BERKELEY, CA (UroToday.com) - Pathology reports delineate management options for patients with urological malignancies. However, the complexity of such medical documents often places them beyond the understanding of the average patient. We measured the reading index of five pathology reports from a single institution for eight different urological procedures. We then modified these reports in an effort to identify sources of obstruction to readability.
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We found that, in general, pathology reports are written at a grade level well above the reading level of the average American. In fact, standard reports may require as high as a 12th grade level. Moreover, simple deletion of gross specimen description and immunohistochemistry results did not routinely result in significant reading level improvements. When these reports were modified further by replacing histology terms with lay terms, the reading level was not consistently improved. Only the reports for radical and partial nephrectomy and for radical orchiectomy demonstrated improved readability.
In the future, creation of patient-centered resources for understanding pathology results may require a patient-centered outcomes research approach. At our institution, we utilized both an expert panel of clinicians as well as a patient advisory board to develop a patient-centered pathology report now being evaluated in a pilot study. As the population continues to age, an increasing number of patients (and their caregivers or significant others) may face challenges in trying to comprehend their pathology. Moreover, with the promotion of meaningful-use criteria, it will be pivotal, from both a financial and administrative perspective, to ensure that patients can access and understand this information.
Matthew Mossanen, MD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Resident, Department of Urology, University of Washington, Seattle, WA USA