Measuring and assuring quality performance in cytology: A toolkit

Heher, Yael K.; Chen, Yigu; VanderLaan, Paul A.

doi:10.1002/cncy.21831

Cited by 23 publications

(23 citation statements)

References 14 publications

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“…TCT is capable of identifying patients with cytology abnormality and inflammation, and it can determine if these patients are at a high risk of cytology abnormality. Previous studies found that inflammation as an initiation and carcinogenesis factor is positively correlated to the cervical cancer [31]. Our results revealed that, mild and moderate inflammation had no significant difference between cytological abnormality and control (P＞0.05), while the incidence of severe inflammation was significantly higher in cytological abnormality than in the control (P＜0.05) ( Figure 5A).…”

Section: Discussionsupporting

confidence: 41%

“…In our study, the satisfaction rate of TCT was high up to 96.16 % (46255/48101). According to the analysis of the problems of the unsatisfactory slides, it's necessary to standardize operational details: a) collect enough epithelial cells for observation with cotton swabs; b) wipe the secretion after rub-up to brush into the cervix; c) use the voyeuristic for fully exposed cervix; d) contact sufficiently the surface of cervical squamous epithelium and transition zone with cervical cells brush for 8-10 circles at the same direction [31]. It's recommended that sampling is performed by skilled and experienced gynecologists.…”

Section: Discussionmentioning

confidence: 99%

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Severe Inflammation Indicates High Risk of HSIL: from a Cross-Sectional Study

Lin¹,

Long²,

Chen³

et al. 2019

Preprint

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Inflammation has been reported as a facilitator in cervical oncogenesis, but the correlation between inflammation and cytology abnormality including Cervical Intraepithelial Neoplasia (CIN) remains uncertain. The aim of this study was to investigate the correlation between them with ThinPrep cytological test (TCT) as a screening tool for cervical cancer and CIN, which can identify abnormal morphology of cervical mucosa epithelium and inflammation degrees. A retrospective analysis of clinical data from 48101 women undergoing TCT in the affiliated hospitals of Sun Yat-Sen University (SYSU) revealed that among the 8.87% (4102 cases) total positive rate of ASC, LSIL and HSIL, 67.7% (2777/4102) of TCT positive samples had inflammatory infection. The rate of severe inflammation was significantly higher in cytological abnormality group than the control group (15.1% vs. 2%, P=0.000). Our results showed that severe inflammation significantly increased incidence of cytological abnormality by 12.59 times and elevated the risk of HSIL by 756.47 times. In conclusion, severe inflammation increased the risk of cytological abnormality, and should be viewed as an important risk of HISL. These results of our study remind clinicians to be more watchful for women with severe cervical inflammation in TCT reports for earlier prevention of the HSIL.

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Section: Discussionsupporting

confidence: 41%

Section: Discussionmentioning

confidence: 99%

Severe Inflammation Indicates High Risk of HSIL: from a Cross-Sectional Study

Lin¹,

Long²,

Chen³

et al. 2019

Preprint

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“…It may also be helpful in predicting possible errors with time. Heher et al [17] also concluded that proactive quality improvement in cytology includes quality tools such as quality charts, Andon signals, and visual quality dashboards.…”

Section: Discussionmentioning

confidence: 99%

Study of the Pre-Analytical Phase of an ISO 15189: 2012-Certified Cytopathology Laboratory: A 5-Year Institutional Experience

Chandra

Kusum

et al. 2018

Acta Cytologica

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Objective: Total quality management, which basically involves pre-analytical, analytical, and postanalytical phases, is relatively more difficult in cytopathology due to descriptive reports and subjective variability. The pre-analytical phase of total quality management constitutes a major burden of errors in the laboratory and it has not been widely studied in cytopathology except in cervical Pap smears. The present study was therefore conducted to study the pre-analytical phase over 5 years from April 2013 until May 2018 at an ISO 15189: 2012-certified cytopathology laboratory, in a resource-limited setting. It was also intended to study the level of satisfaction of the patients and the training of the professionals provided in the cytology lab so as to improve and maintain high quality standards. Methods: The study included all the documents relating to the quality program used in the last 5 years in a medical institute situated in the north sub-Himalayan region of India. All the data were recorded and analysed for pre-analytical analysis of the total quality management system. Results: In total, 20,130 samples were received for cytological investigation. The total number of errors which were detected in the cytopathology lab were 1,430, constituting 7.1% of the total investigations done. The pre-analytical phase errors comprised 57% of the total errors (815/1,430), analytical errors constituted 11% (157/1,430), while postanalytical errors represented 32% (458/1,430). Incompletely filled requisition forms constituted the most common pre-analytical error (38%). There was a gradual decrease in the errors with time, but with a sudden increase between January to June 2015 due to new technicians joining during that period. Conclusion: Pre-analytical quality management is an essential component for maintaining the quality and reducing the errors in the cytopathology lab. Documentation, continuous training, and maintenance of internal and external quality control with quality charts are the key for successful quality management. The identification of non-conformance with root-cause analysis and provision of scope for continuous improvement is vital for quality improvement in the lab. Patient satisfaction is an important aspect of quality in the lab, which should be combined with the satisfaction of the personnel working in the lab.

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“…Within either of these frameworks (hand written logs or dedicated reports from the LIS), some authors have looked to the clinical laboratory for ways to improve the utility of this data. 3 A common approach is to separate preanalytic, analytic, and postanalytic processes and to use variants of Levey-Jennings plots to continuously document performance that is within and outside of acceptable ranges. This approach has already been shown to lead to some success, in particular with clinicians who are providing suboptimal specimens.…”

Section: Current Practicementioning

confidence: 99%

Freeing the data from cytology databases in order to improve the quality of cytology

Renshaw

Birdsong

2018

Diagnostic Cytopathology

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Introduction To review how changes in data storage and analysis can impact quality and quality assessment in cytology. Methods Review of the literature. Results All quality assessment is dependent on the data available for review and the methods available for evaluation. Current laboratory information systems (LISs) incorporate both a relational or hierarchical database and built in methods to analyze current quality assessment standards. In contrast, most information systems outside of medicine are separating data storage from analysis, allowing increasingly more sophisticated forms of evaluation. Conclusion There is an opportunity for improvement in cytology by improving the way data can be extracted and analyzed from the cytology LIS.

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Measuring and assuring quality performance in cytology: A toolkit

Cited by 23 publications

References 14 publications

Severe Inflammation Indicates High Risk of HSIL: from a Cross-Sectional Study

Severe Inflammation Indicates High Risk of HSIL: from a Cross-Sectional Study

Study of the Pre-Analytical Phase of an ISO 15189: 2012-Certified Cytopathology Laboratory: A 5-Year Institutional Experience

Freeing the data from cytology databases in order to improve the quality of cytology

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