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Guest Lecture
9.45–10.30 Wednesday 17 September 2003. Csp Colposcopy Guidelines
Author(s) -
Kitchener H. C.
Publication year - 2003
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1046/j.1365-2303.14.s1.1_5.x
Subject(s) - colposcopy , medicine , credibility , context (archaeology) , quality assurance , set (abstract data type) , quality (philosophy) , quality management , cervical screening , medical education , operations management , computer science , cervical cancer , management system , political science , paleontology , philosophy , external quality assessment , epistemology , pathology , cancer , law , biology , programming language , economics
The success of the Cervical Screening Programme (CSP) is due in part to its management being underpinned by Quality Assurance. These measures ensure uniform standards across the country. Since 1992 Colposcopy Guidelines have been in place; these were updated in 1997 and have just been redefined. It is entirely consistent with the National CSP that colposcopy is governed by Guidelines. The aim of clinical practice guidelines is to raise the standard of care and improve outcomes. The objectives are, therefore:a) to develop evidence based guidelines; b) to ensure the guidelines are widely adopted.The credibility of guidelines is crucial to their adoption and this depends far more on the demonstration of an evidence base than that the authors are ‘experts’. Development by a professional group or body who are seen as having a legitimate role is very important as is involvement of all ‘stakeholders’ in ensuring acceptability. In terms of their nature, guidelines should be valid i.e. they will achieve what they are intended to achieve, and they should be robust i.e. they will work when implemented by different individuals in different settings. Colposcopy lends itself well to guidelines because it is largely a routine practice, but substandard care can have serious consequences. In previous years there has been a set of Guidelines for Practice 1, 2 and a set of Quality Standards 3 . On this occasion these two components have been put together in a simple publication. It needs to be borne in mine that the new guidelines were being developed in the context of a number of potential changes which could interact with each other and impact on the Guidelines. These include: The process for the development of the Guidelines included an Editor, an editorial group, and a group of contributors to produce a draft set of evidence based guidelines across 18 areas. New areas covered included HIV +ve women, immuno suppressed women, and working practice. The draft has been available for comment for several months and amendments have been made. Clearly there are areas where evidence is lacking and where different views are expressed. The most contentious area not surprisingly is in the topic of managing mild dyskaryosis; controversy in this has persisted for many years. The quality standards are either attainable or within attainment and are a driver for rising standards. These programme practice guidelines and standards have earned UK colposcopy international respect. They provide a benchmark for QA assessment and will continue to require amendment as new developments come into being.