Kitchener H C
Aberdeen Maternity Hospital, Foresterhill.
Br J Obstet Gynaecol. 1991 Nov;98(11):1112-6. doi: 10.1111/j.1471-0528.1991.tb15363.x.
To audit various aspects of colposcopy practice throughout the United Kingdom on behalf of BSCCP.
A postal questionnaire was circulated to those responsible for colposcopy services in all districts in the United Kingdom in 1988, followed by a smaller survey of 40 clinics in 1990 to detect any trends.
Information was sought on colposcopy workload, referral criteria, treatment method and follow-up, waiting times, staffing and training.
There was a 71% response to the national survey of 1988 practice which alone accounted for 80,000 new referrals for colposcopy. Cytological criteria for colposcopy referral were generally liberal. In 1988 laser ablation was the single most popular method, and waiting times for colposcopy varied, with 79% of patients being seen within 8 weeks of referral. Colposcopy clinics run by non-gynaecologists, mainly genito-urinary physicians, were reported by 32% of districts. Half the respondents did not have accurate statistics, only 17% being computerized, and dissatisfaction with clerical support was widespread. Resources are required to improve administration and data collection. The principal findings from the 1990 data subset were a 10% reduction for new patient referrals compared with 1988 and the use of diathermy loop excision by one-third as their preferred treatment.
This audit of colposcopy has provided useful information as well as a means of monitoring trends in colposcopy activity in the future.
代表英国宫颈细胞学和阴道镜检查协会(BSCCP)审核英国阴道镜检查实践的各个方面。
1988年向英国所有地区负责阴道镜检查服务的人员发放了邮政调查问卷,随后于1990年对40家诊所进行了规模较小的调查以发现任何趋势。
收集有关阴道镜检查工作量、转诊标准、治疗方法和随访、等待时间、人员配备和培训的信息。
对1988年实践的全国性调查有71%的回复率,仅此项就占80,000例新的阴道镜检查转诊病例。阴道镜检查转诊的细胞学标准普遍较为宽松。1988年,激光消融是最常用的方法,阴道镜检查的等待时间各不相同,79%的患者在转诊后8周内得到诊治。32%的地区报告有由非妇科医生(主要是泌尿生殖科医生)管理的阴道镜检查诊所。一半的受访者没有准确的统计数据,只有17%实现了计算机化,对文书支持的不满很普遍。需要资源来改善管理和数据收集。1990年数据子集的主要发现是,与1988年相比,新患者转诊减少了10%,三分之一的诊所将电热圈切除术作为首选治疗方法。
这次阴道镜检查审核提供了有用的信息,也为未来监测阴道镜检查活动的趋势提供了一种手段。