Automated rescreening in cervical cytology. Mathematical models for evaluating overall process sensitivity, specificity and cost.
OBJECTIVE
To develop mathematical models to assist decision makers with the difficult task of evaluating the use of automated rescreening in the process of screening cervical smears.


METHODS
Using assumptions about incidence, per smear screening costs, and the sensitivity and specificity of cytotechnologists, pathologists and the rescreening device, basic probability models were developed to describe the overall sensitivity, specificity and cost of the screening process.


RESULTS
The optimal screening policy is highly dependent on assumptions, and an automated system can significantly affect the overall system cost and accuracy.


CONCLUSIONS
Mathematical planning models are valuable tools to assist decision makers in the design of a screening process for cervical smears.
Kaminsky
F C
FC
Productivity Sciences, Inc., Greenfield, Massachusetts, USA.
Benneyan
J C
JC
Mullins
D L
DL
D001331:Automation; D003657:Decision Making; D005069:Evaluation Studies as Topic; D005188:False Negative Reactions; D005260:Female; D006285:Health Planning; D006291:Health Policy; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000295:instrumentation*; D007091:Image Processing, Computer-Assisted / Q000191:economics / Q000295:instrumentation*; D008403:Mass Screening / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D008962:Models, Theoretical; D011785:Quality Assurance, Health Care; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology; D014626:Vaginal Smears / Q000295:instrumentation*