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CAP Protocols and the Power of Synoptic Pathology Reporting

Over at CAP Today, there is a great new post from the president of the College of American Pathologists (CAP), R. Bruce Williams, MD. Entitled "From the President’s Desk: A shared vision for cancer staging, 1/18," the post delves into how effective cancer staging protocols have been through the years in light of the latest updates from the American Joint Committee on Cancer (AJCC) staging manual. Dr. Williams goes into his own experiences with the streamlined reports and synoptic style and the reason why it has been a revolutionary path to improving physician communication and promoting better patient care.

While CAP has been encouraging members to utilize synoptic reporting in order to provide dynamic information on cancer diagnoses since 2009, it wasn't a requirement for accreditation until 2015. But still, in all of that time, they have been strongly supportive of using synoptic solutions to incorporate their electronic Cancer Checklists (eCCs). The eCCs are the prescribed fields and data points that pathologists must follow in their reporting in order to properly provide AJCC staging and to accurately assess and communicate the tumor diagnosis. There are multiple solutions for capturing this information, including CAP eFRM from CAP and mTuitive, but the result from using a synoptic format is the same.

Dr. Williams recounts a tumor conference he had with multiple members of all different departments when he asked what people thought of the Cancer Protocols being used in pathology reporting:

"Everybody agreed the reporting templates had greatly increased the effectiveness of communication between pathologists and physicians in all these fields because they could now quickly find what they were looking for. We had 13 different pathologists writing narrative reports back then, and it seems the clinicians often had trouble finding what they needed. Now everyone knew where to find their nugget and could be certain it was included."

That early success with improved communication that eliminates subjectivity, vague wording, and enforces best practices and uniform reporting continues today with the release of AJCC's latest staging manual and the newest Cancer Protocols from CAP. While CAP often (at least annually if not 2-3 times a year) updates their eCCs to best reflect the most vital data to be captured by pathologists, it has been many years since AJCC updated their staging information. And this latest revision is a tall order that greatly empowers pathologists to provide the most precise information on their specimens.

We’ve had enough time with it now to confirm that the new edition is more ambitious, impressive, and perhaps even more groundbreaking than its predecessors. The eighth edition features 12 entirely new staging systems and reflects the input of a greatly expanded team of international experts. It comprises 83 chapters, was three years in the making, and represents the work of 434 individuals from six continents, 23 countries, and 188 institutions. There is a searchable electronic version incorporating additional staging forms and other supplementary resources. It’s a big step up.

This massive overhaul of reporting standards has been a huge success for capturing information and relaying it to the necessary caregivers in order to provide insightful care as quickly as possible. At mTuitive, we have been updating our users with the latest Cancer Protocols to ensure they are in compliance and remain on the cutting edge of pathology and cancer care. With our automated formulas, required fields, and easy-to-use interface, pathologists are able to meet the criteria they need and fill out the templates comprehensively yet quickly.

The President of CAP also points out the power of structured data capture when he talks about why reports devoid of narrative nonsense and unnecessary fluff is far superior to the alternative. "Because the CAP volunteers who write the protocols are practicing pathologists, they know that sometimes too much is too much. Succinct, synoptic reports enable our members to give managing clinicians a sharp, quick, complete picture of what they need to know to apply the new staging system at the point of care."

It's an excellent read that is well worth checking out to understand where Cancer Protocols have been, where they are now, and a glimpse into where they might go next. Please go read it and learn more about why synoptic reporting has been a revolutionary standard in pathology that should be adopted in other specialties. Improved communication, informed care, and accelerated research are all great things to which every physician should aspire and from which we all benefit.


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