Darwish-Yassine May, Garvin Ann D, Johnston Carolyn M, Zoschnick Lauren, Conners Amy, Laing Shannon, Wojcik Christopher
From the Cancer Control Services Program (Dr Darwish-Yassine), the Center for Healthy Communities (Ms Laing), and the Center for Data Management and Translational Research (Mr Wojcik), Michigan Public Health Institute, Okemos; the Cancer Prevention and Control Section, Michigan Department of Community Health, Lansing (Ms Garvin); the Comprehensive Cancer Center (Dr Johnston) and the Department of Obstetrics and Gynecology (Dr Zoschnick), University of Michigan Health System, Ann Arbor; and the Clinical Laboratory, St Joseph Mercy Hospital, Ann Arbor (Ms Conners). Dr Darwish-Yassine is now with Central Administration, Michigan Public Health Institute.
Arch Pathol Lab Med. 2015 May;139(5):650-5. doi: 10.5858/arpa.2013-0620-OA.
The Michigan Public Health Institute and the Michigan Cancer Consortium's Cervical Cancer Committee conducted a national survey of health care providers, thanks to funding from the Centers for Disease Control Cooperative Agreement 5U47CI000743-02. Papanicolaou test screening practices were examined, emphasizing the relationship between clinical and laboratory practices. This survey found differing screening practices among providers of women's health care.
To collect information from family medicine practitioners, women's nurse practitioners, obstetricians and gynecologists, and certified nurse-midwives on Papanicolaou and human papillomavirus testing; to discuss how those practices align with current cytology screening and follow-up recommendations from professional organizations (US Preventive Services Task Force, American Cancer Society, American College of Obstetricians and Gynecologists, and American Society for Colposcopy, and Cervical Pathology); and ultimately, to make recommendations aimed at standardizing practice performance.
This survey was conducted in part to examine clinicians' practices and their perceptions of laboratory performance, to evaluate items that are known to enhance quality of care, and to examine factors that may prohibit universal implementation of best standards of care. The survey used a self-administered questionnaire, distributed to 9366 clinicians, with 1601 (17.1%) completed surveys.
This assessment shows a clear lack of consensus among practitioners in performing Papanicolaou testing. It demonstrates how differently patients are tested, based on the providers' screening practices, and demonstrates specific cervical cancer screening practice disparities between and among the 4 provider groups, both in Papanicolaou testing and in the use of human papillomavirus testing.
A unified mandate for screening is needed to standardize screening practices.
在疾病控制中心合作协议5U47CI000743 - 02的资助下，密歇根公共卫生研究所和密歇根癌症联盟的宫颈癌委员会对医疗服务提供者进行了一项全国性调查。调查了巴氏试验筛查实践，重点关注临床和实验室实践之间的关系。这项调查发现女性医疗服务提供者之间存在不同的筛查实践。
从家庭医生、女性执业护士、妇产科医生和认证助产士那里收集关于巴氏试验和人乳头瘤病毒检测的信息；讨论这些实践如何与专业组织（美国预防服务工作组、美国癌症协会、美国妇产科医师学院、美国阴道镜及宫颈病理学会）当前的细胞学筛查和后续建议保持一致；最终提出旨在规范实践操作的建议。
开展这项调查部分是为了检查临床医生的实践及其对实验室表现的看法，评估已知可提高医疗质量的项目，并研究可能阻碍普遍实施最佳医疗标准的因素。该调查使用了一份自填式问卷，分发给9366名临床医生，共收到1601份（17.1%）完成的调查问卷。
这项评估表明，临床医生在进行巴氏试验方面明显缺乏共识。它展示了根据医疗服务提供者的筛查实践，患者接受检测的方式存在多大差异，并展示了4个医疗服务提供者群体在巴氏试验和人乳头瘤病毒检测的使用方面，彼此之间以及群体内部存在的特定宫颈癌筛查实践差异。
需要一个统一的筛查指令来规范筛查实践。
