Abstract
Objective
Optimization of colposcopy practice requires a program of quality assurance including
the monitoring of performance indicators. The European Federation of Colposcopy (EFC)
aimed to identify a list of quality indicators for colposcopic practice, which are
relevant, reproducible and practical across all of the member countries.
Study design
A five-round Delphi consultation was conducted in 30 full, 5 associate and 4 potential
member countries in order to determine a core list of quality indicators including
optimal target ranges.
Results
Six indicators were selected from a list of 37 proposed standards. Two further rounds
of consultation were conducted to determine expert opinion on the target level for
each of the standards. The six indicators identified and corresponding targets were:
documentation of whether or not the squamocolumnar junction has been seen (100%);
colposcopy prior to treatment for abnormal cervical cytology (100%); percentage of
excisional treatments/conizations to contain cervical intra-epithelial neoplasia grade
two or worse (≥85%); percentage of excised lesions/conizations with clear margins
(≥80%); and two indicators concerned the number of cases to be colposcoped per year:
≥50 low-grade/minor and ≥50 high-grade/major cytological abnormalities.
Conclusions
A Delphi consultation identified six EFC quality indicators. These are a first step
in an international attempt to optimize colposcopy practice throughout Europe. The
current targets are based on expert opinion and may need adaptation in the future.
Data are needed from European colposcopy settings to determine whether the indicators
are achievable practice-based benchmarks and will help in improving and fine tuning
the list of performance indicators and targets.
Keywords
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Article info
Publication history
Published online: July 08, 2013
Accepted:
June 23,
2013
Received in revised form:
May 11,
2013
Received:
December 13,
2012
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
