The ASC/SIL Ratio for Cytopathologists as a Quality Control Measure

Monitoring the relative frequency of the interpretations of atypical squamous cells (ASC) and squamous intraepithelial lesions (SIL) has been proposed as a quality control measure. To assess its value, an ASC/SIL ratio was calculated every 6 months for 3.5 years, and confidential feedback was provided to 10 cytopathologists (CPs). By using simple regression analysis, we analyzed the initial and final ASC/SIL ratios for individual CPs and for the entire group. The ratio was below the upper benchmark of 3:1 for all but 1 CP during every 6-month period. The ratio for all CPs combined showed a downward trend (from 2.05 to 1.73). The ratio for 6 CPs decreased, and for two of them the decrease was statistically significant. One CP showed a statistically significant increase in the ASC/SIL ratio. The decrease for some CPs likely reflects the salutary effect of confidential feedback and counseling.