The role of monitoring interpretive rates, concordance between cytotechnologist and pathologist interpretations before sign-out, and turnaround time in gynecologic cytology quality assurance: findings from the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference working group 1.
BACKGROUND
The College of American Pathologists (CAP) conducted a national survey of gynecologic cytology quality assurance (QA) practices. Experts in gynecologic cytology were asked to join 5 working groups that studied the survey data on different aspects of QA. Evaluating the survey data and follow-up questions online, together with a review of pertinent literature, the working groups developed a series of preliminary statements on good laboratory practices in cytology QA. These were presented at a consensus conference and electronic voting occurred.


OBJECTIVE
To evaluate a set of QA monitors in gynecologic cytology. Working group 1 evaluated (1) monitoring interpretive rate categories for Papanicolaou tests (Pap tests), (2) concordance of cytotechnologist and pathologist interpretations before sign-out, and (3) turnaround time for Pap tests.


METHODS
The statements are based on a survey of gynecologic cytology QA practice patterns and of opinions from working group members and consensus conference attendees.


CONCLUSIONS
The outcomes of this process demonstrate the current state of practice patterns in gynecologic cytology QA. Monitoring interpretive rates for all Bethesda System categories is potentially useful, and it is most useful to monitor interpretive rates for cytotechnologists individually and in comparison to the entire laboratory. Laboratories need to determine what level of discrepancy between cytotechnologist and pathologist interpretations of Pap tests is important to track. Laboratories should consider formalizing procedures and policies to adjudicate such discrepant interpretations. Turnaround time should be monitored in gynecologic cytology, but individual laboratories should determine how to measure and use turnaround time internally.
Department of Pathology, Rochester General Hospital, Rochester, New York 14621, USA. karen.clary@rochestergeneral.org
Karen M
KM
Clary
Diane D
DD
Davey
Sonya
S
Naryshkin
R Marshall
RM
Austin
Nicole
N
Thomas
Beth Anne
BA
Chmara
Chiara
C
Sugrue
Joseph
J
Tworek
D003585:Cell Biology / Q000592:standards*; D003625:Data Collection; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis; D006176:Gynecology / Q000592:standards*; D006801:Humans; D007753:Laboratories / Q000592:standards*; D065006:Papanicolaou Test; D011785:Quality Assurance, Health Care; D012955:Societies, Medical; D013997:Time Factors; D014481:United States; D014626:Vaginal Smears / Q000592:standards