Monday, August 8, 2011

Synoptic reporting for CNS tumors

Mark W. Becher, MD
Neuropathologist Mark W. Becher, MD published an article this past June in Archives of Pathology and Laboratory Medicine (Vol 135:789-792) entitiled Practical Neuropathology Synoptic Reporting for Central Nervous System Tumors. Dr. Becher writes that "the CAP [College of American Pathologists] CNS protocol, published in 2008, is an immense comprehensive document that is not conducive to simple inclusion in a narrative report". Dr. Becher notes that few neuropathologists actually apply the CAP protocol in their daily practice. However, he concludes that because of "the multidisciplinary nature of CNS tumor diagnoses, neuropathologists typically collect clinical, demographic, and imaging data on all CNS tumor cases. These data can readily be entered into a primary synoptic report that could replace our standard narrative report." Dr. Becher describes a synoptic checklist designed to accompany, and possibly replace, the standard narrative surgical neuropathology report, stating that it is more streamlined and easier to use than the exhaustive CAP checklist; as such, it is more useful to both clinicians and data collectors. Here is a link to the CAP surgical neuropathology checklist. The CAP should consider Dr. Becher's proposed checklist and adapt its own accordingly.


shipcolldoc said...

Indeed the CAP checklist is over-inclusive and excessively cumbersome. I/we use it because use of CAP "cancer" checklists is essential to continuing accreditation of our cancer center by the ACS and other associations and agencies. I just append it in a microscopic description or comment in addition to my usual narrative report. I don't favor synoptic reports replacing narrative reports, particularly since they don't allow one to easily go into the nuances of diagnoses that don't easily fit the WHO classification or are not yet recognized by the WHO.

Brian E. Moore, MD, MEd said...

I wholeheartedly concur with 'shipcolldoc'.