This new transparency is what's needed to focus attention on the need for cancer specialists to practice according to evidence-based science, he says.
"Sometimes doctors tend to practice medicine according to what was best when they graduated from residency," Brawley says. "Continuing medical education [CME] requirements have allowed a group of doctors to practice what may have been very appropriate 20 or 25 years ago, but CME has not forced them to evolve as the science has evolved. Now, this sort of system [in Pennsylvania] may actually do just that."
Brawley estimates that in his experience, "a large minority"—as many as 25% of medical oncologists—"stray from published regimens governing cancer care, basically putting chemotherapy regimens together that have never been tested in any patient. I wish they would be much more focused on what the scientific studies show."
Variation in cancer performance scores comes from a reliable source: the American College of Surgeons' Commission on Cancer, which has monitored a growing number of quality measures for cancer centers nationally as a condition for their accreditation since 2005.
Daniel McKellar, MD, commission co-chair, explains that the CoC "has been providing accredited cancer programs with reports on their compliance with these measures so they can compare themselves to other programs. But we never made these public before."
"The PHCQA came to us and said, 'Boy, we'd really like to have some publicly reported cancer measures—would you consider working with us to allow accredited cancer programs to volunteer this data on our website?' And we thought this would be a great opportunity for public reporting on cancer."