Quality assessment of smear microscopy by stratified lot sampling of treatment follow-up slides
- Author
- L Otero, A Van Deun, J Agapito, R Ugaz, G Prellwitz, E Gotuzzo and Patrick Van Der Stuyft (UGent)
- Organization
- Abstract
- SETTING: Ten peripheral laboratories performing routine acid-fast bacilli (AFB) smear microscopy in Lima, Peru. OBJECTIVES: To test whether external quality assessment (EQA) rechecking of AFB smears becomes more efficient with stratified lot sampling of treatment follow-up smears. DESIGN: In 2 consecutive years, a stratified lot sample of 36 treatment follow-up slides and 24 diagnostic slides were randomly selected and blindly rechecked. A second controller determined the final result for discordant slides. Feedback was provided to laboratory technicians during supervisory visits. RESULTS: More false-negative errors were found in the follow-up slides than in the tuberculosis suspect slides: 25 vs. 3. This represented a yield of 3.5% in 720 follow-up slides and only 0.6% in 480 diagnostic slides. Positive predictive values were high in both years. Respectively three and eight laboratories did not reach a relative sensitivity of >65% during the first and second year, and a clear improvement was seen in only one laboratory. Excessive workload seemed to preclude raising the level of routine performance. CONCLUSIONS: EQA with stratified lot sampling of treatment follow-up slides proved very efficient and effective for identifying laboratories with substandard performance in a setting with low positivity rates in routine diagnostic smears.
- Keywords
- quality control, diagnosis, sputum smear microscopy, tuberculosis, BLINDED RECHECKING, ACID-FAST BACILLI, FLUORESCENCE MICROSCOPY, SPUTUM, TUBERCULOSIS, DIAGNOSIS, YIELD, TB
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Citation
Please use this url to cite or link to this publication: http://hdl.handle.net/1854/LU-2023783
- MLA
- Otero, L., et al. “Quality Assessment of Smear Microscopy by Stratified Lot Sampling of Treatment Follow-up Slides.” INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, vol. 15, no. 2, 2011, pp. 211–16.
- APA
- Otero, L., Van Deun, A., Agapito, J., Ugaz, R., Prellwitz, G., Gotuzzo, E., & Van Der Stuyft, P. (2011). Quality assessment of smear microscopy by stratified lot sampling of treatment follow-up slides. INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, 15(2), 211–216.
- Chicago author-date
- Otero, L, A Van Deun, J Agapito, R Ugaz, G Prellwitz, E Gotuzzo, and Patrick Van Der Stuyft. 2011. “Quality Assessment of Smear Microscopy by Stratified Lot Sampling of Treatment Follow-up Slides.” INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE 15 (2): 211–16.
- Chicago author-date (all authors)
- Otero, L, A Van Deun, J Agapito, R Ugaz, G Prellwitz, E Gotuzzo, and Patrick Van Der Stuyft. 2011. “Quality Assessment of Smear Microscopy by Stratified Lot Sampling of Treatment Follow-up Slides.” INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE 15 (2): 211–216.
- Vancouver
- 1.Otero L, Van Deun A, Agapito J, Ugaz R, Prellwitz G, Gotuzzo E, et al. Quality assessment of smear microscopy by stratified lot sampling of treatment follow-up slides. INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE. 2011;15(2):211–6.
- IEEE
- [1]L. Otero et al., “Quality assessment of smear microscopy by stratified lot sampling of treatment follow-up slides,” INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, vol. 15, no. 2, pp. 211–216, 2011.
@article{2023783, abstract = {{SETTING: Ten peripheral laboratories performing routine acid-fast bacilli (AFB) smear microscopy in Lima, Peru. OBJECTIVES: To test whether external quality assessment (EQA) rechecking of AFB smears becomes more efficient with stratified lot sampling of treatment follow-up smears. DESIGN: In 2 consecutive years, a stratified lot sample of 36 treatment follow-up slides and 24 diagnostic slides were randomly selected and blindly rechecked. A second controller determined the final result for discordant slides. Feedback was provided to laboratory technicians during supervisory visits. RESULTS: More false-negative errors were found in the follow-up slides than in the tuberculosis suspect slides: 25 vs. 3. This represented a yield of 3.5% in 720 follow-up slides and only 0.6% in 480 diagnostic slides. Positive predictive values were high in both years. Respectively three and eight laboratories did not reach a relative sensitivity of >65% during the first and second year, and a clear improvement was seen in only one laboratory. Excessive workload seemed to preclude raising the level of routine performance. CONCLUSIONS: EQA with stratified lot sampling of treatment follow-up slides proved very efficient and effective for identifying laboratories with substandard performance in a setting with low positivity rates in routine diagnostic smears.}}, author = {{Otero, L and Van Deun, A and Agapito, J and Ugaz, R and Prellwitz, G and Gotuzzo, E and Van Der Stuyft, Patrick}}, issn = {{1027-3719}}, journal = {{INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE}}, keywords = {{quality control,diagnosis,sputum smear microscopy,tuberculosis,BLINDED RECHECKING,ACID-FAST BACILLI,FLUORESCENCE MICROSCOPY,SPUTUM,TUBERCULOSIS,DIAGNOSIS,YIELD,TB}}, language = {{eng}}, number = {{2}}, pages = {{211--216}}, title = {{Quality assessment of smear microscopy by stratified lot sampling of treatment follow-up slides}}, url = {{http://www.ingentaconnect.com/content/iuatld/ijtld/2011/00000015/00000002/art00013}}, volume = {{15}}, year = {{2011}}, }