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UK National Renal Transplant EQA Scheme

UK National Renal Transplant EQA Scheme. Ian Roberts Department of Cellular Pathology, Oxford Radcliffe Hospitals. The National Renal Transplant EQA Scheme is sponsored by Fujisawa Ltd. EQA in Histopathology. maintenance & improvement of diagnostic standards

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UK National Renal Transplant EQA Scheme

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  1. UK National Renal Transplant EQA Scheme Ian Roberts Department of Cellular Pathology, Oxford Radcliffe Hospitals The National Renal Transplant EQA Scheme is sponsored byFujisawa Ltd

  2. EQA in Histopathology • maintenance & improvement of diagnostic standards • education vs performance assessment • required for CPD and CPA • RCPath EQA steering committee - • sets performance standards • investigates substandard performance

  3. EQA in Histopathology • substandard performance: • anonymous letter of enquiry • NQA Advisory panel informed and determine whether low EQA scores reflect standards of routine practice • site visit • review panel • Medical Director informed

  4. EQA in Histopathology • “ these procedures should be activated only in exceptional circumstances, and should cause no more concern to EQA participants than the possibility of being reported for incompetence by a colleague”

  5. EQA in Histopathology • slides circulated to participants • responses submitted to scheme organiser • feedback of group diagnoses to participants • cases discussed at participants meeting • diagnoses scored • persistent substandard performers identified • remedial action

  6. diagnoses scored • persistent substandard performers identified • remedial action Renal Transplant EQA Scheme • slides circulated to participants • responses submitted to scheme organiser • feedback of group diagnoses to participants • cases discussed at participants meeting • slides circulated to participants • responses submitted to scheme organiser • feedback of group diagnoses to participants • cases discussed at participants meeting

  7. Renal Transplant EQA Scheme • 44 participants from 31 centres • Case submission: • 7 sets of slides (H&E and PAS/silver) • diagnostic lesion is present in all slides • biopsy is adequate by Banff criteria

  8. Renal Transplant EQA Scheme • participants divided into 6 cells • Circulations organised using Genpath software: • sets circulation dates • automatic reminder letters

  9. Educational value • enables pathologists to compare their diagnoses and their Banff grading with the whole group • identifies differences in use of terminology • identifies misunderstanding of the Banff classification and its application • ongoing measure of the reproducibility of Banff criteria • highlights areas of diagnostic difficulty

  10. Terminology

  11. Application

  12. Reproducibility

  13. Reproducibility

  14. Reproducibility

  15. Difficult diagnoses

  16. Difficult diagnoses

  17. Renal Transplant EQA Scheme • identifies practical difficulties in the application of the Banff schema in routine practice • identifies areas of diagnostic difficulty that should be specifically addressed in the future

  18. Renal Transplant EQA Scheme • identifies practical difficulties in the application of the Banff schema in routine practice • identifies areas of diagnostic difficulty that should be specifically addressed in the future • for the patients: • improves the diagnostic accuracy of the pathologist looking at their biopsy

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