Reporting Margin Status in Synoptic Reports.

Abstract

The format of a synoptic report can significantly affect the accuracy, speed, and preference with which a reader can retrieve information. The purpose of this study was to compare different formats for reporting margin status in synoptic reports of colonic carcinoma. The performance of 17 nonpathologists (cancer registrars and medical and nonmedical personnel) at identifying specific information in various formatted synoptic reports was evaluated using four computerized quizzes that measured both accuracy and speed. Compared with the standard format ("Involved by invasive carcinoma" and "Uninvolved by invasive carcinoma"), reporting margins as "Free" or "Positive" was significantly faster (17%, P < .001) and significantly more accurate (99% v 98%, P = .001). Significantly more errors for the standard format were found in quiz 4 (eight of 272; 2.9%) than the prior three tests combined (nine of 816; 1.1%; P = .05). Using "Free" or "Positive" with either a list format or including bolding of all positive margins was also faster than the standard format but not any faster than simply changing the wording. All users preferred "Free" and "Positive"; no user preferred "Involved by invasive carcinoma" and "Uninvolved by invasive carcinoma." Using "Free" and "Positive" for reporting margin status in synoptic reports is preferred by all users and results in more accurate, faster information retrieval. Errors may be related to fatigue.