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The development and comparative effectiveness of a patient-centered prostate biopsy report: a prospective, randomized study

Prostate Cancer and Prostatic Diseases volume 23, pages 144–150 (2020)Cite this article

Subjects

Abstract

Purpose

The prostate biopsy pathology report represents a critical document used for decision-making in patients diagnosed with prostate cancer, yet the content exceeds the health literacy of most patients. We sought to create and compare the effectiveness of a patient-centered prostate biopsy report compared with standard reports.

Materials and methods

Using a modified Delphi approach, prostate cancer experts identified critical components of a prostate biopsy report. Patient focus groups provided input for syntax and formatting of patient-centered pathology reports. Ninety-four patients with recent prostate biopsies were block randomized to the standard report with or without the patient-centered report. We evaluated patient activation, self-efficacy, provider communication skills, and prostate cancer knowledge.

Results

Experts selected primary and secondary Gleason score and the number of positive scores as the most important elements of the report. Patients prioritized a narrative design, non-threatening language and information on risk classification. Initial assessments were completed by 87% (40/46) in the standard report group and 81% (39/48) in the patient-centered report group. There were no differences in patient activation, self-efficacy, or provider communication skills between groups. Patients who received the patient-centered report had significantly improved ability to recall their Gleason score (100% vs. 85%, p = 0.026) and number of positive cores (90% vs. 65%, p = 0.014). In total, 86% of patients who received the patient-centered report felt that it helped them better understand their results and should always be provided.

Conclusions

Patient-centered pathology reports are associated with significantly higher knowledge about a prostate cancer diagnosis. These important health information documents may improve patient-provider communication and help facilitate shared decision-making among patients diagnosed with prostate cancer.

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Acknowledgements

The authors acknowledge the research support from the Pacific Northwest Prostate Cancer SPORE (P50-CA097186) and the Institute for Prostate Cancer Research.

Funding

Funding

This work was supported by the Pacific Northwest Prostate Cancer SPORE (P50-CA097186) and the Institute for Prostate Cancer Research.

Author information

Authors and Affiliations

  1. Section of Urology, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada

    Jasmir G. Nayak & Benjamin Shiff

  2. Department of Urology, University of Washington, Seattle, WA, USA

    Nicholas Scalzo, Alice Chu, James T. Kearns, William J. Ellis, Daniel W. Lin, Jonathan L. Wright & John L. Gore

  3. Department of Urology, New York University, New York, NY, USA

    Geolani W. Dy

  4. Department of Urology, University of Pittsburgh Medical Center, Hermitage, PA, USA

    Liam C. Macleod

  5. Division of Urological Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Matthew Mossanen

  6. Department of Pathology, University of Washington, Seattle, WA, USA

    Lawrence D. True

Authors
  1. Jasmir G. Nayak
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  2. Nicholas Scalzo
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  3. Alice Chu
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  4. Benjamin Shiff
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  7. Liam C. Macleod
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  8. Matthew Mossanen
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  9. William J. Ellis
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  10. Daniel W. Lin
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  11. Jonathan L. Wright
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  12. Lawrence D. True
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  13. John L. Gore
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Corresponding author

Correspondence to John L. Gore.

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The authors declare that they have no conflict of interest.

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Nayak, J.G., Scalzo, N., Chu, A. et al. The development and comparative effectiveness of a patient-centered prostate biopsy report: a prospective, randomized study. Prostate Cancer Prostatic Dis 23, 144–150 (2020). https://doi.org/10.1038/s41391-019-0169-7

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