POS-818 ESTABLISHING AN EFFECTIVE CLINICAL DATA COLLECTING TOOL FOR PROPER EVALUATION OF RENAL BIOPSY

Abstract

The renal biopsy is currently being used to achieve optimal patient care in the era of personalized and precision medicine. Indeed, clinicopathological correlation is mandatory to establish an accurate diagnosis of kidney diseases. Otherwise, the final pathology report would only be describing patterns of injury which will not help the treating physician to decide the appropriate therapy. Clinical information oriented to the kidney diseases such as history, physical examination, investigation and management plan, is not always accessible for renal pathologists. With the advances in technology, our aim is to create a quality-improved, standardized, uniform, electronic, efficient, and environmentally friendly clinical data collecting form to be completed for each renal biopsy request. Thirty-three renal pathologists with various levels of experience in Canadian health care institutions, all of them members of the Canadian Society of Pathology, Renal Pathology Working Group, were invited individually by e-mail to respond to a survey. The survey comprised two parts: native and transplant renal biopsies. The questions in the survey pertained to the necessity of inclusion of specific elements of clinical information in the categories of history, physical examination, investigations and management plan. Based on the responses to the survey and comments, the pilot preliminary form was modified. Upon our institutional Quality Improvement Review Committee (QIRC) review, a formal waiver of the requirement for REB (Research Ethics Board) approval was obtained. PDF files of the clinical data collecting form were distributed to more than 80 nephrologists by e-mail. These forms could only be completed electronically, and no handwriting was permitted. The nephrologists were encouraged to complete these forms for hypothetically patients or real patient data. Estimated time for completing the form was recorded. Nephrologists also made some comments on the form itself. Simultaneously, a further short survey to measure the satisfaction of all users was sent. Twenty renal pathologists representing 14 different academic centers, completed the survey. The rate of agreement on the survey questions ranged from 38.89% to 100.00%. On the other hand, 21 nephrologists and their assistants have responded. Average time needed to complete a PDF form is 11.11 minutes (ranges between 6 and 20 minutes). Few nephrologists considered it too long and they have no enough time to complete it. Overall, the suggestions were to modify it and make it more clinically relevant. Among survey respondents, 50% were satisfied with using these forms and the same percentage of those clinicians would recommend it to their colleagues. Clinical data is important for an accurate diagnosis in renal pathology. An electronic, efficient, and environmentally friendly clinical data collecting form was developed through consensus by renal pathologists in Canada. We have tested the form by sending it to the nephrologists to be used with each renal biopsy request. This innovation would help with the flow, workload and turnaround time making our service more accurate and efficient.