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Although no standard for minimum reliability of a quality indicator exists, high reliability is desirable if indicators are intended for accountability or quality improvement.12 We considered inter-rater reliability to be inadequate when the kappa statistic was http://www.selleckchem.com/products/byl719.html set of 92 Cancer Quality-ASSIST indicators, we excluded 3 because they were duplicative of other indicators, and 9 because either the data elements were not routinely in the medical record or we concluded that they would require excessive abstraction time. We also excluded 3 indicators not applicable to the sample or setting (eg, care during stem cell transplant). One included indicator (for pain screening) was split into 2 indicators (inpatient and outpatient). We therefore attempted to abstract 78 and 47 of the 92 quality indicators in the Veterans Affairs Greater Los Angeles Health Care System and Johns Hopkins http://www.selleckchem.com/products/SB-431542.html Hospital/Sidney Kimmel Comprehensive Cancer Center study samples, respectively (the Johns Hopkins Hospital/Sidney Kimmel Comprehensive Cancer Center study did not include http://www.selleck.cn/products/ipi-145-ink1197.html chemotherapy or radiation therapy indicators). The mean abstraction time at Johns Hopkins Hospital/Sidney Kimmel Comprehensive Cancer Center was approximately 2.5 hours for patients with a hospitalization and at Veterans Affairs Greater Los Angeles Health Care System was 2.3 hours. Of the successfully evaluated indicators, 22 had inadequate reliability (kappa