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Review
. 2022 Nov;130(11):860-871.
doi: 10.1002/cncy.22607. Epub 2022 Jun 6.

The value of monitoring amended reports in cytopathology quality programs: A biennial review

Vanda F Torous  1 , Martha B Pitman  1 , Yael K Heher  1
Affiliations
Free article
Review

The value of monitoring amended reports in cytopathology quality programs: A biennial review

Vanda F Torous et al. Cancer Cytopathol. 2022 Nov.
Free article

Abstract

Background: Quality and safety are the foundation of the practice of cytopathology. Review of key performance indicator (KPI) data can shine a light on laboratory vulnerabilities and potential areas for targeted improvement. The rate and content of amendment reports is a frequently monitored KPI in anatomic pathology, but few have studied its value in cytopathology. The goal of this study was to examine the frequency, classification, and outcome of amendments for a large cytopathology laboratory.

Methods: All amendment reports issued for cases during a 2-year period from July 2019 to June 2021 were included in the study. Amendments were classified into three error type root causes: Specimen Identification Error, General Report Defects, and Diagnostic Error.

Results: A total of 202 amendment reports were issued equating to a rate of 0.275%. A total of 83 (41.1%) were gynecologic cases and 119 (58.9%) were nongynecologic cases. Within the gynecologic cases, 13 (15.7%) cases were due to Specimen Identification Error, 13 (15.7%) cases were due to Diagnostic Error, and 57 (68.7%) cases were due to General Report Defects. Within the nongynecologic cases, 15 (12.6%) cases were due to Specimen Identification Error, 30 (25.2%) cases were due to General Report Defects, and 74 (62.2%) cases were due to Diagnostic Error with 32 of these due to true diagnostic change. Discovery methods included following re-review after additional clinical information was provided, reinterpretation after additional ancillary testing was performed, or conference review. There was no correlation with years in practice.

Conclusions: Studying amendment reports is an underrecognized and valuable quality assurance tool. Amendments can help provide information about types of errors, monitor laboratory processes, and help guide quality improvement endeavors.

Keywords: amendments; cytology; diagnostic error; quality and safety; quality assurance.

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References

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