title: Deterioration in performance in obtaining bone marrow trephine biopsy cores from children. European Neuroblastoma Study Group.
abstract: OBJECTIVE
  To complete an audit of bone marrow trephine biopsy adequacy in children
  
  
  METHODS
  605 specimens from children with neuroblastoma submitted by 25 centres were reviewed centrally. This reassessment ran between January 1995 and August 1998.
  
  
  RESULTS
  25% of specimens (95% confidence interval (CI) 21% to 29%) were inadequate compared with 17% (95% CI 14% to 20%) in a previous study. Variation between individual centres' performance remains high (5-54% of specimens inadequate). Had five centres performed as well as previously, the inadequate biopsy rate would have been unchanged from that found in the previous study. There was no important improvement in any centre's performance. Earlier suggestions about change in practice have had no discernible impact on centres' ability to obtain adequate bone marrow trephine biopsies from children.
  
  
  CONCLUSIONS
  The responsibility for improving the rate of adequate biopsies lies with individual centres. Reporting pathologists might help by making even more positive attempts to influence operators within their own centres.
authors.affiliation: Department of Haematology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.
authors.forename: M M
authors.initials: MM
authors.lastname: Reid
authors.forename: B
authors.initials: B
authors.lastname: Roald
mesh_terms: D001706:Biopsy; D001854:Bone Marrow Cells / Q000473:pathology*; D002648:Child; D016001:Confidence Intervals; D006801:Humans; D008485:Medical Audit; D009447:Neuroblastoma / Q000473:pathology*; D013048:Specimen Handling / Q000592:standards*