Results from the 2019 American Society of Cytopathology survey on rapid on-site evaluation—Part 1: objective practice patterns

Abstract Introduction Rapid on-site evaluation (ROSE) is a service provided by cytologists that helps ensure specimen adequacy and appropriate triage for ancillary testing. However, data on the current utilization patterns across different practice settings is lacking. Materials and Methods To obtain an accurate and timely assessment of the current state of practice of ROSE, a 14 question online survey was constructed by the Clinical Practice Committee of the American Society for Cytopathology (ASC). The survey was available to the membership of the ASC over a three week period in early 2019. Results A total of 541 responses were received, including 255 cytopathologists/pathologists, 261 cytotechnologists, 19 cytology resident/fellow trainees, and 6 others. ROSE was offered as a clinical service by 95.4% of respondents, with telecytology for ROSE utilized in 21.9% of practices. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was the procedure most frequently reported to utilize ROSE (mean 59.1%, median 70%). Cytotechnologists were involved in ROSE in the majority of practices. The number of daily ROSE procedures correlated with annual non-gynecologic cytology volumes. Approximately 70% of ROSE procedures were reported to take longer than 30 minutes on average for the cytologist. Conclusions Based on the results of this survey of cytologists, the reported practice patterns for the utilization of ROSE vary considerably. The data presented here can help inform future guideline recommendations and the implementation of ROSE in different clinical settings.