dc.contributor.author | Ellis, I O | |
dc.date.accessioned | 2018-08-24T08:24:44Z | |
dc.date.available | 2018-08-24T08:24:44Z | |
dc.date.issued | 2006-02-01 | |
dc.identifier.citation | Ellis, I O (2006). Impact of a national external quality assessment scheme for breast pathology in the uk. Journal of Clinical Pathology 59 (2), 138-145 | |
dc.identifier.issn | 0021-9746 | |
dc.identifier.uri | http://hdl.handle.net/10379/9127 | |
dc.description.abstract | Background: This article presents the results and observed effects of the UK National Health Service Breast Screening Programme (NHSBSP) external quality assurance scheme in breast histopathology.
Aims/Methods: The major objectives were to monitor and improve the consistency of diagnoses made by pathologists and the quality of prognostic information in pathology reports. The scheme is based on a twice yearly circulation of 12 cases to over 600 registered participants. The level of agreement was generally measured using k statistics.
Results: Four main situations were encountered with respect to diagnostic consistency, namely: ( 1) where consistency is naturally very high-this included diagnosing in situ and invasive carcinomas ( and certain distinctive subtypes) and uncomplicated benign lesions; ( 2) where the level of consistency was low but could be improved by making guidelines more detailed and explicit-this included histological grading; ( 3) where consistency could be improved but only by changing the system of classification-this included classification of ductal carcinoma in situ; and ( 4) where no improvement in consistency could be achieved-this included diagnosing atypical hyperplasia and reporting vascular invasion. Size measurements were more consistent for invasive than in situ carcinomas. Even in cases where there is a high level of agreement on tumour size, a few widely outlying measurements were encountered, for which no explanation is readily forthcoming.
Conclusions: These results broadly confirm the robustness of the systems of breast disease diagnosis and classification adopted by the NHSBSP, and also identify areas where improvement or new approaches are required. | |
dc.publisher | BMJ | |
dc.relation.ispartof | Journal of Clinical Pathology | |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 Ireland | |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/3.0/ie/ | |
dc.subject | medullary carcinoma | |
dc.subject | local recurrence | |
dc.subject | follow-up | |
dc.subject | consistency | |
dc.subject | diagnosis | |
dc.subject | lesions | |
dc.subject | cancer | |
dc.subject | interobserver | |
dc.subject | variability | |
dc.subject | criteria | |
dc.title | Impact of a national external quality assessment scheme for breast pathology in the uk | |
dc.type | Article | |
dc.identifier.doi | 10.1136/jcp.2004.025551 | |
dc.local.publishedsource | http://europepmc.org/articles/pmc1860326?pdf=render | |
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