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.