Reporting Gleason grade/score in synoptic reports of radical prostatectomies

CONTEXT The format of a synoptic report can significantly affect the accuracy, speed, and preference with which a reader can retrieve information. OBJECTIVE The objective of this study is to compare different formats of Gleason grading/score in synoptic reports of radical prostatectomies. METHODS The performance of 16 nonpathologists (cancer registrars, MDs, medical non-MDs, and nonmedical) at identifying specific information in various formatted synoptic reports using a computerized quiz that measured both accuracy and speed. RESULTS Compared to the standard format (primary, secondary, tertiary grades, and total score on separate lines), omitting tertiary grade when Not applicable reduced accuracy (72 vs. 97%, P < 0.001) and increased time to retrieve information 63% (P < 0.001). No user preferred to have tertiary grade omitted. Both the biopsy format (primary + secondary = total score, tertiary on a separate line) and the single line format (primary + secondary + (tertiary) -> total score) were associated with increased speed of data extraction (18 and 24%, respectively, P < 0.001). The single line format was more accurate (100% vs. 97%, P = 0.02). No user preferred the biopsy format, and only 7/16 users preferred the single line format. CONCLUSIONS Different report formats for Gleason grading significantly affect users speed, accuracy, and preference; users do not always prefer either speed or accuracy.