Comparative effectiveness of a patient-centered prostate biopsy report in clinical prostate cancer practice.

Abstract

145 Background: The prostate biopsy pathology report is a critical decision-making document for men newly-diagnosed with prostate cancer, yet the content may be beyond the health literacy of most patients. We compare the effectiveness of a patient-centered prostate biopsy report developed through patient-centered outcomes research methods with standard synoptic reports. Methods: Using a modified Delphi approach, a multidisciplinary group of prostate cancer experts provided consensus for the critical components of a prostate biopsy report for treatment decision-making. Patient focus groups provided input for syntax and formatting to inform the design of a patient-centered pathology report. 94 patients with recent prostate biopsies were block randomized to receive the standard report with or without the patient-centered report. We evaluated patient self-efficacy, provider communication and empathy, and prostate cancer knowledge at pathology disclosure. We compared study groups with descriptive statistics. Results: Experts selected primary and secondary Gleason score and number of positive cores as the important elements of a prostate biopsy report. Patients prioritized a narrative word structure, clear language, a tabular format for histologic grade, and information on risk classification. Initial assessments were completed by 84% (79/94) of participants including 40/46 in the standard report group and 39/48 in the patient-centered report group. Patients who received the patient-centered report had significantly improved ability to recall their Gleason score (100% vs. 85%, p = 0.03) and number of positive cores (90% vs. 65%, p = 0.01). Provider communication and patient self-efficacy were uniformly high and did not differ between groups. 88% of patients who received the patient-centered report felt that it helped them better understand their pathology results. Conclusions: A patient-centered prostate biopsy pathology report is associated with significantly higher knowledge about a new prostate cancer diagnosis. These health information documents may help facilitate shared decision-making among patients newly diagnosed with prostate cancer.