Utility of EFC quality indicators for colposcopy in daily practice: results from an independent, prospective multicenter trial

TY - JOUR

T1 - Utility of EFC quality indicators for colposcopy in daily practice: results from an independent, prospective multicenter trial

AU - Luyten, Alexander

AU - Hagemann, Ingke

AU - Scherbring, Sarah

AU - Boehmer, Gerd

AU - Gieseking, Friederike

AU - Woelber, Linn

AU - Glasenapp, Frank

AU - Hampl, Monika

AU - Kuehler-Obbarius, Christina

AU - van den Bergh, Marcus

AU - Leeson, Simon

AU - Redman, Charles

AU - Petry, Karl Ulrich

AU - Studiengruppe Kolposkopie eV (SGK) and G-CONE (German Colposcopy Network)

N1 - Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

PY - 2015/8

Y1 - 2015/8

N2 - OBJECTIVES: The accuracy of colposcopy as the gold standard to manage abnormal screening tests depends on qualification and well defined standards. A recent survey of the European Federation for Colposcopy (EFC) found strong heterogeneity in the practice of colposcopy across Europe. EFC defined four quality indicators (QIs) to enable quality assessment in colposcopy as one tool to harmonize colposcopy standards. We undertook a pilot project to estimate the utility of these QIs for an independent external quality assessment in daily routine colposcopy.STUDY DESIGN: Participating colposcopy clinics used newly developed software for data collection. Data were automatically anonymized, encrypted and stored in a secure relational database located within the clinics' network and allowed for an independent external benchmarking comparing the performance of participating clinics according to EFC QIs.RESULTS: 10,869 patients referred for routine colposcopy were included. On average none of the four EFC QIs was fulfilled. One target was almost met with 83.3% instead of 85% excisional treatments/conizations containing CIN2+ and for another QI the difference of 94.4% instead of 100% cases having a colposcopic examination prior to treatment for abnormal cervical cytology was mainly explained by wrong documentation. For a third QI, visibility of the squamocolumnar junction (SCJ) was only reported in 90.9% instead of 100% but reporting improved to 94.7% after a consensus meeting. The last QI, >80% clear margins in excised lesions/conizations were not considered as useful by some clinics and therefore not documented.DISCUSSION AND CONCLUSIONS: At least 3 out of 4 QIs seemed to be useful for quality assessment in colposcopy but will need rewording and readjustment. All tools for an independent electronic quality assessment with the use of EFC-QI are available and could be used to achieve a high quality standard in colposcopy across Europe.

AB - OBJECTIVES: The accuracy of colposcopy as the gold standard to manage abnormal screening tests depends on qualification and well defined standards. A recent survey of the European Federation for Colposcopy (EFC) found strong heterogeneity in the practice of colposcopy across Europe. EFC defined four quality indicators (QIs) to enable quality assessment in colposcopy as one tool to harmonize colposcopy standards. We undertook a pilot project to estimate the utility of these QIs for an independent external quality assessment in daily routine colposcopy.STUDY DESIGN: Participating colposcopy clinics used newly developed software for data collection. Data were automatically anonymized, encrypted and stored in a secure relational database located within the clinics' network and allowed for an independent external benchmarking comparing the performance of participating clinics according to EFC QIs.RESULTS: 10,869 patients referred for routine colposcopy were included. On average none of the four EFC QIs was fulfilled. One target was almost met with 83.3% instead of 85% excisional treatments/conizations containing CIN2+ and for another QI the difference of 94.4% instead of 100% cases having a colposcopic examination prior to treatment for abnormal cervical cytology was mainly explained by wrong documentation. For a third QI, visibility of the squamocolumnar junction (SCJ) was only reported in 90.9% instead of 100% but reporting improved to 94.7% after a consensus meeting. The last QI, >80% clear margins in excised lesions/conizations were not considered as useful by some clinics and therefore not documented.DISCUSSION AND CONCLUSIONS: At least 3 out of 4 QIs seemed to be useful for quality assessment in colposcopy but will need rewording and readjustment. All tools for an independent electronic quality assessment with the use of EFC-QI are available and could be used to achieve a high quality standard in colposcopy across Europe.

U2 - 10.1016/j.ejogrb.2015.05.020

DO - 10.1016/j.ejogrb.2015.05.020

M3 - SCORING: Journal article

C2 - 26071669

VL - 191

SP - 43

EP - 47

JO - EUR J OBSTET GYN R B

JF - EUR J OBSTET GYN R B

SN - 0301-2115

ER -