Introduction
The standardization of laboratory tests is one of the most important and urgent subjects in the area of laboratory medicine and clinical pathology, not only in analytical tests but also in morphological tests. Control surveys using slidefilms have been the only way for the external quality control of morphological laboratory tests. But they consume a lot of money and man power, so only a small part of possible facilities and no individual can have participated in them. The internet and its world wide web system was adopted to strikingly lower hurdles in front of the possible participants of such surveys.
Materials and Methods
16 digitized photographs of laboratory tests with questions were put on a home page named 'the Survey Web' (http://202.242.169.152/clap/survey.html), so that anyone who has access to this home page can join as a regular participant. Answers were received via e-mail, and in few weeks after the deadline, the summarized results and the assessments commented by specialists were issued at the same home page for the participants to check their results by themselves.
At present, the survey categories are urinary examination, hematology and microbiology, and in the near future, clinical immunology, cytology, anatomical pathology and clinical physiology will be included.
Results
Although the quality of photographs on the computer monitors fell behind that of slidefilms, every specialist of each field judged that the minimum requirements were filled from the viewpoint of the purpose of this survey. After announcement at some internet newsgroups, 889 times of access to the Survey Web were made during two months, and six voluntary answers were received from three clinical laboratories and three laboratory technicians in Japan. Further, three contacts were made from U.S., Russia and South Africa.
Only one participant reported that one of 16 graphics was not displayed properly at her site, but the cause of this problem could not be clarified.
Conclusion
It is believed that this project can strongly promote the standardization in skills of morphological identification not only in Japan but also all over the world, so co-promoters in various countries are welcome.
Acknowledgment
I am grateful to Dr. Yasuhiro OHBA, Kinki University, Dr. Kiichi ITOH, Kanagawa Prefectural College of Medical Technology, Dr. Kiyoaki WATANABE, Keio University, Dr. Harushige KANNO, Chiba University and the volunteer group of the Japanese Association of Clinical Laboratory Physicians for their great support to this project.
This work was supported by a Grant-in-Aid from the Ministry of Science, Education and Culture of Japan (Grant No.08772180).
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