Communicating laboratory test results for rheumatoid factor: what do patients and physicians want?

Figures & data

Table 1 Physician demographic characteristics (N=348)

Characteristic	Statistics
Age, mean (SD)a	48 (9.61)
Sex, n (%)
Male	220 (63)
Female	61 (18)
Unreported	67 (19)
Country, n (%)
United States	102 (29)
United Kingdom	99 (28)
Germany	97 (28)
Switzerland	50 (14)
Specialty, n (%)
United States
General/family practice	26 (26)
Internal medicine	26 (26)
Rheumatology	25 (24)
Allergy and immunology	25 (24)
United Kingdom
General/family practice	32 (32)
Internal medicine	32 (32)
Rheumatology	25 (25)
Allergy and immunology	10 (10)
Germany
General/family practice	27 (28)
Internal medicine	25 (26)
Allergy and immunology	25 (26)
Rheumatology	20 (20)
Switzerland
General/family practice	33 (66)
Internal medicine	15 (30)
Allergy and immunology	1 (2)
Rheumatology	1 (2)

Note:

a N=216 for this characteristic due to nonresponses on the optional survey item.

Table 2 Physician survey responses (N=348)

	n (%)
1. When you order laboratory tests for your patients, do they receive a report of their laboratory results (paper or electronic)?
• Yes, patients always receive a report of their lab results	66 (19)
• Patients sometimes receive a report of their lab results, depending on the kinds of tests ordered	77 (22)
• Patients sometimes receive a report of their lab results, depending on other factors	97 (28)
• No, patients do not receive a report of their lab results	108 (31)
2. How much general information about the lab tests is currently provided on the lab reports your patients receive?a
• There is no general information about the lab tests provided	130 (37)
• There is a small amount of general information about the lab tests provided	181 (52)
• There is a large amount of general information about the lab test provided	37 (11)

	1 strongly disagree n (%)	2 n (%)	3 n (%)	4 n (%)	5 strongly agree n (%)
3. Given the abundant information that patients receive today on the Internet and other sources, how much do you agree with the following statements about lab results/reports for your patients?a
I sometimes find it challenging to communicate with my patients about lab results	55 (16)	76 (22)	103 (30)	77 (22)	33 (10)
It could help my patients if more general information about the tests were provided on their reports	32 (9)	66 (19)	88 (26)	117 (34)	40 (12)
It could improve my relationship with my patients if more information were provided on their reports	38 (11)	74 (22)	107 (31)	83 (24)	40 (12)

	1 strongly disagree n (%)	2 n (%)	3 not applicable	4 n (%)	5 strongly agree n (%)
4. How much do you agree with these same statements specifically regarding RF tests?a
I sometimes find it challenging to communicate with my patients about RF test results	41 (12)	88 (25)	82 (24)	109 (32)	26 (7)
It could help my patients if more general information about RF tests were provided on their reports	28 (8)	76 (22)	86 (25)	117 (34)	40 (11)
It could improve my relationship with my patients if more RF information were provided on their reports	36 (11)	84 (24)	105 (30)	91 (26)	1 (9)

Notes:

a Data were missing for this question, resulting in total number of responses provided <348; percentages presented reflect the relative percentage of responses for this item.

Abbreviation: RF, rheumatoid factor.

Table 3 Physician suggestions for additional information to be included in laboratory test reports

Theme	% of participants with comment within this theme	Theme description	Quote
Meaning of results	27	Physicians would want to see a description of the meaning of test results	“What the result may mean and its implications” “General information regarding the significance of high or low values”
False-positives or false-negatives	9	Physicians would want to see a description of false-positives and false-negatives	“Detailing in addition to normal values examples of false negatives and positives and the differential”
Prompt to contact provider with questions	7	Physicians would want to see some prompting language to patients regarding follow-up to questions from the test results	“Info: ask your doctor” “That test result is NOT a diagnosis usually. Ask your doctor to interpret.”
Results are not a diagnosis	5	Physicians would want to see some language on the context of interpretation of test results	“The disclaimer that above or below normal is not necessarily diagnostic or abnormal” “Explanation that low titer positivity does not make a diagnosis”

Table 4 Patient demographic characteristics (N=211)

Sex (female), n (%)	189 (90)
Age, mean (SD)	52.7 (10.0)
Race, n (%)
• White	188 (89)
• African-American	9 (4)
• Other	13 (6)
• Preferred not to answer	1 (0.5)
Ethnicity (non-Hispanic), n (%)	198 (94)
Residence (United States), n (%)	203 (96)
Education, n (%)
• Below high school	1 (0.5)
• High school	21 (10)
• Some college	100 (47)
• Undergraduate degree	45 (21)
• Advanced degree	42 (20)
• Preferred not to answer	2 (1)
Insurance, n (%)
• Private	91 (43)
• Medicare	68 (32)
• Medicaid	23 (11)
• Military	8 (4)
• None	7 (3)
• Other (VA, national, other)	12 (6)
• No answer	2 (1)
Diagnosis, n (%)
• Rheumatoid arthritis	103 (49)
• SLE	97 (46)
• Both	11 (5)
Had laboratory test within last 3 months, n (%)	154 (73)

Abbreviations: SLE, systemic lupus erythematosis; VA, Veteran’s Administration.

Figure 1 Doctor–patient communication regarding general laboratory test reports.

Notes: ^aMissing one case, ^bmissing two cases, ^cmissing three cases.

Figure 2 Doctor–patient communication regarding the RF laboratory test report.

Notes: ^aMissing six cases, ^bMissing one case.
Abbreviation: RF, rheumatoid factor.

Figure 3 What kinds of information would you like to be added to the laboratory reports you receive to help you better understand the test results and what the results mean to you and your health? (N=209).

Note: N=209; Missing data for two patients.

Figure 4 Patients’ attitudes regarding desired information in the RF report (N=168).

Notes: ^aMissing four cases, ^bMissing five cases.
Abbreviation: RF, rheumatoid factor.

Table 5 Most frequent themes in suggestions for improvement to information contained in mock laboratory test report

Theme	% of participants with comment within this themea	Theme description	Quote
None/nothing	41	Patients request no additional information	“I think this report should be an industry standard”
Meaning of the results	16	Patients would like to know why the test was ordered and what could affect the results	“Maybe a more thorough explanation of possible meds or other things that might affect the results”
Recommended next steps	15	Patients ask for providing information about the next steps	“What are the next steps and how often does the test need to be repeated?”
History of results	5	Patients request providing past test results	“Recap of past tests if applicable”
Procedural details	4	Patients request to know details about who will see the report and when and how it will be reviewed	“The time between the lab testing and when the doctor actually sees or reviews the lab results”

Note:

a Out of 211 patients, 126 chose to skip this open-response question.