.63-0.88). There were no differences in the use of preoperative chemoradiation for T4/M0 rectal cancer. Survival was slightly higher in colon cancer patients from intervention hospitals but unrelated to the phase of the programme in which the hospital was at the time of diagnosis.

    Conclusions: Some positive effects of external peer review on cancer care were found, but the results need to be interpreted cautiously due to the ambiguity of the outcomes and possible confounding factors.

    Original languageEnglish
    Pages (from-to)850-858
    Number of pages9
    JournalBritish Jounal of Cancer
    Volume110
    Issue number4
    DOIs
    Publication statusPublished - 18-Feb-2014

    Keywords

    • peer review
    • quality improvement
    • external quality assessment
    • accreditation
    • visitatie
    • colorectal neoplasms
    • III COLON-CANCER
    • RECTAL-CANCER
    • PREOPERATIVE RADIOTHERAPY
    • SOUTHERN NETHERLANDS
    • HEALTH-CARE
    • ACCREDITATION
    • CHEMOTHERAPY
    • REGISTRATION
    • QUALITY
    • THERAPY

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