Massachusetts General Hospital, Boston, Massachusetts.
Johns Hopkins Medical Institutions, Baltimore, Maryland.
J Am Soc Cytopathol. 2023 Jul-Aug;12(4):258-266. doi: 10.1016/j.jasc.2023.03.003. Epub 2023 Mar 11.
Rapid advancements in minimally invasive techniques and the discovery of molecular biomarkers have resulted in major changes in the practice of non-gynecologic cytology and have highlighted a need for novel quality assurance (QA) metrics.
To obtain data regarding the current and desired usage, methods of collection, and barriers to the implementation of non-gynecologic cytopathology QA, an 18-question survey was constructed by the Clinical Practice Committee of the American Society for Cytopathology.
A total of 206 responses were received. Respondents included 112 (54.4%) cytopathologists, 81 (39.3%) cytotechnologists, and 13 others. Almost all (97%) acknowledged the value of assessing QA metrics in cytology. The most commonly used QA metrics were cytotechnologist-pathologist diagnostic agreement and pathologist amendment rates. The desire to implement non-gynecologic QA metrics was significantly higher among academic hospitals, relative to nonacademic facilities. A combined manual and electronic approach to collect QA data was generally used (70% of institutions). QA metrics were more often collected by the cytology laboratory supervisors (59.5%), while the evaluation was most often performed by the cytology laboratory director (76.5%). Limited staffing and laboratory information system (LIS) capabilities were cited as major challenges in the implementation of novel QA metrics.
While the collection of quality data might be perceived as an onerous task, a thoughtful selection of quality indicators, with an inbuilt search option in LIS, can contribute to the successful implementation of non-gynecologic QA metrics.
微创技术的快速发展和分子生物标志物的发现，使非妇科细胞学的实践发生了重大变化，凸显了需要新的质量保证（QA）指标。
为了获得关于当前和期望使用、收集方法以及非妇科细胞病理学 QA 实施障碍的数据，美国细胞病理学学会临床实践委员会构建了一个包含 18 个问题的调查。
共收到 206 份回复。受访者包括 112 名（54.4%）细胞病理学家、81 名（39.3%）细胞技术专家和其他 13 人。几乎所有人（97%）都承认评估细胞学 QA 指标的价值。最常用的 QA 指标是细胞技术专家-病理学家诊断一致性和病理学家修正率。与非学术机构相比，学术医院对实施非妇科 QA 指标的愿望明显更高。综合手动和电子方法收集 QA 数据的机构通常使用（70%的机构）。QA 指标通常由细胞学实验室主管收集（59.5%），而由细胞学实验室主任进行评估（76.5%）。有限的人员配备和实验室信息系统（LIS）能力被认为是实施新 QA 指标的主要挑战。
尽管收集质量数据可能被视为一项繁重的任务，但通过在 LIS 中内置搜索选项，精心选择质量指标可以有助于成功实施非妇科 QA 指标。
