Monitoring and evaluation of breast cancer screening programmes : Selecting candidate performance indicators

In the scope of the European Commission Initiative on Breast Cancer (ECIBC) the Monitoring and Evaluation (M&E) subgroup was tasked to identify breast cancer screening programme (BCSP) performance indicators, including their acceptable and desirable levels, which are associated with breast cancer (BC) mortality. This paper documents the methodology used for the indicator selection. The indicators were identified through a multi-stage process. First, a scoping review was conducted to identify existing performance indicators. Second, building on existing frameworks for making well-informed health care choices, a specific conceptual framework was developed to guide the indicator selection. Third, two group exercises including a rating and ranking survey were conducted for indicator selection using pre-determined criteria, such as: relevance, measurability, accurateness, ethics and understandability. The selected indicators were mapped onto a BC screening pathway developed by the M&E subgroup to illustrate the steps of BC screening common to all EU countries. A total of 96 indicators were identified from an initial list of 1325 indicators. After removing redundant and irrelevant indicators and adding those missing, 39 candidate indicators underwent the rating and ranking exercise. Based on the results, the M&E subgroup selected 13 indicators: screening coverage, participation rate, recall rate, breast cancer detection rate, invasive breast cancer detection rate, cancers > 20 mm, cancers ≤10 mm, lymph node status, interval cancer rate, episode sensitivity, time interval between screening and first treatment, benign open surgical biopsy rate, and mastectomy rate. This systematic approach led to the identification of 13 BCSP candidate performance indicators to be further evaluated for their association with BC mortality

Basic notions of information structure

This article takes stock of the basic notions of Information Structure (IS). It first provides a general characterization of IS — following Chafe (1976) — within a communicative model of Common Ground(CG), which distinguishes between CG content and CG management. IS is concerned with those features of language that concern the local CG. Second, this paper defines and discusses the notions of Focus (as indicating alternatives) and its various uses, Givenness (as indicating that a denotation is already present in the CG), and Topic (as specifying what a statement is about). It also proposes a new notion, Delimitation, which comprises contrastive topics and frame setters, and indicates that the current conversational move does not entirely satisfy the local communicative needs. It also points out that rhetorical structuring partly belongs to IS.Peer Reviewe