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

Abstract

ABSTRACT Introduction: Pancreatic cancer surgery is highly complex and associated with significantperioperative risk, high mortality and morbidity, low quality of life, and increased healthcarecosts. Establishing quality indicators to monitor these procedures may improve care qualityand outcomes. This study aims to define a set of quality indicators to evaluate pancreatic cancersurgery 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 pancreaticsurgeons, one from each center where these complex surgeries are authorized in Catalonia, toachieve 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 indicatorsencompasses critical aspects including positive tumor resection margin, lymph nodes retrieved,Journal Pre-proof3 /21postoperative complications, hospital readmission, reoperation, 90-day mortality and one-yearsurvival.Conclusion: The outcome of this study is a set of agreed quality indicators to measure, describeand monitor the quality and outcomes of pancreatic cancer surgery. These quality indicatorscan be used as a foundation for benchmarking studies and systematic evaluations of quality ofcare and enhanced surgical performance in pancreatic cancer.