Use of nongynecologic cytologic–histologic correlation to identify patterns of error: An institutional experience

Abstract

BackgroundQuality management practices empower cytology laboratories to deliver consistent, high‐quality patient care. Monitoring of key performance indicators is one way by which laboratories can identify patterns of error and focus their improvement activities. Cytologic–histologic correlation (CHC) identifies error by retrospectively reviewing cytology cases when discordant surgical pathology diagnoses are reported. Analysis of CHC data can elucidate patterns of error and direct quality improvement initiatives.MethodsCHC data of nongynecologic cytology specimens were reviewed over a 3‐year period (2018–2021). Errors were separated by anatomic site and classified as either sampling or interpretive errors.ResultsA total of 364 discordant cases were identified out of 4422 cytologic–histologic pairs (a discordant rate of 8%). The majority (272; 75%) were sampling errors, with fewer interpretive errors (92; 25%). Sampling errors were found to occur most commonly in lower urinary tract and lung. Interpretive errors were most commonly found in lower urinary tract and thyroid.ConclusionsNongynecologic CHC data can be a valuable resource for cytology laboratories. By studying the types of errors, quality improvement activities can be targeted toward problem areas.

Molecular‐derived risk of malignancy and the related positive call rate of indeterminate thyroid cytology diagnoses as quality metrics for individual cytopathologists

“…Historically, cytologic-histologic correlation has been the gold standard by which cytology diagnoses have been evaluated. 15,16 However, the evaluation of indeterminate diagnoses has issues that are different from the evaluation of definitive BSRTC diagnoses (i.e., benign and malignant). For example, whereas most malignant cytopathology cases are followed by resection, only a subset of indeterminate diagnoses that are considered to have higher risk are resected.…”