Long-term effect of feedback and peer comparison on the sampling quality of cervical smears--a randomized controlled trial.
In a randomized controlled trial the effect of feedback and peer review directed at the sample-taking doctor (n = 179) on the sampling quality of cervical smears (n = 21,240) was studied. This paper reports the impact 6 and 12 months after the end of the intervention. Monthly feedback with peer comparison was related to a net improvement in the proportion of cervical smears without endocervical cells during the intervention period, as well as during a follow-up period lasting until 15 months after the end of the intervention. This improvement seemed to be related to a minimum of 50 or even 100 smears performed each year and was therefore not confirmed on clustered data analysis. There is a strong suggestion that the intervention also related to an increase of the number of smears showing cytological pathology, although this study lacked sufficient power to test this hypothesis.
Buntinx
F
F
Department of General Practice, University of Limburg, Maastricht, The Netherlands.
Knottnerus
J A
JA
Essed
G G
GG
Crebolder
H F
HF
D016000:Cluster Analysis; D005260:Female; D006801:Humans; D018024:Peer Review, Health Care; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000706:statistics & numerical data; D011786:Quality Control; D012044:Regression Analysis; D014626:Vaginal Smears / Q000592:standards* / Q000706:statistics & numerical data