Cytopathology Education and Technology Consortium

Transcription

1 American Society of Cytopathology Executive Board Meeting AGENDA May 3, 2010, 7:30 AM 4:00 PM, Central Valencia Room Intercontinental Hotel Chicago, Illinois Cytopathology Education and Technology Consortium Dr. Diane Davey Information ASC National Office 100 West 10 th Street, Suite 605 * Wilmington, Delaware (302) * (302) (fax)

2 CYTOPATHOLOGY EDUCATION AND TECHNOLOGY CONSORTIUM NOVEMBER 15, 2009, 3:30, PM, MST AMERICAN SOCIETY OF CYTOPATHOLOGY ANNUAL MEETING DENVER, COLORADO MINUTES CO-CHAIRS: George Birdsong, M.D. and Lynnette Savaloja, SCT(ASCP) RECORDER: Beth Jenkins MEETING ATTENDEES: George Birdsong, M.D., Thomas A. Bonfiglio, M.D., Lydia Howell, M.D., David Wilbur, M.D., Lynnette Savaloja, SCT(ASCP), Karen Atkison, MPA, CT(ASCP), Patricia Wasserman, M.D., Diane Davis Davey, M.D., Matt Riding, B.S., CT(ASCP). GUESTS: Maribeth Gagnon, CDC NOVEMBER 9, 2008 MINUTES The CETC approved minutes of the CETC meeting held in Orlando, Florida on November 15, CMS AND CDC UPDATE Ms. Gagnon updated the Consortium on the activities of the CMS and CDC. She reported that the CDC is undergoing reorganization that will help flatten the layers. The Coordinating Centers will be discontinued and the Division of Laboratory Services will be merged with National Center for Emerging and Zoonotic Infectious Disease (NCEZID). The current activity at the CDC is working on the H1N1 response. The DLS is providing four members to respond to the Emergency Outreach Communication Center. The DLS is responsible for Laboratory Outreach Communication messages and respond to the state and regional Public Health Laboratories. The Cytology Proficiency Test proposed rule was published in January 2009 with the 17 CLAIC recommendations and a number of questions. There were 690 positive and negative comments. Currently, the CMS is reviewing the comments. There were 659 letters of comments from sixteen organizations and 643 individuals. From theses the CDC received over 5,000 unique comments. The majority of the comments (66%) were the CAP grass roots letter. The majority said to withdraw the rule and replace with an educational program. No decision has been made as of the date of this meeting. Of the comments received, physicians commented 4 to 1 over cytotechnologists. A question was raised about the CMS if the current data of the test results are taken into account in the deliberations of the rule changing. In response, Ms. Gagnon said that none of the results have been reviewed by the government. In fact, the government does not have access to the information for analysis. It is suggested to share the information with CMS, if the organizations are willing. CAP has received requests from CMS on the overall statistics and certain laboratory statistics since 2006 and CAP has complied with every request. This information has been sent on a yearly basis and on special requests made by CMS throughout the years. CAP has published several papers regarding the overall statistics and slide performance since

3 Ms. Judy Yost presented to CLIAC that the pass rate has improved from the start of the program. In 2005, the passing rate was 91% compared to 97% in CMS commented that the value added of cytology PT identifies those who shouldn t screen and demonstrates the high quality of those who do. The CETC could summarize and send the data to CMS if the PT providers are willing to share. CLIAC is meeting February 9-10, 2010, there are two issues that will be discussed, first will be biochemical genetic testing and the second day will be discussing the CLIA special issues around the Patient Electronic Health records. There have been issues identified by the Health Information Policy Group that CLIA may be a barrier to first alter to receive results and second to integrate issues. Three organizations submitted applications for the Evaluation of Current Practices in Reporting Gynecologic Cytology Test Results and Cytology Proficiency Testing grant and each applicant were processed through an objective review process. The grant was awarded to CAP and Michigan Public Health Institute. The CAP indicated that they will be requesting assistance from the organizations for their input. The CAP objectives of the cooperative agreement with the CDC are to: Collect information on laboratory practices in gynecologic cytology including best practices and benchmarking for quality assurance. Make know the current state of quality assurance within cytopathology. Learn how government and accreditation metrics are monitored and used for quality assurance. Learn how HPV testing and Pap proficiency testing are incorporated into laboratory metrics. Advances in Pap testing and HPV testing indicate that it is important to determine the current quality metrics used in cytopathology laboratories. Provide factual information for CDC and the Centers for Medicaid and Medicare Services. Evaluate the findings and establish a consensus, best-practice quality assurance program for cytopathology laboratories. A distinctive part of the grant plan suggested by the pathologists is to hold meeting of stakeholder organizations to discuss the data and best practices before finalizing the recommendations. The survey will attempt to find how laboratories benchmark their quality metrics, what benchmarks are used, and how unacceptable performance is dealt when a problem is identified. The information gleaned in the grant project will provide information to establish a consensus, best-practice quality assurance program for cytopathology laboratories, and to determine the role and effect of HPV testing and proficiency testing within a quality assurance program. STATEMENT ON HPV DNA TEST UTILIZATION The Statement on HPV DNA Test Utilization was published in Cancer Cytopathology in June, Dr. Solomon updated the Consortium via on the Practice Improvement in Cervical Screening and Management held in June The meeting was recently summarized by Dr. Ann Moriarty in the September 2009 issue of The ASC Bulletin. Briefly, participants agreed to four key points: 2

4 1. Adolescent cervical cancer prevention programs should focus on prevention of HPV infection through universal HPV vaccination; 2. Screening should start at age 21 years: Screening of adolescents (age 20 and under) is potentially harmful because it can lead to unnecessary evaluation and treatment; 3. Some adolescents will continue to be screened despite guidelines that discourage screening at this age. Protecting these women from unnecessary procedures requires adherence to the guidelines for the management of adolescents with abnormal cervical cytology and cervical cancer precursors. 4. It is very important for adolescents to have access to family planning and to prevention of acquisition and harmful sequelae of sexually transmitted infections (STIs) other than HPV. Dr. Davey mentioned that she heard some negative feedback regarding the published statement about the ASC-H testing. There were papers published immediately following the HPV DNA Test Utilization Statement publications that noted the average positive rates were actually much lower than the ALTS Study. Dr. Davey will be writing a paper that recommends the HPV Test be used in older women with ASC-H and be considered as a co-test. Dr. Davey s article will be published in the ASCCP Journal. There will be another workshop, under the aegis of the ASCCP (among other societies and groups to be included), is in very preliminary planning stages. It will coincide with the American Cancer Society s effort to consider revised cervical cancer screening recommendations. The meeting will include a diverse range of experts -- clinicians, laboratorians, those in private practice and in academia, and those in public health -- to consider if and how to integrate molecular testing into cervical screening and management recommendations. VALIDATION DOCUMENT The draft of the Molecular Test Validation and Verification in Anatomic Pathology, has been updated by Dr. George Birdsong and Ms. Lynnette Savaloja. The document is intended to provide an overview of what is required and recommended to properly verify or validate new molecular tests that are being performed in the anatomic pathology laboratory. The document will be circulated to the Consortium members for comments. This is intended to be published on Web sites or organizations Newsletters rather than a peer reviewed Journal. (Attached is the updated Validation Document.) FUTURE OF CYTOPATHOLOGY SUMMIT The Consortium members discussed the CETC role in helping with the information processed from the Future of Cytopathology Summit. The ASC will continue the Future of Cytopathology Task Force, which will be co-chaired by Dr. George Birdsong and Ms. Sue Zaleski. Once the information is approved by the ASC, the CETC would be an avenue of distributing the information from the summit to the other organizations. 3

5 It was also suggested to add representatives to the CETC from the Association of Molecular Pathology and American Society of Cell Biologists. This will be explored at a future meeting of the CETC. SOCIETY UPDATES ASC DR. BIRDSONG Drs. Birdsong and Davey reviewed the ASC written report submitted to the Consortium. ASCP - DR. BONFIGLIO Dr. Bonfiglio stated that ASCP is continuing to increase their education programs and is continuing the expansion of online education activities. The ASCP Board of Registry (ASCP BOR) is now the ASCP Board of Certification as of October 31, 2009; this is the result of the merge with the ASCP BOR and NCS. ASCT - MS. SAVALOJA The ASCT has updated the Wage and Employment Survey and this information will be shared with the CETC. The ASCT will have the ASCT President and the Professional Standards and Practice Committee Chair as representatives to the CETC. CAP - DR. WASSERMAN Dr. Wasserman reviewed the CAP written report submitted to the Consortium noting that The CAP Pathology and Laboratory Quality Center is a forum for the development of evidencebased and/or consensus practice guidelines and white paper papers in areas directly involving pathologist and laboratory medicine. The CAP is encouraging everyone to submit ideas via the CAP Web site. PSC - DR. HOWELL The PSC is planning their companion meeting at the upcoming USCAP meeting. The meeting will focus on Fine-needle aspiration of Thyroid Lesions: Dr. Martha Pitman is the current President. NEXT MEETING The Consortium may meet by conference call through out the year and will be meeting during the 58 th Annual Scientific Meeting of the ASC in Boston, Massachusetts, November