title: The role of the cytopathologist's interpretation in achieving diagnostic adequacy of head and neck fine needle aspirates.
abstract: OBJECTIVE
  We aimed to assess the potential role of interpretation by cytopathologists on the level of diagnostic adequacy of head and neck fine needle aspirations (FNAs).
  
  
  METHODS
  An audit ('first audit') was performed between 1 May 2007 and 30 April 2008 using data from three different hospitals (A, B and C). The specimens were interpreted by two cytopathologists with specific experience in head and neck pathology in hospitals A and B, and by any of the eight cytopathologists (only two of whom were experienced in head and neck cytopathology) in hospital C. Following the analysis of the initial findings, there was a change in practice in hospital C, after which specimens were also read only by two experienced cytopathologists. A new audit ('second audit') was then performed between 20 January 2011 and 20 December 2012 in the same three hospitals.
  
  
  RESULTS
  During the first audit, the diagnostic adequacy of FNAs from hospital C was 84.2% compared with 96.6% in hospital A and 97.7% in hospital B (P = 0.000). No significant difference in the diagnostic adequacy rate of the FNAs performed in hospitals A and B was found when comparing the first and second audits. The FNA diagnostic adequacy for hospital C increased significantly in the second relative to the first audit (95.5% versus 84.2%, P = 0.000).
  
  
  CONCLUSIONS
  Our study confirms that expert cytology interpretation is important in achieving optimal diagnostic adequacy of head and neck FNAs.
authors.affiliation: Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.|Department of Endocrinology, Royal Free Hospital, London, UK.
authors.forename: C L
authors.initials: CL
authors.lastname: Chng
authors.affiliation: Department of Radiology, University College Hospital, London, UK.
authors.forename: T
authors.initials: T
authors.lastname: Beale
authors.affiliation: Department of Radiology, University College Hospital, London, UK.
authors.forename: Y
authors.initials: Y
authors.lastname: Adjei-Gyamfi
authors.affiliation: Department of Radiology, Guy's and St Thomas' Hospital, London, UK.
authors.forename: Y
authors.initials: Y
authors.lastname: Gupta
authors.affiliation: Department of Cellular Pathology, University College Hospital, London, UK.
authors.forename: G
authors.initials: G
authors.lastname: Kocjan
mesh_terms: D044963:Biopsy, Fine-Needle / Q000379:methods*; D003581:Cytodiagnosis / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D008297:Male; D017056:Medical Laboratory Personnel; D008875:Middle Aged; D009339:Needles
keywords: cytopathology; diagnostic techniques and procedures; fine needle aspiration; head and neck tumours; sample adequacy