Quality metrics in non-gynecologic cytology: results from the 2022 American Society of Cytopathology survey

Introduction: Rapid advancements in minimally invasive techniques and the discovery of molecular biomarkers have resulted in major changes in the practice of non-gynecologic cytology and have highlighted a need for novel quality assurance (QA) metrics.

Materials and methods: To obtain data regarding the current and desired usage, methods of collection, and barriers to the implementation of non-gynecologic cytopathology QA, an 18-question survey was constructed by the Clinical Practice Committee of the American Society for Cytopathology.

Results: A total of 206 responses were received. Respondents included 112 (54.4%) cytopathologists, 81 (39.3%) cytotechnologists, and 13 others. Almost all (97%) acknowledged the value of assessing QA metrics in cytology. The most commonly used QA metrics were cytotechnologist-pathologist diagnostic agreement and pathologist amendment rates. The desire to implement non-gynecologic QA metrics was significantly higher among academic hospitals, relative to nonacademic facilities. A combined manual and electronic approach to collect QA data was generally used (70% of institutions). QA metrics were more often collected by the cytology laboratory supervisors (59.5%), while the evaluation was most often performed by the cytology laboratory director (76.5%). Limited staffing and laboratory information system (LIS) capabilities were cited as major challenges in the implementation of novel QA metrics.

Conclusions: While the collection of quality data might be perceived as an onerous task, a thoughtful selection of quality indicators, with an inbuilt search option in LIS, can contribute to the successful implementation of non-gynecologic QA metrics.