Department of Gynaecological Oncology, University Hospitals of Leicester, Leicester, UK.
Eur J Obstet Gynecol Reprod Biol. 2013 Sep;170(1):255-8. doi: 10.1016/j.ejogrb.2013.06.032. Epub 2013 Jul 25.
Optimization of colposcopy practice requires a program of quality assurance including the monitoring of performance indicators. The European Federation of Colposcopy (EFC) aimed to identify a list of quality indicators for colposcopic practice, which are relevant, reproducible and practical across all of the member countries.
A five-round Delphi consultation was conducted in 30 full, 5 associate and 4 potential member countries in order to determine a core list of quality indicators including optimal target ranges.
Six indicators were selected from a list of 37 proposed standards. Two further rounds of consultation were conducted to determine expert opinion on the target level for each of the standards. The six indicators identified and corresponding targets were: documentation of whether or not the squamocolumnar junction has been seen (100%); colposcopy prior to treatment for abnormal cervical cytology (100%); percentage of excisional treatments/conizations to contain cervical intra-epithelial neoplasia grade two or worse (≥85%); percentage of excised lesions/conizations with clear margins (≥80%); and two indicators concerned the number of cases to be colposcoped per year: ≥50 low-grade/minor and ≥50 high-grade/major cytological abnormalities.
A Delphi consultation identified six EFC quality indicators. These are a first step in an international attempt to optimize colposcopy practice throughout Europe. The current targets are based on expert opinion and may need adaptation in the future. Data are needed from European colposcopy settings to determine whether the indicators are achievable practice-based benchmarks and will help in improving and fine tuning the list of performance indicators and targets.
阴道镜检查实践的优化需要包括性能指标监测的质量保证计划。欧洲阴道镜检查学会（EFC）旨在确定一套与所有成员国相关、可重复且实用的阴道镜检查实践质量指标。
在 30 个正式成员国、5 个准成员国和 4 个潜在成员国中进行了五轮德尔菲咨询，以确定包括最佳目标范围的核心质量指标列表。
从提出的 37 项标准中选择了 6 项指标。进行了另外两轮咨询，以确定专家对每个标准目标水平的意见。确定的 6 项指标及其相应的目标是：记录是否观察到鳞柱状交界（100%）；异常宫颈细胞学检查前进行阴道镜检查（100%）；包含宫颈上皮内瘤变二级或更高级别切除治疗/锥切的比例（≥85%）；切除病变/锥切有明确边缘的比例（≥80%）；以及两个与每年阴道镜检查的病例数有关的指标：低级别/小病变≥50 例和高级别/大细胞学异常≥50 例。
德尔菲咨询确定了 EFC 的 6 项质量指标。这是在欧洲范围内优化阴道镜检查实践的国际尝试的第一步。目前的目标是基于专家意见，未来可能需要调整。需要来自欧洲阴道镜检查环境的数据来确定这些指标是否是可实现的基于实践的基准，并有助于改进和微调性能指标和目标列表。
