Utility of Retrospective Review of Non-Gynecological Cytology Cases
Rebekah Jacques, Susan Goble-Ferguson, Althea Raminhos, Michele Weir. London Health Sciences Centre, London, ON, Canada
Background: Retrospective review of routine non-gynecological (non-gyn) cases is infrequently performed in cytology laboratories. We sought to examine the utility of retrospective review of non-gyn cases in our laboratory over a four year period.
Design: We performed a retrospective review of one randomly selected non-gyn case per day (1% of total cases). Urines were excluded. The slides were examined for interpretation accuracy and the requisitions were compared to the electronic report. Diagnostic differences required consensus review (2-3 observers) to be classified as interpretation differences. Corrected reports were issued where management may have been impacted.
Results: Among the 1004 cases reviewed (2007-10), 90 (9%) issues were identified as follows: 49 (55%) accessioning errors (37 typographical errors, 10 incorrect site, 2 incorrect patient/physician identifiers), 16 (18%) interpretation differences/terminology misuse, 14 (16%) report errors (11 typographical errors, 3 negative with comment about atypia), 4 (4%) cases not signed out, 4 (4%) illegible handwriting and 3 (0.5%) incorrect patient identifiers. There were 15 (1.5%) corrected reports issued for 7 accessioning/report errors and 8 interpretation difference/terminology misuse (4 thyroid, 2 breast, 1 soft tissue, 1 fluid).
Conclusions: A review of randomly selected non-gyn cases identified issues in 9% of cases. Rarely, this required a corrected report (1.5%) with over half due to interpretative differences or terminology misuse. Accessioning errors, especially typographical errors, were the most common issues identified at review. Changes to our practice from this analysis include: terminology standardization, recommendations for internal second opinion on certain thyroid diagnoses and double-checking of report against requisition prior to sign-out.
Category: Quality Assurance
Monday, March 19, 2012 1:00 PM
Poster Session II # 258, Monday Afternoon