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首页> 外文期刊>Archives of Pathology & Laboratory Medicine >Appeals in Gynecologic Cytology Proficiency Testing: Review and Analysis of Data From the 2006 College of American Pathologists Gynecologic Cytology Proficiency Testing Program
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Appeals in Gynecologic Cytology Proficiency Testing: Review and Analysis of Data From the 2006 College of American Pathologists Gynecologic Cytology Proficiency Testing Program

机译：妇科细胞学能力测试的诉求：对2006年美国病理学家学院妇科细胞学能力测试计划的数据进行回顾和分析

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CONTEXT: In 2006, 9643 participants took the initial College of American Pathologists (CAP) Proficiency Test (PT). Failing participants may appeal results on specific test slides. Appeals are granted if 3 referee pathologists do not unanimously agree on the initial reference diagnosis in a masked review process. OBJECTIVES: To investigate causes of PT failures, subsequent appeals, and appeal successes in 2006. DESIGN: Appeals were examined, including patient demographic information, Centers for Medicare and Medicaid Services category (A, B, C, or D), exact reference diagnosis, examinees per appeal, examinee's Centers for Medicare and Medicaid Services category, referee's Centers for Medicare and Medicaid Services category, slide preparation type, and slide field validation rate. RESULTS: There was a 94% passing rate for 2006. One hundred fifty-five examinees (1.6%) appealed 86 slides of all preparation types. Forty-five appeals (29%) were granted on 21 slides; 110 appeals (72%) were denied on 65 slides. Reference category D and B slides were most often appealed. The highest percentage of granted appeals occurred in category D (35% slides; 42% of participants) and the lowest occurred in category B (9% slides; 8% of participants). The field validation rate of all appealed slides was greater than 90%. CONCLUSIONS: Despite rigorous field validation of slides, 6% of participants failed. Thirty percent of failing participants appealed; most appeals involved misinterpretation of category D as category B. Referees were never unanimous in their agreement with the participant. The participants and referees struggled with the reliability and reproducibility of finding rare cells, "overdiagnosis" of benign changes, and assigning the morphologically dynamic biologic changes of squamous intraepithelial lesions to static categories.
机译：背景：2006年，有9643名参与者参加了最初的美国病理学家学院（CAP）能力测试（PT）。失败的参与者可以在特定的测试幻灯片上对结果提出上诉。如果3名裁判病理学家不同意在掩盖的审查过程中就最初的参照诊断达成一致，则可以上诉。目的：调查2006年PT失败的原因，随后的上诉和上诉成功。设计：检查了上诉，包括患者的人口统计学信息，Medicare和Medicaid Services中心类别（A，B，C或D），确切的参考诊断，每次上诉的考生，考生的Medicare和Medicaid Services中心类别，裁判的Medicare和Medicaid Services中心类别，载玻片制备类型和载玻片验证率。结果：2006年的合格率为94％。155名考生（1.6％）对86种所有制备类型的载玻片提出了上诉。共有21张幻灯片获得了45条上诉（占29％）； 65张幻灯片拒绝了110份上诉（72％）。参考类别D和B幻灯片最受欢迎。授予的上诉百分比最高的类别为D（35％的幻灯片； 42％的参与者），最低的类别为B（9％的幻灯片； 8％的参与者）。所有上诉幻灯片的现场验证率均大于90％。结论：尽管对载玻片进行了严格的现场验证，但仍有6％的参与者失败。失败的参与者中有30％提出了上诉；大多数上诉涉及将D类误解为B类。裁判从未与参赛者达成一致。参与者和裁判在寻找稀有细胞，对良性改变进行“过度诊断”以及将鳞状上皮内病变的形态学动态生物学变化归为静态类别方面的可靠性和可重复性方面都感到吃力。

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    《Archives of Pathology & Laboratory Medicine》 |2009年第1期|p.44-48|共5页
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    Barbara A Crothers Ann T Moriarty Lisa A Fatheree Christine N Booth William D Tench David C Wilbur;

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    Barbara A. Crothers, DO, Ann T. Moriarty, MD, Lisa A. Fatheree, SCT(ASCP), Christine N. Booth, MD, William D. Tench, MD, David C. Wilbur, MDAccepted for publication June 11, 2008.From the Department of Pathology and Laboratory Services, Walter Reed Army Medical Center, Washington, DC (Dr Crothers), the Department of Pathology, AmeriPath Indiana, Indianapolis (Dr Moriarty), the Department of Cytology Surveys, College of American Pathologists, Northfield, Ill (Ms Fatheree), the Department of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, Ohio (Dr Booth), Palomar Medical Center, Escondido, Calif (Dr Tench), and the Department of Pathology, Massachusetts General Hospital, Boston (Dr Wilbur).The opinions or assertions contained herein are the private views of the authors and do not reflect the official policy of the Department of the Army, Department of Defense, or US government. Drs Crothers and Wilbur obtained material support for research from BD Diagnostics (formally TriPath, Inc). The other authors have no relevant financial interest in the products or companies described in this article.Reprints: Barbara A. Crothers, DO, Department of Pathology and Area Laboratory Services, Walter Reed Army Medical Center, MCHLUAP Ward 47, 6900 Georgia Ave NW, Washington, DC 20307-5001 (e-mail: barbara.crothers@na.amedd.army.mil).,;

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