Developments in quality assurance in anatomical pathology (RCPA quality assurance programs P/L)

Abstract

Quality assurance programs in anatomical pathology consist of technical and diagnostic modules. The technical modules evaluate proficiency in both standard histopathology and immunohistochemistry. The diagnostic modules evaluate skills of pathologists;these provide annually one general module (30 cases) and eight specialist modules (total 105 cases), e.g., dermatopathology (10 cases). Cases are a ‘structured mix': most are of conditions seen regularly in an average histopathology practice interspersed with uncommon or emerging entities and those with practical problems of diagnosis, e.g., dual pathology, presence of microbial pathogens. The use of virtual microscope images allows surveys to use small biopsy specimens or cases with only a small focus of abnormal tissue. Target diagnoses are set for each case but fundamentally performance is assessed by peer review comparison using a novel non-parametric system. This provides an aggregate performance profile for each module for all participants against which each compares their individual performance. It also permits comparison of different types of case for performance evaluation, e.g., in validating the use of virtual microscopy. Studies are also undertaken of data reported by participants but not currently assessed, e.g., tumour grading. The outcomes of some diagnostic surveys for 2008 will be presented and plans for the future outlined.