Ellis D W, Srigley J
Royal College of Pathologists of Australasia, Sydney, Australia.
Clinpath Laboratories, Adelaide, Australia.
Virchows Arch. 2016 Jan;468(1):51-9. doi: 10.1007/s00428-015-1834-4. Epub 2015 Aug 28.
Key quality parameters in diagnostic pathology include timeliness, accuracy, completeness, conformance with current agreed standards, consistency and clarity in communication. In this review, we argue that with worldwide developments in eHealth and big data, generally, there are two further, often overlooked, parameters if our reports are to be fit for purpose. Firstly, population-level studies have clearly demonstrated the value of providing timely structured reporting data in standardised electronic format as part of system-wide quality improvement programmes. Moreover, when combined with multiple health data sources through eHealth and data linkage, structured pathology reports become central to population-level quality monitoring, benchmarking, interventions and benefit analyses in public health management. Secondly, population-level studies, particularly for benchmarking, require a single agreed international and evidence-based standard to ensure interoperability and comparability. This has been taken for granted in tumour classification and staging for many years, yet international standardisation of cancer datasets is only now underway through the International Collaboration on Cancer Reporting (ICCR). In this review, we present evidence supporting the role of structured pathology reporting in quality improvement for both clinical care and population-level health management. Although this review of available evidence largely relates to structured reporting of cancer, it is clear that the same principles can be applied throughout anatomical pathology generally, as they are elsewhere in the health system.
诊断病理学中的关键质量参数包括及时性、准确性、完整性、符合当前公认标准、沟通的一致性和清晰度。在本综述中，我们认为，随着全球电子健康和大数据的发展，一般来说，如果我们的报告要符合目的，还有另外两个常常被忽视的参数。首先，人群层面的研究已清楚表明，作为全系统质量改进计划的一部分，以标准化电子格式提供及时的结构化报告数据具有重要价值。此外，通过电子健康和数据链接与多个健康数据源相结合时，结构化病理报告对于公共卫生管理中的人群层面质量监测、基准比较、干预措施及效益分析至关重要。其次，人群层面的研究，特别是用于基准比较时，需要一个统一的、基于证据的国际标准，以确保互操作性和可比性。多年来，肿瘤分类和分期一直被视为理所当然，但癌症数据集的国际标准化目前才通过国际癌症报告协作组织（ICCR）开展。在本综述中，我们提供证据支持结构化病理报告在临床护理和人群层面健康管理质量改进中的作用。尽管本现有证据综述主要涉及癌症的结构化报告，但很明显，相同原则通常可应用于整个解剖病理学，就像在卫生系统的其他领域一样。
