Nathan Perlis1, Antonio Finelli2, Mike Lovas3,4, Alexis Lund2, Amelia Di Meo2, Katherine Lajkosz2, Alejandro Berlin4,5, Janet Papadakos6, Sangeet Ghai7, Dominik Deniffel7, Eric Meng2, David Wiljer8, Shabbir Alibhai9, Vasiliki Bakas10, Adam Badzynski11, Odelia Lee11, Joseph Cafazzo4,11, Masoom A Haider7. 1. University Health Network: Princess Margaret Cancer Centre - Department of Surgical Oncology, Toronto General Hospital - Sprott Department of Surgery, Division of Urology, University of Toronto, Toronto, Canada. Nathan.perlis@uhn.ca. 2. University Health Network: Princess Margaret Cancer Centre - Department of Surgical Oncology, Toronto General Hospital - Sprott Department of Surgery, Division of Urology, University of Toronto, Toronto, Canada. 3. University Health Network - Toronto General Hospital, Healthcare Human Factors, Toronto, Canada. 4. University Health Network - Princess Margaret Cancer Centre, Smart Cancer Care, Toronto, Canada. 5. University Health Network - Princess Margaret Cancer Centre, Radiation Oncology, University of Toronto, Toronto, Canada. 6. University Health Network - Princess Margaret Cancer Centre: Cancer Education, Toronto, Canada. 7. University Health Network and Sinai Health System - Joint Department of Medical Imaging (JDMI), University of Toronto, Toronto, Canada. 8. University Health Network - Toronto General Hospital, Education Technology Innovation at UHN Digital, Toronto, Canada. 9. University Health Network - Princess Margaret Cancer Centre, Department of Medicine, University of Toronto, Toronto, Canada. 10. University Health Network - myUHN Patient Portal, Patient Experience, Toronto, Canada. 11. University Health Network - Centre for Global eHealth Innovation, University of Toronto, Toronto, Canada.
Abstract
PURPOSE: Standard radiology reports (SRR) are designed to communicate information between doctors. With many patients having instantaneous access to SRRs on patient portals, interpretation without guidance from doctors can cause anxiety and panic. In this pilot study, we designed a patient-centred prostate MRI template report (PACERR) to address some of these challenges and tested whether PACERRs improve patient knowledge and experience. MATERIALS AND METHODS: Patients booked for clinical prostate MRI were randomly assigned to SRR or SRR + PACERR. Questionnaires included multiple-choice that targeted 4 domains (understanding, usefulness, next steps, emotional experience) hypothesized to improve with patient-centred reports and short answer questions, testing knowledge regarding MRI results. Clinical encounters were observed and recorded to explore whether adding PACERR improved communication. Likert scaled-responses and short-answer questions were compared using Mann-Whitney U test and Kruskal-Wallis test. RESULTS: Of the 40 participants, the majority were MRI naïve (70%). Patients receiving a PACERR had higher scores in the categories of patient understanding (mean: 4.17 vs. 3.39, p=0.006), usefulness (mean: 4.58 vs. 3.07, p<0.001), and identifying next steps (mean: 1.89 vs. 3.03, p=0.003) but not emotional experience (mean: 4.18 vs. 3.79, p=0.22). PACERR participants found the layout and design more patient friendly (mean: 4.47 vs. 2.61, p<0.001) and easier to understand (mean: 4.37 vs. 2.38, p<0.001). In the knowledge section, overall, the PACERR arm scored better (87% vs. 56%, p=0.004). CONCLUSION: With the addition of prostate MRI PACERR, participants had better understanding of their results and felt more prepared to involve themselves in discussions with their doctor.
PURPOSE: Standard radiology reports (SRR) are designed to communicate information between doctors. With many patients having instantaneous access to SRRs on patient portals, interpretation without guidance from doctors can cause anxiety and panic. In this pilot study, we designed a patient-centred prostate MRI template report (PACERR) to address some of these challenges and tested whether PACERRs improve patient knowledge and experience. MATERIALS AND METHODS: Patients booked for clinical prostate MRI were randomly assigned to SRR or SRR + PACERR. Questionnaires included multiple-choice that targeted 4 domains (understanding, usefulness, next steps, emotional experience) hypothesized to improve with patient-centred reports and short answer questions, testing knowledge regarding MRI results. Clinical encounters were observed and recorded to explore whether adding PACERR improved communication. Likert scaled-responses and short-answer questions were compared using Mann-Whitney U test and Kruskal-Wallis test. RESULTS: Of the 40 participants, the majority were MRI naïve (70%). Patients receiving a PACERR had higher scores in the categories of patient understanding (mean: 4.17 vs. 3.39, p=0.006), usefulness (mean: 4.58 vs. 3.07, p<0.001), and identifying next steps (mean: 1.89 vs. 3.03, p=0.003) but not emotional experience (mean: 4.18 vs. 3.79, p=0.22). PACERR participants found the layout and design more patient friendly (mean: 4.47 vs. 2.61, p<0.001) and easier to understand (mean: 4.37 vs. 2.38, p<0.001). In the knowledge section, overall, the PACERR arm scored better (87% vs. 56%, p=0.004). CONCLUSION: With the addition of prostate MRI PACERR, participants had better understanding of their results and felt more prepared to involve themselves in discussions with their doctor.
Authors: Jasmir G Nayak; Nicholas Scalzo; Alice Chu; Benjamin Shiff; James T Kearns; Geolani W Dy; Liam C Macleod; Matthew Mossanen; William J Ellis; Daniel W Lin; Jonathan L Wright; Lawrence D True; John L Gore Journal: Prostate Cancer Prostatic Dis Date: 2019-08-28 Impact factor: 5.554