The NSW Oncology Group identified structured pathology reporting as a high priority for improving clinical decision support. Unlike the United Kingdom or the United States, there is no structure for development and dissemination of structured (or synoptic) pathology reports against a national standard for cancer in Australia. There is limited evidence or research to demonstrate that structured pathology reports are beneficial to clinical treatment, clinical decision making or that they reduce workload. However, clinicians agree that it is good practice to have guidelines, standard report formats and minimum data items.
The Cancer Institute NSW, in conjunction with the Royal College of Pathologists of Australasia (RCPA) and Cancer Australia, convened a Round Table on 28 June 2007. The subject was the use of structured pathology reports in cancer, and the aims of the Round Table were to discuss clinical drivers for structured requests and reporting; identify current projects and practices in each state; and to identify a national pathway for the development, review and publication of agreed voluntary standards for structured pathology reports for each type of cancer. All who were present at the Round Table agreed that structured reporting of cancer cases in anatomical pathology and haematology is likely to contribute to better cancer control through improvements in:
- clinical management and treatment planning
- cancer notification, registration and aggregated analyses; and
The Cancer Institute NSW secured funding in February 2008 through the Department of Health & Ageing’s Quality Use of Pathology Program (QUPP) to work with the RCPA and Cancer Australia to develop six reporting protocols (lung, melanoma, breast, colorectal, lymphoma and prostate) and a toolkit, in partnership with national clinician and pathologist organisations. The toolkit or framework documents and the six cancer protocols have been developed and are available here.
A second round of funding from the Department of Health & Ageing’s Quality Use of Pathology Program has been awarded to promote and expand the use of structured reporting of cancer. The planned program of work includes:
- developing further protocols in conjunction with international bodies;
- undertaking a national program of education on the developed cancer protocols (breast, melanoma, lung, lymphoma, colorectal and prostate); and
- developing a recommended report format in which to report the structured information from the protocols.
This program of work is being overseen by the Royal College of Pathologists Australasia with clinical consultation from the Cancer Institute NSW, and in conjunction with Cancer Australia.