Juskevicius R, Zou K H, Cibas E S
Department of Pathology, Pitt County Memorial Hospital and Brody School of Medicine, East Carolina University, Greenville, NC, USA.
Am J Clin Pathol. 2001 Sep;116(3):331-5. doi: 10.1309/0BL4-6H9V-DQVV-UGXR.
In pursuit of physician-specific performance data in cytology, we have been calculating the ASCUS/SIL (atypical squamous cells of undetermined significance/squamous intraepithelial lesion) ratio of cytopathologists (CPs) and providing confidential feedback every 6 months. At the same time, thin-layer technology was introduced as an alternative to conventional smears. Thus we analyzed factors that may influence the ASCUS/SIL ratio, particularly the effect of periodic feedback on outliers (defined by a professional benchmark). For 3 years, the mean ASCUS/SIL ratio for all CPs decreased significantly from 2.92 to 1.87. There was great variability in the mean ASCUS/SIL ratio among 12 CPs (range, 1.11-5.89). Of the 6 CPs who worked continuously during this time, 2 showed a statistically significant decrease in their ASCUS/SIL ratio, including the CP with the highest ratio; 1 showed a significant increase. The mean ASCUS/SIL ratio did not correlate well with years of CP experience or with individual annual case volume. The ASCUS/SIL ratio of some CPs can decrease significantly over time. Whether it was due to feedback or the introduction of thin-layer preparations could not be determined.
为了获取细胞病理学中医师的特定表现数据，我们一直在计算细胞病理学家（CPs）的非典型鳞状细胞意义不明确/鳞状上皮内病变（ASCUS/SIL）比率，并每6个月提供一次保密反馈。与此同时，引入了薄层技术作为传统涂片的替代方法。因此，我们分析了可能影响ASCUS/SIL比率的因素，特别是定期反馈对异常值（由专业基准定义）的影响。在3年时间里，所有CPs的平均ASCUS/SIL比率从2.92显著降至1.87。12名CPs的平均ASCUS/SIL比率存在很大差异（范围为1.11 - 5.89）。在这段时间内持续工作的6名CPs中，2名的ASCUS/SIL比率有统计学意义的下降，包括比率最高的CP；1名有显著上升。平均ASCUS/SIL比率与CP的工作年限或个人年度病例量的相关性不佳。一些CPs的ASCUS/SIL比率会随时间显著下降。无法确定这是由于反馈还是薄层制片的引入所致。
