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.
University Health Network - Toronto General Hospital, Healthcare Human Factors, Toronto, Canada.
Support Care Cancer. 2022 Aug;30(8):6857-6876. doi: 10.1007/s00520-022-07108-0. Epub 2022 May 10.
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.
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.
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).
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.
标准放射学报告(SRR)旨在在医生之间传递信息。由于许多患者可以在患者门户上即时访问 SRR,因此未经医生指导的解读可能会引起焦虑和恐慌。在这项试点研究中,我们设计了一种以患者为中心的前列腺 MRI 模板报告(PACERR)来解决其中的一些挑战,并测试了 PACERR 是否可以提高患者的知识和体验。
预约临床前列腺 MRI 的患者被随机分配到 SRR 或 SRR+PACERR 组。问卷包括多项选择题,针对 4 个目标领域(理解、有用性、下一步、情绪体验),假设这些目标领域可以通过以患者为中心的报告和测试 MRI 结果相关知识的简答题来改善。观察和记录临床就诊情况,以探讨添加 PACERR 是否可以改善沟通。使用 Mann-Whitney U 检验和 Kruskal-Wallis 检验比较了 Likert 评分响应和简答题。
在 40 名参与者中,大多数是 MRI 新手(70%)。接受 PACERR 的患者在患者理解(平均值:4.17 比 3.39,p=0.006)、有用性(平均值:4.58 比 3.07,p<0.001)和确定下一步(平均值:1.89 比 3.03,p=0.003)方面的得分更高,但在情绪体验方面没有差异(平均值:4.18 比 3.79,p=0.22)。PACERR 参与者认为布局和设计更符合患者需求(平均值:4.47 比 2.61,p<0.001),也更容易理解(平均值:4.37 比 2.38,p<0.001)。在知识部分,总体而言,PACERR 组的得分更高(87%比 56%,p=0.004)。
通过添加前列腺 MRI PACERR,参与者对自己的结果有了更好的理解,并感到更有准备与医生进行讨论。