Rapid On-Site Evaluation Technical Exercise Using Digital Pathology: Peer Comparison in an External Quality Assurance...

Area of Science:

• Cytopathology
• External Quality Assurance (EQA)
• Diagnostic Pathology

Background:

• The Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP) offers external quality assurance (EQA) for pathology laboratories.
• A cytopathology technical program was established in 2018 to assess routine cytopreparatory techniques.
• The pilot focused on standard operating procedures and laboratory performance during rapid on-site evaluation (ROSE).

Purpose of the Study:

• To assess diagnostic adequacy and provide technical recommendations for thyroid fine-needle aspiration biopsy (FNAB) samples using whole slide images in a ROSE setting.
• To evaluate laboratory performance in routine cytopreparatory techniques.
• To identify variations in standard operating procedures and diagnostic feedback during ROSE.

Main Methods:

• Four whole slide imaging cases of Diff-QuikTM stained thyroid FNAB preparations were provided to RCPAQAP Cytopathology diagnostic program participants.
• Participating laboratories assessed on-site adequacy and provided technical recommendations.
• A laboratory practice questionnaire was also administered.

Main Results:

• 186 submissions were received across four virtual cases.
• Participant assessment of on-site adequacy showed high concordance in some cases.
• Variation was observed in initial diagnostic evaluation and technical recommendations.

Conclusions:

• Rapid on-site evaluation (ROSE) is a standard procedure globally but shows susceptibility to variation.
• Peer comparison in an EQA exercise highlighted inconsistencies in ROSE across standard operating procedures, diagnostic adequacy, feedback, and recommendations.
• Standardization of ROSE procedures is crucial for consistent diagnostic quality.