How Do We Define and Measure Optimal Care for Cancer Survivors? An Online Modified Reactive Delphi Study

SIMPLE SUMMARY: We aimed to determine ‘what quality criteria do survivorship experts consider to be important in achieving optimal cancer survivorship care?’. An online modified reactive Delphi study was conducted over two rounds. Experts included consumers, clinicians, researchers, policymakers and quality and accreditation groups. In round 1, experts ranked the importance of 68 criteria, derived from the international literature across three domains: Policy, process and outcome. In round 2, experts ranked their top 10 criteria per domain. These 30 items formed the Quality Framework. A consensus meeting considered priority items from the Quality Framework and the feasibility of data collection. Prioritized items focused on having a policy supporting provision of survivorship care; the existence of a survivorship program (policy); appropriate processes to assess survivors’ needs following treatment and to stratify to appropriate models of care (process); and reporting survivors’ patient-reported outcomes, quality of life and survival rates (outcome). ABSTRACT: This research sought to answer the question ‘what quality criteria do survivorship experts consider to be important in achieving optimal cancer survivorship care?’. An online modified reactive Delphi survey consisting of two rounds was completed with experts including consumers, clinicians, researchers, policymakers and quality and accreditation professionals. Survey items were based on international literature and considered three domains: Policy, process and outcome. In round 1 (R1), experts ranked the importance of 68 criteria on a five-point Likert scale. Criteria were retained if scored 4 (important) or 5 (very important) by >75% participants. In round 2 (R2), experts ranked top 10 criteria per domain. Response rates were 79% (70/89) and 84% (76/91), respectively. After R1, six criteria were removed and six were added. From R2, ten items for each domain were retained. These 30 items formed the Quality Framework. A consensus meeting considered priority items from the Quality Framework and feasibility of data collection. Prioritized items included having a policy on survivorship care; the existence of a multidisciplinary survivorship program (policy); appropriate processes to assess survivors’ emotional, psychological and physical needs following treatment and stratification to appropriate models of care (process); and collecting patient-reported outcomes, quality of life and survival rates (outcome).