Defining melanoma quality indicators: A modified Delphi approach

Purpose To identify consensus-based quality indicators to evaluate melanoma care. Methods Melanoma quality indicators were identified from a literature review. Twenty-nine indicators in six topic domains were subsequently developed: diagnosis and diagnostic biopsy, patient experience, treatment, pathology, symptom management, survivorship. Clinical experts in melanoma from Ontario and international jurisdictions, representing the disciplines of surgery, pathology, primary care, medical oncology, radiation oncology, and palliative care, in addition to a health system leader, an epidemiologist and a patient and family advisor were invited to participate on the Delphi Panel. Panelists were asked to rate indicators on a nine-point Likert scale for appropriateness. Two iterations of electronic surveys were anonymously completed, followed by a virtual consensus meeting to prioritize quality and outcome melanoma indicators. Results Twenty-three panel members participated in the modified-Delphi process. Twenty-three quality indicators reflecting high-quality melanoma care across the care continuum were prioritized based on a defined consensus agreement of ≥ 80 % although only 4 were measurable from current administrative databases. These indicators were assessed for measurement feasibility and four of these were deemed feasible to measure from administrative databases along with eight standard indicators. Conclusion Melanoma outcome and quality indicators were identified using a modified-Delphi process for inclusion in a provincial cancer system performance report.