Quality control in cytopathology. A system for simultaneous monitoring of accuracy and education and for proficiency testing.

Because of its very nature, cytopathology has not lent itself well to quality control. At the University of North Carolina, we practice an internal quality control system based on peer review, interprofessional dialogue and utilization of follow-up information. Recently reported cytology specimens are rescreened and correlated with related surgical specimens. This review is summarized in a weekly conference, at which retrospective accuracy judgments are made for each case under the supervision of the medical director and head cytotechnologist. Diagnostic accuracy is thus monitored. Accuracy is also improved since education is simultaneously monitored. A practical proficiency-testing program built into this system is described.