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撒哈拉以南非洲地区乳腺病理报告需求评估及肿瘤概要模板的制定

Assessment of Breast Pathology Reporting Needs and Development of Tumor Synoptic Templates in Sub-Saharan Africa.

作者信息

Nkya Gilbert Z, Omoyiola Oluwatosin Zainab, Betiku Omolade Adefolabi, Ng Dianna L, Fernandes Fabiola Couto, Tacula Neybi Stella, Carrilho Carla, Pallangyo Angela Elisha, Adegoke Omolade O, Gilliland Jamie L, Mremi Alex Richard, Edelweiss Marcia

机构信息

From the Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania (Nkya, Pallangyo, Mremi).

the Department of Morbid Anatomy & Forensic Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ife, Nigeria (Omoyiola, Betiku).

出版信息

Arch Pathol Lab Med. 2025 Apr 1;149(4):340-346. doi: 10.5858/arpa.2024-0101-OA.

Abstract

CONTEXT.—: Breast pathology reports include many important details to guide clinical management. Reports with missing critical data elements are commonly seen in non-subspecialized pathology practices. The use of synoptic templates has been shown to improve pathology reports. Although synoptic templates are readily available from professional societies, many are not tailored to low-resource settings.

OBJECTIVE.—: To perform an assessment of current breast pathology reporting at 3 referral hospitals in sub-Saharan Africa and design a locally adapted breast cancer synoptic template.

DESIGN.—: We conducted semi-structured interviews with key stakeholders involved in breast cancer care, including pathologists, radiologists, oncologists, and surgeons, from Nigeria, Tanzania, and Mozambique. Moreover, each stakeholder reviewed a preliminary synoptic template that was compiled by using templates from the College of American Pathologists, Royal College of Pathologists, and International Collaboration on Cancer Reporting and was asked to score each data element as essential, optional, or exclude. A locally adapted synoptic template was then designed from the needs assessment. Using the adapted templates, a retrospective review of breast cancer pathology reports from 2020 to 2022 was conducted to determine the completeness of reports at the 3 institutions.

RESULTS.—: A total of 17 physicians were interviewed. Review of pathology reports revealed that none of the reports across all 3 sites contained all data elements considered essential by local physicians.

CONCLUSIONS.—: There is an urgent need to improve breast pathology reporting in sub-Saharan Africa. Development and implementation of synoptic templates in collaboration with key stakeholders has the potential to improve pathology reporting practices in low-resource settings.

摘要

背景

乳腺病理报告包含许多指导临床管理的重要细节。在非专科病理实践中,常见到缺少关键数据元素的报告。已证明使用概要模板可改善病理报告。尽管专业协会可轻易获取概要模板,但许多模板并非针对资源匮乏地区量身定制。

目的

评估撒哈拉以南非洲3家转诊医院当前的乳腺病理报告情况,并设计一个适合当地情况的乳腺癌概要模板。

设计

我们对尼日利亚、坦桑尼亚和莫桑比克参与乳腺癌护理的关键利益相关者进行了半结构化访谈,这些利益相关者包括病理学家、放射科医生、肿瘤学家和外科医生。此外,每位利益相关者都审查了一个初步的概要模板,该模板是使用美国病理学家学会、皇家病理学家学会和癌症报告国际合作组织的模板汇编而成的,并被要求将每个数据元素评为必不可少、可选或排除。然后根据需求评估设计了一个适合当地情况的概要模板。使用改编后的模板,对2020年至2022年的乳腺癌病理报告进行了回顾性审查,以确定这3家机构报告的完整性。

结果

共采访了17名医生。对病理报告的审查显示,所有3个地点的报告中均没有包含当地医生认为必不可少的所有数据元素。

结论

撒哈拉以南非洲迫切需要改善乳腺病理报告。与关键利益相关者合作开发和实施概要模板有可能改善资源匮乏地区的病理报告实践。

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