Research Article Estimation of an Optimal Chemotherapy Utilisation Rate for Upper Gastrointestinal Cancers: Setting an Evidence-Based Benchmark for the Best-Quality Cancer Care Weng Ng, 1,2,3 Susannah Jacob, 1,2,3 Geoff Delaney, 1,2,3 Viet Do, 1,2,3 and Michael Barton 1,2,3 1 Ingham Institute for Applied Medical Research, Liverpool, Sydney, NSW, Australia 2 Collaboration for Cancer Outcomes Research and Evaluation, Sydney, NSW, Australia 3 Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia Correspondence should be addressed to Weng Ng; weng.ng@swsahs.nsw.gov.au Received 1 December 2014; Accepted 23 February 2015 Academic Editor: Paolo Gionchetti Copyright © 2015 Weng Ng et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Aims. he proportion of patients with upper gastrointestinal cancers that received chemotherapy varies widely in Australia and internationally, indicating a need for a benchmark rate of chemotherapy utilisation. We developed evidence-based models for upper gastrointestinal cancers to estimate the optimal chemotherapy utilisation rates that can serve as useful benchmarks for measuring and improving the quality of care. Materials and Methods. Optimal chemotherapy utilisation models for cancers of the oesophagus, stomach, pancreas, gallbladder, and primary liver were constructed using indications for chemotherapy identiied from evidence-based guidelines. Results. Based on the best available evidence, the optimal proportion of upper gastrointestinal cancers that should receive chemotherapy at least once during the course of the patients’ illness was estimated to be 79% for oesophageal cancer, 83% for gastric cancer, 35% for pancreatic cancer, 80% for gallbladder cancer, and 27% for primary liver cancer. Conclusions. he reported chemotherapy utilisation rates for upper gastrointestinal cancers (with the exception of primary liver cancer) appear to be substantially lower than the estimated optimal rates suggesting that chemotherapy may be underutilised. Further studies to elucidate the reasons for the potential underutilisation of chemotherapy in upper gastrointestinal tumours are required to bridge the gap between the ideal and actual practice identiied. 1. Introduction One of the most fundamental requirements to the provision of quality cancer care is to ensure that patients receive timely and appropriate treatment following their diagnosis [1]. he Institute of Medicine’s National Cancer Policy Board in the United States have concluded in their “Ensuring the Quality of Cancer Care” report that a substantial number of cancer patients were receiving suboptimal treatment and recom- mended establishment of benchmarks for quality improve- ments [1]. In addition, the EUROCARE-4 study postulated that some of the survival diferences seen in certain tumour groups between the European countries may be related to the variation in the utilisation of treatments such as adjuvant chemotherapy in node-positive breast cancer, as well as the variable application of evidence-based guidelines [2]. Collectively, the upper gastrointestinal cancers represent approximately 7% of all registered cancers in Australia [3]. Major discrepancies between the optimal and actual rates of radiotherapy utilisation for upper gastrointestinal cancers have previously been demonstrated [4]. Several population- based studies have reported large variations in the proportion of patients with upper gastrointestinal cancers who have received chemotherapy, but there are no current bench- marks for comparison [5–16]. In this study, we constructed evidence-based models to estimate the optimal chemother- apy utilisation rates in patients with upper gastrointestinal Hindawi Publishing Corporation Gastroenterology Research and Practice Volume 2015, Article ID 753480, 10 pages http://dx.doi.org/10.1155/2015/753480