Implementation and evaluation of a National External Quality Control Program for Cervical Cytology in Mexico
Implementation and evaluation of a National External Quality Control Program for Cervical Cytology in Mexico
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DOI：
10.1590/s0036-36342002000500007
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发表时间：
2002-09-01
期刊：
影响因子：
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通讯作者：
de la Fuente, Juan Ramón
中科院分区：
文献类型：
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作者：
Flisser, Ana;García-Malo, Felipe;de la Fuente, Juan Ramón
Objective.评估细胞学实验室和细胞技术人员的表现，为墨西哥预防和控制宫颈癌国家方案建立有效的外部质量控制。材料与方法。在1998年1月和2月期间，对卫生部所有细胞学实验室的现场评估发现，只有70%的显微镜处于适当的工作条件，试剂过时，工作条件不理想。为细胞学技术人员建立了基于能力验证的室间质量控制程序。制备了50个载玻片组，其中20个Papanicolaou载玻片和10个摄影载玻片。将这些样本集交给细胞学技术人员进行评价，并在一年后通过快递再次进行评价。结果21%的显微镜得到修复，9%得到更换;分发了试剂，改善了实验室设施。只有16%的细胞技术人员通过了最初的熟练程度测试。细胞技术人员接受了进修培训课程：一年后，67%的人通过了熟练程度测试。为了确定每个载玻片都得到了正确的诊断，由专家细胞病理学家或细胞学家重新筛选了41组载玻片，并将他们的诊断与原始诊断进行了比较。37组具有86%至96%的一致性。结论.这种新的宫颈细胞学外部质量控制系统可以及时可靠地评估细胞学技术人员的表现。本文件的英文本也可在以下网址查阅：http://www.insp.mx/ salud/index.html。
Objective. To evaluate cytology laboratories and the performance of cytotechnologists for establishing efficient external quality control for Mexico's National Program for the Prevention and Control of Cervical Cancer. Material and Methods. During January and February 1998, an onsite evaluation of all cytology laboratories of the Ministry of Health found that only 70% of the microscopes were in adequate working conditions, reagents were out of date, and working conditions were sub-optimal. A program for external quality control based on proficiency testing was established for cytotechnologists. Fifty slide sets with 20 Papanicolaou slides and 10 photographic slides were prepared. The sets were given to the cytotechnologists for evaluation and again one year later by courier. Results. Twenty-one percent of microscopes were repaired and 9% replaced; reagents were distributed and laboratory facilities improved. Only 16% of cytotechnologists passed the initial proficiency test. Cytotechnologists received a refresher training course: one year later 67% of them passed the proficiency test. To ascertain that each slide was correctly diagnosed, 41 sets were rescreened by expert cytopathologists or cytologists and their diagnoses compared to the original ones. Thirty-seven sets had 86% to 96% concordance. Conclusions. This new system for external quality control of cervical cytology allowed the opportune and reliable evaluation of the performance of cytotechnologists. The English version of this paper is available too at: http://www.insp.mx/ salud/index.html.