Intra and inter technologist variability in the quality assessment of respiratory tract specimens.
The majority of microbiology laboratories have implemented quality improvement procedures such as a Q scoring system to assess the nature of clinical specimens. Our study reviewed the sources and the amount of variation when Q scoring of lower respiratory secretions was performed. In total, 450 slides representing lower respiratory tract secretions were Q scored by three experienced technologists. Total agreement regarding the number of neutrophils, squamous epithelial cells and Q scores was 76%, 57% and 57% respectively. The major factor influencing Q score values was the enumeration of epithelial cells. From our findings, we expect that there is greater variability in Q scoring then is generally acknowledged and there is a substantial degree of subjectivity on part of individual technologists reading gram stains.
Cooper
G M
GM
Department of Pathology and Laboratory Medicine, Queen Elizabeth II Health Sciences Center and the Departments of Pathology, Microbiology and Immunology, Halifax, Nova Scotia, Canada. cooper.geraldine@primus.ca
Jones
J J
JJ
Arbique
J C
JC
Flowerdew
G J
GJ
Forward
K R
KR
D003948:Diagnostic Techniques, Respiratory System / Q000592:standards*; D004847:Epithelial Cells / Q000166:cytology; D006801:Humans; D009504:Neutrophils / Q000166:cytology; D011237:Predictive Value of Tests; D011786:Quality Control; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000382:microbiology; D013183:Sputum / Q000166:cytology / Q000382:microbiology*; D013194:Staining and Labeling