A computer program that periodically monitors the ability to interpret the antinuclear antibody test

Our laboratory has been developing computer programs that help medical technologists improve their performance of the microscope-based immunofluorescence assay for antinuclear antibodies (ANA). This image-based laboratory test has been associated with poor reproducibility. We have previously described our first program, ANA-Tutor, which systematically teaches the ANA test by using approximately 150 processed digital images of ANA test results. The program we describe here, Pattern Plus Auditor, is a logical extension to ANA-Tutor. Pattern Plus Auditor tests the ability of laboratory personnel to interpret the ANA test, and tracks individual and laboratory performance over time. The program consists of image-based questions that test a variety of ANA staining patterns, including homogeneous, speckled, centromere, nucleolar, mixed patterns, and rare patterns. For each question, the program provides correct answers with explanations and color overlays that highlight key image features. By entering the proper password, users gain access to exam results for individuals and for the laboratory as a whole. Results are available for the current exam, any previous exam, or cumulatively on all exams to date. Intralaboratory testing with computer programs such as Pattern Plus Auditor might be a useful part of quality-assurance procedures for many image-based laboratory tests.