College of American Pathologists
Printable Version

  Give and you shall receive





cap today



January 2007
PAP/NGC Programs Review

David C. Wilbur, MD

We are all familiar with these sayings: “You have only yourself to blame,” “You get out what you put in,” and “Do unto others as you would have them do unto you.”

Interestingly, these phrases all have relevance to the slides you get during your proficiency testing, or PT, event. Where do all those PT slides come from? Well, they come from individuals in laboratories everywhere who take it upon themselves to voluntarily donate their own slides to the CAP PT program. There is no “magical” repository of slides out there that the program can depend on to provide beautiful examples of clear-cut and unequivocal unsatisfactory, normal, and squamous intraepithelial lesion slides—the ones we would all like to see when we open those boxes on “test day.” Thus, if you would like such slides on your test, then you should donate slides that meet these criteria.

As always, the CAP Cytopathology Committee thoroughly reviews all slides submitted and immediately rejects those that do not meet basic criteria. After the initial review, the slides go through a statistically rigorous validation process to ensure that each slide performs, in actual review situations, to an accepted standard. Only then is the slide accepted for circulation in PT sets. The problem is that less than half of donated slides make it through this process to become PT slides. And given the intense nature of the PT procedure, these valuable “validated” PT slides need to be retired in significant numbers because of stain fading, bubbles developing under coverslips, breakage, and changes in interpretation (though the latter is rare).

If you yourself want an abundant supply of slides on your proficiency test, donating your excellent examples makes good sense. After all, we all share a responsibility for ensuring that our test is optimized and fair, consisting of slides that are interpretable and do not raise insoluble differential diagnosis issues (based on the categories that must be chosen for PT purposes). If everyone taking the test followed this principle, the problem of “bad slides” would disappear.

You can donate slides—it’s easy. Donation forms and instructions are on the CAP Web site at in the Accreditation and Laboratory Improvement section, Pap PT Cytology Proficiency Testing. Click on Pap Slide Donation Program.

We’re all responsible for ensuring an optimal PT experience. Please donate today.

Dr. Wilbur, chair of the CAP Cytopathology Committee, is director of cytopathology, Massachusetts General Hospital, Boston.