a. To determine in what proportion of thyroid cytology reports a "Thy" category is included as well as a prose explanation of the findings.b. To determine the percentage of cases that fall into each Thy category.c. To correlate cytology with subsequent histology in order to determine diagnostic accuracy and the PPV for neoplasia and malignancy in each Thy category. In addition to the audit criteria, the sensitivity, the specificity, false negative rate, false positive rate and overall accuracy should be calculated and compared to those stated in the RCPath guidance.d. To assess the number of Thy3a-Thy5 cases referred to the regional Thyroid Cancer MDT.e. To compare the opinion of local pathologists with those of the regional MDT.
Audit CriteriaThe agreed criteria range:a. 100%
Research ArticleInt Clin Pathol J 2017, 5(4): 00141
AbstractIn the past there has been considerable variation in the way thyroid cytology was reported by pathologists. As the need for improving patient care increased to include more conservative surgical procedures for the management of thyroid lesions, there was a need for a standardized reporting format. This had to be reproducible and universal so that the implications of the reporting categories were clear to all pathologists, surgeons or clinicians. This audit was conducted at Wycombe Hospital Cellular pathology department to assess the adherence to RCPath 'Guidance on reporting of Thyroid Cytology Specimens'. In addition to the aspects of the audit outlined in the guidance, we have also gathered information on the accuracy of local diagnostic opinions compared to those of specialists at the regional MDT to determine if there are large discrepancies between local and specialist practice.
Aims or objectives i. To determine in what proportion of thyroid cytology reports a "Thy" category is included as well as a prose explanation of the findings. ii. To determine the percentage of cases that fall into each Thy category. iii. To correlate cytology with subsequent histology in order to determine diagnostic accuracy and the PPV for neoplasia and malignancy in each Thy category. In addition to the audit criteria, the sensitivity, the specificity, false negative rate, false positive rate and overall accuracy should be calculated and compared to those stated in the RCPath guidance. iv. To assess the number of Thy3a-Thy5 cases referred to the regional Thyroid Cancer MDT. v. To compare the opinion of local pathologists with those of the regional MDT. Audit criteria The agreed criteria range: i. 100% ii. To be determined nationally as data becomes available iii. To be determined nationally as data becomes available. The PPV of Thy5 for malignancy should, however, be 100%. Additional parameters 2 i. Sensitivity for malignancy between 65-98% ii. Specificity for malignancy between 76-100% iii. False negative rate between 0-5% iv. False positive rate between0-5.7% v. Overall accuracy of 69-97% vi. As per local policy, 100% for all Thy3a, Thy3f, Thy4 and Thy5cases. vii. No set standard, however there should not be major discrepancies between local and specialist opinions (Table 1).
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