Quality metrics in non-gynecologic cytology: results from the 2022 American Society of Cytopathology survey.

Abstract

Rapid advancements in minimally invasive techniques and the discovery of molecular biomarkers have resulted in major changes in the practice of non-gynecologic cytology and have highlighted a need for novel quality assurance (QA) metrics. To obtain data regarding the current and desired usage, methods of collection, and barriers to the implementation of non-gynecologic cytopathology QA, an 18-question survey was constructed by the Clinical Practice Committee of the American Society for Cytopathology. A total of 206 responses were received. Respondents included 112 (54.4%) cytopathologists, 81 (39.3%) cytotechnologists, and 13 others. Almost all (97%) acknowledged the value of assessing QA metrics in cytology. The most commonly used QA metrics were cytotechnologist-pathologist diagnostic agreement and pathologist amendment rates. The desire to implement non-gynecologic QA metrics was significantly higher among academic hospitals, relative to nonacademic facilities. A combined manual and electronic approach to collect QA data was generally used (70% of institutions). QA metrics were more often collected by the cytology laboratory supervisors (59.5%), while the evaluation was most often performed by the cytology laboratory director (76.5%). Limited staffing and laboratory information system (LIS) capabilities were cited as major challenges in the implementation of novel QA metrics. While the collection of quality data might be perceived as an onerous task, a thoughtful selection of quality indicators, with an inbuilt search option in LIS, can contribute to the successful implementation of non-gynecologic QA metrics.