P1591 - Speaking a Common Language: Pathology Synoptic Checklists Improve Clinician Comprehension

Stephanie L. Yan, MD¹, Kurt Schaberg, MD¹, Nuen Tsang Yang, MS², Eric Mao, MD^1
1University of California Davis, Sacramento, CA; ²University of California Davis, Woodland, CA

Introduction: Mucosal biopsies are routinely performed during endoscopy in inflammatory bowel disease (IBD) patients. Pathology reports influence diagnosis and treatment but heterogeneity in format and language may lead to inconsistency between pathologist’s interpretation and gastroenterologist’s comprehension. Failures in communication or errors in interpretation in the setting of suspected IBD, dysplasia surveillance, and differentiation between ulcerative colitis and Crohn's disease can lead to misdiagnosis or mismanagement. There is a paucity of literature focusing on clinician interpretation of IBD pathology. We investigated the effect of a synoptic table on gastroenterologist comprehension of IBD specimen pathology reports.

Methods: We performed a prospective interventional study at an academic center and recruited gastroenterology fellows as well as pediatric and adult gastroenterology attendings. All participants were given an electronic or paper questionnaire with six sample pathology reports asking the following questions: is active inflammation present, is chronic inflammation present, are the histologic findings representative of IBD, and is there evidence of dysplasia. Participants were also asked to rate confidence in their answers on a 5-point Likert scale. The reports were designed by an expert GI pathologist. We collected demographic data on participant characteristics. After a 6-week washout period, the same questionnaire was distributed with a synoptic table (Table 1). We performed paired t-tests to compare the mean accuracy and confidence scores between the pre- and post-intervention responses.

Results: 39 physicians participated in our study: 9 fellows and 30 attendings. Participants were in practice for a mean of 8.6 years and saw a mean of 12.6 IBD patients per month. Mean accuracy scores were higher post-intervention (0.86 vs 0.81, P = 0.0005). Mean confidence was higher post-intervention, but this was not statistically significant (3.98 vs 3.91, P = 0.242).

Discussion: The improvement in accuracy scores post-intervention suggests that clinician comprehension improved with the addition of the synoptic table. The confidence scores were also higher in the post-intervention group. A synoptic table for IBD pathology reports may provide a standardized way of communicating diagnostic information to clinicians and avoiding misinterpretation.




Disclosures:


Stephanie L. Yan, MD¹, Kurt Schaberg, MD¹, Nuen Tsang Yang, MS², Eric Mao, MD¹. P1591 - Speaking a Common Language: Pathology Synoptic Checklists Improve Clinician Comprehension, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.