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Table 3 List of PACAP-1 interventions per medical specialty

From: Impact of nationwide enhanced implementation of best practices in pancreatic cancer care (PACAP-1): a multicenter stepped-wedge cluster randomized controlled trial

Medical oncology
 InterventionDefinitionOutcomeMeasurement
1Standard information and decision support toolUse of standard information and decision support tool for all pancreatic cancer patient subgroups (e.g., via https://bit.do/beslisboom)SurvivalNCR
2Discussion on chemotherapy (resectable patients)Percentage of resectable pancreatic cancer patients with whom Chemotherapy options are discussed in DPCG centerSurvival
Quality of life
NCR
PROMs
DPCA
3Diagnostics LAPC patient established in DPCG centerPercentage of LAPC patients in the diagnostic phase that are discussed in DPCG MDT meetingSurvival
Quality of life
NCR
PROMs
DPCA
4Post-induction chemotherapy discussion of LAPC patient in DPCG centerPercentage of LAPC patients treated with chemotherapy that are discussed in DPCG MDT meeting after 2 months of therapySurvival
Quality of life
NCR
PROMs
DPCA
5PERTPercentage of patients with EPI who receive PERTSurvival
Quality of life
NCR
PROMs
6Key parameter WHO performance status reportingPercentage of patients with a (suspected) pancreatic malignancy, in whom the WHO performance status is reported at first presentation.NCR
DPCA
7Pre-treatment pathology confirmationPercentage of patients with (suspected) locally advanced and metastatic pancreatic cancer, with histological or cytological proof of pancreatic adenocarcinomaNCR
8PROMsPercentage of patients with a (suspected) pancreatic malignancy who are registered for the PACAP PROMsPROMs
9BiobankingPercentage of patients receiving pancreatic resection for suspected malignancy who are registered for the PancreasParelPancreasParel
Surgery
 InterventionDefinitionOutcomeMeasurement
1Medical oncology referralPercentage of patients with pancreatic cancer referred to medical oncologist for consultation on adjuvant chemotherapySurvival
Quality of life
NCR
PROMs
2PERTPercentage of patients with EPI who receive PERTSurvival
Quality of life
NCR
PROMs
3Synoptic discharge letterPercentage of patients receiving pancreatic resection for a (suspected) malignancy in whom the synoptic complication table is used in the discharge letterDPCA
4Synoptic POCPercentage of patients undergoing pancreatic resection in whom the synoptic POC is used in the operation reportDPCA
5PROMsPercentage of patients receiving pancreatic resection for (suspected) malignancy who are registered for the PACAP PROMsPROMs
6BiobankingPercentage of patients receiving pancreatic resection for (suspected) malignancy who are registered for the PancreasParelPancreasParel
7Standardized complication managementStandardized approach to early detection and treatment of pancreatic fistula (PORSCH trial)Postoperative complicationsDPCA
PROMs
PORSCH
Gastroenterology
 InterventionInterventionOutcomeMeasurement
1Metal stentPercentage of patients with a (suspected) pancreatic malignancy requiring biliary drainage receiving a metal (rather than a plastic) stentComplicationsNCR
DPCA
2PERTPercentage of patients with EPI who receive PERTSurvival
Quality of life
NCR
PROMs
3Pre-treatment pathology confirmationPercentage of patients with (suspected) locally advanced and metastatic pancreatic cancer with histological or cytological proof of pancreatic adenocarcinomaNCR
Pathology
 InterventionDefinitionOutcomeMeasurement
1Synoptic reportingPercentage of patients receiving pancreatic resection for a suspected malignancy in whom the resection specimen is recorded according to the PALGA/Dutch Society of Pathology nationwide synoptic reportNumber of R1 resectionsDPCA
Radiology
 InterventionDefinitionOutcomeMeasurement
1Synoptic reportingPercentage of patients with a (suspected) pancreatic in whom the computed tomography (CT) is recorded according to the Dutch Society of Radiology CT-checklistDPCA
  1. Abbreviations: NCR Netherlands Cancer Registry, PROMS patient reported outcome measures, DPCA Dutch Pancreatic Cancer Audit, DPCG Dutch Pancreatic Cancer Group, LAPC locally advanced pancreatic cancer, MDT multidisciplinary team, PERT pancreatic enzyme replacement therapy, EPI exocrine pancreatic insufficiency, WHO World Health Organization, PACAP Dutch Pancreatic Cancer Project, POC postoperative conclusion, PALGA nationwide network and registry of histo- and cytopathology of the Netherlands