用于外部质量控制的甲状腺细针抽吸细胞学标本的预捕获视频的实现

Stavros K Archondakis
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摘要

目的:本研究的目的是通过使用静态远程细胞学应用程序捕获的视频,研究为希望获得ISO 15189:2012认证的细胞学实验室开发能力测试方案的可行性。方法:本研究对157例患者的252例适当标本进行回顾性选择。在所有病例中,手术切除遵循最初的细胞学诊断。使用了三种细胞学报告的诊断类别。所有病例均经手术标本的组织学诊断证实。每个病例的一个代表性视频通过文件传输协议传输到密码保护的帐户,由3名独立的细胞病理学家远程审查。除了诊断之外,评论者还对数字视频的整体质量进行了评论。对投稿人和审稿人的诊断进行收集、记录和统计评估。结果:细胞学诊断的统计评估发现,基于预捕获视频和常规切片的诊断在诊断准确性方面没有显著差异。观察员间的总体协议从实质性到近乎完美不等。结论:通过静态远程细胞学应用程序制作的视频可作为细胞学诊断验证的替代方法。它是一种快速有效的质量评估和能力测试方法,可以集成到日常工作流程中。预采集视频可显著提高小型细胞学科室的质量指标。预先拍摄的录像也可用于远程会诊和第二意见目的,并改善现有静态远程气象站的性能。
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Implementation of Precaptured Videos of Thyroid Fine-Needle Aspiration Cytology Specimens for External Quality Control Purposes
Objective: The objective of this study was examine the feasibility of developing a proficiency testing scheme for cytology labs wishing to be accredited according to ISO 15189:2012, by using videos captured by static telecytological applications. Methods: The current study was carried out on 252 adequate specimens of 157 patients, retrospectively selected from the department’s registry. In all cases, surgical excision followed the initial cytological diagnosis. Three diagnostic categories of cytological reports were used. All cases were confirmed by histological diagnosis of surgical specimens. One representative video from each case was transferred via file transfer protocol to password-protected accounts for remote review by 3 independent cytopathologists. In addition to diagnosis, reviewers commented on overall digital video quality. Contributor’s and reviewer’s diagnoses were collected, recorded and statistically evaluated. Results: Statistical evaluation of cytological diagnoses detected no significant difference in diagnostic accuracy between the diagnoses proffered on the basis of precaptured videos and conventional slides. The overall interobserver agreement was ranging from substantial to almost perfect. Conclusions: Videos production by static telecytology applications can be used as an alternative method for cytological diagnosis validation. It is a prompt and valid method for quality assessment and proficiency testing and can be integrated into daily workflow. Pre-captured videos can improve significantly small cytology departments’ quality indices. Precaptured videos can also be used for teleconsultation and second opinion purposes and improve the performance of the already existing static telecytology stations.
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