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Research Letter
December 20, 2018

Variation in the Quality of Head and Neck Cancer Care in the United States

Author Affiliations
  • 1currently a medical student at University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  • 2Department of Otolaryngology–Head and Neck Surgery, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  • 3Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan
JAMA Otolaryngol Head Neck Surg. Published online December 20, 2018. doi:10.1001/jamaoto.2018.3632

Variation in clinical care is one of the biggest obstacles facing health care organizations that prevents them from improving outcomes.1 In previous work, Cramer et al2 validated 5 quality metrics for head and neck cancer that meet validity criteria. High adherence to these metrics was associated with a 19% reduced hazard of mortality, suggesting strong suitability for more widespread adoption.2 However, although variation of quality of care has been studied elsewhere, variation of these quality metrics has not been examined in depth. Commission on Cancer hospitals, which have been accredited based on several benchmarks for comprehensive, high-quality cancer care, treat approximately 70% of patients with head and neck cancer in the United States. Therefore, variation among these centers may identify opportunities for improvement that could be addressed through existing quality improvement programs.

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