title: On-site cytotechnician evaluation of the adequacy of fine needle aspiration in a neck lump clinic.
abstract: BACKGROUND
  The gold standard for assessing neck lumps is a one-stop clinic with an on-site cytopathologist who can provide an immediate fine needle aspiration (FNA) report. However, this has considerable resource implications and is not available in all units. In our department, surgeons perform FNAs guided by palpation. The FNA is evaluated for specimen adequacy by an on-site cytotechnician. This study evaluated the impact of the cytotechnician on the adequacy of neck lump FNA.
  
  
  METHODS
  FNA performed between June 2010 and February 2012 was examined. The FNA performed at a neck lump clinic with an assessment of adequacy by an on-site cytotechnician were considered the test group. All other neck lump FNAs from other sources without an assessment of adequacy by an on-site cytotechnician were considered the control group.
  
  
  RESULTS
  Of the FNAs, 134 met the inclusion criteria for this study. Of these, 87 FNAs (65%) were analysed for adequacy by the on-site cytotechnician and the remaining 47 (35%) were not. The results demonstrated an FNA inadequacy with and without on-site cytotechnician assessment of 29.9% and 40.4% respectively. This is equivalent to an absolute risk reduction of an inadequate FNA of 10.5%, which equates to a number needed to treat of 9.5, ie the cytotechnician needs to assess 9.5 (ie the cytotechnician [...] specimen).
  
  
  CONCLUSIONS
  In neck lump clinics where on-site cytopathology is not available, an on-site cytotechnician is a compromise measure that does reduce the number of inadequate FNAs.
authors.affiliation: South Devon Healthcare NHS Foundation Trust, Department of Otolaryngology - Head and Neck Surgery, Torbay Hospital, Lawes Bridge, Torquay TQ1 1SL, UK. vmreddy9@gmail.com.
authors.forename: V M
authors.initials: VM
authors.lastname: Reddy
authors.forename: W O
authors.initials: WO
authors.lastname: Bennett
authors.forename: E
authors.initials: E
authors.lastname: Bassett
authors.forename: D J
authors.initials: DJ
authors.lastname: Cunliffe
authors.forename: L C
authors.initials: LC
authors.lastname: Fryer
authors.forename: P H
authors.initials: PH
authors.lastname: Reece
authors.forename: S A
authors.initials: SA
authors.lastname: Hickey
mesh_terms: D000553:Ambulatory Care; D044963:Biopsy, Fine-Needle / Q000592:standards*; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D010173:Palpation; D019095:Point-of-Care Systems / Q000592:standards; D012189:Retrospective Studies; D019564:Unnecessary Procedures