New evidence-based guideline to tackle synoptic reporting of bone marrow data

College of American Pathologists (CAP)Mar 14 2016

Clinicians and patients alike will benefit as the Pathology and Laboratory Quality Center (the Center) of the College of American Pathologists (CAP) releases a new evidence-based guideline that tackles the complexities of reporting findings from bone marrow specimens.

Published in an early online release of the ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE, "BONE MARROW SYNOPTIC REPORTING FOR HEMATOLOGIC NEOPLASMS" provides recommendations that—for the first time in an evidence-based model—help pathologists and laboratories consistently, accurately, and comprehensively report bone marrow findings directly relevant for patient outcomes. "Diseases emerging from bone marrow analyses—such as blood cancers—can be difficult to distinguish from a wide variety of noncancer causes, and often additional testing and data integration is required beyond morphologic evaluation of the bone marrow," explains Cordelia E. Sever, MD, FCAP, a hematopathologist at Presbyterian Hospital, Albuquerque, N.M.

"This guideline provides recommendations for the specific clinical and laboratory data sets to include various specimen types, testing modalities, and clinical parameters," Dr. Sever said. "Combining the essential data elements will help pathologists and laboratories produce clear, complete, and consistent synoptic reports that address the most relevant diagnostic and prognostic information."

Synoptic reporting is a clinical documentation framework that has improved how findings for solid tumors such a breast and lung cancers are reported.

But until now, no evidence-based framework has been established assist pathologists and laboratories in the synoptic reporting of bone marrow data to guide optimal patient care. The guideline is not intended to replace the CAP Cancer Protocol for bone marrow hematopoietic neoplasms, which remains a strong foundation for bone marrow reporting and provides guidance on additional important report components and attributes of specific hematopoietic neoplasms.

On behalf of the CAP's Center, Dr. Sever led the seven-member panel of pathologists and hematopathologists who developed the guideline. The panel systematically reviewed more than 1,500 published articles of relevant comparative studies and examined evidence from more than 300 articles to develop draft recommendations, which were revised and finalized based on clinician feedback garnered during an open comment period. The Center's guideline development process follows the Institute of Medicine's (IOM) "Clinical Practice Guidelines We Can Trust."