Recommendations for reporting measures of diagnostic accuracy.

This article serves as the third in a series that offers recommendations for optimal data reporting, specifically focusing on the statistical methods most frequently reported in Cytopathology articles. Measures of diagnostic accuracy were among the most commonly reported results in Cytopathology, with sensitivity and/or specificity reported in 32% of the reviewed articles. This article will provide a brief overview of common measures of diagnostic accuracy, including sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, overall diagnostic accuracy, receiver operating characteristic (ROC) curve, and area under the curve (AUC).

Parametric or nonparametric statistical tests: Considerations when choosing the most appropriate option for your data.

This article serves as the second in a series that offers recommendations for optimal data reporting, specifically focusing on statistical methods most frequently reported by the Cytopathology audience. The inaugural article, Recommendations for reporting statistical results when comparing proportions, dealt with the most common category of reported statistical tests over 2.5 years of Cytopathology articles-comparing proportions.

Recommendations for reporting statistical results when comparing proportions.

This article serves as the first in a series that will offer recommendations for optimal data reporting, specifically focusing on statistical methods most frequently reported by the Cytopathology audience. Recommendations for reporting statistical results when comparing proportions is the first topic in the series since comparing proportions, particularly utilising the chi-square test, was the most commonly reported inferential statistical test category over 2.5 years of Cytopathology articles.

Opportunity to elevate the quality of data reporting in Cytopathology.

Accurate and thorough data analysis and reporting are essential to ensuring that the findings of research studies are interpreted appropriately. A detailed methods section in a manuscript contains enough information to permit a researcher with access to the study components, including the data, to replicate the findings. This descriptive study of 2.

Small core needle biopsies in cytology practice: a survey of members of the American Society of Cytopathology.

Introduction: The introduction of a new generation of core needle biopsies (CNBs) for endoscopic procedures has prompted reconsideration of the role of cytopathologists in the handling of small biopsies. The American Society of Cytopathology (ASC) has therefore conducted a survey with the intention of elucidating current practices regarding the handling of small CNBs.

Materials And Methods: The membership of the ASC was invited by email to participate in an online survey over a 2-month period.

Endoscopic ultrasound-guided FNA and ProCore biopsy in sampling pancreatic and intra-abdominal masses.

Background: ProCore fine-needle biopsy (FNB) was introduced to improve the diagnostic yield of endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) sampling. The aim of this study was to evaluate EUS-guided sampling of intra-abdominal masses and compare the diagnostic utility of conventional EUS-FNA and ProCore FNB.

Methods: EUS-guided biopsy samples (FNA and/or EchoTip ProCore FNB) were retrospectively retrieved over the course of 23 months.

Amended reports: development and validation of a taxonomy of defects.

Amended pathology reports produce rework, confusion, and distrust. To develop a reproducible amendment taxonomy we derived a classification from 141 amended reports, then validated it with 130 new cases before 4 observers independently reviewed 430 cases measuring agreement (k). Next, agreement in classifying 30 other amended reports in 7 institutions was measured.

Dissemination of Lean methods to improve Pap testing quality and patient safety.

Objective: To determine if the implementation of Lean methods resulted in improved Pap test quality and diagnostic accuracy in 5 clinician practices.

Materials And Methods: We performed a 1-year case-control study that included 5,384 control (preintervention) and 5,442 case (postintervention) women who had a Pap test procured by 1 of 5 clinicians. Using Lean methods, the clinicians increased their focus of Pap test procurement by creating a "one-by-one" workflow and recorded process completion using a Lean checklist.

Interobserver variability in human papillomavirus test results in cervicovaginal cytologic specimens interpreted as atypical squamous cells.

We studied interobserver variability in the proportions of human papillomavirus (HPV)-positive results for atypical squamous cells of undetermined significance (ASCUS) and atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) diagnoses among 5 pathologists from the me laboratory during a 2-year period. These proportions were compared with individual pathologist's ASCUS/squamous intraepithelial lesion (SIL) ratios. Of 1,299 ASCUS diagnoses, 32.

Frequency and outcome of cervical cancer prevention failures in the United States.

We measured the frequency and outcome of cervical cancer prevention failures that occurred in the Papanicolaou (Pap) and colposcopy testing phases involving 1,646,580 Pap tests in 4 American hospital systems between January 1, 1998, and December 31, 2004. We defined a screening failure as a 2-step or greater discordant Pap test result and follow-up biopsy diagnosis. A total of 5,278 failures were detected (0.

Urine cytology discrepancies: frequency, causes, and outcomes.

Although urine cytology is used for the early detection and surveillance of urothelial carcinoma, there has been little study of the frequency, causes, and outcomes of cytologic-histologic discrepancies. We obtained histologic follow-up in 361 (6.2%) of 5,785 voided, 124 (19.

Effectiveness of Toyota process redesign in reducing thyroid gland fine-needle aspiration error.

Our objective was to determine whether the Toyota Production System process redesign resulted in diagnostic error reduction for patients who underwent cytologic evaluation of thyroid nodules. In this longitudinal, nonconcurrent cohort study, we compared the diagnostic error frequency of a thyroid aspiration service before and after implementation of error reduction initiatives consisting of adoption of a standardized diagnostic terminology scheme and an immediate interpretation service. A total of 2,424 patients underwent aspiration.

Errors in thyroid gland fine-needle aspiration.

Scant published data exist on redesigning pathology practice based on error data. In this first step of an Agency for Healthcare Research and Quality patient safety project, we measured the performance metrics of thyroid gland fine-needle aspiration, performed root cause analysis to determine the causes of error, and proposed error-reduction initiatives to address specific errors. Eleven cytologists signed out 1,543 thyroid gland aspirates in 2 years, and surgical pathology follow-up was obtained in 364 patients.

Double slide viewing as a cytology quality improvement initiative.

Few studies have measured the effect of pre-sign out double viewing of cytology cases as a means to decrease error. Three Agency for Healthcare Research and Quality-funded project sites performed pre-sign out double viewing of 431 pulmonary cytology cases. Two-step or more differences in diagnosis were arbitrated as interpretive errors, and the effect of double viewing was measured by comparing the frequency of cytologic-histologic correlation-detected errors in the previous 2 years with the double-viewing period.

Variability in cytologic-histologic correlation practices and implications for patient safety.

Context: The Clinical Laboratory Improvement Amendments of 1988 require that laboratories perform cytologic-histologic correlation, although the optimal methods and the value of performing correlation have not been determined.

Objective: To determine the similarities and differences in how laboratories perform cytologic-histologic correlation.

Design: One hundred sixty-two American laboratories were sent a letter requesting copies of the materials they used in the cytologic-histologic correlation process.

Use of physician extenders in surgical pathology practice.

Context: Use of a variety of nonphysician personnel for surgical pathology gross examination is generally known to be increasing, although detailed information regarding nonphysician use is currently unavailable.

Objective: To measure and describe the use of nonphysician personnel for surgical pathology gross examination in order to gain a better understanding of the current surgical pathology workforce.

Design: A voluntary, mailed questionnaire containing items related to the use of multiple nonphysician personnel types in surgical pathology was distributed to (1) a cross-sectional sample (n = 968) of US pathologists and (2) a purposive sample of pathologist directors of surgical and/or anatomic pathology (n = 77) located at teaching institutions.

Pathology resident attitudes and opinions about pathologists' assistants.

Context: Changes in health care economics and organization have resulted in increased use of nonphysician providers in most health care settings. Attitudinal acceptance of nonphysician providers is important in the current health care environment.

Objectives: To obtain descriptive information regarding pathology resident attitudes and opinions about pathologists' assistants in anatomic pathology practice and to assess the implications of resident attitudes and opinions for pathology practice and training.