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.
Centers for Disease Control, Public Health Service, Atlanta, GA 30333.
A R
AR
Yobs
A E
AE
Plott
M D
MD
Hicklin
S A
SA
Coleman
W W
WW
Johnston
P R
PR
Ashton
I F
IF
Rube
J C
JC
Watts
Z M
ZM
Naib
R J
RJ
Wood
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