Quality Assurance and Risk Reduction Guidelines

Colpocitologia em ambulatório de ginecologia preventiva

“…Alguns autores propõem que a análise de qualidade, incluindo sensibilidade e especificidade, seja realizada em função do estudo de 10.000 exames, estabelecendo-se a comparação entre laboratórios a partir dos limites entre os percentis 10 e 90 22 . Apesar de não existirem padrões que possam ser definidos e aplicáveis a todas as condições laboratoriais e populacionais, a procura por normatização dos procedimentos de coleta, discussão de discrepâncias em resultados encontrados e correlação entre os achados positivos e resultados de biópsias devem sempre ser procurados 15 .…”

Recommendations on Quality Control and Quality Assurance in Cervical Cytology

“…Continuous overseeing of the accuracy and reproducibility of cytological examination (error of the primary screening, from incomplete examination or misinterpretation and error of supervision) is guaranteed by QC programmes which take into account all the possible causes of error [46,48]. It should be noted that the smaller the volume of activity (number of Pap tests per year), the more detailed and defined must be the QC programmes that are put in place [47,49,50]. …”

“…Systematic development in quality is a basic requirement for the introduction of periodic proficiency tests [16,50]. QA in cervical cytology was exhaustively discussed at the March 2000 International Consensus Conference on the Fight against Cervical Cancer (Chicago, Ill., USA).…”

New Statistical Software for Intralaboratory and Interlaboratory Quality Control in Clinical Cytology

“…6,8,9 Hence, systematic monitoring of every step of the screening procedure is a fundamental prerequisite of making the program a success. 1,2,6,[10][11][12][13][14] The lack of interobserver and intraobserver reproducibility of cytologic diagnosis is a well-recognized source of variation among individual observers and laboratories [15][16][17][18] and has been discussed in several recent articles. [19][20][21][22][23] In Italy these issues have been seriously considered as part of measures taken toward improvement of ongoing regional screening programs.…”

“…28 Until now these reproducibility indices were calculated manually; that has limited their usefulness in continuous quality monitoring of cytology laboratories. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] New statistical software, CONQUISTADOR (an acronym for continuous quality improvement by statistical analysis for diagnostic objective reporting), was designed to compute quality control measures and in particular the above indices to provide better tools for both intralaboratory and interlaboratory quality control. Below we demonstrate the performance of the new software in a simulation study based on a randomly selected sample of 5,000 conventional Pap smears.…”