To assess a large national sample of bladder cancer pathology reports to determine if they contained the components necessary for clinical decision making.
We examined a random sample of 507 bladder cancer pathology reports from the national Veterans Administration (VA) Corporate Data Warehouse to assess whether each included information on the four report components explicitly recommended by the College of American Pathologists' protocol for the examination of such specimens: histology, grade, presence vs. absence of muscularis propria in the specimen, and microscopic extent. We then assessed variation in the proportion of reports lacking at least one component across VA facilities.
108 of 507 reports (21%) lacked at least one of the four components, with microscopic extent and presence vs. absence of muscularis propria in the specimen most commonly missing (each in 11% of reports). There was wide variation across facilities in the proportion of reports lacking at least one component, ranging from 0% to 80%.
One fifth of bladder cancer pathology reports lack information needed for clinical decision making. The wide variation in incomplete report rates across facilities implies that some facilities already have implemented best practices assuring complete reporting while others have room for improvement. Future work to better understand barriers and facilitators of complete reporting may lead to interventions that improve bladder cancer care.
Urology. 2016 Aug 30 [Epub ahead of print]
Florian R Schroeck, Erik A Pattison, Daniel W Denhalter, Olga V Patterson, Scott L DuVall, John D Seigne, Douglas J Robertson, Brenda Sirovich, Philip P Goodney
White River Junction VA Medical Center, White River Junction, VT; Section of Urology, Dartmouth Hitchcock Medical Center, Lebanon, NH; Norris Cotton Cancer Center, Dartmouth Hitchcock Medical Center, Lebanon, NH; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth College. Electronic address: ., White River Junction VA Medical Center, White River Junction, VT; Section of Urology, Dartmouth Hitchcock Medical Center, Lebanon, NH., VA Salt Lake City Health Care System and University of Utah, Salt Lake City, UT., Section of Urology, Dartmouth Hitchcock Medical Center, Lebanon, NH; Norris Cotton Cancer Center, Dartmouth Hitchcock Medical Center, Lebanon, NH., White River Junction VA Medical Center, White River Junction, VT; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth College.