The advantage of using a synoptic pathology report format for cutaneous melanoma

Sydney Melanoma Unit, Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia.
Histopathology (Impact Factor: 3.45). 01/2008; 52(2):130-8. DOI: 10.1111/j.1365-2559.2007.02921.x
Source: PubMed


Although the synoptic format is being increasingly used for primary cutaneous melanoma pathology reporting, no study assessing its value has yet been reported in the literature. The aim was to determine whether the use of synoptic reports increases the frequency with which pathological features that may influence prognosis and guide management are documented.
Melanoma pathology reports (n = 1692) were evaluated; 904 were in a synoptic format [671 Sydney Melanoma Unit (SMU) reports and 233 non-SMU reports] and 788 were non-synoptic (184 SMU reports and 604 non-SMU reports). Reports (n = 1354) from 677 patients who had both a SMU report and a non-SMU report were compared. Almost all features were reported more frequently in synoptic than in non-synoptic reports (P < 0.001). No significant differences were found in the frequency of reporting the main pathological features between SMU and non-SMU synoptic reports. Synoptic reports were more frequently used by SMU (78%) than by non-SMU pathologists (28%).
This is the first study to provide objective evidence that synoptic pathology reports for melanoma are more complete than non-synoptic reports (regardless of whether the reports are generated within or outside a specialist melanoma centre). All synoptic reports should include the facility for free text, be tailored to individual institutional requirements and be updated regularly to be of maximal value.

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    • "In addition, there was no correlation between Tip60 expression and other each clinical characteristic (e.g., ulceration, sun exposure, subtypes of melanoma) (Supplementary Table S2 online). Since our melanoma cohort was established from 1990 to 2010 and the database was limited, we were not able to perform analyses for the correlations between Tip60 expression and standard microscopic staging factors (Scolyer et al., 2004; Karim et al., 2008), genotypic changes (e.g., BRAF mutation), and other clinical and histopathological characteristics (Viros et al., 2008; Bauer et al., 2011). "
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    Preview · Article · Jun 2012 · Journal of Investigative Dermatology
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    • "A landmark study in the early 1990s, which audited pathology practice patterns at 532 institutions in three countries, found that the one practice associated with completeness of pathology reporting for colorectal cancer specimens was use of a standardized report or checklist [8]. Since that time, researchers have consistently demonstrated that synoptic reports (even paper-based 'checklist' formats) vastly improve the quality of pathology reporting in colorectal [1,2,9-13], breast [1,9,14-16], lung [1,17], prostate [1], pancreatic [18], melanoma [19], and hematolymphoid cancers [20]. More recently, synoptic reporting has been shown to improve the quality of surgical reporting for a variety of malignancies, including colorectal [7], breast [21], thyroid [22], and pancreatic cancers [23], as well as non-malignant operative procedures [24,25]. "
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    ABSTRACT: The dominant method of reporting findings from diagnostic and surgical procedures is the narrative report. In cancer care, this report inconsistently provides the information required to understand the cancer and make informed patient care decisions. Another method of reporting, the synoptic report, captures specific data items in a structured manner and contains only items critical for patient care. Research demonstrates that synoptic reports vastly improve the quality of reporting. However, synoptic reporting represents a complex innovation in cancer care, with implementation and use requiring fundamental shifts in physician behaviour and practice, and support from the organization and larger system. The objective of this study is to examine the key interpersonal, organizational, and system-level factors that influence the implementation and use of synoptic reporting in cancer care. This study involves three initiatives in Nova Scotia, Canada, that have implemented synoptic reporting within their departments/programs. Case study methodology will be used to study these initiatives (the cases) in-depth, explore which factors were barriers or facilitators of implementation and use, examine relationships amongst factors, and uncover which factors appear to be similar and distinct across cases. The cases were selected as they converge and differ with respect to factors that are likely to influence the implementation and use of an innovation in practice. Data will be collected through in-depth interviews, document analysis, observation of training sessions, and examination/use of the synoptic reporting tools. An audit will be performed to determine/quantify use. Analysis will involve production of a case record/history for each case, in-depth analysis of each case, and cross-case analysis, where findings will be compared and contrasted across cases to develop theoretically informed, generalisable knowledge that can be applied to other settings/contexts. Ethical approval was granted for this study. This study will contribute to our knowledge base on the multi-level factors, and the relationships amongst factors in specific contexts, that influence implementation and use of innovations such as synoptic reporting in healthcare. Such knowledge is critical to improving our understanding of implementation processes in clinical settings, and to helping researchers, clinicians, and managers/administrators develop and implement ways to more effectively integrate innovations into routine clinical care.
    Full-text · Article · Mar 2012 · Implementation Science
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    • "The use of a clinical synoptic report can facilitate communication between the members of the multidisciplinary cancer care team [11,12]. Synoptic means 'summarized' and refers to the presentation of information in a tabular, rather than descriptive form. "
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