title: Early Stage Bladder Cancer: Do Pathology Reports Tell Us What We Need to Know?
abstract: OBJECTIVE
  To assess a large national sample of bladder cancer pathology reports to determine if they contained the components necessary for clinical decision-making.
  
  
  METHODS
  We examined a random sample of 507 bladder cancer pathology reports from the national Department of Veterans Affairs Corporate Data Warehouse to assess whether each included information on the 4 report components explicitly recommended by the College of American Pathologists' protocol for the examination of such specimens: histology, grade, presence vs absence of muscularis propria in the specimen, and microscopic extent. We then assessed variation in the proportion of reports lacking at least 1 component across Department of Veterans Affairs facilities.
  
  
  RESULTS
  One hundred eight of 507 reports (21%) lacked at least 1 of the 4 components, with microscopic extent and presence vs absence of muscularis propria in the specimen most commonly missing (each in 11% of reports). There was wide variation across facilities in the proportion of reports lacking at least 1 component, ranging from 0% to 80%.
  
  
  CONCLUSIONS
  One-fifth of bladder cancer pathology reports lack information needed for clinical decision-making. The wide variation in incomplete report rates across facilities implies that some facilities already have implemented best practices assuring complete reporting whereas others have room for improvement. Future work to better understand barriers and facilitators of complete reporting may lead to interventions that improve bladder cancer care.
authors: VA Outcomes Group, White River Junction VA Medical Center, White River Junction, VT; Section of Urology, Dartmouth Hitchcock Medical Center, Lebanon, NH; Norris Cotton Cancer Center, Dartmouth Hitchcock Medical Center, Lebanon, NH; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College. Electronic address: florian.r.schroeck@dartmouth.edu.
authors: Florian R
authors: FR
authors: Schroeck
authors: VA Outcomes Group, White River Junction VA Medical Center, White River Junction, VT; Section of Urology, Dartmouth Hitchcock Medical Center, Lebanon, NH.
authors: Erik A
authors: EA
authors: Pattison
authors: VA Salt Lake City Health Care System, Salt Lake City, UT; University of Utah, Salt Lake City, UT.
authors: Daniel W
authors: DW
authors: Denhalter
authors: VA Salt Lake City Health Care System, Salt Lake City, UT; University of Utah, Salt Lake City, UT.
authors: Olga V
authors: OV
authors: Patterson
authors: VA Salt Lake City Health Care System, Salt Lake City, UT; University of Utah, Salt Lake City, UT.
authors: Scott L
authors: SL
authors: DuVall
authors: Section of Urology, Dartmouth Hitchcock Medical Center, Lebanon, NH; Norris Cotton Cancer Center, Dartmouth Hitchcock Medical Center, Lebanon, NH.
authors: John D
authors: JD
authors: Seigne
authors: VA Outcomes Group, White River Junction VA Medical Center, White River Junction, VT; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College.
authors: Douglas J
authors: DJ
authors: Robertson
authors: VA Outcomes Group, White River Junction VA Medical Center, White River Junction, VT; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College.
authors: Brenda
authors: B
authors: Sirovich
authors: VA Outcomes Group, White River Junction VA Medical Center, White River Junction, VT; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College.
authors: Philip P
authors: PP
authors: Goodney
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D000066491:Clinical Decision-Making; D005260:Female; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D012189:Retrospective Studies; D001743:Urinary Bladder / Q000473:pathology*; D001749:Urinary Bladder Neoplasms / Q000473:pathology*