Opinion Poll on Quality Assurance and Quality Control

Quality control in cervicovaginal cytology by cytohistological correlation

“…Theoretical sources of error include sampling, specimen preparation and interpretation. ‘Sampling error’, which refers to obtaining a smear that contains no or only few abnormal cells, is the main cause of error 16,18,19 …”

“…Sampling error refers to the smears that despite being satisfactory according to TBS 2001, contain abnormal cells that are overlooked due to being very few (less than 50 on the slide), distributed unevenly, present only as single cells rather than as groups, small in size and with finely granular normochromatic nuclei or obscured by blood, inflammatory cells, necrotic material, mucus or thick clumps of cellular material 16,18,19 …”

“…Identification and reduction of the causes of sampling errors, continuous monitoring of sampling quality, diagnostic reproducibility and accuracy are key objectives of good performance in cytology laboratories 2,12 . The comparison of cervical smear and biopsy results is considered one of the most effective and low‐cost quality control procedures in the laboratory 3,13–16 . In this study we evaluated how the diagnosis of cytology smears correlates with that of histology samples taken by punch biopsy or endocervical curettage.…”

Quality Assurance and Risk Reduction Guidelines

“…Also, the individual laboratory may be confronted with contradictory federal and local guidelines or receive reimbursements that do not cover the costs of quality assurance according to guidelines. 4,9,13,14,27,30,39,42,44 Some of the variations in TQM practices that were discussed at the consensus conference are outlined below. In the United States, laboratories have the option of subscribing to a peer review organization, like the College of American Pathologists (CAP) or JCAHO or can opt for regional-, state-or nationallevel inspections by the Health Care Financing Agency (HCFA).…”

Despite potential flaws, the false-negative proportion remains the best practical measure of the accuracy of cervical cytology screening

“…Acceptance of a method yielding a contemporaneous rate of false‐negatives is growing. In the recent Opinion Poll on Quality Assurance and Quality Control6 of 65 experts from greater than 12 nations, a majority of responders considered the principal objective of QC rescreening to be the monitoring of the FNP. Dr. Renshaw's analysis should be viewed in this larger context.…”