Pathologists aid in patient understanding and quality of care

With the passage of the 21^st Century Cures Act in 2021, patients were granted access to their medical test results without delay—often before their physician can review them.

Pathology reports aren’t written with patients as a target audience and they contain complex medical terminology which can often lead to patient confusion and anxiety.

To address this, researchers led by Cathryn Lapedis, M.D., M.P.H., of the Department of Pathology at Michigan Medicine, recently examined how a pathology explanation clinic, or PEC, could improve the experience of a small group of patients newly diagnosed with prostate cancer. 

In this model, patients interfaced directly with a pathologist familiar with the patient’s case, who reviewed their slides and provided an indepth explanation of the tissue findings that led to the diagnosis. 

The pathologist then summarized this meeting for the patients’ urologic oncologist, including any questions about treatment or prognosis raised by the patient (PEC follow up note.) 

Qualitative interviews over a six month follow up period with 10 study participants revealed that following the PEC visit, patients had an indepth understanding of their diagnosis, including visual changes in their cancer cells which determined the Gleason score (i.e the grade of their cancer.)

They were also more prepared emotionally and cognitively for a discussion with their oncologist, which supported patients in making informed treatment decisions that align with their values.

On the clinician side, oncologists were appreciative of the PEC follow up and noted that the PEC patients were more prepared and able to ask more indepth and nuanced questions about prognosis and treatment decision when meeting with the urologic oncologist. 

These PECs also led to overall quality improvement by ensuring that all outside biopsy slides were re-reviewed and that any changes in the patient’s diagnosis were clearly communicated across the care team. 

In some patient cases, this additional communication supported patients in choosing clinically appropriate but lower risk treatment options such as active surveillance. 

Additional authors include Sarah E. Bergholtz, BS, M.P..H, Sophia R. Kurnot, B.S., Esha Elahi, Melissa DeJonckheere, Ph..D, Sarah T. Hawley, Ph.D., M.P.H., Scott R. Owens, M.D., Simpa Salami, M.D., M.P.H., and Todd M. Morgan, M.D. 

Paper cited: “A longitudinal mixed-methods study of pathology explanation clinics in patients with newly diagnosed localized prostate cancer,” American Journal of Clinical Pathology. DOI: 10.1093/ajcp/aqae008

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