Retrospective evaluation of gynecologic cytodiagnosis. II. Interlaboratory reproducibility as shown in rescreening large consecutive samples of reported cases.
Two laboratories exchanged and rescreened a large sample of cases with cervicovaginal smears they had consecutively accessioned to examine the reproducibility of gynecologic cytodiagnosis under optimum conditions. At least a "working agreement" (diagnoses within +/- 1 category on a ten-category scale) was achieved in diagnoses of normal, benign reaction and squamous abnormality (from minimal dysplasia though invasive cancer) in 18,859 cases (96.8%), of endometrial abnormality in 21 cases (42%) and of "unsatisfactory" in 99 cases (20.7%). Larger differences occurred in greater than or equal to 30% of cases except in the categories of "normal" and "benign reaction," reaching a maximum of 82% for moderate dysplasia. Reexamining 382 cases decreased disagreement by category to the 20% to 65% range only in the five categories of dysplasia plus carcinoma in situ. Agreement was not predicated on the presence of endocervical cells or squamous metaplasia; the basis for "unsatisfactory" calls was not uniform. Comparison of the laboratories' diagnoses with referee diagnoses or, on 178 cases, with tissue diagnoses also demonstrated differences in diagnostic criteria.
Yobs
A R
AR
Centers for Disease Control, Public Health Service, Atlanta, GA 30333.
Plott
A E
AE
Hicklin
M D
MD
Coleman
S A
SA
Johnston
W W
WW
Ashton
P R
PR
Rube
I F
IF
Watts
J C
JC
Naib
Z M
ZM
Wood
R J
RJ
D000328:Adult; D002584:Cervix Uteri / Q000473:pathology; D003581:Cytodiagnosis / Q000592:standards*; D005069:Evaluation Studies as Topic; D005260:Female; D006176:Gynecology / Q000379:methods*; D006801:Humans; D008403:Mass Screening; D012189:Retrospective Studies; D014626:Vaginal Smears