Response analysis in histopathology external quality assessment schemes

Abstract

Aims - To develop a computerised method for analysing the results of histopathology external quality assessment (EQA) schemes which can provide confidential personal reports to individual participating pathologists. Methods - A program was developed using the OMNIS database system, running on Apple Macintosh or IBM compatible computers. Results - The program produces a general report of participants' responses to each case, and a choice of two types of personal report. One of these provides a list of the participant's diagnoses with a list of the most popular (Consensus) diagnoses for comparison. The other provides automatically calculated scores for the pathologist's performance along with simple statistical evaluation. The scores can be calculated by comparison with the consensus of the group or with correct diagnoses if they are known. A histogram indicating the distribution of performance within the group can be produced. The program can accept uncertainty in the form of differential diagnosis lists from participants. Potentially dangerous diagnostic errors can be identified and handled separately. Participants are identified only by code numbers and confidentiality can easily be enforced. The program is currently being used in the national renal pathology EQA scheme and in the local general histopathology scheme in the East Midlands. Conclusions - This program offers solutions to problems which have bedevilled the organisers of histopathology EQA schemes. It offers confidential advice to pathologists and will help to identify areas where an individual might benefit from continuing career grade medical education. It raises the possibility of the development of nationally agreed standards of performance in the reporting of pathological specimens, and it may be applicable to other specialties where textual reports are produced.