Abstract：
OBJECTIVE: To evaluate intervention of structured reporting after wrong-site surgery that occurred after localization of an incorrect breast biopsy marker.
METHODS: An IRB-exempt retrospective database review identified patients who underwent core-needle biopsy of a breast lesion from July 1, 2014 to July 1, 2020. They were divided into three cohorts: 2014 pre-intervention/pre-sentinel, 2017 pre-intervention/post-sentinel, and 2019 post-intervention of structured reports. One hundred reports per cohort were reviewed for documentation of marker and shape. Statistical analysis was performed with mixed-effects logistic regression model and chi-squared test with P < 0.05 considered significant.
RESULTS: The 2014 cohort consisted of 100 patients with 122 biopsies. Twenty-seven (22.1%) were excluded: 5/122 (4.1%) lesion resolution, 22/122 (18.0%) no documentation whether marker was/was not placed. Of the 95 biopsies remaining, 4/95 (4.2%) had no marker placed, 62/95 (65.3%) reported marker only, and 29/95 (30.5%) reported marker and shape. In the 2017 cohort, 100 patients underwent 108 biopsies. Four/108 (3.7%) were excluded: lesion resolution. Of the 104, 10/104 (9.6%) had no marker placed, 22/104 (21.2%) reported marker only, and 72/104 (69.2%) reported marker and shape. In the 2019 cohort, 100 patients underwent 114 biopsies. Two/114 (1.8%) were excluded: lesion resolution. Of the 112, 3/112 (2.7%) had no marker placed, 3/112 (2.7%) reported marker only, and 106/112 (94.6%) reported marker and shape. The predicted probability of both marker placement and shape described were statistically greater for 2019 compared to the other cohorts (P < 0.05).
CONCLUSIONS: Using structured reports facilitates and improves documentation of breast biopsy markers and may potentially reduce the risk of medical errors.
METHODS: An IRB-exempt retrospective database review identified patients who underwent core-needle biopsy of a breast lesion from July 1, 2014 to July 1, 2020. They were divided into three cohorts: 2014 pre-intervention/pre-sentinel, 2017 pre-intervention/post-sentinel, and 2019 post-intervention of structured reports. One hundred reports per cohort were reviewed for documentation of marker and shape. Statistical analysis was performed with mixed-effects logistic regression model and chi-squared test with P < 0.05 considered significant.
RESULTS: The 2014 cohort consisted of 100 patients with 122 biopsies. Twenty-seven (22.1%) were excluded: 5/122 (4.1%) lesion resolution, 22/122 (18.0%) no documentation whether marker was/was not placed. Of the 95 biopsies remaining, 4/95 (4.2%) had no marker placed, 62/95 (65.3%) reported marker only, and 29/95 (30.5%) reported marker and shape. In the 2017 cohort, 100 patients underwent 108 biopsies. Four/108 (3.7%) were excluded: lesion resolution. Of the 104, 10/104 (9.6%) had no marker placed, 22/104 (21.2%) reported marker only, and 72/104 (69.2%) reported marker and shape. In the 2019 cohort, 100 patients underwent 114 biopsies. Two/114 (1.8%) were excluded: lesion resolution. Of the 112, 3/112 (2.7%) had no marker placed, 3/112 (2.7%) reported marker only, and 106/112 (94.6%) reported marker and shape. The predicted probability of both marker placement and shape described were statistically greater for 2019 compared to the other cohorts (P < 0.05).
CONCLUSIONS: Using structured reports facilitates and improves documentation of breast biopsy markers and may potentially reduce the risk of medical errors.
摘要：
目的：评估在定位错误乳腺活检标记后发生的错误部位手术后结构化报告的干预。
方法：一项IRB豁免回顾性数据库审查确定了从2014年7月1日至2020年7月1日接受乳腺病变粗针活检的患者。他们分为三个队列：2014年干预前/哨兵，2017年干预前/哨兵后，和2019年结构化报告介入后。每个队列审查了100份报告，以记录标记和形状。采用混合效应logistic回归模型和卡方检验进行统计学分析，P<0.05认为有显著性。
结果：2014年队列包括100例患者和122例活检。27例（22.1%）被排除：5/122（4.1%）病变消退，22/122（18.0%）没有记录标记是否被/未被放置。在剩下的95个活检中，4/95（4.2％）没有放置标记，62/95（65.3％）仅报告标记，29/95（30.5%）报告了标记和形状。在2017年的队列中，100例患者接受了108例活检。排除4/108（3.7％）：病变消退。在104人中，10/104（9.6％）没有放置标记，22/104（21.2％）仅报告标记，72/104（69.2％）报告了标记和形状。在2019年的队列中，100例患者接受了114次活检。排除2/114（1.8％）：病变消退。在112人中，3/112（2.7％）没有放置标记，3/112（2.7％）仅报告标记，106/112（94.6%）报告了标记和形状。与其他队列相比，2019年描述的标记物放置和形状的预测概率在统计学上更高(P<0.05)。
结论：使用结构化报告可促进和改善乳腺活检标记的记录，并可能降低医疗差错的风险。
方法：一项IRB豁免回顾性数据库审查确定了从2014年7月1日至2020年7月1日接受乳腺病变粗针活检的患者。他们分为三个队列：2014年干预前/哨兵，2017年干预前/哨兵后，和2019年结构化报告介入后。每个队列审查了100份报告，以记录标记和形状。采用混合效应logistic回归模型和卡方检验进行统计学分析，P<0.05认为有显著性。
结果：2014年队列包括100例患者和122例活检。27例（22.1%）被排除：5/122（4.1%）病变消退，22/122（18.0%）没有记录标记是否被/未被放置。在剩下的95个活检中，4/95（4.2％）没有放置标记，62/95（65.3％）仅报告标记，29/95（30.5%）报告了标记和形状。在2017年的队列中，100例患者接受了108例活检。排除4/108（3.7％）：病变消退。在104人中，10/104（9.6％）没有放置标记，22/104（21.2％）仅报告标记，72/104（69.2％）报告了标记和形状。在2019年的队列中，100例患者接受了114次活检。排除2/114（1.8％）：病变消退。在112人中，3/112（2.7％）没有放置标记，3/112（2.7％）仅报告标记，106/112（94.6%）报告了标记和形状。与其他队列相比，2019年描述的标记物放置和形状的预测概率在统计学上更高(P<0.05)。
结论：使用结构化报告可促进和改善乳腺活检标记的记录，并可能降低医疗差错的风险。
