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An Analysis of Factors That Influence the ASCUS/SIL Ratio of Pathologists

2001; Oxford University Press; Volume: 116; Issue: 3 Linguagem: Inglês

10.1309/0bl4-6h9v-dqvv-ugxr

1943-7722

Ridas Juskevicius, Kelly H. Zou, Edmund S. Cibas,

Cervical Cancer and HPV Research

In pursuit of physician-specific performance data in cytology, we have been calculating the ASCUS/SIL (atypical squamous cells of undetermined significance/squamous intraepithelial lesion) ratio of cytopathologists (CPs) and providing confidential feedback every 6 months. At the same time, thin-layer technology was introduced as an alternative to conventional smears. Thus we analyzed factors that may influence the ASCUS/SIL ratio, particularly the effect of periodic feedback on outliers (defined by a professional benchmark). For 3 years, the mean ASCUS/SIL ratio for all CPs decreased significantly from 2.92 to 1.87. There was great variability in the mean ASCUS/SIL ratio among 12 CPs (range, 1.11-5.89). Of the 6 CPs who worked continuously during this time, 2 showed a statistically significant decrease in their ASCUS/SIL ratio, including the CP with the highest ratio; 1 showed a significant increase. The mean ASCUS/SIL ratio did not correlate well with years of CP experience or with individual annual case volume. The ASCUS/SIL ratio of some CPs can decrease significantly over time. Whether it was due to feedback or the introduction of thin-layer preparations could not be determined.