The outcomes movement has its roots in studies conducted in the 1970s and '80s, which showed that there was substantial geographic variability in medical practice in the United States and that such variability was driven by nonmedical factors. Outcomes management has several key components: the development and implementation of guidelines; measurement, pooling, and dissemination of clinical and outcomes data; and refinement of guidelines based on analysis of those data. Cancer has lagged behind many other areas of medicine in pursuing outcomes research and management. The National Comprehensive Cancer Network (NCCN) has made a commitment to perform outcomes research within its member institutions and has begun to pool and analyze selected patterns of care and outcomes data. The network's ultimate goal is the creation of a uniform outcomes measurement system to monitor guideline compliance.
