Lung Cancer QPI Measurability V2 - ISD Scotland · 2019-03-29 · 2.1 107/2014 Final Amendments made out-with review, incorporating additional data item into the dataset updating

Lung Cancer QPI Measurability v3.4

Lung Cancer

Measurability of Quality Performance Indicators Version 3.4

To be read in conjunction with:

Lung Cancer Quality Performance Indicators

Lung Cancer QPI Dataset (Latest published version)

Lung Cancer QPI Measurability v3.4 2

Measurability of Quality Performance Indicators for Lung Cancer

Please refer to the Lung Cancer Quality Performance Indicators published by Healthcare Improvement Scotland for a full description of individual QPIs. Please refer to the Lung Cancer QPI Dataset published by ISD Scotland for a full description of individual data items.

Document control: This version:

Title Lung Cancer Measurability of QPIs Version/Issue Number 3.4

Effective From 1st January 2016 Author Jane Garrett, ISD

Document Type Guidance Document status Final

Document Purpose To outline how QPIs should be measured using the agreed National Minimum Core Dataset

Summary of changes Changes made out-with review to support data collection and reporting.

V3.4 Mar 2019 Final In addition to reporting by Hospital of Diagnosis, the following QPIs should also be reported by Board of Surgery: QPIs: 7, 13(i)

Revision History

Version Date Status Summary of Changes QPI (s) Author

2.0 01/04/2014 Final Amendments made as per agreed changes following 9 month review, updated with new MDT QPI, and checked against published QPIs and dataset.

1 DE

2.1 07/2014 Final Amendments made out-with review, incorporating additional data item into the dataset updating the MDT QPI

1 CJA

2.2 11/2014 Final Changes made out-with review to support data collection and reporting 2,9,11 JG

2.3 06/2015 Final Baseline review updates 1,2,3,5,7,8,9,10,11,12,13 JG

2.4 08/2015 Final Amended outwith review 2 CJA

2.5 Nov 2015 Final Amended outwith review 12 JG

2.6 Mar 2016 Final Amended outwith review 13 JG

2.7 April 2016 Final Amended outwith review 13 CJA

2.8 May 2016 Final Amended outwith review 13 KH

3.0 Mar 2017 Final

Changes made following Formal Review. NB: Formal Review measurability changes

apply to patients diagnosed in year 4 data collection (1st January 2016 – 31

st

December 2016) with the exception of measures which require new data items. These changes will apply to patients diagnosed in year 5 data collection (1

st January 2017-

31st December 2017).

Year 4: 3,4,5,9,10,12,13

CJA

Year 5: 2,6,8,11,14,15,16

3.1 May 2017 Final Amendment outwith review Year 4: 10 CJA

3.2 May 2017 Final Amendment outwith review Year 4: 10 CJA

3.3 Nov 2017 Final Amendment outwith review Year 4: 13

CJA Year 5: 2, 11

http://www.healthcareimprovementscotland.org/programmes/cancer_care_improvement/cancer_resources/cancer_qpis.aspx

http://www.isdscotland.org/Health-Topics/Cancer/Cancer-Audit/


3.4 March 2019 Final Amendment outwith review NB Changed to include new TNM code Implemented

from 01/01/2018 2, 9,10,11,14 JG

Updates from Previous Version

QPI Summary of changes (Changed to include new TNM code Implemented from 01/01/2018) (March 2019)

2 Num (iii) add ‘IIIC’, Den (iii) - add ‘IIIC’, amend ‘(([TLUNG = T4] AND [NLUNG = N2] AND [MLUNG = M0] ) OR ( [NLUNG = N3] AND [MLUNG = M0] ) OR ( [MLUNG = M1 OR M1A OR M1B]))’ to ‘(([TLUNG = T1 OR T1A OR T1B OR T1C OR T2A OR T2B] AND [NLUNG = N3] AND [MLUNG = M0] ) OR ( [TLUNG = T3 OR T4] AND [NLUNG = N2] AND [MLUNG = M0]) OR ([TLUNG = T3 OR T4] AND [NLUNG = N3] AND [MLUNG = M0] ) OR ( [MLUNG = M1 OR M1A OR M1B OR M1C]))

6 Den (ii) amend ‘T1a’ to ‘T1’, add ‘T1 OR T1mi OR’, ‘T1c OR’, ‘ T2’

8 Den add ‘M1c’

9 Den Remove ‘T1mi’, add ‘T1 OR’, ‘OR T1c’, ‘OR N2’ add ‘T2’, Footer amend ‘N2; T1b N2; T2a N2; T2b N2; T3 N1; T3 N2; T4 N0; T4 N1’ to ‘T1a-c, T2a,b N2 M0; T3, N1 M0 ; T4 N0, N1 M0’

11 Desc (ii), Num (ii) add ‘IIIC’; Den (ii) add ‘IIIC’ amend ‘(([TLUNG = T4] AND [NLUNG = N2] AND [MLUNG = M0] ) OR ( [NLUNG = N3] AND [MLUNG = M0] ) OR [MLUNG = M1 OR M1A OR M1B]’ to ‘(([TLUNG = T1 OR T1A OR T1B OR T1C OR T2A OR T2B] AND [NLUNG = N3] AND [MLUNG = M0] ) OR ( [TLUNG = T3 OR T4] AND [NLUNG = N2] AND [MLUNG = M0]) OR ([TLUNG = T3 OR T4] AND [NLUNG = N3] AND [MLUNG = M0] OR [MLUNG = M1 OR M1A OR M1B OR M1C] )’

14 Den add ‘T1 OR T1mi OR’, ‘OR T1c OR T2 OR T2a]’

QPI Summary of changes (excluding formatting changes) (Nov 2017)

2 Numerator (iii): inserted ‘non-squamous’; EGFR - inserted ‘or Undertaken’ and added ‘[EGFR = OR 5]’. Denominator (iii): inserted ‘non-squamous’, removed HISTSURG ‘11’. (Query 1431 & 1459)

11 Numerator (i): replaced [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 <> 96] with [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 1 or 2 or 4 or 5 or 7] (Query 1484)

13 Biological Therapy: change CHEMENDATE to CHEMDATE. (Query 1472)

QPI Summary of changes (excluding formatting changes) (May 2017)

10 Denominator amended brackets as highlighted - [ORIGIN = 1] AND [HIST = 21 OR 32] AND [PSTATUS = 0 OR 1] AND [TLUNG <> T0] AND ([TLUNG <> TX] AND [NLUNG =N0]) AND [NLUNG <> Nx] AND [MLUNG = M0] AND [MODE1 <> 94 OR 95] AND [SURGTYPE <> 1 OR 2 OR 3 OR 4]


9 NR for Denominator – removed ‘C’ from TLUNG, NLUNG and MLUNG

10

Denominator changed from ‘[ORIGIN = 1] AND [HIST = 21 OR 32] AND [PSTATUS = 0 OR 1] AND [TLUNG <> cT0 OR cTx] AND [NLUNG <> cNx] AND [MLUNG = cM0] AND [MODE1 <> 94 OR 95] AND [SURGTYPE <> 1 OR 2 OR 3 OR 4]’ to ‘[ORIGIN = 1] AND [HIST = 21 OR 32] AND [PSTATUS = 0 OR 1] AND [TLUNG <> T0] AND [TLUNG <> TX] AND [NLUNG = NO] AND [NLUNG <> Nx] AND [MLUNG = M0] AND [MODE1 <> 94 OR 95] AND [SURGTYPE <> 1 OR 2 OR 3 OR 4]’; NR for Denominator – removed ‘C’ from TLUNG, NLUNG and MLUNG


QPI Summary of changes (excluding formatting changes) (Formal Review March 2017)

2

Description iii - replaced ‘analysis of predictive markers’ with ‘molecular profiling’; Denominator (i) removed ‘and Patients receiving supportive care’ and ‘AND Type of First Cancer Treatment not coded as Suportive Care’ – ‘AND [MODE1 <> 07]’; Numerator (iii) removed ‘adenocarcinoma’ and replaced ‘analysis of predictive markers’ with

‘molecular profiling’, replaced ‘Predictive Markers Test’ with Epidermal Growth Factor Receptor status, inserted ‘or Inconclusive’ – OR 4, inserted ‘AND Oncogenic Anaplastic Lymphoma Kinase [ALK] status coded as Positive or Negative or Inconclusive – AND [ALK = 1 OR 2 OR 4]; Denominator (iii) removed ‘adenocarcinoma’, replaced ‘AND

Histology/Cytology Following Surgery coded as Adenocarcinoma OR where Histology/Cytology Following Surgery is not available, Histology/Cytology coded as

Adenocarcinoma’ with ‘’;- ( [HISTSURG =12] OR ( [HISTSURG = 8 OR 95 OR 96 OR 99] AND [HIST = 12] ) )’ with ‘AND Histology/Cytology Following Surgery coded as NSCLC, or where Histology/Cytology Following Surgery is not available; NR Numertor inserted ‘OR [ALK = 99]’; NR Exclusion removed ‘OR [MODE1 = 99]’

3 QPI 3 – Bronchoscopy ARCHIVED

4 Description replaced ‘are being treated with’ to ‘receive’, changed ‘who undergo’ to ‘that undergo’; Numerator replaced ‘are treated with curative intent’ to ‘received curative treatment’ changed ‘who undergo’ to ‘that undergo’; Denominator replaced ‘are treated with curative intent’ to ‘received curative treatment’

5 QPI 5 – Investigation of Mediastinal Malignancy ARCHIVED

6

Denominator (i) inserted ‘and patients who undergo stereotactic ablative radiotherapy (SABR)’, ‘AND Stereotactic Ablative Radiotherapy (SABR) not coded as Yes – AND [SABR <> 1]’; Denominator (ii) inserted ‘and patients who undergo stereotactic ablative radiotherapy (SABR)’, ‘AND Stereotactic Ablative Radiotherapy (SABR) not coded as Yes – AND [SABR <> 1]’; NR Exclusion (i) & (ii) inserted ‘OR [SABR = 99]’

8 QPI Title inserted ‘or stereotactic ablative radiotherapy (SABR)’; Description inserted ‘or SABR’; Numerator inserted ‘or Stereotactic Ablative Radiotherapy (SABR) coded as Yes – OR [SABR = 1]’; NR Numerator inserted ‘OR [SABR = 99]’

9 QPI Title changed ‘non small cell lung (NSCLC) cancer’ to ‘non small cell lung cancer (NSCLC)

10 Description and Numerator inserted footnote ‘*b – Patients with TxN1-3Mc disease will be included within the measurement of this QPI’

11

QPI Title removed ‘inoperable’; Description removed ‘platinum based’ inserted ‘or biological therapy where appropriate’, (i) inserted ‘(SACT)’, (ii) inserted ‘that are EGFR or ALK positive’ replaced ‘doublet chemotherapy including platinum as their first line regimen’ with ‘biological therapy’; Denominator (i) removed ‘Patients who are participating in clinical trials’, ‘AND Patient Entered into Clinical Trial not coded as Yes – AND [TRIAL <> 1]’; Numerator (ii) changed performance status from 0-1 to 0-2, inserted ‘that are

EGFR / ALK positive’ and replaced ‘doublet chemotherapy, including platinum, as their first line regimen’ to ‘biological therapy’, replaced ‘Systemic Therapy Agent 1-3 {Lung Cancer} coded as Cisplatin/Vinorelbine palliative and neoadjuvant, Carboplatin/Vinorelbine, Carboplatin/Gemcitabine, Cisplatin/Etoposide, Cisplatin/Docetaxel, Cisplatin/Gemcitabine, Carboplatin/Etoposide, Cisplatin/Pemetrexed, Carboplatin/Pemetrexed, Carboplatin/paclitaxel - [CHEMAGENT1 = 1 OR 2 OR 3 OR 5 OR 6 OR 7 OR 11 OR 15 OR 17 OR 18] with ‘Type of Systemic Anti Cancer Therapy 1-3 coded as biological therapy – [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 7]’; Denominator (ii) changed performance status from 0-1 to 0-2, inserted ‘that are EGFR / ALK positive’ replaced

‘chemotherapy’ with ‘SACT treatment’ removed ‘Patients with known EGFR mutation’, inserted ‘or 2’, ‘AND Epidermal Growth Factor Receptor (EGFR) status coded as positive; OR Oncogenic Anaplastic Lymphoma Kinase (A LK) status coded as positive; AND – AND ([EGFR = 1] OR [ALK = 1]’, removed ‘AND Epidermal Growth Factor Receptor (EGFR) Status not coded as Positive – AND EGFR <> 1]’; NR Numerator removed ‘(ii) [CHEMAGENT1 = 99]’ and reformatted to read ‘(i) and (ii) [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99]’; NR Exclusion (i) removed ‘OR [TRIAL = 99]’, (ii) removed ‘OR [EGFR = 99]’; NR Denominator inserted ‘OR ([EGFR = 99] AND

[ALK = 99])’

12 Numerator (i) removed ‘first line’; Denominator(i) inserted ‘and’; Denominator (ii) inserted ‘and’, removed ‘(ii)’.

13

Numerator removed ‘/CHEMDATE’, changed reference to CHEMDATE to ‘CHEMENDATE1,2, &3’ within Biological Therapy; Denominator (i) Palliative Chemotherapy and

Biological Therapy amended to ‘PALLIATIVE CHEMOTHER APY AND BIOLOGICAL THERAPY TO BE SPLIT FOR NSCLC and SCLC - Palliative Chemotherapy NSCLC - Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung cancer; AND Histology/Cytology Following Surgery coded as NSCLC, or where Histology/Cytology Following Surgery is not available, Histology/Cytology coded as NSCLC; AND Type of Systemic Anti-Cancer Therapy coded as Palliative. - [ORIGIN = 1] AND ( [HISTSURG = 11 OR 12 OR 13 OR 14 OR 31] OR ( [HISTSURG = 8 OR 95 OR 96 OR 99] AND [HIST = 11 OR 12 OR 13 OR 14 OR 31] ) ) AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 4], Palliative Chemotherapy SCLC - Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung cancer; AND Histology/Cytology Following Surgery coded as SCLC, or where Histology/Cytology Following Surgery is not available, Histology/Cytology coded as SCLC; AND Type of Systemic Anti-Cancer Therapy coded as Palliative. - [ORIGIN = 1] AND [HISTSURG = 21 OR 32] OR ( [HISTSURG = 8 OR 95 OR 96 OR 99] AND [HIST = 21 OR 32] ) AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 4], Biological Therapy NSCLC - Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung cancer; AND Histology/Cytology Following Surgery coded as NSCLC, or where Histology/Cytology Following Surgery is not available, Histology/Cytology coded as NSCLC; AND Type of Systemic Anti-Cancer Therapy coded as Biological therapy. - [ORIGIN = 1] AND ( [HISTSURG = 11 OR 12 OR 13 OR 14 OR 31] OR ( [HISTSURG = 8 OR 95 OR 96 OR 99] AND [HIST = 11 OR 12 OR 13 OR 14 OR 31] ) ) AND


[CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 7], Biological Therapy SCLC - Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung cancer; AND Histology/Cytology Following Surgery coded as SCLC, or where Histology/Cytology Following Surgery is not available, Histology/Cytology coded as SCLC; AND Type of Systemic Anti-Cancer Therapy coded as Biological therapy. - [ORIGIN = 1] AND [HISTSURG = 21 OR 32] OR ( [HISTSURG = 8 OR 95 OR 96 OR 99] AND [HIST = 21 OR 32] ) AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 7]; NR Numerator (i) Biological therapy amended CHEMDATE1 to ‘CHEMENDATE1’; NR Denominator (i) inserted ‘Palliative Chemotherapy/ Biological Therapy (NSCLC / SCLC) - ( [HISTSURG = 99] AND [HIST

= 99] ) OR ( [HISTSURG = 95] AND [HIST = 99] ) OR ( [HISTSURG = 96] AND [HIST = 99] ) OR [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99]

14 Inserted New QPI – Stereotactic Ablative Radiotherapy (SABR) in Inoperable Stage I Lung Cancer

15 Inserted New QPI – Pre-treatment Diagnosis

16 Inserted New QPI – Brain Imaging


13 (Update to Query 1127) Changes made in March ‘16 to Chemoradiotherapy in specification (i), Numerator (i) now also made to Chemoradiotherapy in specification (ii), Numerator (ii). (Update to Query 1157) Changes made in April ’16 in Specification (ii) Numerator (ii) Radical Radiotherapy corrected from 30-days to 90-days

QPI Summary of changes (excluding formatting changes) (April 2016)

13

(Query 1157) Spec (i) & (ii) Num (i) & (ii) Radical Radiotherapy amended from [DOD – RCOMPDATE1 ≤ 90]) OR ([RADIOTYPE2 = 2] AND [DOD – RCOMPDATE2

≤ 90]) AND ([RADIOTYPE3 = 2] AND [DOD – RCOMPDATE3 ≤ 90])) AND [DOD <> 10/10/1010] to ((RADIOTYPE1 = 2 AND [DOD – RCOMPDATE1 ≤

30]) OR ([RADIOTYPE2 = 2 AND [DOD – RCOMPDATE2 ≤ 30]) OR ([RADIOTYPE3 = 2 AND [DOD – RCOMPDATE3 ≤ 30])) AND [DOD <> 10/10/1010]

QPI Summary of changes (excluding formatting changes) (March 2016)

13

(Query 1127) Spec (i) Num (i) amended to Radical Radiotherapy [DOD – RCOMPDATE1 ≤ 30]) AND([RADIOTYPE2 = 2] OR [DOD – RCOMPDATE2 ≤ 30]) AND ([RADIOTYPE3 = 2] OR [DOD – RCOMPDATE3 ≤ 30])) AND [DOD <> 10/10/1010] Adjuvant Chemotherapy (([CHEMTYPE1 = 2] AND [DOD - CHEMENDATE1 ≤ 30]) OR ([CHEMTYPE2 = 2] AND [DOD – CHEMENDATE2 ≤ 30]) OR ([CHEMOTYPE3 = 2] AND [DOD – CHEMENDATE3 ≤ 30])) AND [DOD <> 10/10/1010] Chemoradiotherapy (([CHEMTYPE1 = 5] AND [DOD – RCOMPDATE1 ≤ 30]) OR ([CHEMTYPE2 = 5] AND [DOD – RCOMPDATE2 ≤ 30]) OR ([CHEMOTYPE3 = 5] AND [DOD – RCOMPDATE3 ≤ 30])) AND [DOD <> 10/10/1010] Palliative Chemotherapy (([CHEMTYPE1 = 4] AND [DOD - CHEMENDATE1 ≤ 30]) OR ([CHEMTYPE2 = 4] AND [DOD – CHEMENDATE2 ≤ 30]) OR ([CHEMOTYPE3 = 4] AND [DOD – CHEMENDATE3 ≤ 30])) AND [DOD <> 10/10/1010] Biological Therapy (([CHEMTYPE1 = 7] AND [DOD - CHEMDATE1 ≤ 30]) OR ([CHEMTYPE2 = 7] AND [DOD – CHEMDATE2 ≤ 30]) OR ([CHEMOTYPE3 = 7] AND [DOD – CHEMDATE3 ≤ 30])) AND [DOD <> 10/10/1010]

QPI Summary of changes (excluding formatting changes) (November 2015)

12

(Query 1060) Denominator amended to (ii) [ORIGIN = 1] AND [HISTSURG = 21 OR 32] OR ( [HISTSURG = 8 OR 95 OR 96 OR 99] AND [HIST = 21 OR 32] ) AND ( [RADIOTYPE1 <> 2 OR 6] AND [CHEMTYPE1 <> 5] AND [SURGTYPE <> 1 OR 2 OR 3 OR 4] ) AND [MODE1 <> 94] AND [CHEMTYPE1 <> 95] AND [TRIAL <> 1] And to NR DEN(ii) ( [HISTSURG = 99] AND [HIST = 99] ) OR ( [HISTSURG = 95] AND [HIST = 99] ) OR ( [HISTSURG = 96] AND [HIST = 99] ) OR ([RADIOTYPE1 <> 2 OR 6] AND [CHEMTYPE1 <> 5] AND SURGTYPE = 99]) OR ([CHEMTYPE1 <> 5] AND [SURGTYPE <> 1 OR 2 OR 3 OR 4] AND [RADIOTYPE1 = 99]) OR ([RADIOTYPE1 <> 2 OR 6] AND [SURGTYPE <> 1 OR 2 OR 3 OR 4] AND [CHEMTYPE1 = 99])

QPI Summary of changes (excluding formatting changes) (August 2015)

2 Denominator (i) amend [HISTSURG = 95] AND [HIST = 95] to [HISTSURG = 95] OR [HIST = 95] text to be 'AND Histology/Cytology Following Surgery OR Histology/Cytology not coded as Patients who Refuse Investigations'

QPI Summary of changes (excluding formatting changes) (June 2015)

1 Numerator amended to Date Discussed by Care Team (MDT) not coded as not applicable; AND Date Discussed by Care Team (MDT) is before or equal to Date of Definitive Treatment OR Date of Definitive Treatment is equal to not applicable.[MDTDATE <> 10/10/1010] AND ([MDTDATE ≤ DEFTREATDATE]


OR [DEFTREATDATE = 10/10/1010])

2

Description – numerical order; Num(ii) added ‘or Other specific non-small cell carcinomas; [HISTSURG = OR 14], or Other specific non-small cell carcinomas’ [HIST = OR 14-; Num(iii) added adenocarcinoma; Den (iii) added adenocarcinoma, deleted Patients with squamous cell NSCLC), NSCLC, not otherwise specified (NOS), Other specific non-small cell carcinomas, Combination of non-small cell components, NSCLC, not otherwise specified (NOS), Other specific non-small cell carcinomas, Combination of non-small cell components.- HISTSURG [OR 13 OR 14 OR 31], HIST [OR 13 OR 14 OR 31]

3 Num add on or before Date of Bronchoscopy - ≤ BDATE

5

Description and Num add undergoing treatment with curative intent (radical radiotherapy, radical chemoradiotherapy or surgical resection); Den added undergoing treatment with curative intent (radical radiotherapy, radical chemoradiotherapy or surgical resection), change treatment to investigation, add AND Radiotherapy Course Type coded as Radical or chemoradiotherapy; OR Type of Systemic Anti-Cancer Therapy coded as Chemoradiotherapy; OR Definitive Surgery Performed {Lung Cancer} coded as Pneumonectomy, Lobectomy, Wedge, Segmental; AND Mediastinal/SCF Sampling Results, delete Type of First Cancer Treatment, change all therapies to investigation; add AND ( [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 2 OR 6] OR [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 5] OR [SURGTYPE = 1 OR 2 OR 3 OR 4] ) change MODE1 to MEDSAMP; NR Exc change [MODE1 – 99] to [MEDSAMP = 99]; NR DEN add OR ([RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99 OR <> 2 OR 6] AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99 OR <> 5] AND SURGTYPE = 99]) OR ([CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99 OR <> 5] AND [SURGTYPE = 99 OR <> 1 OR 2 OR 3 OR 4] AND [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99]) OR ([RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99 OR <> 2 OR 6] AND [SURGTYPE = 99 OR <> 1 OR 2 OR 3 OR 4] AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99])

7 QPI7 replaced with new measurability

8

Num change Radiotherapy Dose: Total Administered {Cancer} 1-3 greater than or equal to 54 to Radiotherapy course type coded as Radical, or Chemoradiotherapy – TOTDOSE to RADIOTYPE; Den add and Patients with stage IV (M1a or M1b) disease, AND TNM Metastases Classification (clinical) not coded as M1, M1a or M1b. - AND [MLUNG <> M1 OR M1A OR M1B]; NR NUM change TOTDOSE to RADIOTYPE; NR EXC add OR [MLUNG = 99]

9

DEN delete ‘and Patients receiving Stereotactic radiotherapy) and AND NOT (Radiotherapy Fractions: Total Administered {Cancer} 1-3 = 50Gy AND Radiotherapy Fractions: Total Administered {Cancer} 1-3 = 3-8) - OR ( [TOTDOSE1 > 50] AND [FRACTIONS1 = 3 OR 4 OR 5 OR 6 OR 7 OR 8] ) OR ( [TOTDOSE2 > 50] AND [FRACTIONS2 = 3 OR 4 OR 5 OR 6 OR 7 OR 8] ) OR ( [TOTDOSE3 > 50] AND [FRACTIONS3 = 3 OR 4 OR 5 OR 6 OR 7 OR 8] ) )

10

NUM delete AND Radiotherapy Dose: Total Administered {Cancer} 1-3 is greater than or equal to 40Gy - AND [TOTDOSE1 ≥ 40 OR TOTDOSE2 ≥ 40 OR TOTDOSE3 ≥ 40]; NR NUM delete OR [TOTDOSE1 OR TOTDOSE2 OR TOTDOSE3 = 999.999]; NR DEN change OR [CTLUNG <> 99] OR [CNLUNG <> 99] to OR [CTLUNG = 99] OR [CNLUNG = 99]

11 NR DEN change [PSTATUS =99] to [PSTATUS =9]

12

Num(i) change are receiving to receive first line, delete Type of Systemic Anti-Cancer Therapy (SACT) 2-3, add Neoadjuvant, Adjuvant, Chemoradiotherapy – delete OR CHEMTYPE 2 OR CHEMTYPE3 , add [CHEMTYPE 1 = 1 OR 2 OR 4 OR 5]; DEN(i) delete OR CHEMTYPE2 OR CHEMTYPE3; add Num(ii); add DEN(ii); NR NUM add (i) and (II) delete OR CHEMTYPE2 OR CHEMTYPE3); NR DEN add (ii); the wording ‘with palliative intent’ removed.

13

Change Heading to Mortality following treatment for lung cancer; add ‘and 90 day’ to title and description; Specification(i)Num(i) change to Chemoradiotherapy(([CHEMTYPE1 = 5] AND [DOD – RCOMPDATE1 ≤ 30]) AND ([CHEMTYPE2 = 5] AND [DOD – RCOMPDATE2 ≤ 30]) AND ([CHEMOTYPE3 = 5] AND [DOD – RCOMPDATE3 ≤ 30])) AND [DOD <> 10/10/1010]; DEN(i) delete (Excluding patients receiving palliative radiotherapy), Chemoradiotherapy change OR [RADIOTYPE1 OR RADIOTYPE2 to AND [RADIOTYPE1 OR RADIOTYPE2; add Specification(ii); add NR NUM (ii); NR Exclusion change Surgery, Adjuvant Chemotherapy, Chemoradiotherapy, and Palliative Chemotherapy/ Biological Therapy [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99] NB Not recorded for RADIOTYPE1-3 excluded from denominator for Radical Radiotherapy to n/a; add NR DEN(ii);

QPI Summary of changes (excluding formatting changes) (September 2014)

2 NR for denominator should be changed to: ( [HISTSURG = 99] AND [HIST = 99] ) OR ( ([TLUNG = 99] OR [NLUNG = 99]) AND [MLUNG <> M1 OR M1A OR M1B] ) OR ( [MLUNG=99] )


9 the Numerator and Denominator > 54Gy should be ≥ 54Gy as stated in the QPI documentation

11 NR for denominator should be changed to: [HIST = 99] OR [PSTATUS = 99] OR [SURGTYPE = 99 ] OR ( ([TLUNG = 99] OR [NLUNG = 99]) AND [MLUNG <> M1 OR M1A OR M1B] ) OR ( [MLUNG=99] )

QPI Summary of changes (excluding formatting changes) (July 2014)

1 Amended MDT QPI.

2 ‘Not Recorded for Denominator’ removed [ORIGIN = 99] OR as it is not listed in the dataset codes and values. PSTATUS = 99 changed too PSTATUS = 9

3 ‘Not Recorded for Denominator’ removed [ORIGIN = 99] OR as it is not listed in the dataset codes and values.

4

‘Not Recorded for Denominator’ now includes ([HISTSURG = 99] AND [HIST = 99] ) OR ( [HISTSURG = 95] AND [HIST = 99] ) OR ( [HISTSURG = 96] AND [HIST = 99] ) OR ([RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99 OR <> 2 OR 6] AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99 OR <> 5] AND SURGTYPE = 99]) OR ([CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99 OR <> 5] AND [SURGTYPE = 99 OR <> 1 OR 2 OR 3 OR 4] AND [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99]) OR ([RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99 OR <> 2 OR 6] AND [SURGTYPE = 99 OR <> 1 OR 2 OR 3 OR 4] AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99])

5 ‘Not Recorded for Denominator’ removed [ORIGIN = 99] OR as it is not listed in the dataset codes and values.

6 ‘Not Recorded for Denominator’ removed [ORIGIN = 99] OR as it is not listed in the dataset codes and values, SURGTYPE = 99 added to NR Numerator (i) and NR Exclusion (i) and remove from NR Denominator (i)

7 ‘Not Recorded for Denominator’ removed [ORIGIN = 99] OR as it is not listed in the dataset codes and values, Amended NR Denominator from AND SURGTYPE = 99 to OR SURGTYPE = 99

8 Removed carcinoid tumour from ‘Denominator’ - ‘Not Recorded for Denominator’ removed [ORIGIN = 99] OR as it is not listed in the dataset codes and values.

9

AND Radiotherapy Course Type (1-3) coded as 94 or 95; AND ([RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 <> 94 OR 95]) AND added to ‘Denominator’ - ‘Not Recorded for Denominator’ removed [ORIGIN = 99] OR as it is not listed in the dataset codes and values, and amended fields CTLUNG, CNLUNG, CMLUNG to TLUNG, NLUNG, MLUNG; SACT1-3 removed as not specified in denominator criteria. Numerator; CHEMTYPE removed as RADIOTYPE = chemoradiotherapy. Not Recorded for Numerator & Not recorded for Exclusion: CHEMTYPE removed as RADIOTYPE = chemoradiotherapy.

10

AND Radiotherapy Dose: Total Administered {Cancer} 1-3 is greater than or equal to 40Gy. AND [TOTDOSE1 ≥ 40 OR TOTDOSE2 ≥ 40 OR TOTDOSE3 ≥ 40] added to ‘Denominator’; in ‘Not recorded for Numerator’ AND changed to OR between TOTDOSE and CHEMAGENT; ‘Not Recorded for Denominator’ removed [ORIGIN = 99] OR as it is not listed in the dataset codes and values, and amended fields CTLUNG, CNLUNG, CMLUNG to TLUNG, NLUNG, MLUNG

11 ‘Not Recorded Exclusion’ TRIAL = 99 not 4; Not Recorded for Denominator’ removed [ORIGIN = 99] OR as it is not listed in the dataset codes and values

12 ‘Not Recorded for Denominator’ removed [ORIGIN = 99] OR as it is not listed in the dataset codes and values, and [HIST = 99] OR

13

‘Not Recorded for Denominator’ removed [ORIGIN = 99] AND as it is not listed in the dataset codes and values. Remove AND [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 <> 3] from Denominator (surgery, adjuvant chemotherapy, chemoradiotherapy and palliative chemotherapy/ biological therapy); amended adjuvant chemotherapy [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 1] to [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 2]

QPI Summary of changes (excluding formatting changes) (April 2014)

1 Inserted new MDT QPI.

2 Previously QPI 1. ‘Not Recorded for Denominator’ for 1(i) updated to include: ( [HISTSURG = 99] AND [HIST = 99] ) OR ( [HISTSURG = 96] AND [HIST = 99] ) OR ( [HISTSURG = 95] AND [HIST = 99] )

3 Previously QPI 2.

4 ‘Not Recorded for Denominator’ now includes: ( [HISTSURG = 99] AND [HIST = 99] ) OR ( [HISTSURG = 96] AND [HIST = 99] ) OR ( [HISTSURG = 95] AND [HIST = 99] )





8 ‘Numerator’ updated to include TOTDOSE ≥ 54, and [TOTDOSE1 OR TOTDOSE2 OR TOTDOSE3 <> 888.888 OR 999.999]. ‘Not Recorded for Numerator’ updated with correct NR value for TOTDOSE.

9 ‘Denominator’ updated to include TOTDOSE ≥ 54 and RADIOTYPE <> patient died before radiotherapy treatment or patient refused radiotherapy treatment.

12 ‘Denominator’ updated to include ‘HISTSURG’ field. ‘Not Recorded for Denominator’ now includes: ( [HISTSURG = 99] AND [HIST = 99] ) OR ( [HISTSURG = 96] AND [HIST = 99] ) OR ( [HISTSURG = 95] AND [HIST = 99] )

13 Numerator and Denominator specification updated to separate all treatment types


QPI 1: Multi-Disciplinary Team (MDT) Meeting

QPI Title: Patients with newly diagnosed lung cancer should be discussed by a multi-disciplinary team prior to definitive treatment.

Description: Proportion of patients with lung cancer who are discussed at MDT meeting before definitive treatment.

Numerator

Number of patients with lung cancer discussed at the MDT before definitive treatment. Date Discussed by Care Team (MDT) not coded as not applicable; AND Date Discussed by Care Team (MDT) is before or equal to Date of Definitive Treatment OR Date of Definitive Treatment is equal to not applicable. [MDTDATE <> 10/10/1010] AND ([MDTDATE ≤ DEFTREATDATE] OR [DEFTREATDATE = 10/10/1010])

Denominator

All patients diagnosed with lung cancer (excluding patients who died before first treatment). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND ‘Origin of Tumour’ is coded as lung carcinoma; AND ‘Type of First Cancer Treatment not coded as Patient died before treatment’. [ORIGIN = 1] AND [MODE1 <> 94]

Not recorded for numerator

Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target [MDTDATE = 09/09/0909] OR [DEFTREATDATE = 09/09/0909]

Not recorded for exclusion

Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard. [MODE1 = 99]

Not recorded for denominator

Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard N/A


QPI 2: Pathological Diagnosis

QPI Title: Where possible patients should have a pathological diagnosis of lung cancer

Description:

Proportion of patients who have a pathological diagnosis of lung cancer. Please note: This QPI measures 3 distinct elements:

i. Patients with lung cancer who have a pathological diagnosis; ii. Patients with a pathological diagnosis of non small cell lung cancer (NSCLC) who have tumour subtype identified; and iii. Patients with a pathological diagnosis of NSCLC who have molecular profiling undertaken.

Specification (i)

Numerator (i)

Number of patients with lung cancer who have a pathological diagnosis (including following surgical resection). Histological/Cytological Diagnosis Following Surgery {Lung Cancer} not coded as Negative histology, Patient refused investigation, Not applicable, OR where Histological/Cytological Diagnosis Following Surgery {Lung Cancer} is not available, Histological/Cytological Diagnosis {Lung Cancer} not coded as Negative histology, Patient refused investigation, Not applicable [HISTSURG <> (8 OR 95 OR 96) ] OR ( [HISTSURG = 96 OR 95 OR 8 OR 99] AND [HIST <> (8 OR 95 OR 96) ] )

Denominator (i)

All patients with lung cancer. (Excluding patients who refuse investigations or surgical resection). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour [ORIGIN] coded as lung carcinoma; AND both Histology/Cytology Following Surgery OR Histology/Cytology not coded as Patients who Refuse Investigations, OR Definitive Surgery Performed {Lung Cancer} not coded as Patient refused surgery. [ORIGIN = 1] AND NOT ( ( [HISTSURG = 95] OR [HIST = 95] ) OR [SURGTYPE = 95] )

Specification (ii)

Numerator (ii)

Number of patients with a pathological diagnosis of NSCLC who have a tumour subtype identified. Histology/Cytology Following Surgery coded as Squamous or Adenocarcinoma or Other specific non-small cell carcinomas; OR where Histology/Cytology Following Surgery is not available, Histology/Cytology coded as Squamous or Adenocarcinoma or Other specific non-small cell carcinomas [HISTSURG = 11 OR 12 OR 14] OR ( [HISTSURG = 99 OR 96 OR 95 OR 8] AND [HIST = 11 OR 12 OR 14] )

Denominator (ii)

All patients with a pathological diagnosis of NSCLC. (No exclusions)

Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour [ORIGIN] coded as lung carcinoma; AND Histology/Cytology Following Surgery coded as Squamous, Adenocarcinoma, NSCLC, not otherwise specified (NOS), Other specific non-small cell carcinomas, Combination of non-small cell components; OR where Histology/Cytology Following Surgery is not available, Histology/Cytology coded as Squamous, Adenocarcinoma, NSCLC, not otherwise specified (NOS), Other specific non-small cell carcinomas, Combination of non-small cell components ;

[ORIGIN = 1] AND ( [HISTSURG =11 OR 12 OR 13 OR 14 OR 31] OR ( [HISTSURG = 99 OR 96 OR 95 OR 8] AND [HIST=11 OR 12 OR 13 OR 14 OR 31] ) )


Specification (iii)

Numerator (iii)

Number of patients with a pathological diagnosis of stage IIIB, IIIC or IV non-squamous NSCLC who have molecular profiling undertaken.

Epidermal Growth Factor Receptor [EGFR] status coded as Positive or Negative or Inconclusive or Undertaken; AND Oncogenic Anaplastic Lymphoma Kinase [ALK] status coded as Positive or Negative or Inconclusive

[EGFR = 1 OR 2 OR 4 OR 5] AND [ALK = 1 OR 2 OR 4]

Denominator (iii)

All patients with a pathological diagnosis of stage IIIB, IIIC or IV non-squamous NSCLC. (Excluding Patients with performance status 4).

Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung carcinoma; AND Histology/Cytology Following Surgery coded as NSCLC, or where Histology/Cytology Following Surgery is not available, Histology/Cytology coded as non-squamous NSCLC; AND TNM Tumour Classification (Clinical) coded as Stage IIIB or Stage IV; AND WHO/ ECOG Performance Status Not coded as 4 [ORIGIN = 1] AND ( [HISTSURG = OR 12 OR 13 OR 14 OR 31] OR ( [HISTSURG = 8 OR 95 OR 96 OR 99] AND [HIST = OR 12 OR 13 OR 14 OR 31] ) ) AND (([TLUNG = T1 OR T1A OR T1B OR T1C OR T2 OR T2A OR T2B] AND [NLUNG = N3] AND [MLUNG = M0] ) OR ( [TLUNG = T3 OR T4] AND [NLUNG = N2] AND [MLUNG = M0]) OR ([TLUNG = T3 OR T4] AND [NLUNG = N3] AND [MLUNG = M0] ) OR ( [MLUNG = M1 OR M1A OR M1B OR M1C])) AND [PSTATUS <> 4]


Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target (i) ( [HISTSURG = 99] AND [HIST=99] ) (ii) N/A Not recorded for HISTSURG and HIST will be excluded from the denominator for (ii) (iii) [EGFR=99] OR [ALK = 99]


Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard.

(i) ( [HISTSURG = 99] AND [HIST = 99] ) OR [SURGTYPE = 99] (ii) N/A (iii) [PSTATUS = 9]


Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard (i) ( [HISTSURG = 99] AND [HIST = 99] ) OR ( [HISTSURG = 96] AND [HIST = 99] ) OR ( [HISTSURG = 95] AND [HIST = 99] ) (ii) ( [HISTSURG = 99] AND [HIST = 99] ) (iii) ( [HISTSURG = 99] AND [HIST = 99] ) OR ( ([TLUNG = 99] OR [NLUNG = 99]) AND [MLUNG <> M1 OR M1A OR M1B] ) OR ( [MLUNG=99] )


QPI 4: PET CT in Patients Being Treated with Curative Intent

QPI Title: Patients with lung cancer who are being treated with curative intent should have a PET CT Scan (Positron Emission Tomography – Computed Tomography) prior to treatment.

Description: Proportion of patients with non small cell lung cancer (NSCLC) who receive curative treatment (radical radiotherapy, chemoradiotherapy or surgical resection) that undergo PET CT prior to start of treatment.

Numerator:

Number of patients with NSCLC who receive curative treatment (radical radiotherapy, radical chemoradiotherapy or surgical resection) that undergo PET CT prior to start of treatment.

Date of Integrated FDG-PET/CT scan not inapplicable, and on or before Date of First Cancer Treatment

[PETDATE ≤ FIRSTTREATDATE] AND [PETDATE <> 10/10/1010]

Denominator:

All patients with NSCLC who receive curative treatment (radical radiotherapy, radical chemoradiotherapy or surgical resection). (No exclusions). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung carcinoma; AND Histology/Cytology Following Surgery coded as NSCLC, or where Histology/Cytology Following Surgery is not available, Histology/Cytology coded as NSCLC; AND Radiotherapy Course Type coded as Radical or chemoradiotherapy; OR Type of Systemic Anti-Cancer Therapy coded as Chemoradiotherapy; OR Definitive Surgery Performed {Lung Cancer} coded as Pneumonectomy, Lobectomy, Wedge, Segmental. [ORIGIN = 1] AND ( [HISTSURG = 11 OR 12 OR 13 OR 14 OR 31] OR ( [HISTSURG = 8 OR 95 OR 96 OR 99] AND [HIST = 11 OR 12 OR 13 OR 14 OR 31] ) ) AND ( [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 2 OR 6] OR [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 5] OR [SURGTYPE = 1 OR 2 OR 3 OR 4] )


Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target [PETDATE = 09/09/0909] OR [FIRSTTREATDATE = 09/09/0909]


Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard. NA


Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard

([HISTSURG = 99] AND [HIST = 99] ) OR ( [HISTSURG = 95] AND [HIST = 99] ) OR ( [HISTSURG = 96] AND [HIST = 99] ) OR ([RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99 OR <> 2 OR 6] AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99 OR <> 5] AND SURGTYPE = 99]) OR ([CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99 OR <> 5] AND [SURGTYPE = 99 OR <> 1 OR 2 OR 3 OR 4] AND [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99]) OR ([RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99 OR <> 2 OR 6] AND [SURGTYPE = 99 OR <> 1 OR 2 OR 3 OR 4] AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99])


QPI 6: Surgical Resection in non Small Cell Lung Cancer

QPI Title: Patients with non small cell lung cancer (NSCLC) should undergo surgical resection.

Description:

Proportion of patients who undergo surgical resection for NSCLC. Please note: This QPI measures 2 distinct elements:

i. Patients with NSCLC who undergo surgical resection; and ii. Patients with stage I – II NSCLC who undergo surgical resection.

Numerator (i) and (ii):

Number of patients with (i) non small cell lung cancer (NSCLC) and (ii) stage I-II (T1aN0- T2bN1, or T3N0) NSCLC, who undergo surgical resection. Definitive Surgery Performed {Lung Cancer} coded as Pneumonectomy, Lobectomy, Wedge, Segmental [SURGTYPE = 1 OR 2 OR 3 OR 4]

Denominator (i):

All patients with non small cell lung cancer (NSCLC). (Excludes patients who refuse surgery, patients who die before surgery, and patients who undergo stereotactic ablative radiotherapy (SABR)). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung cancer; AND Histology/Cytology Following Surgery coded as NSCLC, or where Histology/Cytology Following Surgery is not available, Histology/Cytology coded as NSCLC; AND Definitive Surgery Performed {Lung Cancer} not coded as Patient refused surgery or Patient died before surgery; AND Stereotactic Ablative Radiotherapy (SABR) not coded as Yes. [ORIGIN = 1] AND ( [HISTSURG = 11 OR 12 OR 13 OR 14 OR 31] OR ( [HISTSURG = 8 OR 95 OR 96 OR 99] AND [HIST = 11 OR 12 OR 13 OR 14 OR 31] ) ) AND [SURGTYPE <> ( 94 OR 95) ] AND [SABR <> 1]

Denominator (ii):

All patients with stage I-II (T1N0-T2bN1,or T3N0) NSCLC. (Excludes patients who refuse surgery, patients who die before surgery, and patients who undergo stereotactic ablative radiotherapy (SABR)). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung cancer; AND Histology/Cytology Following Surgery coded as NSCLC, or where Histology/Cytology Following Surgery is not available, Histology/Cytology coded as NSCLC; AND TNM Tumour Classification (Clinical) coded as Stage 1 or Stage 2; AND Final surgery performed [OPCODE] not coded as patient who refuses surgery or patient who died before surgery; AND Stereotactic Ablative Radiotherapy (SABR) not coded as Yes. [ORIGIN = 1] AND ( [HISTSURG = 11 OR 12 OR 13 OR 14 OR 31] OR ( [HISTSURG = 8 OR 95 OR 96 OR 99] AND [HIST = 11 OR 12 OR 13 OR 14 OR 31] ) ) AND ( ( [TLUNG = T1 OR T1mi OR T1a OR T1b OR T1c OR T2 OR T2a OR T2b] AND [NLUNG = N0 OR N1] AND [MLUNG = M0] ) OR ( [TLUNG = T3] AND [NLUNG = N0] AND [MLUNG = M0] ) ) AND [SURGTYPE <> ( 94 OR 95) ] AND [SABR <> 1]



Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target (i) [SURGTYPE = 99] (ii) [SURGTYPE = 99]


Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard. (i) [SURGTYPE = 99] OR [SABR = 99] (ii) [SURGTYPE = 99] OR [SABR = 99]



(i) [ORIGIN = 99] OR ( [HISTSURG = 99] AND [HIST = 99] ) OR ( [HISTSURG = 95] AND [HIST = 99] ) OR ( [HISTSURG = 96] AND [HIST = 99] )

(ii) ( [HISTSURG = 99] AND [HIST = 99] ) OR ( [HISTSURG = 95] AND [HIST = 99] ) OR ( [HISTSURG = 96] AND [HIST = 99] ) OR [TLUNG = 99] OR [NLUNG = 99] OR [MLUNG = 99]


QPI 7: Lymph Node Assessment

QPI Title: In patients with non small cell lung cancer (NSCLC) undergoing surgery adequate assessment of lymph nodes should be made at time of surgical procedure.

Description: Proportion of patients with NSCLC undergoing surgery who have adequate sampling of lymph nodes (at least 1 node from at least 3 N2 stations) performed at time of primary tumour resection.

Numerator:

Number of patients with NSCLC undergoing surgical resection by lobectomy or pneumonectomy that have at least 1 node from at least 3 N2 stations sampled at time of resection or at previous mediastinoscopy. [N2NODES = 3]

Denominator:

All patients with NSCLC undergoing surgical resection by lobectomy or pneumonectomy. (No exclusions). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung cancer; AND Histology/Cytology Following Surgery coded as NSCLC, or where Histology/Cytology Following Surgery is not available, Histology/Cytology coded as NSCLC; AND Definitive Surgery Performed {Lung Cancer} coded as lobectomy or pneumonectomy. [ORIGIN = 1] AND ( [HISTSURG = 11 OR 12 OR 13 OR 14 OR 31] OR ( [HISTSURG = 8 OR 95 OR 96 OR 99] AND [HIST = 11 OR 12 OR 13 OR 14 OR 31] ) ) AND [SURGTYPE = 1 OR 2]


Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target [N2NODES = 99]


Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard. N/A



( [HISTSURG = 99] AND [HIST = 99] ) OR ( [HISTSURG = 95] AND [HIST = 99] ) OR ( [HISTSURG = 96] AND [HIST = 99] ) OR [SURGTYPE = 99]


QPI 8: Radiotherapy in Inoperable Lung Cancer

QPI Title: Patients with inoperable lung cancer should receive radiotherapy ± chemotherapy, or stereotactic ablative radiotherapy (SABR).

Description: Proportion of patients with lung cancer not undergoing surgery who receive radiotherapy with radical intent (54Gy or greater) ± chemotherapy, or SABR.

Numerator:

Number of patients with lung cancer not undergoing surgery who receive radical radiotherapy (≥ 54Gy) ± chemotherapy, or SABR Radiotherapy course type coded as Radical, Chemoradiotherapy, or Stereotactic Ablative Radiotherapy (SABR) coded as Yes [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 2 OR 6] OR [SABR = 1]

Denominator:

All patients with lung cancer not undergoing surgery. (Excluding Patients with Small Cell Lung Cancer (SCLC), Patients who refuse radiotherapy, Patients who die prior to treatment and Patients with stage IV (M1a, M1b or M1c) disease). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; Origin of Tumour coded as lung cancer; AND Definitive Surgery Performed {Lung Cancer} coded as Inoperable, Patient refused surgery, or Not applicable; AND Histological/Cytological Diagnosis {Lung Cancer} not coded as Small cell carcinoma (SCLC), or Small cell/non-small cell components; AND Radiotherapy Course Type 1-3 not coded as Patient refused radiotherapy treatment , or Patient died before radiotherapy treatment; AND TNM Metastases Classification (clinical) not coded as M1, M1a, M1b OR M1c. [ORIGIN = 1] AND [SURGTYPE = 6 OR 95 OR 96 ] AND [HIST <> 21 OR 32] AND [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 <> ( 94 OR 95) ] AND [MLUNG <> M1 OR M1A OR M1B OR M1C]


Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99] OR [SABR = 99]


Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard. [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3=99] OR [HIST = 99] OR [MLUNG = 99] NB SURGTYPE = 99 excluded from denominator


Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard [SURGTYPE = 99 ]


QPI 9: Chemoradiotherapy in Locally Advanced Non Small Cell Lung Cancer

QPI Title: Patients with inoperable locally advanced non small cell lung cancer (NSCLC) should receive potentially curative radiotherapy and concurrent or sequential chemotherapy.

Description: Proportion of patients with NSCLC not undergoing surgery who receive radical radiotherapy, to 54Gy or greater, and concurrent or sequential chemotherapy.

Numerator:

Number of patients with stage IIIA NSCLCa with performance status 0-1, not undergoing surgery who receive chemoradiotherapy (radiotherapy

≥ 54Gy and concurrent or sequential chemotherapy). Radiotherapy Course Type 1-3 coded as Chemoradiotherapy

[RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 6]

Denominator:

All patients with stage IIIAa NSCLC, with performance status 0-1, not undergoing surgery who receive radical radiotherapy ≥ 54Gy.

(Excludes

Patients who refuse treatment, Patients who die before treatment, Patients receiving Continuous Hyperfractionated Radiotherapy).

Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; Origin of Tumour coded as lung cancer; AND Histology/Cytology coded as NSCLC; AND WHO/ECOG Performance Status coded as 0 or 1; AND Definitive Surgery Performed {Lung Cancer} coded as Inoperable, or Not applicable; AND TMN Tumour Classification (Clinical) coded as Stage IIIA; Radiotherapy Course Type (1-3) coded as Radical; AND Radiotherapy Course Type (1-3) coded as 94 or 95; AND NOT (Radiotherapy Fractions: Total Administered {Cancer} 1-3 = 54Gy AND Radiotherapy Fractions: Total Administered {Cancer} 1-3 = 36)

[ORIGIN = 1] AND [HIST = 11 OR 12 OR 13 OR 14 OR 31] AND [PSTATUS = 0 OR 1] AND [SURGTYPE = 6 OR 96] AND ( ( [TLUNG = T1 OR T1a OR T1b OR T1c OR T2 OR T2a OR T2b] AND [NLUNG = N2] AND [MLUNG = M0] ) OR ( [TLUNG = T3] AND [NLUNG = N1] AND [MLUNG = M0] ) OR ( [TLUNG = T4] AND [NLUNG = N0 OR N1] AND [MLUNG = M0] ) ) AND ( [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 2 OR 6] ) AND ([RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 <> 94 OR 95]) AND NOT ( ( [TOTDOSE1 = 54] AND [FRACTIONS1 = 36] ) OR ( [TOTDOSE2 = 54] AND [FRACTIONS2 = 36] ) OR ( [TOTDOSE3 = 54] AND [FRACTIONS3 = 36] )

a Stage IIIA includes: T1a-c, T2a,b N2 M0; T3, N1 M0 ; T4 N0, N1 M0



Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target

NB Not recorded for RADIOTYPE will be excluded from denominator


Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard. [TOTDOSE1 OR TOTDOSE2 OR TOTDOSE3 = 999.999] OR [FRACTIONS1 OR FRACTIONS2 OR FRACTIONS3 = 99] NB Not recorded for RADIOTYPE and SURGTYPE will be excluded from denominator



[HIST = 99] OR [PSTATUS = 99] OR [SURGTYPE = 99 ] OR [TLUNG = 99] OR [NLUNG = 99] OR [MLUNG = 99] OR [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99]


QPI 10: Chemoradiotherapy in Limited Stage Small Cell Lung Cancer

QPI Title: Patients with limited stage small cell lung cancer (SCLC) should receive platinum-based chemotherapy and (concurrent or sequential) radiotherapy.

Description:

Proportion of patients with limited stage (stage I – IIIB)*b SCLC treated with radical intent who receive both platinum-based chemotherapy, and

radiotherapy to 40Gy or greater. * Patients with TxN1-3Mo disease will be included within the measurement of this QPI.

Numerator:

Number of patients with T1-4, N0-3, M0 (stage I to IIIB)b SCLC, performance status 0 or 1 who receive chemoradiotherapy (radiotherapy >

40Gy and concurrent or sequential platinum-based chemotherapy). Radiotherapy Course Type 1-3 coded as Chemoradiotherapy; OR Type of Systemic Anti-Cancer Therapy (SACT) 1-3 coded as Chemoradiotherapy; AND Systemic Therapy Agent 1-3 {Lung Cancer} coded as Cisplatin/Vinorelbine palliative and neoadjuvant, Carboplatin/Vinorelbine, Carboplatin/Gemcitabine, Cisplatin/Etoposide, Cisplatin/Docetaxel, Cisplatin/Gemcitabine, Carboplatin/Etoposide, Carboplatin single agent, Cisplatin/Pemetrexed, Carboplatin/Pemetrexed, Carboplatin/paclitaxel,

[RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 6] AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 5] AND [CHEMAGENT1 OR CHEMAGENT2 OR CHEMAGENT3 = 1 OR 2 OR 3 OR 5 OR 6 OR 7 OR 11 OR 12 OR 15 OR 17 OR 18]

Denominator:

All patients with T1-4, N0-3, M0 (stage I to IIIB) SCLC, performance status 0 or 1. (Excludes Patients who refuse treatment, Patients who die before treatment, and Patients who undergo surgical resection.).

Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung cancer; AND Histology/Cytology coded as SCLC; AND WHO/ ECOG Performance Status coded as 0 or 1; AND TMN Tumour Classification (Clinical) coded as Stage I to IIIB; AND Type of First Cancer Treatment not coded as Patient Refused All Treatment or Patient died prior to Treatment); AND Definitive Surgery Performed {Lung Cancer} not coded as Pneumonectomy, Lobectomy, Wedge, Segmental

[ORIGIN = 1] AND [HIST = 21 OR 32] AND [PSTATUS = 0 OR 1] AND [TLUNG <> T0] AND ([TLUNG <> TX] AND [NLUNG = N0]) AND [NLUNG <> Nx] AND [MLUNG = M0] AND [MODE1 <> 94 OR 95] AND [SURGTYPE <> 1 OR 2 OR 3 OR 4]


Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99] OR [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99] OR [CHEMAGENT1 OR CHEMAGENT2 OR CHEMAGENT3 = 99]


Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard. [MODE1 = 99] OR [SURGTYPE = 99]



[HIST = 99] OR [PSTATUS = 99] OR [TLUNG = 99] OR [NLUNG = 99] OR [MLUNG = 99]

b Patients with TxN1-3Mo disease will be included within the measurement of this QPI.


QPI 11: Systemic Anti Cancer Therapy in Non Small Cell Lung Cancer

QPI Title: Patients with non small cell lung cancer (NSCLC) should receive systemic anti cancer therapy, where appropriate.

Description:

Proportion of patients with NSCLC not undergoing surgery who receive chemotherapy or biological therapy where appropriate. Please note: This QPI measures two distinct elements:

i. Patients with NSCLC who receive systemic anti cancer therapy (SACT); and ii. Patients with stage IIIB, IIIC and IV NSCLC that are EGFR or ALK positive who receive biological therapy.

Specification (i)

Numerator (i)

Number of patients with NSCLC not undergoing surgery who receive systemic anti cancer therapy Type of Systemic Anti-Cancer Therapy (SACT) 1-3 not coded as Not applicable [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 1 or 2 or 4 or 5 or 7]

Denominator (i)

All patients with NSCLC not undergoing surgery. (Excludes Patients who refuse chemotherapy, and Patients who die before treatment). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; Origin of Tumour coded as lung cancer; AND Histology/Cytology coded as NSCLC; AND Definitive Surgery Performed {Lung Cancer} coded as Inoperable, or Not applicable; AND Type of First Cancer Treatment not coded as Patient died prior to Treatment, AND Type of Systemic Anti-Cancer Therapy (SACT) 1-3 not coded as Patient refused SACT Treatment. [ORIGIN = 1] AND [HIST = 11 OR 12 OR 13 OR 14 OR 31] AND [SURGTYPE = 6 OR 96 ] AND [MODE1 <> 94] AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 <> 95]

Specification (ii)

Numerator (ii)

Number of patients with stage IIIB, IIIC or IV NSCLC, with performance status 0-2 not undergoing surgery that are EGFR / ALK positive who receive biological therapy. Type of Systemic Anti Cancer Therapy 1-3 coded as biological therapy [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 7]


Denominator (ii)

All patients with stage IIIB, IIIC or IV NSCLC, with performance status 0-2 not undergoing surgery that are EGFR or ALK positive (Excludes Patients who refuse SACT treatment, Patients who die before treatment, and Patients who are participating in clinical trials). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung cancer; AND Histology/Cytology coded as NSCLC; AND WHO/ ECOG Performance Status coded as 0 or 1 or 2; AND Definitive Surgery Performed {Lung Cancer} coded as Inoperable, or Not applicable; AND Epidermal Growth Factor Receptor (EGFR) status coded as positive; OR Oncogenic Anaplastic Lymphoma Kinase (ALK) status coded as positive; AND Type of First Cancer Treatment not coded as Patient died prior to Treatment; AND Type of Systemic Anti-Cancer Therapy (SACT) 1-3 not coded as Patient refused SACT Treatment; AND Patient Entered into Clinical Trial not coded as Yes; AND TMN Tumour Classification (Clinical) coded as Stage IIIB, IIIC or IV; [ORIGIN = 1] AND [HIST = 11 OR 12 OR 13 OR 14 OR 31] AND [PSTATUS = 0 OR 1 OR 2] AND [SURGTYPE = 6 OR 96 ] AND ([EGFR = 1] OR [ALK = 1]) AND [MODE1 <> 94 ] AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 <> 95] AND [TRIAL <> 1] AND (([TLUNG = T1 OR T1A OR T1B OR T1C OR T2 OR T2A OR T2B] AND [NLUNG = N3] AND [MLUNG = M0] ) OR ( [TLUNG = T3 OR T4] AND [NLUNG = N2] AND [MLUNG = M0]) OR ([TLUNG = T3 OR T4] AND [NLUNG = N3] AND [MLUNG = M0] OR [MLUNG = M1 OR M1A OR M1B OR M1C] )


Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target (i) and (ii) [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99]


Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard. (i) [MODE1 = 99] OR [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99] (ii) [MODE1 = 99] OR [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99] OR [TRIAL = 99]


Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard (i) [HIST = 99] OR [SURGTYPE = 99 ] (ii) [HIST = 99] OR [PSTATUS = 9] OR [SURGTYPE = 99 ] OR ( ([TLUNG = 99] OR [NLUNG = 99]) AND [MLUNG <> M1 OR M1A OR M1B OR M1C] ) OR

([MLUNG=99] ) OR ([EGFR = 99] AND [ALK = 99])


QPI 12: Chemotherapy in Small Cell Lung Cancer

QPI Title: Patients with small cell lung cancer (SCLC) should receive chemotherapy

Description: Proportion of patients with SCLC who receive first line chemotherapy ± radiotherapy

Specification (i)

Numerator (i)

Number of patients with SCLC who receive chemotherapy ± radiotherapy. Type of Systemic Anti-Cancer Therapy (SACT) 1 coded as Neoadjuvant, Adjuvant, Chemoradiotherapy, or Palliative [CHEMTYPE1 = 1 OR 2 OR 4 OR 5]

Denominator (i)

All patients with SCLC. (Excludes Patients who refuse chemotherapy, Patients who die before treatment, and Patients who are participating in clinical trials). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung cancer; AND Histology/Cytology Following Surgery coded as SCLC, or where Histology/Cytology Following Surgery is not available, Histology/Cytology coded as SCLC; AND Type of First Cancer Treatment not coded as Patient died prior to Treatment; AND Type of Systemic Anti-Cancer Therapy (SACT) 1 not coded as Patient refused SACT Treatment; AND Patient Entered into Clinical Trial not coded as Yes. [ORIGIN = 1] AND [HISTSURG = 21 OR 32] OR ( [HISTSURG = 8 OR 95 OR 96 OR 99] AND [HIST = 21 OR 32] ) AND [MODE1 <> 94] AND [CHEMTYPE1 <> 95] AND [TRIAL <> 1]

Specification (ii)

Numerator (ii)

Number of patients with SCLC not undergoing treatment with curative intent who receive palliative chemotherapy. Type of Systemic Anti-Cancer Therapy (SACT) 1 coded as Palliative [CHEMTYPE1 = 4]

Denominator (ii)

All patients with SCLC not undergoing treatment with curative intent (Excludes: Patients who refuse chemotherapy; Patients who die prior to treatment; and Patients who are participating in clinical trials). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung cancer; AND Histology/Cytology Following Surgery coded as SCLC, or where Histology/Cytology Following Surgery is not available OR Histology/Cytology coded as SCLC; AND Radiotherapy Course Type not coded as Radical or chemoradiotherapy; AND Type of Systemic Anti-Cancer Therapy not coded as Chemoradiotherapy; AND Definitive Surgery Performed {Lung Cancer} not coded as Pneumonectomy, Lobectomy, Wedge, Segmental AND Type of First Cancer Treatment not coded as Patient died prior to Treatment; AND Type of Systemic Anti-Cancer Therapy (SACT) 1 not coded as Patient refused SACT Treatment; AND Patient Entered into Clinical Trial not coded as Yes. [ORIGIN = 1] AND [HISTSURG = 21 OR 32] OR ( [HISTSURG = 8 OR 95 OR 96 OR 99] AND [HIST = 21 OR 32] ) AND ( [RADIOTYPE1 <> 2 OR 6] AND [CHEMTYPE1 <> 5] AND [SURGTYPE <> 1 OR 2 OR 3 OR 4] ) AND [MODE1 <> 94] AND [CHEMTYPE1 <> 95] AND [TRIAL <> 1]



Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target (i) and (ii) [CHEMTYPE1 = 99]


Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard. (i) and (ii) [MODE1 = 99] OR [CHEMTYPE1 = 99] OR [TRIAL = 99]


Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard (i) ( [HISTSURG = 99] AND [HIST = 99] ) OR ( [HISTSURG = 95] AND [HIST = 99] ) OR ( [HISTSURG = 96] AND [HIST = 99] ) (ii) ( [HISTSURG = 99] AND [HIST = 99] ) OR ( [HISTSURG = 95] AND [HIST = 99] ) OR ( [HISTSURG = 96] AND [HIST = 99] ) OR ([RADIOTYPE1 <> 2 OR 6] AND [CHEMTYPE1 <> 5] AND [SURGTYPE = 99]) OR ([CHEMTYPE1 <> 5] AND [SURGTYPE <> 1 OR 2 OR 3 OR 4] AND [RADIOTYPE1 = 99]) OR ([RADIOTYPE1 <> 2 OR 6] AND [SURGTYPE <> 1 OR 2 OR 3 OR 4] AND [CHEMTYPE1 = 99])


QPI 13: Mortality following treatment for lung cancer

QPI Title: 30 and 90 day mortality following treatment for lung cancer.

Description:

Proportion of patients with lung cancer who die within 30 or 90 days of active treatment* for lung cancer. *Active treatment includes:

Surgery

Radical radiotherapy (> 54Gy)

Adjuvant Chemotherapy

Chemoradiotherapy

Palliative Chemotherapy

Biological Therapy

Specification (i)

Numerator (i)

Number of patients with lung cancer who receive active treatment* who die within 30 days of treatment*.

Date of Death is not coded as inapplicable and is within 30 days of date of active treatment [either – DSURG / RCOMPDATE / CHEMENDATE ]

Surgery

[DOD – DSURG ≤ 30] AND [DOD <> 10/10/1010]

Radical Radiotherapy

((RADIOTYPE1 = 2 AND [DOD – RCOMPDATE1 ≤ 30]) OR ([RADIOTYPE2 = 2 AND [DOD – RCOMPDATE2 ≤ 30]) OR

([RADIOTYPE3 = 2 AND [DOD – RCOMPDATE3 ≤ 30])) AND [DOD <> 10/10/1010]

Adjuvant Chemotherapy

(([CHEMTYPE1 = 2] AND [DOD - CHEMENDATE1 ≤ 30]) OR ([CHEMTYPE2 = 2] AND [DOD – CHEMENDATE2 ≤ 30]) OR

([CHEMOTYPE3 = 2] AND [DOD – CHEMENDATE3 ≤ 30])) AND [DOD <> 10/10/1010] Chemoradiotherapy

(([CHEMTYPE1 = 5] AND [DOD – RCOMPDATE1 ≤ 30]) OR ([CHEMTYPE2 = 5] AND [DOD – RCOMPDATE2 ≤ 30]) OR

([CHEMOTYPE3 = 5] AND [DOD – RCOMPDATE3 ≤ 30])) AND [DOD <> 10/10/1010] Palliative Chemotherapy

(([CHEMTYPE1 = 4] AND [DOD - CHEMENDATE1 ≤ 30]) OR ([CHEMTYPE2 = 4] AND [DOD – CHEMENDATE2 ≤ 30]) OR

([CHEMOTYPE3 = 4] AND [DOD – CHEMENDATE3 ≤ 30])) AND [DOD <> 10/10/1010]

Biological Therapy

(([CHEMTYPE1 = 7] AND [DOD - CHEMDATE1 ≤ 30]) OR ([CHEMTYPE2 = 7] AND [DOD – CHEMDATE2 ≤ 30]) OR

([CHEMOTYPE3 = 7] AND [DOD – CHEMDATE3 ≤ 30])) AND [DOD <> 10/10/1010]

Denominator (i)

All patients with lung cancer who receive active treatment.

Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung cancer; AND Active treatment for each treatment type [either – SURGTYPE OR RADIOTYPE1-3 OR CHEMTYPE1-3].


Surgery [ORIGIN = 1] AND [SURGTYPE = 1 OR 2 OR 3 OR 4 OR 5 OR 98]

Radical Radiotherapy [ORIGIN = 1] AND [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 2]

Adjuvant Chemotherapy [ORIGIN = 1] AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 2]

Chemoradiotherapy [ORIGIN = 1] AND ( [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 5] AND [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 6] )

PALLIATIVE CHEMOTHERAPY AND BIOLOGICAL THERAPY TO BE SPLIT FOR NSCLC and SCLC

Palliative Chemotherapy NSCLC Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung cancer; AND Histology/Cytology Following Surgery coded as NSCLC, or where Histology/Cytology Following Surgery is not available, Histology/Cytology coded as NSCLC; AND Type of Systemic Anti-Cancer Therapy coded as Palliative.

[ORIGIN = 1] AND ( [HISTSURG = 11 OR 12 OR 13 OR 14 OR 31] OR ( [HISTSURG = 8 OR 95 OR 96 OR 99] AND [HIST = 11 OR 12 OR 13 OR 14 OR 31] ) ) AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 4] Palliative Chemotherapy SCLC Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung cancer; AND Histology/Cytology Following Surgery coded as SCLC, or where Histology/Cytology Following Surgery is not available, Histology/Cytology coded as SCLC; AND Type of Systemic Anti-Cancer Therapy coded as Palliative. [ORIGIN = 1] AND [HISTSURG = 21 OR 32] OR ( [HISTSURG = 8 OR 95 OR 96 OR 99] AND [HIST = 21 OR 32] ) AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 4] Biological Therapy NSCLC Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung cancer; AND Histology/Cytology Following Surgery coded as NSCLC, or where Histology/Cytology Following Surgery is not available, Histology/Cytology coded as NSCLC; AND Type of Systemic Anti-Cancer Therapy coded as Biological therapy. [ORIGIN = 1] AND ( [HISTSURG = 11 OR 12 OR 13 OR 14 OR 31] OR ( [HISTSURG = 8 OR 95 OR 96 OR 99] AND [HIST = 11 OR 12 OR 13 OR 14 OR 31] ) ) AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 7] Biological Therapy SCLC Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung cancer; AND Histology/Cytology Following Surgery coded as SCLC, or where Histology/Cytology Following Surgery is not available, Histology/Cytology coded as SCLC; AND Type of Systemic Anti-Cancer Therapy coded as Biological therapy. [ORIGIN = 1] AND [HISTSURG = 21 OR 32] OR ( [HISTSURG = 8 OR 95 OR 96 OR 99] AND [HIST = 21 OR 32] ) AND


[CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 7]

Specification (ii)

Numerator (ii)

Number of patients with lung cancer who receive treatment with curative intent (surgery, radical radiotherapy or chemoradiotherapy) who die within 90 days of treatment.

Date of Death is not coded as inapplicable and is within 90 days of date of active treatment [either – DSURG / RCOMPDATE / CHEMENDATE]

Surgery

[DOD – DSURG ≤ 90] AND [DOD <> 10/10/1010]

Radical Radiotherapy

((RADIOTYPE1 = 2 AND [DOD – RCOMPDATE1 ≤ 90]) OR ([RADIOTYPE2 = 2 AND [DOD – RCOMPDATE2 ≤ 90]) OR

([RADIOTYPE3 = 2 AND [DOD – RCOMPDATE3 ≤ 90])) AND [DOD <> 10/10/1010] Chemoradiotherapy

(([CHEMTYPE1 = 5] AND [DOD – RCOMPDATE1 ≤ 90]) OR ([CHEMTYPE2 = 5] AND [DOD – RCOMPDATE2 ≤ 90]) OR

([CHEMOTYPE3 = 5] AND [DOD – RCOMPDATE3 ≤ 90])) AND [DOD <> 10/10/1010]

Denominator (ii)

All patients with lung cancer who receive treatment with curative intent (surgery, radical radiotherapy or chemoradiotherapy).

Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour coded as lung cancer; AND Active treatment for each treatment type [either – SURGTYPE OR RADIOTYPE1-3 OR CHEMTYPE1-3].

Surgery [ORIGIN = 1] AND [SURGTYPE = 1 OR 2 OR 3 OR 4 OR 5 OR 98]

Radical Radiotherapy [ORIGIN = 1] AND [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 2]

Chemoradiotherapy [ORIGIN = 1] AND ( [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 5] AND [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 6] )

Not recorded for numerator (i)

Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target Surgery [DOD = 09/09/0909] OR [DSURG = 09/09/0909] Radical Radiotherapy [DOD = 09/09/0909] OR [RCOMPDATE = 09/09/0909] Adjuvant Chemotherapy


[DOD = 09/09/0909] OR [CHEMENDATE1 = 09/09/0909] Chemoradiotherapy [DOD = 09/09/0909] OR [RCOMPDATE = 09/09/0909] Palliative Chemotherapy [DOD = 09/09/0909] OR [CHEMENDATE1 = 09/09/0909] Biological Therapy [DOD = 09/09/0909] OR [CHEMDATE1 = 09/09/0909]

Not recorded for numerator (ii)

Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target Surgery [DOD = 09/09/0909] OR [DSURG = 09/09/0909] Radical Radiotherapy [DOD = 09/09/0909] OR [RCOMPDATE = 09/09/0909] Chemoradiotherapy [DOD = 09/09/0909] OR [RCOMPDATE = 09/09/0909]


Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard. n/a

Not recorded for denominator (i)

Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard Surgery [SURGTYPE = 99]

Radical Radiotherapy [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99]

Adjuvant Chemotherapy, Chemoradiotherapy, and Palliative Chemotherapy/ Biological Therapy [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99] Palliative Chemotherapy/ Biological Therapy (NSCLC / SCLC) ( [HISTSURG = 99] AND [HIST = 99] ) OR ( [HISTSURG = 95] AND [HIST = 99] ) OR ( [HISTSURG = 96] AND [HIST = 99] ) OR [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99]


Not recorded for denominator (ii)



Chemoradiotherapy [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99]


QPI 14: Stereotactic Ablative Radiotherapy (SABR) in inoperable stage I lung cancer

QPI Title: Patients with inoperable stage I lung cancer should receive stereotactic ablative radiotherapy (SABR).

Description: Proportion of patients with stage I lung cancer not undergoing surgery who receive SABR.

Numerator:

Number of patients with stage I lung cancer not undergoing surgery who receive SABR Stereotactic Ablative Radiotherapy (SABR) coded as Yes [SABR = 1]

Denominator:

All patients with stage I lung cancer not undergoing surgery (Excluding Patients with small cell lung cancer (SCLC), Patients who refuse SABR, and Patients who die prior to treatment). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; Origin of Tumour coded as lung cancer; AND TNM Tumour Classification (Clinical) coded as Stage 1; AND Definitive Surgery Performed {Lung Cancer} coded as Inoperable, or Not applicable; AND Histological/Cytological Diagnosis {Lung Cancer} not coded as Small cell carcinoma (SCLC), or Small cell/non-small cell components; AND SABR not coded as Patient refused SABR; AND Type of First Cancer Treatment not coded as Patient died prior to Treatment [ORIGIN = 1] AND ([TLUNG = T1 OR T1mi OR T1a OR T1b OR T1c OR T2 OR T2a] AND [NLUNG = N0] AND [MLUNG = M0]) AND [SURGTYPE = 6 OR 95 OR 96 ] AND [HIST <> 21 OR 32] AND [SABR <> 95] AND [MODE1 <>94]


Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target [SABR = 99]


Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard. [HIST = 99] OR [SABR = 99] OR [MODE1 = 99]


Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard [TLUNG = 99] OR [NLUNG = 99] OR [MLUNG = 99] OR [SURGTYPE = 99]


QPI 15: Pre-treatment diagnosis

QPI Title: Where possible patients should have a cytological / histological diagnosis prior to treatment.

Description:

Proportion of patients who receive curative treatment (radical radiotherapy, radical chemoradiotherapy or surgical resection) that have a cytological / histological diagnosis prior to treatment.

Numerator:

Number of patients who receive curative treatment (radical radiotherapy, radical chemoradiotherapy or surgical resection) that have a cytological / histological diagnosis prior to treatment. Date of Histological/Cytological Diagnosis not coded as not applicable; AND Date of Histological/Cytological Diagnosis is before Date of First Cancer Treatment [HISTDATE <> 10/10/1010] AND [HISTDATE < FIRSTTREATDATE]

Denominator:

All patients with lung cancer who receive curative treatment (radical radiotherapy, radical chemoradiotherapy or surgical resection). (Excluding patients who refuse investigations). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour [ORIGIN] coded as lung carcinoma; AND Radiotherapy Course Type coded as Radical; AND Histologlcal / Cytological Diagnosis {Lung Cancer} (Pre-Treatment) not coded as Patient refused investigation. Radical Radiotherapy [ORIGIN = 1] AND [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 2] AND [HIST <> 95] Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour [ORIGIN] coded as lung carcinoma; AND Radiotherapy Course Type coded as chemoradiotherapy; OR Type of Systemic Anti-Cancer Therapy coded as Chemoradiotherapy; AND Histologlcal / Cytological Diagnosis {Lung Cancer} (Pre-Treatment) not coded as Patient refused investigation.

Chemoradiotherapy [ORIGIN = 1] AND ( [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 5] AND [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 6] ) AND [HIST <> 95] Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour [ORIGIN] coded as lung carcinoma; AND Definitive Surgery Performed {Lung Cancer} coded as Pneumonectomy, Lobectomy, Wedge, Segmental; AND Histologlcal / Cytological Diagnosis {Lung Cancer} (Pre-Treatment) not coded as Patient refused investigation Surgery [ORIGIN = 1] AND [SURGTYPE = 1 OR 2 OR 3 OR 4] AND [HIST <> 95]


Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target [HISTDATE = 09/09/0909] OR [FIRSTTREATDATE = 09/09/0909]



Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard. [HIST = 99]




Chemoradiotherapy [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99] OR [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99]


QPI 16: Brain Imaging

QPI Title: Patients with N2 disease who are undergoing curative treatment should have brain imaging performed prior to commencing treatment.

Description:

Proportion of patients with N2 disease who receive curative treatment (radical radiotherapy, radical chemoradiotherapy or surgical resection) that undergo contrast enhanced CT or contrast enhanced MRI prior to the start of treatment.

Numerator:

Number of patients with N2 disease who receive curative treatment (radical radiotherapy, radical chemoradiotherapy or surgical resection) that undergo contrast enhanced CT or contrast enhanced MRI prior to the start of treatment. Date of Brain Imaging (Pre-treatment) not inapplicable, and Date of Brain Imaging is before Date of First Cancer Treatment [BRAINDATE <> 10/10/1010] AND [BRAINDATE <FIRSTTREATDATE]

Denominator:

All patients with N2 disease who receive curative treatment (radical radiotherapy, radical chemoradiotherapy or surgical resection). (Excluding patients who decline brain imaging). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Origin of Tumour [ORIGIN] coded as lung carcinoma; AND TNM Nodal Classification (Clinical) coded as N2; AND Radiotherapy Course Type coded as Radical or chemoradiotherapy; OR Type of Systemic Anti-Cancer Therapy coded as Chemoradiotherapy; OR Definitive Surgery Performed {Lung Cancer} coded as Pneumonectomy, Lobectomy, Wedge, Segmental; AND Brain Imaging not coded as Patient declined. [ORIGIN = 1] AND [NLUNG = N2] AND ( [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 2 OR 6] OR [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 5] OR [SURGTYPE = 1 OR 2 OR 3 OR 4] ) AND [ BRAIN <> 95]


Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target [BRAINDATE = 09/09/0909] OR [FIRSTTREATDATE = 09/09/0909]


Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard. [BRAIN = 99]


Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard [NLUNG = 99] OR ([RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99 OR <> 2 OR 6] AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99 OR <> 5] AND SURGTYPE = 99]) OR ([CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99 OR <> 5] AND [SURGTYPE = 99 OR <> 1 OR 2 OR 3 OR 4] AND [RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99]) OR ([RADIOTYPE1 OR RADIOTYPE2 OR RADIOTYPE3 = 99 OR <> 2 OR 6] AND [SURGTYPE = 99 OR <> 1 OR 2 OR 3 OR 4] AND [CHEMTYPE1 OR CHEMTYPE2 OR CHEMTYPE3 = 99])

Documents

Lung Cancer QPI Measurability V2 - ISD Scotland · 2019-03-29 · 2.1 107/2014 Final Amendments made out-with review, incorporating additional data item into the dataset updating