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In this study, overall improvement appeared to be driven largely by improvement in preanalytic Papanicolaou (Pap) test sampling, because longer institutional participation also was associated with improved sampling sensitivity. The authors hypothesized that Pap test sampling may have improved secondary to the introduction of liquid\u2010based technology, which was implemented in many laboratories during the study time frame. Through the performance of continuous data tracking and retrospective root cause analysis to identify factors that may have influenced any observed changes in performance indicators, institutions may learn which initiatives are successful or unsuccessful. 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