Advancement in the quality of operative documentation: A systematic review and meta-analysis of synoptic versus narrative operative reporting.

Abstract

The operative report is vital for patients and central to surgical quality assessment. Narrative operative reports are often poor quality. Synoptic reporting can improve documentation. The objective was to identify and appraise studies comparing synoptic and narrative operative reporting. A systematic review of the literature was performed. The primary outcome was completion of critical elements for an operative report. Additional secondary outcomes were measured. Meta-analysis was performed where possible. Quality analysis was performed using Newcastle-Ottawa Scale (NOS). 1471 citations were identified; 16 studies included. Mean NOS was 7.09 out of 9 (+/-- SD 1.73). Meta-analysis demonstrated that synoptic reporting was significantly more complete (SMD 1.70, 95% CI 1.13 to 2.26; I2 98%). Completion time was shorter with synoptic reporting (mean difference-0.86, 95% CI -1.17 to-0.55). Secondary outcomes favoured synoptic reporting. Synoptic reporting platforms outperform narrative reporting and should be incorporated into surgical practice.