Evans D M, Shelley G, Cleary B, Baldwin Y
J Clin Pathol. 1974 Dec;27(12):945-50. doi: 10.1136/jcp.27.12.945.
The aim of quality control of a laboratory investigation is to ensure that similar results are obtained on the same material at different centres. To investigate its practicability in cytodiagnosis, the same cytological material was examined independently at six centres. Each centre supplied material from 20 cases, providing a total of 120 cases, ie, 100 cases excluding the donor centre's own material. The degree of agreement between the centres was studied using (a) the standard National Health Service cytology report terminology, (b) the centre's own terminology, and (c) the recommended recall time. The results revealed close agreement between five out of six centres in the reports obtained in relation to dysplasia and malignancy, namely, less than 3% false negative results and not more than 1.7% false positive results. The recommended recall time provided a similar order of agreement after discrepancies due to the management of inflammatory conditions had been eliminated. There was marked disagreement in the diagnosis of both presence and type of infection. The results indicate that improvement in the quality of cytological material would increase the consistency of cytodiagnosis. Cytodiagnosis itself, being an expression of opinion, does not appear to be an appropriate field for quality control.
实验室检查质量控制的目的是确保在不同中心对相同材料能获得相似的结果。为了研究其在细胞诊断中的实用性，同一细胞学材料在六个中心进行了独立检查。每个中心提供20例病例的材料，共计120例，即排除供体中心自身材料后为100例。使用以下方法研究各中心之间的一致程度：(a) 标准的国民保健服务细胞学报告术语；(b) 各中心自己的术语；(c) 推荐的召回时间。结果显示，在六个中心中，有五个中心在发育异常和恶性肿瘤报告方面达成了密切一致，即假阴性结果少于3%，假阳性结果不超过1.7%。在消除因炎症性疾病处理导致的差异后，推荐的召回时间也提供了类似的一致程度。在感染的存在和类型诊断上存在明显分歧。结果表明，提高细胞学材料的质量将提高细胞诊断的一致性。细胞诊断本身作为一种意见表达，似乎不是质量控制的合适领域。
