Intra and inter technologist variability in the quality assessment of respiratory tract specimens

The majority of microbiology laboratories have implemented quality improvem ent procedures such as a Q scoring system to assess the nature of clinical specimens. Our study reviewed the sources and the amount of variation when Q scoring of lower respiratory secretions was performed. In total, 450 slid es representing lower respiratory tract secretions were Q scored by three e xperienced technologists. Total agreement regarding the number of neutrophi ls, squamous epithelial cells and Q scores was 76%, 57% and 57% respectivel y. The major factor influencing Q score values was the enumeration of epith elial cells. From our findings, we expect that there is greater variability in Q scoring then is generally acknowledged and there is a substantial deg ree of subjectivity on part of individual technologists reading gram stains . (C) 2000 Elsevier Science Inc. All rights reserved.