How Synoptic Reporting Supports Patient Outcomes Analysis

One of the biggest benefits of moving from narrative (text) pathology reporting formats to synoptic (coded values) is enhanced research capabilities.  When your data is trapped in text blocks where different word forms and modifiers can change meaning, it is difficult to extract meaningful data to drive out patient outcomes.  Structured practices for reporting and particularly use of synoptic formats (templates), improve reporting quality according to several leading studies [1, 2].

Analyzing Synoptic Values for Melanomas

Recently I was working with a client to demonstrate how analysis tools work in conjunction with synoptic reports.  It was rewarding to see how quickly various assumptions about correlations between data values can be tested.  The synoptic reports created efficiently, out of normal operations, form a valuable research database.

We used a set of surgery reports on melanoma excisions captured over about a 5 year period.  We began by focusing on one particular measure, “Breslow’s thickness” (depth of the tumor on the skin), at diagnosis to see how it varied with other parameters in the case record.  Within about 10 minutes and using only end user tools like Microsoft Excel, we were able to establish the following:  

• There was no significant difference in average Breslow’s thickness by age or gender. 
• Breslows thickness correlated positively with age – although to a lesser extent than we guessed before seeing the values.
• Where family history of skin cancer existed, the patient was likely to be diagnosed at a smaller tumor thicknesses.  

We believe this last finding may confirm the value of information and education about skin cancer (communicated as a result of the experiences of relatives) in achieving earlier diagnoses. Conversely, patients who did not have a family history of melanoma were more likely to be diagnosed with a thicker tumor.

Synoptic Reporting, a Valuable Research Asset  

These results were not conducted as part of a formal study and are not the basis for any major conclusions about skin cancer.  They do however, demonstrate the value of synoptic reports as a research asset that can be leveraged quickly, without IT support, to uncover outcomes worthy of further study.