QLTI-18. Feasibility of capturing clinical quality indicators in high-grade glioma and alignment with guideline-recommended care

Abstract PURPOSE In 2022, 58 Clinical Quality Indicators (CQIs) covering key aspects of glioma care were developed for an Australian brain cancer registry via a Delphi process [1]. Evidence supports MDT-managed patients have higher concordance with treatment guidelines [2]. This study examines: 1) adherence to MDT discussions and treatment guidelines, and 2) feasibility of MDT data extraction. METHODS Data sources included hospital/oncology EMRs, MDT minutes, and correspondence. Thirty-nine of 58 CQIs related to high-grade glioma (HGG) were selected, covering ECOG, diagnostics, extent of resection, post-operative MRI, radiotherapy and chemotherapy. MDT discussions, trial screening, and key referrals (e.g. allied health, palliative care) were analyzed. For MDT – discussed cases, further analysis assessed receipt of guideline-recommended therapy (GRT) and reasons for non-completion. RESULTS The study cohort diagnosed between 2016-2020 comprised 183 patients: WHO Grade IV glioma (n=159) and Grade III (n=22), anaplastic astrocytoma (n=15) and oligodendroglioma (n=7). MDT discussions at initial diagnosis were undertaken in 168/183 (92%) cases. Of those discussed, 129/168 (77%) completed GRT, 30/168 (18%) partially completed GRT, and 9/168 (5%) did not complete GRT. Primary reasons for incomplete GRT included disease progression (n=13/39, 33%), patient decision (n=12/39, 31%), death (n=6/39, 15%), change in performance status (n=2/39, 5%), clinical decision (n=2/39, 5%), other comorbidities (n=3/39, 8%) and a geographical move in patient care (n=1/39, 3%). Automated data extraction was feasible for referral to the MDT, radiotherapy details, demographics, age, and date of diagnosis. However, manual data extraction was needed for all other CQIs including MDT discussions, recommendations and GRT completion/reasons for incompletion. CONCLUSION Aligning tailored documentation with information systems will improve the efficiency of capturing HGG CQIs, including MDT referrals and recommendations. While reasons for non-GRT delivery were feasible to identify, they required manual data extraction. Integrating CQIs into routine automated systems will support longitudinal outcome tracking and benchmarking across patient cohorts.