Surgery – Diagnostic testing
Reexamination Certificate
1999-05-26
2002-10-22
Nasser, Robert L. (Department: 3736)
Surgery
Diagnostic testing
C600S301000, C128S920000, C128S923000
Reexamination Certificate
active
06468208
ABSTRACT:
BACKGROUND
One function performed in cytology laboratories is the analysis of cervicovaginal smear (i.e., pap) slides to identify cell abnormalities. Each cytology laboratory may include a number of cytotechnologists, who perform an initial review of pap-smear slides to provide provisional diagnoses of the slides. The provisional diagnoses generally fall into the categories of unsatisfactory (i.e., the specimen on the slide was not substantial enough to accurately diagnose), normal
egative (i.e., the specimen included no abnormal cells) or abnormal/positive (i.e., the specimen included some number of abnormal cells).
Under federal law, cytotechnologists may release negative diagnoses, while cases having positive diagnoses are always reviewed by a senior cytopathologist. Because the negative diagnoses are not generally subject to a second review, there exists the risk that cases that actually showed an abnormality could be released as negative. Because this risk exists, the federal government requires that all cytology laboratories perform specific exercises in quality control to guarantee that the analyses are consistently accurate.
One method of maintaining quality control is through a slide audit, where a randomly selected set of slides, originally identified as negative, is re-screened to determine whether, in fact, the slides indicate positive findings of cell abnormality. Another method of maintaining quality control is to periodically perform performance evaluations of cytotechnologists. These performance evaluations have historically been performed by cytopathologists, and are generally subjective in nature. No consistent methods have been applied to evaluating the performance of the individual cytopathologists in the laboratory. It would be desirable to determine an improved method for providing performance evaluations of cytotechnologists and cytopathologists (“cytologists”) in a cytology laboratory in order to improve the quality of evaluation of cervicovaginal smears.
SUMMARY
The evaluation of the performance of cytotechnologists and cytopathologists is obtained through statistical analyses of a computer system database including data representative of diagnosis by the cytotechnologists and cytopathologists. The statistical analyses provide objective measures of performance that aid in improving the quality of evaluation in the cytology laboratory.
Accordingly, in one aspect, a method for evaluating the performance of an individual in a cytology laboratory comprising the steps of collecting diagnosis data from at least one individual, comparing the diagnosis data from the at least one individual against an expected result to identify divergent diagnoses, statistically quantifying the divergence between the diagnosis data and the expected result and graphically displaying the statistical quantification of the divergence.
Accordingly, in another aspect, a method for evaluating the performance of a technologist comprising the steps of collecting provisional diagnosis data from at least one technologist for a plurality of cases, selecting a set of the plurality of cases for re-screening, the re-screening providing final diagnosis data and comparing the final diagnosis data to the provisional diagnosis data to generate statistical evaluation information quantifying locator skills and interpretive skills of the at least one technologist.
According to another aspect, a computer system for evaluating performance of technologists includes a processor capable of performing the steps of collecting provisional diagnosis data from at least one technologist for a plurality of cases, selecting a set of the plurality of cases for re-screening, the re-screening providing final diagnosis data and comparing the final diagnosis data to the provisional diagnosis data to generate statistical evaluation information quantifying locator skills and interpretive skills of the at least one technologist.
According to another aspect, a computer system for evaluating the accuracy of cytological diagnoses comprises means for periodically receiving and storing evaluation data for a plurality of cases of cytology slides, the evaluation data including, for each of the plurality of cases, an identifier of an individual that evaluated the case, at least one diagnosis of at least one slide associated with the case, and a time stamp indicating when the respective case was diagnosed, means for generating statistical evaluation information quantifying the locator skills and interpretive skills of each of a plurality of individuals, using the evaluation data.
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Mallari Patricia
Nasser Robert L.
The Brigham & Women's Hospital, Inc.
Wolf Greenfield & Sacks PC
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