AIMS: To develop quality indicators (QIs) for the evaluation of the prevention and management of cancer therapy-related cardiovascular toxicity. METHODS AND RESULTS: We followed the European Society of Cardiology (ESC) methodology for QI development which comprises (i) identifying the key domains of care for the prevention and management of cancer therapy-related cardiovascular toxicity in patients on cancer treatment, (ii) performing a systematic review of the literature to develop candidate QIs, and (iii) selecting of the final set of QIs using a modified Delphi process. Work was undertaken in parallel with the writing of the 2022 ESC Guidelines on Cardio-Oncology and in collaboration with the European Haematology Association, the European Society for Therapeutic Radiology and Oncology and the International Cardio-Oncology Society. In total, 5 main and 9 secondary QIs were selected across five domains of care: (i) Structural framework, (ii) Baseline cardiovascular risk assessment, (iii) Cancer therapy related cardiovascular toxicity, (iv) Predictors of outcomes, and (v) Monitoring of cardiovascular complications during cancer therapy. CONCLUSION: We present the ESC Cardio-Oncology QIs with their development process and provide an overview of the scientific rationale for their selection. These indicators are aimed at quantifying and improving the adherence to guideline-recommended clinical practice and improving patient outcomes.

Baghdad Heart Center Baghdad Teaching Hospital Medical City Baghdad Iraq

Cardio oncology Program MedStar Heart and Vascular Institute Washington DC USA

Cardio Oncology Unit Department of Translational Medical Sciences Federico 2 University Naples Italy

Cardiology Department Hôpitaux de Paris Hôpital Lariboisière 2 Rue Ambroise Paré Paris France

Cardiology department La Paz University Hospital IdiPAZ Research Institute Madrid Spain

Department of Cardiology Division of Medicine Oslo University Hospital Ullevål Oslo Norway

Department of Cardiology Leeds Teaching Hospitals NHS Trust Leeds UK

Department of Cardiology Mauriziano Hospital Turin Italy

Department of Community Cardiology Clalit Health Services Tel Aviv Jaffa Israel

Department of Internal Medicine 3 Cardiology Angiology Intensive Care Medicine Saarland University Medical Center Homburg Germany

Department of Oncology and Hemato Oncology University of Milan Milan Italy

Department of Pulmonary Circulation Thromboembolic Diseases and Cardiology Centre of Postgraduate Medical Education Otwock Poland

Division of Applied Technology for Clinical Care Florence Nightingale Faculty of Nursing Midwifery and Palliative Care King's College London James Clerk Maxwell Building 57 Waterloo Road London SE1 8WA UK

Division of Hematology Oncology Transplantation University of Minnesota Minneapolis MN USA

Faculty of Health Sciences Ben Gurion University of the Negev Beersheba Israel

IIBSant Pau Hospital de la Santa Creu i Sant Pau CiberCV Barcelona Spain

Institute of Clinical Medicine University of Oslo Oslo Norway Division of Research and Innovation Akershus University Hospital Lørenskog Norway

Institute of Hematology and Transfusion Medicine Warsaw Poland

IRCCS European Institute of Oncology Milan Italy

Jefe Servicio Oncología Médica Hospital Universitario Ramón y Cajal Madrid Spain

LARC C so Venezia 10 Turin Italy

Leeds Institute for Data Analytics University of Leeds Leeds UK

Leeds Institute of Cardiovascular and Metabolic Medicine University of Leeds Leeds UK

MSC National Research Institute of Oncology Garnarska 11 31 115 Krakow Poland

National Heart and Lung Institute Imperial College London and Cardio Oncology Service Royal Brompton Hospital London UK

Newcastle Centre of Excellence in Cardio Oncology Calvary Mater Newcastle Hunter Medical Research Institute John Hunter Hospital University of Newcastle NSW Australia

Patient Advocate London UK

Research Medical Unit INSERM U 942 University of Paris Paris France

Royal Marsden NHS Trust and Institute of Cancer Research London UK

School of Medicine Insubria University Varese Italy

Scientific Council of Cardiology Iraqi Board for Medical Specializations Baghdad Iraq

University Hospital Hradec Králové Sokolská 5005 Hradec Králové Czech Republic

University Hospital Ramon y Cajal Madrid Spain

University of Cyprus Medical School Nicosia Cyprus

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