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Table 4 Summary of opinions from pathologists/molecular biologists versus clinicians regarding requesting and reporting in Belgium

From: Molecular pathology testing for non-small cell lung cancer: an observational study of elements currently present in request forms and result reports and the opinion of different stakeholders

Question

Answers from the laboratory side

Answers from clinicians

Elements on the request form

Which elements do you often miss? N = 18

Which elements do you always enter? N = 28

  Primary diagnosis

3 (17%)

28 (100%)

  Previous tests performed

3 (17%)

12 (43%)

  Original activating mutation

7 (39%)

19(68%)

  Previous therapies

9 (50%)

11 (39%)

  Tumor stage

4 (22%)

12 (43%)

  Type of progression

4 (22%)

7 (25%)

  Time of progression

3 (17%)

0 (0%)

  Clinical question (reason for testing)

9 (50%)

21 (75%)

In an ideal world: who is allowed to request additional tests?

N= 21

N= 24

  Only pathologist

2 (10%)

2 (8%)

  Pathologist and clinician

18 (86%)

20 (83%)

  Only clinician

1 (5%)

2 (8%)

  Other

0 (0%)

0 (0%)

Current situation: who is allowed to request additional tests?

N= 18

N= 24

  Only pathologist

1 (6%)

4 (17%)

  Pathologist and clinician

9 (50%)

15 (63%)

  Only clinician

7 (39%)

5 (21%)

  Other (depends on the initial requester)

1 (6%)

0 (0%)

Which of the following items regarding the request form are important?

N= 0

N= 6

  The request form is dedicated for molecular testing

-

4 (67%)

  The request form is dedicated for specific cancer types

-

5 (83%)

  An online version of the request form is available

-

0 (0%)

  The indications for testing are indicated on the request form

-

6 (100%)

  The testing techniques are indicated on the request form

-

6 (100%)

  The tissue/blood recipient is indicated on the request form

-

5 (83%)

  The transport medium is indicated on the request form

-

4 (67%)

  The max delay for transport is mentioned on the request form

-

4 (67%)

What is the reporting flow in your hospital?

N= 18

N= 7

  1 integrated report: biomarker results are added when available—WITH a conclusion per biomarker—WITH a conclusion on ALL biomarkers at the end

6 (33%)

3 (43%)

  1 integrated report: biomarker results are added when available—WITH a conclusion per biomarker—WITHOUT a conclusion on ALL biomarkers at the end

8 (44%)

4 (57%)

  1 integrated report: biomarker results are added when available—WITHOUT a conclusion per biomarker—WITH a conclusion on ALL biomarkers at the end

0 (0%)

0 (0%)

  Separate reports are released for each biomarker result

3 (17%)

0 (0%)

  Other

1 (6%)

0 (0%)

How do you receive the report?

N= 0

N= 7

  On paper

-

3 (43%)

  Via email

-

1 (14%)

  Via the hospital information system

-

6 (86%)

  Via telephone

-

0 (0%)

  Other

-

0 (0%)

  Question

Answers from the laboratory side

Answers from clinicians

Elements on the result report

What do you think the clinician needs on the report? N = 19

What do you read on the report? N = 28

  Clinical interpretation

14 (74%)

27 (96%)

  Description of the analytical method

1 (5%)

13 (46%)

  Sensitivity of the test method

8 (42%)

13 (46%)

  % neoplastic cells

4 (21%)

27 (96%)

  Genotyping result

3 (16%)

18 (64%)

  Tested regions of the target gene (e.g. which exons)

3 (16%)

15 (54%)

  Variant allelic frequency

0 (0%)

1 (4%)

Is it in your hospital appreciated by the clinician to give an interpretation on the test report?

N = 4

N = 4

  Yes, as a general interpretation (e.g. In general, patients with the L858R mutation in EGFR are sensitive to 1st and 2nd generation anti-EGFR TKI.)

3 (75%)

1 (25%)

  Yes, as a direct advice (e.g. This patient has a L858R mutation in EGFR and should be treated with a 1st generation anti-EGFR TKI)

0 (0%)

2 (50%)

  Yes, both as a general interpretation or direct advice

0 (0%)

1 (25%)

  No, the clinician wants to make the interpretation

0 (0%)

0 (0%)

  No, but for difficult cases the report is discussed with the clinician

0 (0%)

0 (0%)

  I don't know

1 (25%)

0 (0%)

Are some biomarker tests outsourced by your hospital?

N = 6

N = 3

  Yes

5 (83%)

3 (100%)

  No

0 (0%)

0 (0%)

  I don’t know

1 (17%)

0 (0%)

What is the TAT for biomarker testing for NSCLC in your hospital?

N = 6

N = 3

  1–7 days

2 (33%)

3 (100%)

  8–14 days

4 (67%)

0 (0%)

  15–21 days

0 (0%)

0 (0%)

What is the TAT for biomarker testing for NSCLC when tests are outsourced?

N = 5

N = 3

  1–7 days

0 (0%)

0 (0%)

  8–14 days

5 (100%)

3 (100%)

  15–21 days

0 (0%)

0 (0%)