Annals of surgical oncology · 2025
Development and Validation of a Synoptic Operative Report as a Quality Indicator for Thyroid Surgery: A Canadian Study.
СтатьяВалидационное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Watanabe Akie, Yao Susan, Prisman Eitan, Groot Gary, Mitmaker Elliot, Walker G Ross, Wu Jonn, Pasternak Jesse, Lai Chi Kien, Eskander Antoine, Wasserman Jonathan D, Mercier Frederic, Roth Kathryn, Gill Sabrina, Villamil Carlos, Goldstein David, Munro Vicki, Pathak Alok, Lee Debon, Nguyen Anne, Wiseman Sam M
Аннотация
BACKGROUND: Narrative operative reports (NORs) often lack key information that can guide postoperative management of thyroid disease. We aimed to develop and validate a nationally standardized synoptic operative report (SOR) for thyroid surgery.
MATERIALS AND METHODS: Surgeons were surveyed for their opinions of current operative reporting practices. Reportable elements from thyroidectomy NORs were ranked by thyroid disease specialists and reviewed by a national advisory committee to develop a standardized SOR using the Modified Delphi Method. Six thyroid surgeons piloted the SOR. Completeness and reporting frequencies of SOR elements were compared with pre-pilot NORs using Wilcoxon rank sum, chi-squared, and Fisher's exact analyses. A post-pilot survey assessed provider satisfaction.
RESULTS: Among 42 Canadian thyroid surgeons from 9 provinces, 31% expressed dissatisfaction with current reporting practices and 100% expressed interest in a SOR. In total, 109 reportable thyroidectomy elements were collected from 142 NORs and ranked by 46 thyroid disease specialists. Consensus agreed upon a 21-element SOR by a national advisory committee. Among 172 NORs and 170 piloted SORs, SORs had higher median overall completeness (100% [100-100%]) than NORs (65% [47-70%], p < 0.001). SORs improved reporting of cancer-specific elements, including the presence of gross extrathyroidal cancer extension (SOR: 100%, NOR: 43%, p < 0.001) and residual gross disease (SOR: 100%, NOR: 16%, p < 0.001). More than half of users and readers reported improved reporting completeness and impact on patient care with SORs.
CONCLUSIONS: Implementation of a nationally developed thyroid surgery SOR enhanced completeness, delivery of cancer-specific information, and provider satisfaction, which can improve quality of patient care.
MATERIALS AND METHODS: Surgeons were surveyed for their opinions of current operative reporting practices. Reportable elements from thyroidectomy NORs were ranked by thyroid disease specialists and reviewed by a national advisory committee to develop a standardized SOR using the Modified Delphi Method. Six thyroid surgeons piloted the SOR. Completeness and reporting frequencies of SOR elements were compared with pre-pilot NORs using Wilcoxon rank sum, chi-squared, and Fisher's exact analyses. A post-pilot survey assessed provider satisfaction.
RESULTS: Among 42 Canadian thyroid surgeons from 9 provinces, 31% expressed dissatisfaction with current reporting practices and 100% expressed interest in a SOR. In total, 109 reportable thyroidectomy elements were collected from 142 NORs and ranked by 46 thyroid disease specialists. Consensus agreed upon a 21-element SOR by a national advisory committee. Among 172 NORs and 170 piloted SORs, SORs had higher median overall completeness (100% [100-100%]) than NORs (65% [47-70%], p < 0.001). SORs improved reporting of cancer-specific elements, including the presence of gross extrathyroidal cancer extension (SOR: 100%, NOR: 43%, p < 0.001) and residual gross disease (SOR: 100%, NOR: 16%, p < 0.001). More than half of users and readers reported improved reporting completeness and impact on patient care with SORs.
CONCLUSIONS: Implementation of a nationally developed thyroid surgery SOR enhanced completeness, delivery of cancer-specific information, and provider satisfaction, which can improve quality of patient care.