Evaluation of Quality Indicators in Oncology: New Perspectives Comment on "Comprehensive Evaluation of Quality Indicators: Analyzing the Dutch Breast Cancer Audit"

Quality indicators (QIs) measurement aids to assess hospital performance and benchmarking between institutes of a country, which ultimately forms the basis of the quality improvement process. This commentary discusses the study by Verheul et al, which assessed 18 breast cancer QIs from the NABON Breast Cancer Audit (NBCA) using a structured framework evaluating feasibility, discriminative ability, validity, and reliability. Most of the evaluation criteria were fulfilled, except for reliability which was the most important issue raised by the author in the study. The weak reliability of the QIs indicated the importance of statistical evaluation in the development of such clinical QIs.