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Published on: October 10, 2019
Characterizing the Impact of Novel Patient-Centered Pathology Reports on Men Undergoing Prostate Biopsy: The
R Kumar1,2, K Lajkosz3, J Hiemstra1,2
1Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Purpose:
To improve patient-centered communication, some institutions provide online portals for patients to immediately access medical results. However, early access to certain reports could cause patients stress and confusion. Standard pathology reports (SPRs), vital for clinical decision-making, can be difficult for patients to understand and contextualize. Our group designed patient-centered pathology reports (PAPRs) and tested them for patients undergoing prostate biopsy.
Materials And Methods:
Between February 2023 and January 2024, 121 men were randomly assigned to receive either SPRs or SPRs + PAPRs. Before follow-up encounters, participants completed a questionnaire examining their understanding of the reports and experience interacting with them and a validated anxiety questionnaire (STAIS-5). After the visit, patients completed a validated 9-item shared decision-making questionnaire.
Results:
Twenty-four patients were excluded with unanswered questionnaires, leaving 97 patients with evaluable data. There was no difference in shared decision-making between arms. Patients receiving SPRs + PAPRs agreed that their reports were patient friendly (74% vs 20%, P < .001), were easy to understand (71% vs 32%, P < .001), improved experience (83% vs 60%, P = .029), empowered control (65% vs 30%, P = .001), reduced anxiety (81% vs 31%, P < .001), and helped communicating results to others (77% vs 42%, P < .001). The SPR + PAPR group more accurately understood their results (median 4 vs 3 correct answers, P = .003) and treatment options (63% vs 13%, P < .001). Anxiety increased less in the SPR + PAPR arm.
Conclusions:
When comparing PAPRs with SPRs, we did not see evidence of an impact on shared decision-making, but there were statistically significant differences in patient understanding and experience. Generalizability is limited by high resources needed to create PAPRs.
