Using R Statistical Programming to Evaluate the Impact of the Lower Anogenital Squamous Terminology Recommendations on Cervical Biopsy Reporting at a Tertiary Care Academic Center.

Abstract

Context.—: Pathology reports contain a tremendous amount of data but harnessing these data for secondary use in research, operational, or quality work can be challenging. Modern software approaches present an opportunity to extract and distill important information from anatomic pathology reports.

Objective.—: To evaluate cervical biopsy surgical pathology reports before and after the publication of the Lower Anogenital Squamous Terminology (LAST) criteria, using R programming software.

Design.—: We obtained cervical biopsy report data from 2006 to 2017. After validating the R methodology, we used the program to analyze findings in diagnostic terminology and immunohistochemical use relevant to consensus recommendations before and after publication of the LAST criteria.

Results.—: More than 36 000 cervical biopsy diagnoses were analyzed during an 11-year period. An 86% drop in the use of human papillomavirus terms and an 8-fold increase in the use of p16 staining were seen. After the publication of the LAST criteria, there was a 6% decline in the rate of low-grade diagnoses and a 5.4% increase in non-cervical intraepithelial neoplasia (CIN) diagnoses (P < .001 for both) with no significant change in high-grade diagnoses. The fraction of high-grade diagnoses did not increase with p16 use.

Conclusions.—: Using R programing software, we were able to demonstrate changes and trends in cervical biopsy reporting before and after the publication of the LAST criteria. R programing software represents an innovative technique for conducting operational and quality assessments in surgical pathology.